Every poisonous breath you take

In response to a recent question in the Rajya Sabha shortly before his government demitted office, former Minister for Health and Family Welfare in the UPA government Ghulam Nabi Azad stated, “As reported by the Central Pollution Control Board (CPCB), no conclusive information is available regarding high prevalence of respiratory and other diseases due to air pollution.”

This statement contradicts findings from many studies that have established a direct causal link between air pollution and respiratory ailments as well as other adverse health outcomes.

Also, even if unintentionally, the minister’s response ends up questioning the fundamental reason for the existence of the CPCB — indeed, if pollution does not lead to any detrimental consequences for health and well being, then why have a pollution control board in the first place?

It would appear that while China is finally waking up to the dire consequences of pollution, the Indian government still prefers not to acknowledge it. In the face of such denial, it is useful to look at some real world evidence.

A large number of studies demonstrate the adverse health effects of air pollution in both developed and developing countries, including India. These effects range from higher incidence of respiratory ailments, including higher incidence of asthma among children, to lower birth weight and increased infant mortality.

In addition to causing respiratory ailments, exposure to high levels of air pollution can also have longer term health effects, including an increase in the risk of cardiovascular diseases and cancer.

Andrew Foster (Brown University) and Naresh Kumar (University of Iowa) used data from 113 pollution monitoring stations in Delhi and surrounding areas to show that mandated use of CNG in commercial vehicles and relocation of polluting industries led to an improvement in lung function among adults.

In our own study, we used health and pollution data on six Indian cities, to find that increased air pollution leads to greater morbidity among children.

Air pollution, or ambient air quality, is measured by tracking a wide range of air components such as suspended particulate matter — in the form of particles of different sizes (PM10, PM2.5), as well as nitrogen dioxide, sulphur dioxide and carbon monoxide. Like most other countries, the Government of India has specified permissible or safe limits for each of these components through its National Ambient Air Quality Standards (NAAQS).

The NAAQS data shows air pollution levels in most cities frequently exceed safe limits; looking more closely, such violations are more common for particulate pollution.

The key sources for these pollutants tend to be industries, vehicular traffic, and large-scale burning of fossil fuels, with the composition of pollutants varying across cities.

Thus, air pollution containment will necessarily depend upon the city, its local economy, and its environment.

In short, not only do we know that citizens are exposed to air pollution in urban areas, we also know that it adversely affects both adults and children, and that city level policies are going to be critical in controlling and managing air pollution.

A number of initiatives across the world have been successful in controlling air pollution and enhancing the quality of urban life. Historical evidence from cities like London and Los Angeles that have successfully reduced high levels of ambient air pollution to safe levels offers both hope and lessons that may be adapted for tackling air pollution in urban India.

Examples of specific strategies include — monitoring levels of air pollution, policies to reduce industrial emissions, encouraging both environment and user- friendly mass rapid transportation systems, safely integrating bicycles into vehicular traffic, promoting clean fuel usage, investing in energy efficient buildings, and deliberately expanding green spaces.

Other strategies, for example, the successful implementation of cap-and-trade in the United States in the Acid Rain Programme to reduce emissions of sulphur dioxide and nitrogen oxides, also offer useful lessons.

We believe that policies to control pollution should be based in a national framework that allows city planners and policy-makers sufficient flexibility to identify city-specific strategies and financing mechanisms to control air pollution. This is consistent with not only the 74th Amendment to the Constitution of India, but is also consistent with schemes such as the JNNURM.

The importance of local regulation is highlighted in the Foster and Kumar study mentioned above that found pollution control laws led to a significant improvement in respiratory health among residents of Delhi.

The debate surrounding pollution in developing countries like India is often couched in terms of a false choice between growth and employment generation on the one hand and controlling pollution on the other. Promoting a high rate of economic growth and the need to maintain clean breathable air in places where we live, work, and play are not incompatible objectives.

There is no conflict between owning a car and driving responsibly, including checking the car periodically for emission levels.

Similarly, there should not be any conflict between setting up new industries that generate employment while also performing continuous emissions monitoring under a market-oriented cap-and-trade regime.

Policymakers should note that the health burden imposed by pollution can lead to adverse human capital and labour market outcomes and in the long run, decrease productivity, and damage economic growth prospects.

Further, an exacerbation of acute and chronic health problems caused by unabated pollution over an extended period of time can potentially create public unrest. This is not idle speculation; health risks from pollution are greater for the poor and the disadvantaged.

Therefore, if we are serious about ensuring the right to clean water and clean air and reducing inequalities in health, then living in denial of the harms caused by air pollution is not an option.

Ghosh is a senior researcher with Mathematica Policy Research, Princeton, New Jersey. Mukherji is associate professor at Centre for Public Policy, IIM Bangalore. The views are personal