Paramedics in London have seen a 14% rise in the number of patients with breathing problems, as people across the country were warned to avoid exercising outdoors amid record levels of air pollution.
London Ambulance Service said it is still experiencing higher than normal volumes of calls from people with asthma, lung problems and heart conditions.
Doctors in Solihull, near Birmingham, reported a "slight increase" in the number of people coming to them with respiratory problems, while a poll of asthmatics found about a third had suffered an attack as a result of the pollution.
Jason Irving believes air pollution may have triggered his asthma attack The survey, by the charity Asthma UK, found 84% had used their blue reliever inhaler more often than usual.
Air pollution has already reached record levels in Harrow, northwest London, and Rochester, Kent.
High levels of smog are also forecast for East Anglia, the Midlands, Lincolnshire, the Wirral and the north coast of Wales and a health warning remains in force for millions of vulnerable people.
The smog has shrouded many of Britain's most famous landmarks 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.
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.
At the Acute Medical Unit in Solihull, half of the patients seen in the first hour of opening on Thursday reported difficulties breathing.
Air quality is expected to improve on Friday and Saturday. Pic: Defra They include Jason Irving, who suffered an asthma attack and is now receiving treatment at the unit.
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.
Karen Lytton is treated by a doctor at Solihull's Acute Medical Unit "I think it could well be to do with the poor air quality."
Karen Lytton, a COPD patient who is 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.
"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."
Even those without breathing problems say they have been coughing, wheezing or suffering with sore eyes.
Anyone experiencing such discomfort should consider reducing physical activity, especially outdoors, according to Public Health England.
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