On any given day about 35 mn Indians could be unwell: Study

Pallava Bagla

New Delhi: What ails India? This is not a rhetorical question seeking a debate on secularism or intolerance but a genuine medical question that has baffled researchers.
Interestingly, there are only guesstimates and well- researched studies have never been undertaken. Now the first results from a doctor-certified database is throwing new light on what really ails India. It seems the toxic air of India is giving breathing difficulties to many Indians.

When results of this landmark study are extrapolated it means that on any given day about 35 million people visit a doctor and just to give a comparative figure this is equal to the entire population of Canada or the combined population of the big four metros, New Delhi, Mumbai, Bengaluru and Chennai. Sundeep Salvi, a lead researcher from the Chest Research Foundation, Pune, says, "This is an astounding number of people who are unwell in India."

The researchers report that "of the world's 7.5 billion population in 2015, 1.2 billion people live in India. Around 18 per cent of all global deaths and 20 per cent of loss of global disability-adjusted life years (DALYs) occur in India, making it a country with one of the highest disease burdens in the world. Non-communicable diseases have recently overtaken communicable diseases as the leading causes of mortality and morbidity in India".

The new study finds that more than half of the patients who report to medical facilities do so for ailments related to the respiratory system. Extrapolated it could mean that more than half of India finds itself battling breathing and lung related illnesses. A staggering number indeed!

However, looking at the dangerous levels of outdoor and indoor air pollution that prevail over India this may well be correct.

Recently Prakash Javadekar Minister of State (Independent Charge) of Environment, Forest and Climate Change echoed similar sentiments when he said, "Environmental pollution on account of air pollution causes respiratory diseases in children. Air Pollution in general causes respiratory ailments and also may affect lung function.

"Asthma, chronic obstructive pulmonary disease, chronic bronchitis etc. Are the diseases caused by exposure to increasing air pollution. Air pollution is known to be one of the aggravating factors for many respiratory ailments and cardiovascular diseases."

Salvi blames the "poor quality of air we breathe" as the leading cause of the respiratory diseases.

In this study a staggering over two lakh urban patients visiting primary health care providers on a single given day, were closely examined by a team of scientists from the Institute of Genomics and Integrated Biology (IGIB), New Delhi and the Chest Research Foundation, Pune.

The study found that more than half the patients reported for lung and breathing related illnesses.

According to the study, other common ailments presented were related to digestive system symptoms (25 per cent); circulatory symptoms (12.5 per cent); skin complaints (9 per cent); and endocrine disorders (6.6 per cent); hypertension (14.52 per cent), obstructive airways diseases (14.51 per cent), and upper respiratory tract infections (12.9 per cent).

Salvi says "for the first time we now have a snapshot of what people in India suffer from."

The researchers chose a season neutral date of February 1 in 2011 to conduct this massive study over 880 cities of India. More than 12,000 doctors were involved in this study and the results are published in the December issue of The Lancet - Global Health journal.

Salvi says one of the most alarming findings is that about 21 per cent of those reporting high blood pressure or hypertension were people below 40 years of age.

This Salvi feels "indicates a high burden" and recommends that blood pressure should be regularly monitored even in the age group of less than forty years.

Concurring with the findings, Krishna D Rao and David H Peters from the Health Systems Program, Department of International Health, Johns Hopkins University, Baltimore, US writing an editorial on the research paper suggest that "there are such high rates of hypertension in younger people has important implications for premature death and disability in the most productive years of life, with economic effects that would extend to the families supported by these people".

On a similar basis, Anurag Agrawal, a co-author of the paper and a researcher at IGIB, says that metro cities have higher prevalence of hypertension and that too in the younger age group.

"This is the first time such a national level data" has been collected, says Agrawal, adding now they are finding a clear linkage when the data from their study is overlaid with penetration and use of liquefied petroleum gas (LPG).

Agarwal says there is a distinct fall in lung and breathing related ailments in geographical regions where LPG distribution is widespread.

Salvi suggests this truly mirrors major step taken by Prime Minister Narendra Modi through his "give it up" initiative where the NDA government has been urging rich Indians to give up the subsidy they enjoy on LPG cylinders so that poor households who still cook using wood and coal can benefit. Indoor pollution is increasingly recognised as a huge avoidable menace.

Salvi feels merely providing the right cooking fuel can help reduce the disease burden.

Even as the big global conference on containing effects of climate change opens in Paris, this small study from India should ideally spur policy makers in India to clean up the toxic air that is polluting large parts of India.