Hyderabad: Respiratory, cardiovascular diseases on the rise as Indian cities grapple with air pollution

Hyderabad: Air pollution in India has reached alarming levels, with fatalities surging by around 60% in the last three decades.

Around 2.1 million people in India die every year due to air pollution-related complications, as per recent reports.

The situation is even more scary for children as around 464 children lose their lives every day in the country due to air pollution-related factors, as per the report of the Health Effects Institute (HEI) based in the US.

The innumerable number of deaths underscores the need for urgent intervention from the respective government agencies and changes in policies to address the air quality crisis prevailing in the country.

India- One of the most polluted countries

India, despite being the fastest-growing economy, is grappling with environmental issues. Of the 100 highly polluted cities across the world for particulate matter 2.5 (PM2.5), 83 are from India, with these cities surpassing the WHO air quality guidelines by at least 10 times.

The national ambient air quality standard (NAAQS) for PM2.5 is 40µg/m3, eight times higher than the standards defined by the WHO. The most polluted cities include Delhi, Gurugram, Ghaziabad, Faridabad, Noida, Lucknow, Varanasi, Agra, Muzaffarpur, Moradabad and Bhiwandi.

Delhi accounts for around 12,000 deaths annually due to air pollution, with annual average exposure to PM2.5 exceeding 100 μg/m3 in 2021 as per a Lancet study. The study also revealed the number of deaths in 10 cities amounted to 33,000 per year.

The National Clean Air Program (NCAP) has planned to cut down the PM10 emissions by 40% by 2025-26 in the selected 131 cities.

Cause of outdoor and indoor air pollution

Being densely populated and urbanized in specific areas, air pollution is high in different cities across India. The poor air quality in the cities in comparison with the rural areas substantiates the claims.

Dr. D S Sowjanya, consultant pulmonologist, Kamineni Hospitals, LB Nagar said, “Industrial emission, vehicular pollution, burning of fossil fuels, wildfires, PM emission from construction areas are common causes of outdoor air pollution”.

The spraying of chemicals in agriculture fields, smoking, and open burning of garbage are other reasons for higher air pollution.

“Burning of biomass fuels, kitchen smoke, perfumes, deodorant, chemical house cleaners, incense sticks, mosquito coils, and smoking contribute to the increase in indoor pollution”, Dr. Sowjanya said.

Cause respiratory problems.

Constant exposure to particulate pollution is highly dangerous despite the defense and repair mechanisms of the lungs. Respiratory function is reduced even in healthy individuals due to severe air pollution. There is a high probability of inflammation due to excess deposits of particulate matter in the respiratory tracts.

“Chronic exposure to air pollution can affect various systems including the respiratory system causing asthma, chronic obstructive pulmonary disease (COPD), and lung cancer. The central nervous system could also be affected resulting in headaches, Alzheimer's, dementia and even affecting the reproductive system”, Dr Sowjanya said.

Cardiovascular problems from air pollution

As per several studies, long-term and even short-term exposure to air pollution can lead to hospitalization for cardiovascular issues including coronary syndrome, arrhythmia, heart failure, stroke, and sudden cardiac death.

Based on epidemiological studies, a 10μg/m3 increase in long-term exposure to PM2.5 was associated with an 11% increase in cardiovascular mortality.

“The particulate matter can cause inflammation and oxidation stress, affecting the lining layer of blood vessels, imbalance in the autonomic nervous system, and increase blood coagulation leading to a lot of cardiovascular problems”, said Dr. L Kiran Kumar Reddy, interventional cardiologist, and HOD, Onus Heart Institute, Hyderabad.

Policy frameworks needed

Despite established laws to reduce pollution and ensure clean air for the populace of the country, the level of air pollution remains high in India. The NAAQS levels are much higher than the WHO-recommended levels in several cities, exposing the lack of adequate intervention from the government agencies including the central and state pollution control boards.

“The government should impose measures to address this novel and emerging health concern. There is an urgent need to ensure quality air to prevent respiratory and cardiovascular diseases”, Dr Kiran Kumar said.