As winter approaches, coughs, throat irritation, sneezing and breathing discomfort become increasingly common, particularly in areas affected by poor air quality. However, these symptoms do not always indicate a respiratory infection. According to pulmonologist Dr Manisha Mendiratta, pollution, cold air, allergies and viral infections can produce similar symptoms, making it difficult to identify the exact cause without considering the complete pattern of illness. Understanding these differences can help people seek appropriate medical care and avoid unnecessary medication.

Pollution-related coughs develop when the respiratory tract is exposed to fine particulate matter, smoke, dust and other airborne irritants. Common symptoms include a dry cough, scratchy throat, burning sensations in the nose, watery eyes, chest tightness and mild breathlessness. These symptoms may become more noticeable after spending time outdoors, travelling through traffic-heavy areas or encountering smoke. In some cases, discomfort improves after moving to an environment with cleaner air. Fever and significant body aches are generally less characteristic of pollution-related irritation.

An infection may be more likely when coughing occurs alongside fever, chills, headaches, fatigue, body aches, a sore throat or nasal congestion. Respiratory viruses responsible for conditions such as the common cold and influenza can cause symptoms that develop and progress over several days. The cough may initially be dry before producing mucus. However, mucus colour alone cannot reliably establish whether an infection is bacterial or whether antibiotics are necessary. Medical evaluation may be required when symptoms are severe, persistent or worsening.

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Cold and dry winter air can also irritate the respiratory tract, particularly among people with asthma or other existing lung conditions. Pollution may intensify these effects, triggering coughing, wheezing and chest tightness. Allergies provide another possible explanation for recurring symptoms, especially when accompanied by repeated sneezing, an itchy nose, watery eyes and clear nasal discharge. Unlike many respiratory infections, allergies generally do not cause fever or significant body aches. Symptoms may continue for weeks or return whenever a person encounters a particular trigger.

Certain warning signs require prompt medical attention rather than being attributed to pollution or seasonal irritation. Persistent or worsening breathlessness, chest pain, rapid breathing, coughing up blood, bluish lips or confusion should be assessed urgently. People with asthma and other chronic respiratory conditions, as well as young children and older adults, may need particular care when respiratory symptoms develop. Antibiotics should not be taken without appropriate medical advice because they do not treat viral infections, and unnecessary use can contribute to antibiotic resistance.

Reducing exposure to polluted air can help limit respiratory irritation during periods of poor air quality. People can check local air-quality updates, reduce prolonged outdoor exertion when pollution levels are high and wear a properly fitted, high-filtration mask when outdoor exposure is unavoidable. Keeping indoor spaces free from cigarette smoke and excessive dust, maintaining hand hygiene and staying up to date with recommended vaccinations can also help protect respiratory health. Adequate hydration and warm fluids may soothe throat discomfort. Ultimately, pollution, allergies and infections can produce overlapping symptoms, and more than one factor may be responsible. Medical advice is important when symptoms persist, worsen or interfere with normal breathing.

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