Air pollution biggest health risk in India says study; Delhi witnesses jump in respiratory problems

Air pollution has contributed to the death of 16.7 lakh people in India in 2019, with over a lakh of them less than a month old.

Air pollution is the biggest health risk in India a new global study by a US-based NGO has revealed and this has contributed to the death of 16.7 lakh people in India in 2019, with over a lakh of them less than a month old.

"Outdoor and household particulate matter pollution contributed to the death of more than 1,16,000 Indian infants in their first month of life in 2019. More than half of these deaths were associated with outdoor PM2.5 and others were linked to the use of solid fuels such as charcoal, wood, and animal dung for cooking," as per the State of Global Air, 2020.

It's a report on global exposure to air pollution and was released by Health Effects Institute (HEI) on October 21. "Long-term exposure to outdoor and household air pollution contributed to over 1.67 million annual deaths from stroke, heart attack, diabetes, lung cancer, chronic lung diseases, and neonatal diseases, in India in 2019," the report said.

Evidence linking air pollution and increase in disease: The report also said there is clear evidence linking air pollution and increased heart and lung disease, creating a growing concern that exposures to high levels of air pollution could exacerbate the effects of COVID-19. Dan Greenbaum, the president of HEI, said an infant's health is critical to the future of every society and this newest evidence suggests an especially high risk for infants born in south Asia and sub-Saharan Africa.

"Although there has been a slow and steady reduction in household reliance on poor-quality fuels, air pollution from these fuels continues to be a key factor in the deaths of these youngest infants," he said. Infants in the first month of life are already at a vulnerable stage. But a growing body of scientific evidence from multiple countries, including recent ICMR-supported studies in India, indicates that particulate air pollution exposure during pregnancy is linked to low birth weight and pre-term birth, the report said.

Neonatal deaths: The new analysis reported in the State of Global Air this year estimates that nearly 21 per cent of neonatal deaths from all causes are attributable to ambient and household air pollution. "Addressing impacts of air pollution on adverse pregnancy outcomes and newborn health is really important for low- and middle-income countries, not only because of the high prevalence of low birth weight, preterm birth, and child growth deficits but because it allows the design of strategic interventions that can be directed at these vulnerable groups," said Kalpana Balakrishnan, an expert in air pollution and health.

Schemes of Central government: "The Pradhan Mantri Ujjwala Yojana Household LPG programme and other schemes have helped to dramatically expand access to clean energy, especially for rural households. More recently, the National Clean Air Programme has spurred action on major air pollution sources in cities and states around the country," it said. This report comes as COVID-19 -- a disease for which people with heart and lung disease are particularly at risk of infection and death -- has claimed more than 1,10,000 lives in India.

Delhi air quality: Delhi's pollution levels remained in the 'poor' category on Thursday morning with the Air Quality Index (AQI) recorded at 254, government agencies said. Though pollution watchdog Central Pollution Control Board (CPCB) and other agencies forecast improvement in the air quality for Thursday, the AQI remained in the same category as on Wednesday.

The Ministry of Earth Sciences' air quality monitor, SAFAR, said calm surface wind conditions prevail over the Delhi region. "It is forecasted that the air quality will be in the 'poor' to marginally 'very poor' on October 23 and 24," it said. According to the AQI monitoring mobile application SAMEER, Delhi's 10 monitoring stations recorded "very poor" air quality. These include Mundka with AQI of 365, Wazirpur with 352, Anand Vihar with 306, Narela with 358, Bawana with 320, Rohini 342, Dwarka sector 8 with 332, Vivek Vihar- 313 and Jahangirpuri with AQI of 310.

Cases of breathing issues in Delhi: Top doctors in New Delhi are reporting a jump in respiratory problems among its residents, coinciding with the onset of peak pollution season in India`s capital and raising concerns about complications for COVID-19 patients. Doctors from five different Delhi hospitals told Reuters they have received twice the number of patients with respiratory illnesses such as bronchitis in the past two weeks.

Dust and smoke fill Delhi`s air every winter, making breathing difficult for adults and children alike. Government data reviewed by Reuters shows that air quality this October has been worse than in the same month in 2019 and 2018. "Pollutants have an inflammatory effect on the lungs and so does COVID-19," said Dhiren Gupta, a pulmonologist at Sir Ganga Ram Hospital in the city, which has reported more than 340,000 coronavirus cases.

There has not been any study in India to ascertain whether pollution leads to more severe complications among patients infected by the novel coronavirus. But a study by the Harvard T.H. Chan School of Public Health in the United States found that long-term exposure to fine particulate matter known as PM2.5 increased the risk of death from COVID-19.

"We are getting more number of cases with respiratory issues but we have to run COVID-19 tests on them too," said Hema Gupta Mittal, a senior paediatrician at Ram Manohar Lohia Hospital.

In October, the air quality index (AQI) has averaged a "poor" 227 on a scale of 500, well above the "safe" limit of 60. The index measures the concentration of pollutants finer than 2.5 microns in diameter that can reach deep into the lungs and cause deadly diseases including cancer and cardiac problems.

Stubble burning: SAFAR said an increase in stubble fire count was observed around Haryana, Punjab, and neighbouring regions. "The SAFAR synergised stubble fire counts stood at 1428 for Wednesday. The boundary layer wind direction is not fully favourable for pollutant transport towards the Delhi region. The SAFAR model estimate of stubble burning share in PM2.5 is nine per cent for today," it said.

Red Light On, Gaadi Off: The Delhi government has kick-started its 'Red Light On, Gaadi Off' anti-pollution campaign for which it has deployed 2,500 environment marshals at 100 traffic signals across the city to generate awareness and curb vehicular pollution. The drive will go on till November 15 from 8 am to 8 pm. It is an awareness drive by the Delhi government and no person will be issued challans, the government has said.

Most polluted cities in India: The air pollution level in Lucknow has crossed the 300-mark on the Air Quality Index, making it the third most polluted city in the country. For the first time in October, Lucknow had an Air Quality Index (AQI) of 328, figuring in the `very polluted` category on Wednesday.

The Central Pollution Control Board (CPCB) listed seven cities with AQI above 300 for the category. Three of these are in Uttar Pradesh. Besides Lucknow, the other two are Meerut, which is ranked second in the state followed by Baghpat. According to environmental experts, "In Uttar Pradesh, around 96 flyovers are under construction and vehicular movement is at its peak due to the festival season. Weather conditions are favourable for a spike in the air pollutant levels.

State of Global Air, 2020: The report said overall, air pollution is now the largest risk factor for death. According to it, South Asian countries, including India, Bangladesh, Pakistan and Nepal, featured among the top 10 nations with the highest PM2.5 exposures in 2019. "All of these countries experienced increases in outdoor PM2.5 levels between 2010 and 2019," the report stated, adding that since 2010, more than 50 million fewer people have been exposed to household air pollution.

"Although the full links between air pollution and COVID-19 are not yet known, there is clear evidence linking air pollution and increased heart and lung disease creating a growing concern that exposures to high levels of air pollution, during winter months in South Asian countries and East Asia, could exacerbate the effects of COVID-19," the report stated. 

Worldwide: Air pollution kills an estimated seven million people worldwide every year. WHO data shows that 9 out of 10 people breathe air that exceeds WHO guideline limits containing high levels of pollutants, with low- and middle-income countries suffering from the highest exposures. 

From smog hanging over cities to smoke inside the home, air pollution poses a major threat to health and climate. The combined effects of ambient (outdoor) and household air pollution cause about seven million premature deaths every year, largely as a result of increased mortality from stroke, heart disease, chronic obstructive pulmonary disease, lung cancer and acute respiratory infections.

with inputs from agencies