Breathwork is everywhere, whether it’s in yoga studios, corporate retreats or self-help reels. We’re told to “just breathe”. Be mindful. Lower our stress levels. Inhale. Exhale. In the yogic tradition, bringing clean air into our lungs and our body (pranayama in Sanskrit) is about purifying and detoxing, and then exhaling what we don’t need. That all sounds great if you live on a remote island or in the middle of a forest – but what if that air isn’t cleansing us, but making us sick?
According to the World Health Organization, 99% of the global population is exposed to air-pollution levels that exceed its health-based guidelines and air pollution is now the world’s single largest environmental risk, linked to nearly 7 million premature deaths each year. This isn’t an issue of future climate collapse or one that will affect future generations. This is about today – and the damage polluted air is doing to our hearts, lungs, brains and blood vessels.
In some places, air pollution has reached a crisis point. Those places are a warning to other cities across the world of what unregulated and unmitigated air pollution looks like. Take New Delhi, which many consider to be the most polluted capital in the world. During peak pollution periods, PM2.5 concentrations in Delhi regularly exceed WHO guideline levels by roughly 24 times. According to the Air Quality Life Index, that exposure is estimated to reduce life expectancy by almost 12 years. Exposure at these levels is associated with increased risk of heart attacks, strokes, chronic respiratory disease and impaired brain development in children. The result is that 15% of all deaths in Delhi can be attributed directly to air pollution. It’s a slow and invisible poison, which is why it attracts far less attention than more immediate health threats.
When the air becomes so dangerous, the supreme court orders lockdowns – not because of any pandemic, but because of harm to health from breathing the air outside. One justice, Arun Mishra, said: “The world is laughing at us. You are reducing the lifespan of people. Why are people being forced to live in gas chambers? Better to get explosives and kill them all in one go.” A local doctor, attending to patients with respiratory distress, compared the air in Delhi on a bad day to smoking 50 cigarettes a day.
This isn’t a problem that affects just Delhi. The Royal College of Physicians recently published a study suggesting that 30,000 deaths a year in the UK were linked to air pollution. And what would London look like today if low-emission zones (LEZ) and ultra-low-emission zones (ULEZ)hadn’t been brought in? Road transport remains a major source of nitrogen oxides and particulate pollution in urban areas, particularly from diesel vehicles. In London, nitrogen dioxide levels declined by nearly half between 2016 and 2023, with air quality improving at 99% of monitoring sites across the city. A city hall report found that in 2024, nitrogen dioxide was down by about 27% overall across London and PM2.5 from vehicle exhausts was 31% lower in outer London than it would have been without ULEZ expansion. Across the UK, air quality has been improving, but a recent study showed that as of 2024, many areas still breached safe limits far too often.
On a personal note, I would like to see two more improvements in Britain. First, more drivers turning off their engines instead of keeping them running while waiting. A running engine significantly increases the concentration of exhaust fumes in the immediate vicinity. This is damaging to the drivers, passengers and nearby pedestrians alike. How many times have we seen a large SUV waiting with its engine running near a school or park? The driver might have spent an hour in the gym or eating organic but all those health gains would have been wasted – and reversed – by idling their engine, poisoning both themselves and everyone around them.
Second, wood-burning stoves and open fires are frequently marketed as upmarket, sustainable and cosy, yet they produce substantial amounts of fine particulate matter indoors and outdoors. The World Health Organization categorises this as indoor air pollution, a risk factor it has spent decades trying to reduce in low-income countries where people cook over open fires. In wealthier countries, the same exposure is often reframed as a lifestyle choice, despite evidence of harm to respiratory health, especially for those sitting in front of the fire. A recent UK study linked wood burning to nearly 2,500 deaths and more than 27,000 years of life lost annually, and thousands of new cases of asthma and diabetes.
While we can do what we can individually, what ultimately matters most for public health are the air quality policies implemented by cities and governments. Emissions standards, clean air zones, transport planning and regulation of domestic combustion all have measurable effects on exposure and health outcomes. The benefits are immediate and local. Mindfulness is trendy and asks us to use our breath to reduce stress and improve our health. But no amount of calm awareness can offset air that is quietly damaging our health. You can drink green smoothies, practise breathwork or go for a run, but the health impact of those choices is likely to be outweighed by the quality of the air you are breathing while doing them.
Prof Devi Sridhar is chair of global public health at the University of Edinburgh
Fit Forever: Wellness for midlife and beyond
On Wednesday 28 January 2026, join Annie Kelly, Devi Sridhar, Joel Snape and Mariella Frostrup, as they discuss how to enjoy longer and healthier lives, with expert advice and practical tips. Book tickets here or at guardian.live
