Masuk Angin: Could it really be caused by air pollution?


Anggid Primastiti





English / Indonesia

Fine particulate matter (PM2.5) can cause illnesses that mimic cold symptoms and exacerbate respiratory and flu diseases.

🧐 In this article, you’ll learn:

  • Jakarta and its surroundings have often been cited as one of the cities with the worst air quality in the world, with daily PM2.5 levels reaching 75.45 µg/m³ on June 15, 2022.
  • Exposure to PM2.5 pollution has been linked to serious health consequences, such as cough, dizziness, flu and runny nose, and breathing difficulties, all of which are symptoms of masuk angin.
  • Going indoors, closing windows, limiting indoor and outdoor activities that produce fine particles, and using an air purifier may reduce your exposure and protect you from air pollution.

Some of you may have had uncontrollable coughing, runny nose, and difficulty breathing. In fact, it can happen suddenly and without warning. So, what if it's due to air pollution? Is there a link here?

PM2.5, the invisible source of illness

Since pollutants raise the risk of a wide range of diseases, air pollution has been well-documented as a significant public health concern for many regions worldwide. Particulate matter 2.5, a significant component of air pollution, is a mixture of solid and liquid particles in the air with a diameter of less than 2.5 micrometers. This is 30x smaller than a single hair. PM2.5 is damaging because smaller particles are more likely to enter the lungs and bloodstream deeper and unfiltered. According to findings, exposure to PM2.5 pollution has been linked to serious health consequences. Many health issues are not only acute but also chronic.

How Jabodetabek data could be connected to health outcomes due to air pollution

In recent years, Jakarta and its surroundings have often been cited as one of the cities with the worst air quality in the world. According to nafas data, PM2.5 levels in Jakarta reached 75.45 µg/m³ on June 15, 2022. In fact, the World Health Organization (WHO) states that the limit of PM2.5 particulate concentration in the air is 5 µg/m³. This means that the PM2.5 concentration in Jakarta is 15 times more than the limit set by WHO.

The poor air quality in Jakarta and its environs is affecting public health. According to a survey of 1,570 respondents (aged 23-38 years) from Katadata, many Jakarta residents were experiencing acute health issues such as coughing and sneezing (44.6%), headaches (44.3%), and irritation of the eyes, nose, throat, and skin (42%) in 2021. Some residents experienced fatigue, shortness of breath, nasal drip, hypersensitivity, and allergies.

The initial symptoms of severe air pollution will be similar to catching a cold. Unfortunately, people frequently disregard it. Various long-term diseases will haunt us day after day if left unchecked. When you live in an area with severe air pollution, your health is jeopardized.

>These are the early symptoms or short-term effects of air pollution.

😮‍💨 Dry and itchy throat

Smoke, which contains harmful particles can cause a dry, itchy throat. Coughing and sneezing are often the first signs of a dry, itchy throat. There was some evidence linking PM2.5 exposure to chronic cough, which is a physiological mechanism for clearing inhaled particles.

🤒 Headache

There is mounting evidence that air pollution can cause migraines. Various air pollutants, including NO2 and PM2.5, have been linked to migraines. Given the well-documented link between blood flow changes and migraine onset, it is thought that PM2.5 may activate the sympathetic nervous system, which is the primary regulator of the vascular system.

😷 Difficulty breathing

Exposure to air pollution is estimated to cause aggravated asthma, decreased lung function and difficulty breathing. Numerous studies have linked PM2.5 to a variety of health issues, ranging from increased asthma attacks to hospital visits to death. PM2.5 has been linked to an increase in asthma medication use in children, a decline in respiratory function, an increase in emergency room visits, and hospitalization for lung and heart problems.

🤧 Flu and runny nose

Multiple studies have found that being exposed to high levels of air pollution increases your chances of getting sick with influenza. Ambient PM2.5 is a direct transmission mode for influenza virus infection, causing the disease to spread.

📚 A study in Japan with an average PM2.5 concentration of 25.2 μg/m3 suggested an association with an increased runny nose, nasal congestion, coughing, sneezing, and sore eyes. The study suggested that PM2.5 pollution comes from human activities (such as coal burning, oil burning, and traffic emissions) and from nature (such as sea salt and soil).

📖 A Taiwanese study also looked at the association of PM2.5 concentrations in the >11 μg/m3, 11-15 μg/m3, and >15 μg/m3 categories with headaches. The results showed an increased incidence of recurrent headaches at higher PM2.5 concentrations.

Looking at the concentration data in these studies, this is quite concerning when compared to the Indonesian air quality we have been breathing. Let's take a look at the average air quality data in several cities during September 2022!

We can see that the average air quality is far above the limits recommended by WHO and from the concentrations in the studies we mentioned above, with air quality up to 9.2 times the WHO limit for Bandung. So don't be surprised if you suddenly feel the cold symptoms, just look around and start to realize: perhaps the cause is air pollution.

What is the most effective way to reduce air pollution exposure?

There are several steps you can do to protect yourself from air pollution.

  • Routinely monitoring air quality before outdoor activities are highly recommended. When PM2.5 levels are high outside, going indoors may reduce your exposure, though some outdoor particles will enter your home.
  • Limiting indoor and outdoor activities that produce fine particles (for example, burning candles indoors or open burning outdoors) and avoiding strenuous activity in areas with high fine particle levels are some ways to reduce exposure.
  • Using an air purifier, closing windows to avoid dirty air, and exercising indoors are recommended ways to protect yourself from air pollution.

Download the nafas app now to monitor the air quality around you, so you can take the appropriate air pollution preventive actions before going out.


Hong, S. Y., Wan, L., Lin, H. J., Lin, C. L., & Wei, C. C. (2020). Long-Term Ambient Air Pollutant Exposure and Risk of Recurrent Headache in Children: A 12-Year Cohort Study. International journal of environmental research and public health, 17(23), 9140. https://doi.org/10.3390/ijerph17239140.

Hsiao, T.-C., Cheng, P.-C., Chi, K. H., Wang, H.-Y., Pan, S.-Y., Kao, C., Lee, Y.-L., Kuo, H.-P., Chung, K. F., & Chuang, H.-C. (2022). Interactions of chemical components in ambient PM2.5 with influenza viruses. Journal of Hazardous Materials, 423, 127243. https://doi.org/10.1016/j.jhazmat.2021.127243.

Sugiyama, T., Ueda, K., Seposo, X. T., Nakashima, A., Kinoshita, M., Matsumoto, H., Ikemori, F., Honda, A., Takano, H., Michikawa, T., & Nitta, H. (2020). Health effects of PM2.5 sources on children’s allergic and respiratory symptoms in Fukuoka, Japan. Science of the Total Environment, 709, 136023. https://doi.org/10.1016/j.scitotenv.2019.136023.

Takizawa H. (2011). Impact of air pollution on allergic diseases. The Korean journal of internal medicine, 26(3), 262–273. https://doi.org/10.3904/kjim.2011.26.3.262.