By Alex Kirby
BBC News Online environment correspondent in Tirana, Albania
Traffic pollution has increased death rates in parts of this rundown capital by one fifth in the last 10 years.
Tirana's streets are smothered by fumes
The country's vehicle fleet is now more than 12 times larger than in 1990, and many private cars are elderly and so poorly maintained they are a menace.
The government is planning to introduce countrywide pollution checks in the hope of protecting people's health.
But critics suspect it may be too easy to sidestep them, and want a total ban on imports of old and dangerous cars.
When the Communist dictator Enver Hoxha died in 1985 there were about 2,000 cars in the whole of Albania. By 1990 the country's entire fleet of road vehicles numbered something like 15,000.
Today, the government says, there are more than 200,000 cars alone, a figure rising by about 10,000 annually.
Agron Deliu, of the Ministry of Health's Institute of Environmental Studies, said the 90% of Albania's cars which were more than nine years old produced most of the pollution.
Over 80% of them are diesel-powered, and poorly maintained diesel engines emit large quantities of microscopic particles, called PM10s, which can lodge deep in the lungs and are carcinogenic.
The World Health Organization limit for PM10s is 50 microgrammes per cubic metre of air, but at one central Tirana crossroads the 24-hour average exposure was 483 micrograms, with peak-hour levels far higher.
Mr Deliu said: "Our health can't cope with this. In some parts of Tirana the mortality rate has risen by 20% in a decade. Air pollution - and in the cities 90% of it is from vehicles - is very threatening now."
Cars left overnight acquire a coating of filth
Another problem is leaded petrol, used by most of the 40,000 or so petrol-driven cars.
Although it is a potent health threat, especially to the mental development of infants and children, in Albania it is cheaper than unleaded fuel (where that is available at all).
There are no routine tests for lead levels in children's blood.
Mr Deliu also said Italy was exporting to Albania fuel too high in sulphur to be sold domestically or anywhere within the European Union.
The government plans to introduce a vehicle testing scheme in 2005 to get the worst polluters off the road.
It will check not just mechanical features like brakes and lights but also emissions of pollutants.
Brightly painted streets cannot hide the problem
The Environment Minister, Et'hem Ruka, said: "Pollution in Tirana has got far worse in the last three years, and we're very concerned about it."
But many Albanians think their country's endemic corruption will easily find a way round any new system.
One told BBC News Online: "Come on - if you don't want your car to fail the check, all you'll need to do is find a few dollars and you'll be OK."
The Mayor of Tirana, Edi Rama, thinks there is a simpler way to limit pollution anyway.
He said: "It wouldn't be difficult for the government to pass a law banning all imports of old and stolen cars - and it's a fact that most of the cars here have been stolen. These are simple steps: why doesn't the government act?"