Mohamad Qadeer holds up a nebulizer device to the face of his daughter, Rameen, 3, who is suffering from a chest infection amidst soaring air pollution, at Sir Ganga Ram hospital in Lahore. Reuters

In the packed paediatric emergency room of a Lahore public hospital, parents holding sick children lined up for treatment this week, part of a surge of young patients caused by the air pollution crisis in Pakistan's second most populous city.

"We are disturbed and tense," said Mohamad Qadeer, holding a nebulizing device to his three-year-old daughter Rameen's nose, engulfing her face in a billow of steam delivering medication to ease her congested airways.

She and her one-year-old sister Inaaya are among thousands of children suffering from pollution-related health problems. Health officials estimated there has been at least a 50% rise in paediatric patients due to respiratory issues exacerbated by poor air quality in the last month.

Lahore, known historically as a city of gardens, is now choking with toxic smog that placed it as the world's worst for air quality last year.

As cooler temperatures took hold in November, air quality levels spiralled. Twenty-four of the last 30 days had 'hazardous' or 'very unhealthy' air quality, according to Swiss group IQAir.

"It has gotten a lot worse than the previous years and it is affecting the health of the children," said Dr Maria Iftikhar, senior registrar at Sir Ganga Ram hospital's paediatric department.

Shazma Qadeer holds a breathing mask for her one-year-old daughter Inaaya, who is suffering from a respiratory illness amidst soaring air pollution at Sir Ganga Ram Hospital. Reuters

The city of 11 million, considered the cultural capital of Pakistan, has been blanketed in thick haze that partially blocks the sun and shrouds streets with fog at night. The problem becomes more severe in cooler months, as temperature inversion prevents a layer of warm air from rising and traps pollutants closer to the ground.

Mohamad and his wife, Shazma, had tried to keep Rameen and Inaaya safe with masks and limiting time outdoors but after days of coughing and fever the children stopped eating.

Commuters make their way along a street amid dense smog in Lahore.

"We have been sleepless for three nights," said Shazma, bouncing Inaaya on her knee as she held up the nebulizer to her face. More mothers and children waited nearby for their turn and a doctor rushed through the crowds with an infant in her arms, trailing a porter wheeling an oxygen canister pumping air to the baby.

"Inshallah (God willing), they will be better soon ...," Shazma said.

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