Coughing is one of the most common reasons people seek medical advice, especially in cities with high air pollution. But not every cough means an infection. Many people develop a persistent cough simply
due to polluted air. Understanding the difference between a pollution-related dry cough and a viral cough can help patients respond correctly and avoid unnecessary worry or medication.
If you have been scrolling through social media, you would’ve come across reels and memes on how 2026 has started out as a rough year for some people, who have been plagued by a cough fit. We spoke to Dr Swapnil Khadke, HOD & Consultant Critical Care, Fortis Hiranandani Hospital, Vashi, who shares helpful tips on how to figure out which cough needs immediate medical attention and how to take care of it.
A pollution cough is usually dry and irritating. It happens when polluted air containing dust, smoke, vehicle exhaust, or chemical particles enters the airways. A cough as a result of exposure to air (pollution) irritates the throat and lungs, so the body produces a cough reflex, rather than producing mucus to help the body fight off germs. Therefore, this type of cough is typically classified as dry, itchy, and often continual.
The best example of when to identify pollution cough is typically around the time period of outdoor activity or during exposure to high levels of vehicle congestion. People discover that as soon as they spend extended amounts of time inside or wear a respirator or in an alternative environment, their cough begins to dissipate. In addition, people who have pre-existing airway sensitivities, allergies, or other pre-existing breathing difficulties are more likely to also have a pollution cough.
On the other hand, the cause of coughs you would associate with a virus (e.g., cold, flu) would usually be due to some type of viral infection that produces other symptoms before the development of the cough. For example, symptoms that generally accompany viral coughs are: high fever, aches and pains, a sore throat, nasal congested nose, and lethargy (tiredness). In most cases, coughs from a virus develop initially dry, but become productive mucus (or phlegm-producing) at times.
Pollution cough is often less severe early in the day but eventually worsens at night as the person continues to be exposed to polluted air throughout the day. The duration of the cough also provides helpful information. Pollution cough can last for weeks or even months if exposure continues, but it does not usually worsen rapidly. Viral cough typically follows a pattern it starts, peaks within a few days, and gradually improves over one to two weeks as the infection clears.
Response to simple measures is another difference patients can observe. In contrast, viral coughs often improve during the day after the lungs are cleared of accumulated mucus and are most severe at night and in the early morning hours when there is little or no mucus in the lungs. The treatments of pollution and viral coughs are very different; therefore, unless someone is experiencing severe symptoms such as shortness of breath, chest pain, coughing up blood, elevated body temperatures, or coughing for over three weeks, they should seek the advice of a physician.
Understanding these simple clinical clues helps patients make informed decisions. While a pollution cough reflects ongoing environmental irritation, a viral cough signals an infection that needs rest and care. Recognising the difference can prevent unnecessary antibiotic use and encourage timely medical attention when needed.
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