Jacob Sanchez says he’s careful anytime he goes outside.

“It’s something I’ve dealt with my whole life,” Sanchez said.

The Bronx native says he was about five years old when he was diagnosed with asthma.

“It’s basically like if you were to have a pile of bricks compressed against your chest and you’re just trying to gasp for the minimal amount of air,” he explained.

Unfortunately, he’s far from alone. He sees it every day when he gets to work at the front desk at the Boston Road Medical Center in the Bronx.

A Columbia University report says parts of the South Bronx “have one of the highest death and disease rates from asthma in the country.”

City data from 2016 shows there were more than 16,000 children who had emergency department visits related to asthma — higher than any other borough — and nearly 40% of those hospitalized are from the Bronx.

“Out of all the cases I see in a day, probably more than half of them are asthmatic patients” Ana Collado, family nurse practitioner, said.

Ana Collado from SOMOS Community Care says the majority of her asthma patients are under the age of 26.

“I think it’s the prolonged exposure to like pollution in the Bronx,” Collado said.

One of those factors is air pollution from clogged highways. And that traffic is expected to get worse, according to the MTA’s own analysis, because of congestion pricing.

The new toll to try to curb traffic below 60th Street in Manhattan is expected to lead to more car and truck traffic elsewhere, including the Bronx.

“I think that increasing the congestion is going to increase the exposure to all of my patients,” she said.

In the MTA’s environmental impact studies, looking at seven tolling scenarios, it declared there would be no significant potential adverse air quality effects from truck diversions.

But at the same time, the agency has pledged more than $130 million in funding for the borough to mitigate the impact of congestion pricing, including new air filtration units in some schools and an asthma clinic.

“I believe that we have a mission and we’re already starting to work towards it,” she said.

Collado says they have already been working to educate their patients, some who had no idea they were even asthmatic.

That’s why Sanchez says he feels lucky.

“It was always easy for me to be on top of my asthma due to me having the resources,” he said.

He came to the Bronx Road Medical Center for treatment as a kid and now for work as an adult.

He hopes others take the time to get checked, as he waits to see if the congestion toll in Manhattan takes a toll on the health of the people like him in the Bronx.