Health. Danger lurks in every breath you take

At the COP26 in Glasgow, world leaders are expected to take significant decisions related to climate change. And air pollution will be a key factor they are likely to address.

Carbon emissions and other pollutants that affect air quality have a major impact on the health and well-being of living beings. Not without reason then, air pollution is referred to as a silent killer.

But, till now, there has been no concerted, well-calibrated approach to gauge the wider linkage between pollutants in the atmosphere and public health and mortality. Monitoring of air quality (AQ) levels in India has been more of a seasonal and kneejerk response, when crop burning or crackers lit during Diwali severely impact the air in parts of the country.

But this obviously is not enough. Last month, the World Health Organization (WHO) made its air quality guidelines more stringent and called upon the Indian government to revise its standards “in the interest of prioritising and safeguarding public health”.

After 16 years, WHO revised its AQ guidelines in September. The latest recommended annual level for particulate matter (PM) 2.5 has been halved from 10 micrograms per cubic metre to 5 micrograms per cubic metre. By this yardstick, Delhi’s annual PM2.5 readings in 2020 were 16.8 times more than recommended levels, Mumbai overshot it eight-fold, Kolkata 9.4, Chennai 5.4, Hyderabad seven-fold and Ahmedabad exceeded it 9.8-fold.

An analysis by the independent research organisation Centre for Research on Energy and Clean Air stated that three million deaths can currently be attributed to air pollution. This can drop to less than half a million if the 2021 air quality guidelines are adhered to.

The risk of getting sick due to air pollution depends on your health status and exposure to pollutants. Severe pollution causes aggravated cardiovascular and respiratory illness, and the heart and lungs have to work harder to supply oxygen to the body. Long-term exposure to air pollution brings on lung diseases such as asthma, emphysema or chronic obstructive pulmonary disease. The most susceptible include outdoor workers, pregnant women, children under 14 and the elderly. In rural areas, open burning of agriculture residue and indoor pollution due to biomass burning are known to cause fatalities.

Dr Maria Neira, WHO Director, Public Health and Environment, points to the health linkages of COP26 outcomes, at an interaction organised by Climate Trends, a Delhi-based strategic communications initiative. If the climate treaty is accepted then the immediate benefit will be reduction of air pollution, a silent killer around the world, she said. “Health impacts must be at the fore in the fight against air pollution. South Asia can reduce 83 per cent premature deaths if the new WHO guidelines are implemented,” she said.

In fact, government representatives at the interaction said that India was already revisiting current air pollution guidelines.

“We launched the National Clean Air Programme in 2019 to reduce pollution by 25 to 30 per cent. During the launch itself the ministry accepted the need to revisit the AQ standards. We have collected virgin AQ data during the Covid lockdown, when anthropological (human-led) activities were not in play. The Central Pollution Control Board is already working with the National Environmental Engineering Research Institute on revising the AQ standards. They will come up with the new standards soon,” said Dr Sudheer Chintalapati, Joint Director, Ministry of Environment, Forest and Climate Change.

Dr Arun Sharma, Director, National Institute for Implementation Research for Non-Communicable Diseases, called for more health evidence from the ground. The appropriate behaviour for eliminating air pollution is missing among doctors, he said. “We need to know how much a general physician knows about the impact of air pollution on health, in terms of ailments.”

Medical personnel should be trained to communicate the health impact of short- and long-term exposure to air pollutants. “Providing air quality data to doctors would help them take measures needed and bring a change in behavioural patterns,” Sharma concluded.

Clearly, doctors, health professionals and the government need to address the fallout of air pollution with concerted action. We owe that to ourselves and to future generations.