Not every cough means you’re falling sick. And not every cough needs medication. A cough, at its core, is the body’s way of protecting the airways, clearing out irritants, mucus or germs. The challenge begins when you try to figure out why you’re coughing in the first place.
According to Dr Nana Kunjir, Consultant Pulmonologist and Intensivist at Sahyadri Super Speciality Hospital, Pune, most coughs today fall into two broad categories: those caused by environmental irritation, especially pollution, and those caused by viral infections like the common cold. Telling them apart matters because the next step: Rest, medicines, or simply reducing exposure, depends on the cause.
Pollution cough: The pattern gives it away
A pollution-related cough usually announces itself through a clear pattern. People often notice it worsening outdoors, near traffic, construction sites, smoke, or on days when air quality is poor. Spend a few hours indoors with cleaner air, and the cough eases.
This cough is typically dry, tickly and irritating. Many people feel the need to clear their throats repeatedly. Burning eyes, watery eyes, a scratchy throat or chest tightness may also show up, because pollution irritates the eyes, nose and throat along with the lungs.
Dr Kunjir explains that people with asthma, allergic rhinitis or COPD are especially vulnerable. Certain pollutants like ground-level ozone can directly inflame the airways, triggering cough, wheeze or mild breathlessness.
Viral cough: Look for the ‘infection bundle’
A viral cough rarely comes alone. It usually arrives with company, sore throat, runny or blocked nose, sneezing, fatigue, headache, fever or body aches. The timeline is important here. Viral symptoms tend to build up over the first few days, peak, and then gradually improve over a week or so. The cough may linger even after other symptoms settle. It often starts dry and later becomes phlegmy.
Dr Kunjir points out that mucus colour alone doesn’t tell the full story. “What matters more is whether symptoms are improving day by day or getting worse,” he says.
When pollution and viral cough overlap
In real life, things are rarely neat. A viral infection can inflame the airways, and polluted air can keep them irritated. This combination often leads to a cough that lingers longer than expected, especially in cities.
A common situation is when fever and nasal symptoms disappear, but the cough continues for weeks. This is known as a post-viral cough. The infection has largely passed, but the airway remains oversensitive. Talking, laughing, cold air, dust, or strong smells can easily trigger coughing fits.
Pollution cough tends to linger differently
Dr Swapnil Khadke, HOD and Consultant – Critical Care at Fortis Hiranandani Hospital, Vashi, explains that pollution cough behaves differently from a viral cough. It often starts mild, worsens as the day progresses, and can last for weeks or even months if exposure continues.
“The cough is usually dry and persistent. People notice improvement when they move indoors, wear a mask, or reduce exposure,” he says. Those with pre-existing allergies or breathing issues are more likely to experience it.
How the response to simple measures offers clues
Another helpful signal is how your cough responds to basic steps. Pollution cough often improves when exposure is reduced, cleaner air, masks, and indoor time. Viral cough, on the other hand, usually progresses to become worse at night or early in the morning, but improves slowly as the illness settles.
Therapy varies. For a viral cough, one should rest, hydrate, and treat symptoms. For a pollution-related cough, improving irritated air passages and avoiding contact with the irritant are most effective and generally require no antibiotics.
When you should seek medical help
Regardless of the cause, doctors advise medical attention if you experience breathlessness at rest, rapidly worsening wheeze, chest pain, coughing blood, persistent high fever, severe weakness, confusion or low oxygen readings. People with asthma, COPD, heart disease, pregnancy, very young children and older adults should seek help earlier, as they can deteriorate faster with both infections and pollution exposure.
Understanding whether your cough is driven by pollution or infection helps you respond appropriately. A pollution cough signals environmental irritation. A viral cough signals infection and recovery time.As doctors emphasise, recognising the difference not only prevents unnecessary medication use but also ensures timely care when it truly matters.
Disclaimer: Tips and suggestions mentioned in the article are for general information purposes only and should not be construed as professional medical advice. Always consult your doctor or a dietician before starting any fitness programme or making any changes to your diet
