The Australian state of New South Wales is gasping amid its worst levels of air pollution on record as smoke from bush fires causes a spike in hospital visits and reduces visibility for drivers.

Sydney, the country's most populous city, woke up to a thick haze and blood-red sun for the fourth consecutive day on Friday, even as a cooler change brought some relief for firefighters battling scores of wildfires across the southeast.

The bush fires have pushed the harbor city into a rare appearance this week in the world's top 10 cities with the worst air pollution. Having reached as high as No. 8, Sydney was sitting at No. 10 on the Air Visual global rankings on Friday morning — above Jakarta and Shenzhen, and just below Mumbai and Kolkata.