More than one in ten Nepalese now suffer a chronic lung problem like emphysema or bronchitis, as a result of worsening air pollution in the country.
The findings are the result of a study by the Nepal Health Research Council into air quality in the country, which has been labelled the "worst in the world".
Air pollution has become so acute in Nepal that a baby born today can expect to have a two-year shorter life expectancy due solely to problems brought on by the air they breathe.
The study was based on a sample of 13,200 people, evenly spread across 400 clusters in the country. From each geographical cluster, 33 households were selected. All of those surveyed were over the age of 20.
The research found the issue is country-wide, with both urban and rural populations affected – but for different reasons.
Rapid urbanisation, the increase in the number of roads in cities and consumer buying power has led to 3.22 million more vehicles on the Nepalese roads since 1990.
Around 80 per cent of vehicles on the road in Kathmandu today are motorcycles, often purchased cheaply second-hand and are poorly maintained, releasing high levels of toxic gases such as nitrous oxide.
Brick kilns are another leading urban pollutant.
Forming a vital part of the Nepalese economy – there is estimated to be around 1,000 in the country, generating $37 million – they are largely unregulated and often built adjacent to residential areas.
Typically, powder coal is used to bake the clay in the kiln into building materials.
This emits a number of toxic by-products into the atmosphere, including black carbon and sulphur dioxide.
These two factors have contributed to the particulate matter concentration in Kathmandu – the measure of toxic solid particles in the air, such as lead – to reach levels five times greater than the safe amount set by the National Ambient Air Quality Standard of Nepal.
"Fossil fuels are one of the biggest contributors to the air pollution crisis across the [South Asian] region and our dependence on them has to be reduced aggressively, systematically and strategically if governments in the region want to achieve breathable air quality," said Sunil Dahiya of the Global Air Pollution Unit at Greenpeace.
In rural areas, the population has long favoured the burning of firewood or cattle dung to create energy.
According to Nepal’s Biomass Energy Strategy, 77 per cent of energy produced in the country in 2017 was generated in this manner.
While burning these fuels is a cheap way to heat a home, it leads to families breathing in hazardous particles in a confined space, such as mercury.
Just last week a US-based Health Effects Institute study found that the country has the worst air pollution rates in the world.
However, the Nepalese government has introduced several measure to combat air pollution.
It has banned the use of cars older than 20 years old in the Kathmandu Valley, which is home to five million Nepalese.
It has also attempted to move some of the brick kiln factories away from residential areas.
In rural areas, it has introduced an ambitious plan to eradicate the use of biomass energy by 2022 by encouraging the population to adopt renewable alternatives such as biogas.
The World Health Organization has questioned whether these measures have come too late.
It has released a study which found that 10,000 deaths could be attributed to air pollution in the country annually.
This figure is higher than the number of Nepalese who died in the 2015 earthquake.
The organisation has called on the Nepalese government to introduce more reliable public transport in its cities, remove brick kilns from residential areas and monitor the continued use of biomass in rural areas.
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