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A fortnight-long recurring cough post sundown saw an otherwise fit 40-year-old Praveen Singh* head to a pulmonologist. The mid-level corporate executive from Delhi–NCR was diagnosed with allergies triggered by the rising air pollution.
At the other end of the spectrum, 62-year-old Shyam* is an asthma patient. But as air quality deteriorated in the national capital region ahead of Diwali, his morning walks were cut short by the doctor.
As weather patterns change, and autumn gives way to winter, suspended particulate matter increases in the air and cities across the country (especially the Capital) grapple with a spurt in respiratory ailments, among other illnesses. Doctors observe a 15-20 per cent increase in new patients complaining of respiratory ailments, reinforcing New Delhi’s dubious distinction as the asthma capital of the country.
But the World Air Quality report (2023) did not just find New Delhi among the most polluted cities globally, it also put India among the most polluted countries. And the common triggers behind air pollution, across cities, included vehicular emissions, increased construction activity, road works and, in Delhi’s case, stubble burning.
The World Health Organization (WHO) says outdoor air pollution is a major environmental health problem affecting everyone — low-, middle-, and high-income countries. And ambient (outdoor) air pollution in cities and rural areas is estimated to annually cause 4.2 million premature deaths worldwide (2019). Exposure to fine particulate matter causes cardiovascular and respiratory disease, and cancers, it said.
A 2024 report by the World Heart Federation also found a rise in the number of deaths from cardiovascular conditions caused by air pollution over the last decade. “A wide range of health problems, including obesity and diabetes, are being exacerbated by the global policy failure to meet air pollution targets,” it said. Annually an estimated 1.9 million deaths from heart disease and under a million from strokes resulted from outdoor air pollution alone, it added.
Dr Vivek Nangia, Vice Chairman and Head Pulmonology, at Max Super Speciality Hospital (New Delhi), finds more patients coming in with cough, burning sensation in the eyes, headaches and other “allergy-related symptoms” since October. And most did not have a history of allergies, or respiratory ailments. Nangia pins it down to changing weather patterns and rising pollution.
Delhi’s ‘hotspots’
Observing a 15 per cent increase in new cases, Nangia finds allergies and respiratory problems reported mostly by middle-aged working professionals, especially those working long hours outdoors. Schoolchildren are vulnerable, he says, with many reporting bronchitis, allergies, and cough related to poor air quality.
In Delhi, 13 hotspots have been identified with dangerously high 300-plus readings in air quality index (AQI). Dr Avi Kumar, Senior Consultant (Pulmonology), Fortis Escorts (New Delhi), observes a 50 per cent increase in outpatient cases and 10 per cent increase in in-patient or hospitalisation cases. Patients report wheezing and breathlessness, he says.
Big-city woes
India grapples with poor air quality as PM 2.5 concentrations exceed 10 times the WHO guideline. A 2023 report from IQAir identified Begusarai (in Bihar) as the most polluted metropolitan area globally. Mumbai was labelled “unhealthy for sensitive groups”.
Dr Kuldeep Kumar Grover, Head of Critical Care and Pulmonology, CK Birla Hospital (Gurugram), says that, worryingly, chronic conditions like asthma “aren’t showing their usual recovery patterns” within 5-7 days.
“There’s a noticeable rise in bronchitis cases, with severe cough post viral fevers, and even pneumonia is appearing more frequently in both new and older patients,” he says. Blood clotting issues in veins and the heart have become unexpectedly common, and cancer patients remain “in critical state” due to severe pneumonia, he says.
Dr Akanksha Rathi, MD (Preventive and Social Medicine), also flags poor indoor air quality and its effect on pregnant women and newborns.
Dr Mahendra Kawedia, Senior Consultant and Head-Pulmonology at Pune’s Jehangir Hospital, advises against morning walks when AQI is above 300 and recommends fewer strenuous outdoor activities when it’s over 200. Additionally, he advises yoga/ pranayama, besides other lung-support activities, in the battle against polluted air.
(*names changed)
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