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Hazy Days Are Here Again


The haze is returning any day now. But how prepared are you for the gloomy days ahead? Gwen Lee of HealthAnswers finds out you can protect yourself from the harmful effects of smoke haze.

"The children cough and catch cold easily during the haze, but having been through the 1997 gloom, I'm not particularly worried this time, even though my eldest child is an asthmatic." Mrs Chia, 41, mother of three.

"What, Haze Again?"
Just hearing it is enough to bring back unpleasant memories of those smoke-filled hazy days. For months on end, there was no blue in the sky and everything everywhere looked an unhappy grey, not to mention the suffocating burnt smell and the watery eyes.

This annual problem is back to haunt the region again.

In a press briefing yesterday, the Environment Ministry of Singapore announced that with the beginning of the dry season in July, plantation fires are raging again in Sumatra, Indonesia. If the fire smoke rides on the right winds, it will drift across the Straits of Malacca to visit Singapore, as it already has to Malaysia.

Satellite Picture Taken On 17 July 2000

Source: Meteorological Service Singapore

"From past experience, the haze if it hits us, would stay till the end of the dry spell in October," says Wang Mong Lin, Deputy Secretary, Environment Ministry of Singapore. "As for how high the PSI reading would go this time, it depends on wind directions. During the worst haze in 1997, the highest it had shot up to was 138. That fell within the unhealthy range."

PSI stands for Pollutant Standards Index. A network of 19 air monitoring stations will measure air pollutants like sulphur dioxide, oxides of nitrogen, ozone, carbon monoxide and particulate matter. These pollutants are used in the determination of the index.
The PSI value gives an indication of the air quality as shown:
PSI Value PSI Descriptor
1 to 50 Good


101-200 Unhealthy
201-300 Very Unhealthy
Above 300 Hazardous
Source: Singapore Ministry of Environment

Although it is believed that the coming haze episodes would not be as prolonged or severe as in 1997 (because El Nino is not here to prolong the dry spells this year), Wang says all relevant authorities are fully prepared for it. Each body has a haze action plan which describes the actions to be taken should the PSI enter the unhealthy range.

Source: Centre for Remote Imaging, Sensing & Processing (CRISP)

But while the Singapore skies are kept clear by favourable winds from the south to south-east, other parts of the region are not so lucky. According to reports, smoke haze from Sumatra has shrouded as much as half of the Malaysian Peninsula, sparking health fears. Further up north, people living in the four southernmost provinces of Thailand are also experiencing eye problems and respiratory irritations as the haze thickens.

Dealing With Asthma In The Haze
When the days get hazy and the air full of pollutants, asthmatics tend to be the hardest hit.

In Singapore, bronchial asthma affects about 20 percent of the children. It is a condition whereby there is chronic inflammation of the airways. The inflamed airways are more sensitive than normal. When they are exposed to trigger factors such as pollutants or dust particles in the air, the airways become narrowed. When this occurs, the child would experience an asthma attack.

During bad hazy days, children with moderate or severe asthma have to be more careful because the high concentration of particulate matters in the smoke haze may irritate the sensitive airways and trigger off an attack, says Dr Chay Oh Moh, Head & Senior Consultant of Respiratory Medicine, KK Women's and Children's Hospital.

For non-asthmatic children, bad hazy conditions would also bring on mild symptoms like irritation of the eyes, nose or skin rashes.
In 1997, the hospital's Children's Emergency Department indeed registered an increase of 20 percent in asthma attendance and 35 percent in upper respiratory infections (running nose, sore throat, cough, etc). But there was no increase at all in terms of ward admissions.

"This means the majority of the complaints are not serious enough to warrant an admission," explains Dr Chay. "Most complaints are treated at the A&E and the patient can be discharged at once."

Health Advisories For Haze
(Adapted from MOH Haze Plan)

PSI Value PSI Descriptor General Health Effects Health Advisories
Up to 50 Good No problem Life as usual
51 to 100 Moderate (Not Bad) Majority - no problem.

Few with heart disease, lung problem and sensitive airways may have some irritation symptom eg. itchy, teary eyes, runny nose or nose irritation, mild cough.

Life as usual

Those with sensitive airways may continue with regular medicine or consult pharmacist for symptom relievers. They should reduce strenuous outdoor exercise if unwell.

101 to 200 Unhealthy Most people are well but more people will have irritation symptoms.

Those with heart disease, lung problem and sensitive airways, may experience increase symptoms of cough, wheezing or breathing difficulty.

Only those with irritation symptoms need to consult the pharmacist for symptom relievers. Reduce strenuous outdoor activities.

For them:

  • Stay indoors

  • When outdoor, use a respirator mask

  • If there is increased symptoms, consult your doctor on stepping up of your regular medicine.

  • Reduce physical exertion; continue with mild indoor exercise if you are well.

>200 Very Unhealthy Majority will have irritation symptoms.

Those with heart disease, lung problem and sensitive airways may experience worsening of symptoms.

Reduce outdoor activities.

Consult pharmacist for symptom reliever medicine. For them:

  • Stay indoors; if possible in air-conditioned room with windows and doors closed
  • Reduce physical activities
  • Consult your doctor on stepping up regular medicine
  • Seek early medical advice if unwell

On the other hand, the particulate matters found in the hazy air may also affect the elderly who already have underlying heart and lung diseases and cause them to cough or become breathless.

"When the air is too polluted, say the PSI reading falls within the unhealthy range, it is better for elderly persons to stay indoors. They should rest well, sleep well and drink lots of water to flush away any irritants that get into the airways. This way, they can avoid falling sick because once they're ill, it may be difficult to recover while the air is still thick with smoke haze, " advises Dr Chay.

And in the event that smoke haze gets too dense and a mask is needed, Dr Chay says it is important for the public to note that only a proper respirator mask available at some pharmacies may help screen the pollutants. Ordinary paper masks offer no protection against the haze.

Take Extra Care
Like so many Singaporeans who have come to accept the return of haze as an annual affair, the Chia family, when interviewed by HealthAnswers, greeted the news with calm though they have two children with respiratory problems.

The eldest child, Charmaine Chia, 10, has been asthmatic since she was an infant, and recently, her youngest sister Clara, 5, has been wheezy. This means extra precautions have to be taken to prevent their symptoms from worsening.

Speaking from past experience, Mrs Chia said: "Whenever it turned hazy, we have to keep a close eye on my oldest child. To avoid any asthmatic attack, we make sure she takes a puff of her reliever medicine each time she has a slight cough." And throughout the hazy period, Charmaine had to take a puff every night before went to bed.

Mrs Chia confesses that she used to worry about Charmaine's asthmatic condition whenever smoke haze returns, but having been through the worst haze in 1997 unscathed, she is now more confident of helping her daughter manage asthma.

"I think if we take those necessary precautions, her asthmatic attack wouldn't come back. Her school will make sure there is no P.E. lessons when the air is too polluted, so I think she will be fine, " says Mrs Chia who is a working mother.

As for her youngest daughter Clara, Mrs Chia says if her wheezing gets worse during the haze, she would have to take her to any private clinic for a puff on the nebuliser.

"Past experience tells me that even if you stay indoors, the children tend to have more coughs and cold whenever the haze comes on, I am quite prepared for it," says Mrs Chia.

Date reviewed: 20 July 2000

This website and article is not a substitute for independent professional advice. Nothing contained in this website is intended to be used as medical advice and it is not intended to be used to diagnose, treat, cure or prevent any disease, nor should it be used for therapeutic purposes or as a substitute for your own health professional's advice.  All Health and any associated parties do not accept any liability for any injury, loss or damage incurred by use of or reliance on the information.


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