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Air pollution cited as top health risk

A comprehensive report on India’s air quality claims that India’s catastrophic air pollution issues were responsible for the deaths of more than 116,000 infants within the first month of life in 2019. 

Air pollution from power plant chimneys. Toxic air concept. Mother Earth illustration. Image credit: jvdwolf / 123rf
Image credit: jvdwolf / 123rf

The report, titled “State of Global Air 2020” named India and sub-Saharan Africa as two of the world’s major air pollution hotspots. Long-term exposure to both outdoor and household air pollution was said to have contributed to over 1.67 million annual deaths from stroke, heart attack, diabetes, lung cancer, chronic lung diseases and neonatal diseases in India in 2019.

Air pollution is now marked as the most common risk factor for deaths from all health risks. This runs true of both noncommunicable conditions, as well as infectious disease due to the immune system implications of the chronic inflammation caused by air pollution. 

The effects of pollution on health are profound. Not only is air pollution damaging to the lungs, evidence has been uncovered linking the exposure to pollution to heart disease, diabetes and dementia. The elevated risks can be attributed to the inflammation caused by the inhalation of particulate matter.

Of the 116,000 infant deaths, more than half were associated with outdoor PM2.5 pollution. This minute particulate matter is produced by a number of sources – in particular, coal power plants, industry and car exhaust fumes. This is a particular issue in India’s urban metros, where air pollution levels often turn cities into smog chambers. The remaining deaths were linked to use of solid fuels such as charcoal, wood, and animal dung for cooking. This means of pollution is a common issue in rural areas and joins crop burning and runoff pollution from the cities as major issues even away from the densely-packed urban regions.

“This newest evidence suggests an especially high risk for infants born in South Asia and sub-Saharan Africa,” said Health Effects Institute president Dan Greenbaum in a statement. “Although there has been slow and steady reduction in household reliance on poor-quality fuels, the air pollution from these fuels continues to be a key factor in the deaths of these youngest infants.”

Recent years have seen India home to seven of the world’s ten most polluted cities to India. In years before this, fourteen of the world’s fifteen most polluted cities were in India. India is quite plausibly the most heavily-polluted country in the world. Studies like this are showing the true scale of the impact.

India’s industrialisation – and consequent fall in air quality – is, however, a relatively recent phenomenon. The impacts we are witnessing at this stage are simply the initial stages of the potential harm that pollution can cause. Should the issue continue, air pollution – being already a major contributor to climate change – there are far more concerns that are already underway that will become major health issues. Droughts, extreme weather conditions, and ever reducing crop quality are among the devastating impacts of climate change – with manifold public health effects ranging from increased transmission of infectious disease to malnourishment. 

Clean air is a necessity in improving public health, and for reducing the risk of future climate issues. Clean air in India, while seemingly all but impossible to achieve due to the ever-increasing industrialisation and urbanisation of the country is, however, entirely possible. Even within this last year, the lockdowns put in place during the beginning of the COVID-19 pandemic gave India a glimpse of the country with clean air. As industry and transport was closed, and economic activity slowed, air pollution levels within Indian cities reduced to their lowest levels in living memory.

India’s annual death toll would fall by approximately 650,000 if the fall in air pollution levels driven by the country’s lockdown are maintained, according to researchers from the Indian Institute of Technology (IIT) in Delhi and two Chinese universities – Fudan University and Shenzhen Polytechnic. Reduction of economic activity on such a scale is all but unprecedented. Furthermore it is impossible to sustain without creating devastating levels of poverty. However, what is needed when proceeding into the future are investments into green energy and cleaner transport systems, as well as better solutions to dealing with waste products and pollution. 

Reducing reliance on poor-quality fuels in both urban and rural settings could be a major boon to this endeavour, as well as having a positive impact on India’s health system overall. The report notes that particulate air pollution exposure during pregnancy is linked to low birth weight and preterm birth, reducing reliance on these fuels could be a major investment in the health of India’s future children. 

“Addressing impacts of air pollution on adverse pregnancy outcomes and newborn health is really important for low- and middle-income countries, not only because of the high prevalence of low birth weight, preterm birth, and child growth deficits but because it allows the design of strategic interventions that can be directed at these vulnerable groups,” said Kalpana Balakrishnan, an expert in air pollution and health.

Progress is being made, albeit slowly. However, with air pollution now marked as the potential most common risk factor for causes of death, it should be far higher on the list of priorities. Investment into increasing the uptake of green energy and in reducing pollution could be vital to the future of both India’s environment, and the future of its healthcare system.


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