As Dhaka’s skyline grows, so do the medical bills

If you live in Dhaka, you've probably made peace with waking up to the harsh rattle of drilling and falling asleep with a thin layer of dust covering your floor. The noise, the dust—they're just part of life now. We barely blink. It's become the background hum of a growing city.

But what if this familiar routine is slowly poisoning us?

From 2005 to 2018, nearly 24,000 lives were lost in Dhaka due to causes linked to air pollution. That's not just a number. That's someone's parent, sibling, friend—gone, quietly, without headlines or outrage.

As Dhaka ballooned from 50 square kilometres in 1990 to more than 300 today, the city became a construction zone. Towering buildings, new roads, shiny malls—it all came at a cost. And much of that cost is being paid with the air we breathe.

A recent report by Eminence Associates for Social Development, compiled by Dr Md Shamim Hayder Talukder and urban health officer Md Wahiduzzaman, lays bare the uncomfortable truth. Construction alone is responsible for 30% of the city's air pollution. Yes, the very sites that surround us with scaffolding and sand. 

Then come the brick kilns and factories—over 1,000 of them—pumping smoke into the sky, contributing another 29%.

Our vehicles contribute to the burden, too, with emissions accounting for 15% of the pollution. Even air that drifts in from across the border—what experts call "transboundary pollution"—accounts for 10%. Add waste burning and wood-fired cooking stoves, and you get the full picture: a cocktail of toxins hanging over us every single day.

We may not see it, but it's in our lungs. We may not hear about it, but it's shortening our lives. And until we start connecting the dots between that morning drilling and our rising health issues, we'll continue to live in a city where progress comes at the cost of our breath.

Dhaka consistently ranks among the top five cities with the worst air quality in the world. Its Air Quality Index (AQI) regularly exceeds an average of 160, classified as "unhealthy", and is  16 times higher than WHO's recommended annual guideline value.

The mental toll of construction

While the physical consequences of polluted air are more widely recognised, the mental health effects of living near construction zones are often ignored. Yet for many, these are just as debilitating.

Constant drilling, hammering, and heavy machinery generate unrelenting noise, disrupting sleep, increasing anxiety, and contributing to chronic stress. Prolonged exposure to such noise pollution has been linked to higher rates of depression and irritability.

Rumana Akhter, a schoolteacher in Mohammadpur, shares her struggle, "We can't keep the windows open because of the dust, and we can't rest because of the noise. My children can't concentrate on their studies. It's exhausting."

Many Dhaka residents find themselves trapped in a cycle of unrest. For people living near multiple or large-scale construction sites, the mental toll builds over time, manifesting in persistent fatigue, reduced work performance, and even family conflicts. For elderly citizens and those already suffering from mental health conditions, these disturbances can severely worsen their condition.

According to Dr Shuvo, a clinical psychologist, studies from urban centres show that chronic exposure to environmental noise is not just a nuisance; it has physiological consequences. 

Elevated levels of cortisol, the stress hormone, are commonly found in those exposed to ongoing construction noise. Over time, this contributes to hypertension, weakened immunity, and sleep disorders. In a city like Dhaka, where mental health resources are already scarce, these silent pressures are brewing into a larger crisis.

Dhaka consistently ranks among the top five cities with the worst air quality in the world. Its Air Quality Index (AQI) regularly exceeds an average of 160, classified as "unhealthy", and is 16 times higher than WHO's recommended annual guideline value.

The dust we breathe

Microscopic particles such as PM2.5 and PM10, released from cement mixing, demolition, and sand transportation, infiltrate the air we breathe. These particles enter deep into the lungs and bloodstream, causing a range of illnesses, from asthma and bronchitis to cardiovascular disease and lung cancer.

Dr Nazmul Islam, reports a noticeable rise in patients with respiratory distress during peak construction seasons. "Children and the elderly are the most vulnerable," he explains. "Even a healthy adult breathing this dust daily is at serious risk."

According to the World Bank, air pollution is now the leading risk factor for death in Bangladesh, contributing to over 200,000 deaths each year. On average, it reduces life expectancy by nearly five years. Among children, it contributes to stunted growth, asthma, and cognitive impairment. In newborns, it is linked to low birth weight and premature birth.

These health consequences also bring enormous economic costs. In 2019 alone, pollution-related healthcare expenses and lost productivity amounted to $11 billion, or about 4.4–4.8% of the country's GDP.

For individual families, these costs translate into frequent doctor visits, medication purchases, missed workdays, and long-term health management, all of which can be financially draining, especially for lower- and middle-income households. Over time, the burden on the healthcare system and productivity loss weaken national economic growth.

Who is responsible?

Construction companies and real estate developers are directly accountable for neglecting environmental safeguards. Open piles of sand, uncovered trucks, and demolition sites with no dust or noise barriers are commonplace.

According to Iqbal Habib, a renowned architect and urban planner, despite environmental regulations, enforcement is weak. Regulatory bodies such as the Department of Environment (DoE), RAJUK, and the city corporations often fail to monitor construction activities or penalise violators. He argue that these agencies lack both manpower and the political will to take effective action.

Moreover, government policymakers have yet to prioritise sustainable urban planning. There is no integrated national policy to ensure environmentally safe construction practices. This policy vacuum allows them to operate unchecked.

Dust control mechanisms such as regular water sprinkling, dust barriers, and the covering of materials during transport must be made mandatory and strictly enforced.

Replacing traditional clay bricks with eco-friendly concrete blocks would not only reduce air pollution but also preserve fertile topsoil. Noise pollution can be minimised by enforcing work-hour restrictions and applying noise limits in residential zones.

Construction waste, which is often dumped carelessly, should be properly collected and disposed of in designated dumping grounds to prevent further environmental degradation.

Iqbal Habib emphasises, "If we want a city that is liveable for all, we need to rethink construction not just as a technical activity, but a civic responsibility. Our cities are for people, not just buildings."

Experts also call for a more balanced approach to urban development, incorporating green spaces, buffer zones between construction and residential areas, and clear zoning regulations. Urban greenery has a dual role: it acts as a natural air filter and provides psychological relief, reducing stress and improving overall well-being.

Iqbal Habib explains that it is equally important to understand the economic benefits of clean air and a healthier population. 

Long-term planning, stronger regulation, and public investment in green infrastructure can reduce healthcare costs, boost worker productivity, and improve quality of life. For a country striving for economic growth, investing in clean construction practices isn't just a public health measure, it's an economic strategy.

Without strong enforcement, long-term planning and making systemic changes, Dhaka's ambitious development may come at a heavy price.