Respiratory health

10 % of the disease burden

Delhi has a reputation for dismal air pollution – but the issue does not only affect the national capital region. Indoor air pollution is a huge challenge too.
Smog in Delhi. Gupta/picture-alliance/dpa Smog in Delhi.

Ashwini’s four year old daughter has had a persistent cough since November. Her throat is itching. The doctor says her lungs are inflammated because of Delhi’s air pollution. Ashwini has been told steaming is a must, and it would be good to use air purifiers and keep her child indoors. The girl missed more than 20 days of school this winter.

Vikas, a 30 year old cancer survivor, complains about a tough winter. Wheezing bothers him, and he has even been to the emergency ward. He too has been told to use air purifiers.

The poor are disproportionately affected by air pollution, of course. They cannot afford air purifiers or good quality pollution masks. Moreover, they do not benefit from the protected environments of sealed spaces such as cars, offices or well-built apartment houses.

Air pollution has caused concern in the expatriate community as well. For example, Mariela Cruz Alvarez, Costa Rica’s ambassador to India, described in a viral blog post how India has become a threat to her health. At the onset of every winter, Delhi finds itself in international spotlight for poor air quality. This year was no different. At the end of October 2017, some monitoring stations reported an AQI (air quality index) of 999. According to experts, this is equivalent to smoking 45 to 50 cigarettes daily. The Indian National Medical association declared a “public-health emergency”, and Arvind Kejriwal, the chief minister of Delhi, likened the national capital to a “gas chamber” in a tweet.

AQI is based on measurements of PM2.5, the tiny particulate matter emitted by combustion engines. It can slip into the lungs and enter the blood stream, adversely affecting human health. Impacts include cardio and respiratory problems. According to a study published by the science journal The Lancet, various kinds of pollution resulted in 2.5 million deaths in India in 2015 — the highest number anywhere in the world. The World Health Organization has stated that half of the world’s 20 most polluted cities are in India. Indeed, the air quality of places like Gwalior, Allahabad or Patna is worse than Delhi’s.

Yet the Indian government seems to be in denial. The central government has told the parliament that there was no conclusive data to establish a direct correlation between air pollution and death or disease in February 2018.

However, not all state institutions are negligent. The Supreme Court of India has been nudging the Ministry of Environment (MoE) to take nationwide action. Its judges have stressed that the problem does not only concern the national capital region.

Nonetheless, the Central Pollution Control Board, which is subordinate to the MoE was recently reported to have permitted 400 thermal power stations to continue to emit pollutants above the official limit, for up to five more years. Things are thus hardly set to get better. Thermal power generation accounts for about 90 % of industrial emissions. On the upside, the National Green Tribunal has decided that no new thermal power plant will get an environment clearance unless it complies with the new norms.

Rural areas are affected by air pollution too. Indeed, research done by the Indian Institute of Technology Bombay and the Health Effects Institute shows that 75 % of air pollution-related deaths occurred there. Indoor air pollution – which mostly results from cooking on coal, wood or cow dung fires – matters in this context. As the central government’s recent Health of the Nation’s States report showed, indoor air pollution has been coming down significantly since 1990, while outdoor air pollution is getting worse. Together, they accounted for 10 % of the total disease burden in 2016, second only to child and maternal malnutrition.

The nation’s battle against pollution needs much more than ad-hoc, knee-jerk reactions which concentrate on the national capital region only. India must make valiant and persistent efforts to improve the air quality because a healthy workforce and conducive natural environment is essential for the country to enjoy the full benefits of its slowing but still rapid economic growth.

Roli Mahajan is a freelance journalist based in Delhi.

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