Pune: After Diwali day celebrations, the air left behind poses an immediate and serious health threat to many. Firecracker smoke and winter smog can sharply raise levels of fine particulate matter, including PM2.5, which travels deep into the lungs and triggers inflammation, coughing, wheezing and breathlessness.Dr Harsha Jain, pulmonologist at Sahyadri Hospitals in Deccan, added that post-Diwali smoke can have a significant short-term effect on the lungs, especially because it is a mixture of particulate matter and gases from fireworks, burning materials, and accumulated pollution.He said, “Fine particulate matter (PM2.5) can reach deep into the small airways and alveoli. They trigger intense airway inflammation and so, patients with preexisting lung disease such as asthma and COPD can develop wheezing, breathlessness and increased respiratory infections or irritation. Smoke damages the airway’s normal protective mechanisms and can increase susceptibility to respiratory symptoms. Effects may persist even after the fireworks stop as the air may remain polluted for several days after Diwali, particularly when there is low wind and poor atmospheric dispersion.”Preterm babies and children are particularly vulnerable to such high pollution levels. Dr Nakul Pathak, paediatric intensive care and emergency care consultant with Surya Mother and Child Super Speciality Hospital, said, “After Diwali, some children may seem fine during the day but develop persistent coughing or wheezing at night. At our hospital, nearly 50% of children seen in paediatrics OPD the day after Diwali had coughing or wheezing, with no clear underlying cause. They were treated based on clinical assessment. Smoke particles can irritate airways, especially in children with asthma, premature babies and those recovering from chest infections.”Asked what to keep an eye on, he said, “Parents should watch for disturbed sleep, breathing changes or increased inhaler use, and limit outdoor exposure when pollution levels are high. Rapid breathing, chest pulling inwards or difficulty feeding needs immediate medical attention.”Inhaling fine particulate matter can also lead to bronchitis and, in case of chronic lung diseases like COPD, asthma, ILD and fibrotic lung diseases, affect people of all ages, even more so those with comorbidities, said Dr Ashish Dhotre, pulmonologist at Noble Hospital. He added, “Pre-Diwali we advise our patients suffering from these comorbidities to wear a proper mask and avoid going outdoors when the pollution levels are high. For those who can afford it, we suggest installing an air filter. Those who are suffering from any respiratory illnesses or conditions must always keep an inhaler and anti-allergy medications handy as advised by their doctors. In case problems persist, consult your doctor as the smoke may linger inside the lungs for days.”Doctors highlighted that flare-ups often spike in the OPD during Diwali. Dr Sushrut Ganpule, chest medicine consultant at Jupiter Hospital, said, “Asthma cases often increase this season, particularly during Diwali. Usually, there is a surge in these cases in the casualty department. One must strictly adhere to their asthma treatment and not skip doses, especially in festive season. Often, we see people miss their dose as there are guests at home or festive celebrations going around. The second important thing is to avoid moving out of the house, especially in early morning and late night when the PM 2.5 particles are at maximum concentration and the smog is much more. You have to wear an N95 mask whenever the pollution is at its peak. Otherwise, surgical masks are good enough. The fourth important point is to avoid indoor air pollution, especially when people make desserts at home. And usually one has a lot of home cleaning around Diwali season.“