At 8 a.m. on Dec. 3 Hanoi was blanketed in a thick layer of fine dust. Hien, a sanitation worker in Nam Tu Liem, pulled down her mask, coughed several times and quickly covered her mouth with her sleeve. Her chest rattled with each breath. Each coughing fit left her bent over, gripping her broom handle for balance. She pulled her cloth mask higher, knowing it did little to help.
“Just taking one deep breath makes my throat burn and my chest tighten, and I feel extremely breathless,” she says before returning to work amid road dust, exhaust fumes and the smell of garbage.
Sanitation worker Hien in Hanoi, Dec. 3, 2025. Photo by Read/Thuy Quynh |
On a sidewalk 50-year-old taxi driver Mai Van Thien sips a cup of iced tea while waiting for passengers. Within just 10 minutes dust has settled across his car.
Checking an air-quality app, he saw the AQI and PM2.5 levels had exceeded 200, classified as “very unhealthy.”
After several bouts of coughing, he says he has felt shortness of breath and chest tightness in recent days and has installed an air purifier inside his taxi.
A nearby motorbike ride-hailing driver says he is used to heat, rain and traffic jams, but pollution is what exhausts him the most.
His first job of the day was delivering an air purifier to a luxury apartment complex.
“I’m carrying ‘clean air,’ while my own lungs have to filter dust in exchange for a VND35,000 (US$1.33) delivery fee,” he thought to himself, he says.
For the past three days he has left home at 6 a.m., when the streets were still shrouded in a thick gray haze. Even with a mask wound tightly around his nose, he began coughing the moment he started his engine. At every red light, he loosens his mask briefly to catch his breath, but the air he inhales is full of dust and gasoline fumes, making his chest ache and eyes sting.
For nearly a week Hanoi has consistently ranked among the 10 most polluted cities in the world, according to IQAir. On Dec. 3 morning air-monitoring stations in Tay Ho, Gia Lam and Ha Dong all recorded AQI levels above 200. The index stayed at that level on Dec. 6 and dropped a little to over 190 on Monday morning.
City authorities issued advisories urging people, especially the elderly, children and those with respiratory conditions, to limit outdoor activities and wear masks.
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Hanoi shrouded in heavy smog on Dec. 1, 2025. Photo by Read/Thanh Hai |
Experts point to three main causes of Hanoi’s air pollution: emissions from traffic, industries and construction; pollution drifting from neighboring areas and unfavorable weather conditions. The problem worsens in winter, when the city’s basin-like terrain, combined with northeast monsoon winds and thermal inversion, traps pollutants near ground level instead of allowing them to disperse.
According to the WHO, air pollution is a “silent killer.” A 2021 World Bank report said 40% of Hanoi’s population, about 3.5 million people, are exposed to dust concentrations above 45 μg/cu.m, nine times the WHO guideline. Deaths linked to PM2.5, particles 2.5 micrometers or smaller, account for 32% of pollution-related fatalities nationwide, or around 5,800 people.
Data from AirVisual and GEOI since 2019 shows that at peak pollution, breathing Hanoi’s air is equivalent to smoking three to four cigarettes a day.
Dr. Nguyen Huy Hoang of the Vietnam Association for Underwater Medicine and Hyperbaric Oxygen says PM2.5 particles often carry heavy metals like lead and cadmium, toxic organic compounds and even bacterial toxins. These particles can enter various organs, triggering oxidative stress and damaging mitochondria and DNA. The body responds by releasing inflammatory substances, spreading inflammation from the lungs to the cardiovascular system and other organs. PM2.5 exposure increases the risk of atherosclerosis, blood clots, heart attacks and strokes, and can affect the brain, kidneys and nervous system.
Dr. Doan Du Manh of the Vietnam Society for Vascular Diseases says outdoor workers face even greater risks. Motorbike drivers, sanitation and construction workers and street vendors inhale polluted air for hours at a time, leading to chronic cough, allergic rhinitis, shortness of breath and wheezing. Their risk of bronchitis and pneumonia is several times higher than others, as fine dust penetrates deep into the alveoli, damaging lung tissue and causing chronic, hard-to-treat conditions. It can also irritate the eyes and skin and contribute to stress and fatigue.
Experts recommend that outdoor workers wear certified masks such as N95 and replace them daily. They should take breaks indoors, avoid standing near congested roads, wear dust-proof glasses and long-sleeved clothing, and shower and rinse their nose and throat after returning home.
Hydration and good nutrition, especially protein, vegetables and vitamin-C-rich fruits, help strengthen the immune system. Recommended lung-support practices include diaphragmatic breathing and steam inhalation with essential oils. Anyone experiencing prolonged respiratory symptoms, chest pain or severe shortness of breath should seek medical attention.
Workers are also urged to use reliable air-quality apps to monitor pollution levels. When feeling dizzy, breathless or chest tightness, they should take a break as these can be signs the body is reaching its limit from pollution exposure.
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