Prof Rawiwan Oranratmanee was an impressively health-conscious person. Her routine workout included yoga, jogging and cycling, among others. Yet at the age of only 55, she was diagnosed with terminal lung cancer.
"My mother was the most disciplined person in our family when it comes to health," said Jirawan Oranratmanee, 21, a third-year student at Chulalongkorn University.
The dean of the Faculty of Architecture at Chiang Mai University, Rawiwan passed away shortly after her first chemotherapy session. The malignancy was said to have caused by PM2.5 which resulted in a gene mutation.
Bangkok residents are now waking to hazy mornings as many parts of the city are being blanketed in a layer of PM2.5. The Bangkok Metropolitan Administration recently said the air was unhealthy (orange-level) in 54 areas with the situation expected to persist or worsen for at least a week.
The failure to tackle the issue has resulted in the Health Center Data's latest report revealing that in 2024, across Thailand, over 9.4 million people are suffering from diseases caused by air pollution.
And Rawiwan's tragic story is a stark reminder that the particulate matter can be life-threatening.
"My mother was meticulous about food. But most importantly, she never smoked and rarely touched liquor. Therefore, it was never on our radar when the diagnosis came, to our surprise, as lung cancer," Jirawan added.
Following her mother's death, Jirawan has relocated and is now living in Bangkok.
"One of the things that always strikes me is that the government never really has a plan. They start to react when the problem emerges. And in some cases, it is too late to solve," she commented.
As PM2.5 makes an official comeback in Bangkok, the question remains -- is it too late to clear the air?
Bangkok skyscrapers shrouded by PM2.5 pollution.
The respiratory diseases caused by PM2.5 are the most pronounced, such as asthma and lung cancer, but heart disease and stroke are also risks.
"PM2.5 levels of 22 micrograms per cubic metre is equivalent to inhaling PM2.5 from one cigarette. In 2024, Bangkok residents are involuntarily inhaling the equivalent of 3.77 cigarettes per day," said Dr Prakit Vathesatogkit, executive secretary of Action on Smoking and Health Foundation.
Over time, medical researchers have also found strong ties between air pollution and mental health issues. Based on a United States' National Institutes of Health (NIH) study, PM2.5 can lead to depression, anxiety, bipolar disorder, psychosis and suicide in adults. Long-term exposure such that more than six months has the closest link to depression. Furthermore, in late 2023, the NIH published another article stating that higher PM2.5 exposure is associated with an increased risk of dementia -- a loss of thinking, remembering and reasoning skills.
Preeyaporn Suwanaged, director-general of the Pollution Control Department, revealed that in fiscal year 2024, the department received a total of 1,021 pollution complaints, of which 442 or 25% were particulate matter and smoke cases. The area with the highest number of complaints was Bangkok.
"To prepare for the situation in Bangkok and its vicinity, relevant agencies must integrate their operations according to these measures, particularly in controlling particulate matter emissions from vehicles, industries and burning in communities, which are major sources of pollution. This includes promoting and enforcing laws and preparing public health measures, work from home policies and public communication to alert citizens," Preeyaporn emphasised.
In an attempt to overcome limitations and constraints such as systematic and infrastructural level problems, the BMA along with the Thai Health Promotion Foundation recently initiated a project titled "Countdown PM2.5: Collaboration To Fight PM2.5 in 2025".
Bangkok Governor Chadchart Sittipunt said the city has a 365-day plan to reduce particulate matter and also a crisis management plan. This year, stricter measures have been implemented. The plans range from establishing 50 mobile medical units and eight air pollution clinics to prohibiting vehicles entering the city. Trucks that are EV, NGV or EURO 5-6 standard, and those registered on the "Green List", can still enter the zone. Registration started earlier this month.
"In addition, there is a work from home policy, with 100 participating companies and 40,000 employees. The Countdown PM2.5 project to improve the well-being of city dwellers aligns with the BMA's policies for preventing and addressing air pollution issues. Specifically, innovations such as electric vehicle conversion, promoting low-emission transportation and establishing the Bangkok Air Quality Council will directly address the problem and is expected to significantly reduce air pollution levels," Gov Chadchart said recently.
For the general public, the Department of Disease Control hosted a press conference on the topic "Winter Warmth, Safety, And Disease Prevention" earlier this month with an objective to provide practical guidelines for coping with diseases and health risks during this winter season.
"At-risk groups including young children, pregnant women, the elderly, individuals with chronic illnesses and outdoor workers should closely monitor air pollution levels. When PM2.5 levels are high, they should follow the 'Avoid, Close, Use, Reduce' guidelines. Avoid exposure to dust, keep doors and windows closed, wear protective masks for PM2.5, reduce outdoor activities, and reduce the use of vehicles and open burning," said Dr Jurai Wongsawat, spokesperson from the Department of Disease Control.
Nonetheless, the devastating case of Prof Rawiwan demonstrated that health precautions at the individual level could be insufficient to combat the smallest enemy. And it brings us back to the key challenge of air pollution and how it has no boundaries. The harsh reality of PM2.5 is thus calling for change not only at the government, industry or individual level, but at a global level.
"We did everything we could according to health recommendations. We wore masks and went outside for as little as possible, but it was not enough. Therefore, with my story, I want to be another voice that echoes the demand for change," Jirawan said.
