When haze returns, the Air Pollutant Index (API) often becomes the main reference for determining whether outdoor activities should be reduced or schools should consider suspending activities. While API readings provide an important indication of air quality, protecting children during haze requires more than monitoring numbers alone, as their response to air pollution can vary depending on age, health, physical activity and individual circumstances.

Haze can affect children in several ways, with common symptoms including coughing, nasal congestion, headaches, fatigue and breathing difficulties. Even mild symptoms can interfere with concentration, classroom participation and attendance, potentially affecting both learning and daily routines. Children are particularly vulnerable because their lungs and immune systems are still developing, while their higher air intake relative to body weight can increase exposure to fine particulate matter such as PM2.5.

The risks can be greater for children with existing health conditions, including asthma, allergies, eczema, chronic respiratory diseases or heart conditions. Exposure to haze may worsen symptoms even when other children appear unaffected. Beyond physical health, prolonged periods indoors, missing sports and social activities, and concerns about worsening symptoms can also affect children’s emotional wellbeing. Haze preparedness should therefore consider both health protection and the continuity of children’s education and daily activities.

Parents and caregivers are encouraged to monitor air quality through Malaysia’s official Air Pollutant Index Management System and reduce non-essential outdoor activities when air quality reaches unhealthy levels or continues to deteriorate. API readings should also be considered alongside a child’s individual health and symptoms. Children experiencing coughing, wheezing, chest tightness or breathing difficulties should not be encouraged to continue strenuous outdoor activities, while those with asthma or other chronic conditions may need to reduce exposure earlier based on advice from their healthcare providers.

Indoor air quality is another important consideration during haze episodes. Where appropriate, families can keep windows and doors closed to limit the entry of polluted outdoor air and consider using air purifiers equipped with high-efficiency particulate air (HEPA) filters. Activities that generate fine particles indoors, including smoking and burning incense, should also be avoided. When outdoor exposure is unavoidable, a properly fitted N95 or KN95 mask may provide greater protection against fine particles than cloth or surgical masks, provided it fits securely around the face.

Schools also have an important role in protecting students during haze events. Clear haze-response plans should include regular API monitoring, timely communication with parents and adjustments to outdoor activities in accordance with Malaysia’s National Haze Action Plan. Physical education classes, sports, field trips and outdoor assemblies may need to be moved indoors or postponed when conditions deteriorate. Schools should also be aware of students with chronic health conditions and ensure that they have access to prescribed medication and appropriate support.

Maintaining a cleaner indoor learning environment is equally important. Where available, suitable filtration can help minimise the entry and circulation of polluted air in classrooms. Schools may also consider appropriate academic accommodations or home-based learning when haze-related symptoms affect attendance or prolonged poor air quality disrupts normal operations.

Parents and schools should also recognise when professional medical advice is necessary. Medical attention should be sought when symptoms persist, worsen or interfere with a child’s normal activities, with closer monitoring recommended for children with asthma, chronic lung disease, heart conditions or significant allergies. Severe breathing difficulty, significant chest pain, marked wheezing, bluish discolouration around the lips, fingernails or face, unusual drowsiness, confusion or rapidly worsening symptoms require urgent medical attention.

As haze conditions can change quickly, preparedness should begin before children experience significant symptoms. By combining air-quality monitoring with awareness of individual vulnerabilities and early responses, families, schools and healthcare providers can take practical steps to reduce the impact of haze on children’s health, learning and overall wellbeing.

The article is contributed by Dr Sapna Shridhar Patil, Senior Lecturer in Public Health at the School of Medicine, Faculty of Health and Medical Sciences, Taylor’s University.