Lahore’s poor air quality is less of a precedent, more of a taboo- for a world struggling with the very idea of combating environmental health challenges. The numbers, to be honest, are staggering. Did you know that children 15 years and younger–for the better part of their lives–have never breathed a single lungful of clean, fresh air in this city? That is the reality of smog in Lahore, the city that was known for its gardens not more than half a century ago. Now, Lahore stands at the forefront of the worst air quality, guarding itself only with the torch of incongruity and discrepancies. I cannot and will not go into the blame game, as to who started what. I am a physician, a scientist, and a public health specialist. So, I’ll stick to what I know, and what I can tell you, about this slow-onset disaster unfolding around us. Over the past few years, we have become familiar with AirVisual and IQAir. We know PM2.5 and PM10 are bad for health. We have a fair idea and a fair amount of infodumps to understand the source of these pollutants. We know more about the why and how now. We have a fairly basic, broad-stroke idea of what it may be doing to our health and that of our children. But is that enough? By recognizing the danger, can we combat it sufficiently? Some people, persistently dismissive of the crisis that is looming at the crossroads of the city, need to know some facts and how this issue concerns all of us (not just folks with respiratory diseases). Lahore stands at the forefront of the worst air quality, guarding itself only with the torch of incongruity and discrepancies. Air pollutants, such as particulate matter, especially PM2.5, can harm the placental barrier, the wall between a pregnant woman and her fetus. This means that if a pregnant woman is breathing in polluted air, PM2.5, being way too small, can get way past the usual barriers. This entry into the placenta causes changes in the placenta and can harm the growing fetus. The fetus may not grow properly, there can be birth defects, and there can be latter stage pediatric health concerns. And this is when the baby is being exposed to something while being in full protection inside the mother’s womb. Now get this: The equivalence for pm2.5 – 22 µg/m3 PM2.5 equals one cigarette. Lahore has seen PM2.5 exceeding 500 many times in the last 10-15 years. It has been reported that the PM2.5 concentration exceeded 900 µg/m3 at one point. These numbers may seem scientific but are a testament to the facts. Of course, it is a tad bit oversimplified, but it tells you the magnitude of the problem. Now, that was the story before birth. What about after birth? Once the baby starts breathing on its own, s(he) is exposed to the poisonous air directly – almost akin to the baby smoking lots of cigarettes every day. And yes, it is poisonous air, giving poison breath to our children. Some of you might feel that this is an exaggeration. Tell that to the doctors and parents, over-burdened with treating pediatric respiratory illnesses and prescribing broad-spectrum antibiotics to these children multiple times a year. And why? Because of this very air ‘ingenuity’. Does this not make you wonder why we are not even half as crazy about the filth our kids breathe in 24 hours a day, seven days a week than we are about other viruses and bacteria that may infect them. That is a LOT of air they’re taking in. That is a LOT of poison breaths. And we are seeing higher respiratory illnesses among our children. Asthma alone is becoming more common with folks of all ages suffering from its toll-taking ailment. How many parents just know to start broad-spectrum antibiotics the second their kid starts coughing and sniffling? Because they know, they just know, that this is what awaits them and it’s just a matter of time before the next bout of awful coughing. This poisonous air is a contributor to that poor immune response too. The constant bad air changes how their airways respond to all these myriads of viruses and bacteria. The protection is down. But this poison isn’t solely responsible for health disasters. It makes up different branches of consequential inundations highlighted by scientists like myself and others. A recent study by the World Bank estimated the dire circumstance for the economy. It noted that the mean annual damage to the environment in Pakistan is 6% of its GDP. What we know is, that we have no idea of the impact of this constant exposure to the poison would be on our kids when they reach their 30s, 40s, and 50s. Would they be getting emphysema at 30? Would they get lung cancers at 40? Would they need lung transplants at 50? Would they depend on inhalers and oxygen for a large chunk of their lives? There is only one thing I can tell with absolute certainty – Our Kids’ Lives Matter! And actions need to be taken, there need to be plans in place, and there need to be qualified people as oversight for leading the charge to contest Lahore’s struggle with breathing, an unembroidered Human Right! The writer is a public health specialist, known for her remarkable studies and insight into combatting health crises in Pakistan. She tweets @FareehaIrfanMD