OCTOBER 12 — The sudden announcement of school closures across several Malaysian states on 9th October 2026, following worsening haze conditions, has understandably disrupted many families' routines. Parents have been scrambling to arrange alternative childcare, reorganise work commitments, move activities indoors, and ensure their children are adequately protected.

Yet, beyond these immediate inconveniences lies a far more important concern: what is the haze doing to our children's health, and are we paying enough attention to its consequences?

While school closures are necessary precautionary measures, they should also remind us that protecting our children's health goes beyond keeping them indoors for a few days. School closures serve not merely as short-term logistical disruptions, but as critical reminders of continuous health risks. To fully evaluate these risks, we must examine the scientific evidence behind particulate exposure.

What does the evidence tell us?

Haze is not merely smoke that obscures our surroundings. It is a mixture of airborne pollutants, including fine particulate matter (PM2.5) measuring 2.5 micrometres or less in diameter.

These tiny particles can penetrate deep into the lungs, triggering inflammatory responses and potentially affecting other organs.

Scientific evidence consistently links air pollution exposure to respiratory symptoms, worsening asthma, and increased respiratory-related hospital admissions. Children and the elderly are among the populations particularly vulnerable to air pollution. Understanding this vulnerability requires examining the unique anatomical and physiological profile of developing children.

Why are children more vulnerable?

Children are not simply miniature adults. Their lungs and immune systems are still developing, their breathing rates are generally higher, and they may inhale more air relative to their body weight. Furthermore, children naturally spend time playing and engaging in physical activities, which may increase their exposure to polluted air.

During periods of poor air quality, previously healthy children may develop nasal irritation, a runny or blocked nose, sore throat, coughing, eye irritation, or breathing discomfort.

Air pollution's effects aren't only confined to the lungs. Exposure to fine particulate matter and other airborne pollutants can irritate the nose, throat, and airways, causing nasal congestion, sneezing, coughing, throat discomfort, and breathing difficulties. Scientific studies have also linked air pollution exposure to an increased risk of allergic rhinitis, middle-ear infections in children, in addition to respiratory infections, and asthma exacerbations.

While these immediate effects are concerning, prolonged air pollution exposure has also been linked to impaired lung development and potential effects on children's cognitive development, underscoring the need to protect children beyond the current haze episode. This risk extends even further for children managing pre-existing health conditions.

What about children with underlying medical conditions?

Children with pre-existing respiratory conditions may experience worsening symptoms during haze episodes. For example, those with allergic rhinitis may develop increased nasal congestion, sneezing, and nasal irritation. Also pay special attention to children with pre-existing upper and lower airway abnormalities, as these conditions may already compromise normal airflow. Additional respiratory irritation or a concurrent infection can be particularly concerning in children with limited airway reserve.

Children requiring tracheostomies need extra precautions because the tracheostomy bypasses the nose's natural ability to filter, warm, and humidify inhaled air. Parents should be especially attentive to changes in secretion thickness, difficulty clearing secretions, or any deterioration in their child's usual breathing pattern. These clinical concerns highlight the importance of recognizing actionable warning signs.

What warning signs should parents look out for?

Not every cough or runny nose is a cause for alarm. However, parents should recognise symptoms that may indicate more significant respiratory involvement.

Persistent coughing, worsening wheezing, unusual breathlessness, reduced activity, and difficulty feeding in infants should prompt medical assessment. Identifying these red flags allows caregivers to swiftly implement protective indoor and outdoor mitigation strategies.

What immediate measures can parents take?

First, reduce exposure. Parents should monitor the official Air Pollutant Index (API) and follow recommendations from health and education authorities regarding outdoor activities.

When air quality is unhealthy, avoid outdoor exercise and unnecessary exposure.

Indoor air quality is equally important. Keeping windows and doors closed during haze and using appropriately sized air purifiers with high-efficiency particulate air (HEPA) filtration may help reduce indoor PM2.5 concentrations.

Parents should also minimise indoor pollution from cigarette smoke, vaping, incense, and other combustion sources. Children with chronic respiratory conditions should continue their prescribed medications and have an appropriate medical action plan. Beyond these immediate steps, parents must also consider the long-term health outlook after an episode subsides.

Is the impact of haze only temporary?

The more important question is what happens after the haze disappears. Although many immediate symptoms improve as exposure decreases, repeated or prolonged exposure to air pollution can have serious consequences.

Scientific studies have associated long-term exposure to air pollution with impaired lung function development, increased respiratory morbidity, and other adverse health outcomes in children. There is also growing interest in understanding how environmental pollution influences immune responses and inflammation during childhood.

Most importantly, the absence of visible haze should not be mistaken for the absence of harmful air pollution. We cannot afford to treat air pollution as an occasional emergency that demands our attention only when schools are forced to close. Protecting children's respiratory health requires a sustained effort and broad societal responsibility.

A responsibility that extends beyond the haze

We naturally worry when our children develop a fever, cough, or breathing difficulty. Yet the air they breathe every day may receive far less attention.

The current haze episode should remind us that children's respiratory health begins with the environment in which they grow, learn, and play. We should not wait for the skies to turn grey before thinking about the air our children breathe. Nor should our concern disappear when the skies become clear again.

Protecting every little breath is not merely a response to haze. It is a responsibility we share, every single day.

* Associate Professor Dr Jeyasakthy Saniasiaya is a consultant paediatric otorhinolaryngologist at Universiti Malaya.

** This is the personal opinion of the writer or publication and does not necessarily represent the views of Malay Mail.