Only 10 years ago, donning a face-mask in Kathmandu meant a few odd things—you were a doctor, an invalid or just fussy. But in that short decade, face-masks have gone from quirky accessories to vital appendages. Today, everyone—pedestrians, motorists and cyclists—are covering their faces against life threatening airborne particulates. Increasingly, living in Kathmandu has also meant constantly struggling to keep it out of your lungs.

The deteriorating air quality inside the Valley, due to a host of reasons—ranging from vehicular emissions to industrial fumes and forest fires—have increased the health risk associated with regular exposure to dangerous levels of air pollution. In turn, it has also given seed to a thriving market for face-masks that promise to keep its users safe. But how effective are they?

“Masks are no longer an option but has become compulsory in current day Kathmandu,” says Sailendra Dongol, who commutes the city on his bicycle. An active member of the Kathmandu Cycle City (KCC), a group of cycling enthusiasts aiming to make Kathmandu an environment-friendly cycle city by 2020, Dongol believes that cyclist are particularly susceptible to prolonged exposure to Kathmandu’s air.

Earlier this year, having tried several anti-pollution masks available in the market, Dongol finally settled on the newly-launched Totobobo mask. Now six months and hundreds of grey filters later, he finally believes he has found a mask that protects him from harmful pollutants, particularly PM 2.5 and PM 10. 

The Singapore-manufactured Totobobo masks are made from silicon and rubber and are advertised as being ‘leak-proof’. They have two valves placed with interchangeable, activated charcoal filters in each valve, and can be changed depending on the need and desired level of protection. The face-mask with ‘N92’ designated filters means that they can block at least 92 percent of very small particles when properly fitted, while the N96 is effective in filtering 96 percent of the small fine particles and microbial agents that otherwise easily pass through the normal cloth and surgical mask commonly in use in the city.

According to Nelson Labs, an independent testing centre in the US, “N95 respirators are used to filter contaminants such as dust, fumes, mists, as well as microbial agents including tuberculosis bacteria and flu virus. They are certified to filter greater than or equal to 95 percent of all challenged particles free of oil and greater than 0.3 microns in size, much smaller than the PM2.5 microns, the key pollutants that can directly enter inside the lungs.” The Nelson Labs has certified Totobobo with 99.85 percent effectiveness.

In addition to the cutting-edge filters, Totobobo masks can be reshaped to perfectly fit a user by applying external heat from hair driers. “With these masks, I can be assured that there are no leaks,” says Dangol, whose Facebook post about the Totobobo filters went viral in June, “On average, a pair of filters last for about eight hours in Kathmandu.”

Janaki Shrestha from Epic Mountain Bike, the authorised retailer of the Totobobos, confirms that there has been a surge in interest but admits that the masks don’t come cheap. Priced at Rs 4,000, the masks are available in two models TT-01 (for adults) and TT-02 (for adolescents and children). It is, however, the constant investment on filters that put these masks beyond the reach of most Nepalis. 15 sets of N92 respirators go for Rs 2,500, while 10 sets of N96 respirators cost Rs 3,800.

Metro-mask, marketed as the Nepal’s first high-tech anti-pollution mask, is another face-mask popular among cyclists and motorists. Sold at various outlets in the Capital, several celebrities, including Prabal Gurung and Aastha Pokhrel, have been spotted beating Kathmandu’s pollution with metro masks. Currently available in two models—MOTO and CITY—these masks are priced at Rs 3,500 and Rs 1,500. Moto-masks also come with interchangeable filters which need to be replaced depending on the amount of dirt accumulated in the filter. Both the versions of the Metro-masks are better alternatives to the normal cloth masks, but are a bit over-priced and don’t effectively prevent the smaller dust particles, says Drishty Shrestha, a Metro-mask user. According to her, another drawback is that the masks lack certification.

Vogmask, a certified N99 mask with active carbon layer filters that stop harmful gas pollutants like carbon monoxide, besides the PM 0.3 microns particles, was introduced in the Nepali market nine months ago and has since then been doing brisk business. “Those working in development sector are our most frequent customers,” says Shishir Sharma, a distributor of the masks, “More recently, we have seen people purchasing the masks for their entire families.” Priced Rs 3200, Vogmask is a highly efficient filtering face-mask that markets itself as resistant to air pollution, dust, germs, pollen and other airborne contaminants. During the winter, when the air pollution in Kathmandu Valley is at its peak, the mask is effective for up to 6 months, while in summer it is usable for 8 months.

In her post shared on Vogmask Nepal’s Facebook page, Apexya Shrestha, a medical student, wrote about how wearing a Vogmask has protected her from the hazardous levels of air pollution in the city. “One good thing about the Vogmask is that it has both style and function and doesn’t fog up my glasses when I wear it. I felt the difference after using the mask for a week,” she posted.

For Shrestha and those who can afford it, the dangers of commuting in a polluted city have been significantly reduced. But according to Dr Bhupendra Basnet, senior physician at Bir Hospital, it is those who can’t afford the anti-pollution masks that are the real concern. “There has been a marked spike in medical conditions caused by air pollution. Everything, from chronic asthma to eye irritations, has been on the rise,” he confirms. A 2009 joint-report published by Nepal Health Research Council and the World Health Organisation estimated that air pollution causes 1,926 premature deaths in Kathmandu every year. According to Dr Basnet, most patients afflicted with pollution-related ailments either never wore masks or could only afford the ones made from cloth that are widely available in the market. “While surgical or cloth masks filter out some dust, they flatter to deceive. They are not filtering out the harmful airborne particulate matter,” he warns, “But to think masks like the expensive Totobobo will come into wide circulation

is just plain wishful. Instead, we should be seriously thinking about how we can curb the pollution. Anti-pollution masks are short term solutions. But when they become a norm, then you are resigning to the fact that there is no political will to affect any change.”

The recent transit blockade that kept cars and bikes off Kathmandu’s streets for weeks gave the city a momentary glimpse of what it would look like with better regulation. But those heady days are long gone. Today, idling in a dusty traffic jam in Teku, you look around to see that those in SUVs and those on cheap handlebar cycles are breathing in same polluted air. For a city divided on so many fronts, its residents now at least have one thing in common—face-masks.

Reason for alarm

It is certain that the Valley’s denizens are exposed to polluted air, which has severe impacts on public health. However, the sources and the extent of exposure is still unknown, thanks to the absence of air quality monitoring stations in the Capital.

The lack of vital data has left the public unaware of the pollutants in the air they breathe in and has left an already lethargic state mechanism confounded on where to begin their intervention.

The latest Environment Performance Index (EPI) 2016 released in January puts Nepal 177th among 180 countries in terms of air quality. India, China and Bangladesh are the only countries performing worse than Nepal in the effort to improve the dramatic decline in air quality—a leading cause of premature deaths worldwide—accounting for 5.5 million deaths in 2013.

Under air quality, one of the nine assessment areas that determine the overall EPI ranking, the exposure to fine particulate matter (PM2.5), nitrogen dioxide, and the percentage of the population burning solid fuel indoors is measured. Particulate matter (PM 2.5) is considered to be one of the most harmful air pollutants that lodge into human lungs and blood tissues, increasing the chances of lung cancer and other life-threatening respiratory diseases.

In March the same year, another Pollution Index published by Serbia-based research website Numbeo.com ranked Kathmandu as the third most polluted city in the world.

The findings of a research report on ‘Characteristics and sources of polycyclic aromatic hydrocarbons (PAHs) in atmospheric aerosols in Kathmandu Valley’ ELSEVIER journal, published in August last year, found that toxic equivalent quantity of PAHs, the cancer-causing pollutants ranged between 2.74 and 81.5 ng/m3, which is up to 80 times higher than WHO guideline of 1ng/m3. 

The air in Kathmandu Valley was found mixed with extremely high concentration of cancer-causing pollutants, particularly emitted from the use of diesel engine exhausts and biomass fuels like the coal used in brick kilns, found the study led by Maheshwar Rupakheti, from the Institute for Advanced Sustainability Studies in Germany.

The annual concentration of toxic PAHs was found at 155 ± 130 nanogram/m3is comparable to those observed in bigger metropolises like Beijing and Delhi.

Another research, done by Anobha Gurung, a doctoral candidate at Yale University, found that the level of small particulate matter that can easily enter the human body was measured to be over 500 micrograms per cubic metre, 20 times higher than the WHO’s safe upper limit.

A 2014 report of the Ministry of Science, Technology and Environment, showed that Kathmandu’s air contains 400 micrograms of particulate matter up to 10 micrometres in size per cubic metre—around three-fold the permissible limits. The maximum limit set by the National Ambient Air Quality Standards for PM10 is 120µg/m3.