Pulmonologist warns against symptoms that are dismissed as seasonal allergies but require medical attention

The rise in pollution and cooling temperatures create the perfect conditions for a rise in respiratory issues, explains Dr Amit Kumar Mandal.

With winter fast approaching, symptoms such as a runny nose, an irritated throat and a lingering cough are going to be exceedingly common across households. And in many cases, they will be brushed off as seasonal allergies. However, pulmonologist Dr Amit Kumar Mandal believes that the simple explanation often presents an incomplete picture.

“Across much of North India, air quality deteriorates sharply between October and February, and a significant share of what passes for allergy is the respiratory system reacting to polluted air, a distinction that determines whether a symptom is a passing nuisance or an early warning,” he told HT Lifestyle.

The pulmonologist explained that fine particulate matter (PM2.5) is small enough to travel deep into the lungs and enter the bloodstream, where it inflames the airways and produces sneezing, watery eyes and throat irritation that closely resemble allergic rhinitis.

Dr Mandal also cited the State of Global Air 2025 report to state that an estimated two million air-pollution-related deaths occurred in India in 2023, with nearly nine in ten of these linked to non-communicable conditions such as heart disease, lung disease and cancer. He went on to list the symptoms that need medical attention, which are listed as follows.

Symptoms persisting for a long time warrant a medical checkup.

1. A cough that outlasts the season

Allergic symptoms tend to ease once the trigger is removed. However, Dr Mandal noted that a cough that continues beyond two to three weeks, disturbs sleep, brings up mucus or blood, or comes with unexplained weight loss warrants a medical evaluation.

This is because the symptoms may point to asthma, chronic bronchitis, a lung infection or tuberculosis rather than an allergy, he noted.

2. Wheezing, breathlessness and chest tightness

Itching and sneezing are the hallmarks of allergy, but wheezing, breathlessness during routine activity such as climbing a flight of stairs, and a sense of tightness in the chest are not, pointed out the pulmonologist.

In his words, “They suggest airway disease that polluted air is known to trigger and worsen. Chest pain, palpitations, bluish lips or difficulty speaking in full sentences call for emergency care without delay, as PM2.5 exposure is also associated with heart attacks and strokes.”

3. Fever, facial pain and eye symptoms

Dr Mandal pointed out that allergies do not cause fever. Therefore, a raised temperature alongside a blocked nose, facial pain or pressure, or congestion that lingers beyond ten days or worsens after initial improvement points towards a sinus or respiratory infection that needs treatment.

“Itchy eyes are common in polluted weather, but eye pain, blurred vision or redness that does not settle should be examined by a doctor instead of being managed with over-the-counter drops,” he highlighted.

Which groups are at high risk?

According to Dr Mandal, children, older adults, pregnant women and people living with asthma, chronic obstructive pulmonary disease, diabetes or heart disease are more vulnerable and should seek medical opinion at the first sign of persistent symptoms

He noted that it is better than trying to self-medicate, as antihistamines, which are designed to control allergic reactions, do little for pollution-induced inflammation or infection, and repeated use may only delay a correct diagnosis.

“Checking the local Air Quality Index, limiting outdoor exertion when it rises, wearing a well-fitted N95 mask where exposure cannot be avoided and consulting a doctor early remain the most practical safeguards,” he added.

Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.

Dr Amit Kumar Mandal is the senior director of pulmonology at Paras Health, Panchkula. He has more than two decades of clinical experience.