Paramedics in London have seen a 14% rise in the number of patients with breathing problems, as record levels of air pollution lead to warnings about exercising outdoors.
London Ambulance Service said it was experiencing higher than normal volumes of calls from people with asthma, lung problems and heart conditions for the second consecutive day.
West Midlands Ambulance Service, which covers Shropshire, Staffordshire, Warwickshire, Herefordshire and Worcestershire, confirmed it had also experienced a noticeable spike in emergency calls.
A poll of asthmatics by the charity Asthma UK also found about a third had suffered an attack as a result of the smog, while 84% had used their blue reliever inhaler more often than usual.
Air quality is expected to improve on Friday and Saturday. Pic: Defra Air pollution has reached record levels in Harrow, northwest London, and Rochester, Kent. High levels have also been recorded elsewhere in the country.
Public Health England has advised adults and children with lung problems, as well as adults with heart conditions, to consider reducing strenuous physical exercise, especially outdoors.
Much of the concern surrounding the poor air quality is over particulates - the tiny chemical particles emitted by diesel-powered cars and industry that can be inhaled deep into the lungs.
Combined with other pollutants including nitrogen dioxide and ozone, these can cause breathing difficulties.
The smog has shrouded many of Britain's most famous landmarks Asthma sufferers and patients with COPD (chronic obstructive pulmonary disease), a condition which inflames the airways, are particularly vulnerable and may notice their symptoms get worse.
Even those without breathing problems say they have been coughing, wheezing or suffering with sore eyes.
Doctors at the Acute Medical Unit in Solihull, near Birmingham, told Sky News there had been a "slight increase" in the number of people coming to them with respiratory problems.
They include Jason Irving, who suffered an asthma attack and was receiving treatment at the unit.
Jason Irving believes air pollution may have triggered his asthma attack He told Sky News: "I travelled into work as normal this morning and as I was walking in, my chest and my throat were tightening and I was struggling for breath.
"I sat down and occupational health at work had to call an ambulance.
"I think it could well be to do with the poor air quality."
Karen Lytton, a COPD patient who was also receiving treatment at the centre, added: "It's like when you hold your breath until you can't hold it any longer and then try to breathe again.
Karen Lytton is treated by a doctor at Solihull's Acute Medical Unit "It's got worse over the last few days. I get very out of breath and have to stop to use my inhalers.
"I took a taxi yesterday to the shops, rather than trying to walk round."
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