<p>Choking air Indian cities are reporting dangerously high levels of air pollution with Delhi topping the list of the world’s most polluted cities. Nidhi Jamwal discusses the gravity of the situation focusing on the health risks associated with it. </p>.<p> In the month of April, several doctors in Delhi had only one prescription for the patients suffering from severe respiratory problems – Leave Delhi. Delhi’s air, which is a concoction of various toxins and pollutants, was worsening the medical condition of city-residents, especially children, who cough and wheeze each night, warned the doctors. Whereas the authorities are yet to understand the gravity of impacts of air pollution in the capital, the data with city-based hospitals is enough to set the alarm bells ringing. <br /><br />All India Institute of Medical Sciences (AIIMS) has seen a whopping 300 <br />percent rise in respiratory illness cases between 2007-2008 and 2013-2014. The cases in Vallabhbhai Patel Chest Institute (VPCI), too, have shot up from 47,887 to 65,122 during the same time period. <br /><br />Private hospitals have reported an estimated increase of 35 per cent in <br />respiratory ailments during the winter months of October-December, when smog sets in, as against July-August. <br /><br />The rise in respiratory ailments in Delhi corresponds to the rise of air pollution levels in the city. The respirable suspended particulate matter (RSPM) levels in Delhi have gone up from 201 micrograms per cubic metre (µg/m3) in 2008 to 316 µg/m3 in 2014, more than what is considered healthy by the World Health Organization (WHO). RSPMs are tiny and toxic pollutants produced by the vehicles and industries, which when inhaled cling to the lungs and cause various respiratory diseases. <br /><br />Confirming worst fears<br />Last May, the WHO voiced concern over high air pollution levels in Delhi, when the capital was named the world’s most polluted city in the ‘Ambient (Outdoor) Air Pollution in Cities Database 2014’. The WHO’s database of ambient air pollution monitoring from 1,600 cities in 91 countries, covering the period from 2008 to 2013, found the annual average PM2.5 (particulate matter smaller than 2.5 <br />microns) level in Delhi to be as high as 153 µg/m3, which is six times the WHO’s recommended maximum and 12 times the US standards. The Indian government, however, rejected WHO’s report, but environmentalists issued strong warnings against the polluted air.<br /><br />“This database confirms our worst fears about how hazardous air pollution is in our region. Last year, the Global Burden of Disease study pinned outdoor air pollution as the fifth largest killer in India after high blood pressure, indoor air pollution, tobacco smoking, and poor nutrition,” Sunita Narain, director general of New Delhi-based Centre for Science and Environment (CSE) said in a statement. <br /><br />In the past, serious efforts by environmentalists and the intervention of the Supreme Court of India had lead to a cleaner air in the capital. In 1998, the apex court ordered all public transport in the city to switch to compressed natural gas (CNG), a cleaner fuel as compared to petrol and diesel. This not only brought down pollution levels in the city, but also helped register a decline in respiratory illness cases in the city. From a high of 409 µg/m3 in 1995, the RSPM went down to 191 µg/m3 in 2000, and then further to 161 µg/m3 in 2007. At VPCI, the number of OPD cases dipped from 51,694 in 2003-04 to 47,887 in 2006-07. However, 2008 onwards, things started to change and have now reached a stage when RSPM levels in Delhi rose again to 316 µg/m3. <br /><br />CSE, which fought a long and difficult battle to switch city’s public transport to CNG and implement other reforms, feels the advantage of CNG-switch has been lost due to the sheer number of vehicles that are added to Delhi’s roads every day. “The most reduction in emissions between 1998 and 2012 occurred as a result of implementation of four sets of vehicular emission standards, removal of lead [in fuels], reduction of sulphur content, mandatory retirement of older commercial vehicles, and conversion of diesel and petrol run public transport vehicles to compressed natural gas,” reads a scientific study by Rahul Goel of IIT Delhi and Sarath K Guttikunda of IIT Mumbai. <br /><br />Apart from the private cars, another source of pollution in Delhi is the daily exhaust of 80,000 trucks that keep moving in and out of the city during the night time. Most of these trucks are 10 to 20 years old and run on a mixture of diesel and kerosene, spewing toxins into the air. <br /><br />Death by breath<br />Delhi is not the only highly polluted city in India. According to WHO, there are 12 more Indian cities which make to the top-20 list of polluted cities around the world. And, air pollution has huge health costs. A recent study published in Economic & Political Weekly has calculated that 660 million people in India now live in areas where PM2.5 levels exceed the country’s national ambient air-quality standards. This is reducing people’s life expectancy by 3.2 years. Another study has revealed that air pollution in Delhi kills approximately 20,000 to 30,000 people annually. This means 80 deaths every day due to pollution. And, majority of these are due to heart attacks and strokes, and not respiratory disorders. About 45 per cent of these premature deaths could be controlled if Delhi meets the national ambient air quality standard of 60 µg/m3 for PM2.5. <br /><br />Air pollution is taking a toll on children’s health, as shown in a landmark study by Kolkata-based Chittaranjan National Cancer Institute. This study, which spanned over three years and tracked 11,000 school children in Delhi region, has found that key indicators of respiratory health, lung function to palpitation, vision to blood pressure were worse off in children of Delhi (between four and 17 years of age) than their counterparts elsewhere because of high air pollution. <br /><br />Rather than debunking the scientific reports, the government needs to take proactive action against growing air pollution, which may unleash a public health disaster in the country. There is also a need to improve and scale up public transport and last mile connectivity. <br /><br />The Delhi government has already started working in that direction. It has recently decided to apply ‘polluter pays’ principle and impose a congestion tax on incoming trucks and the revenue generated will be used to augment city’s public transport system. Some other green measures are also in the offing. But, controlling the rising levels of air pollution in the Indian cities will require some hard decisions and strict <br />implementation. <br /> </p>
<p>Choking air Indian cities are reporting dangerously high levels of air pollution with Delhi topping the list of the world’s most polluted cities. Nidhi Jamwal discusses the gravity of the situation focusing on the health risks associated with it. </p>.<p> In the month of April, several doctors in Delhi had only one prescription for the patients suffering from severe respiratory problems – Leave Delhi. Delhi’s air, which is a concoction of various toxins and pollutants, was worsening the medical condition of city-residents, especially children, who cough and wheeze each night, warned the doctors. Whereas the authorities are yet to understand the gravity of impacts of air pollution in the capital, the data with city-based hospitals is enough to set the alarm bells ringing. <br /><br />All India Institute of Medical Sciences (AIIMS) has seen a whopping 300 <br />percent rise in respiratory illness cases between 2007-2008 and 2013-2014. The cases in Vallabhbhai Patel Chest Institute (VPCI), too, have shot up from 47,887 to 65,122 during the same time period. <br /><br />Private hospitals have reported an estimated increase of 35 per cent in <br />respiratory ailments during the winter months of October-December, when smog sets in, as against July-August. <br /><br />The rise in respiratory ailments in Delhi corresponds to the rise of air pollution levels in the city. The respirable suspended particulate matter (RSPM) levels in Delhi have gone up from 201 micrograms per cubic metre (µg/m3) in 2008 to 316 µg/m3 in 2014, more than what is considered healthy by the World Health Organization (WHO). RSPMs are tiny and toxic pollutants produced by the vehicles and industries, which when inhaled cling to the lungs and cause various respiratory diseases. <br /><br />Confirming worst fears<br />Last May, the WHO voiced concern over high air pollution levels in Delhi, when the capital was named the world’s most polluted city in the ‘Ambient (Outdoor) Air Pollution in Cities Database 2014’. The WHO’s database of ambient air pollution monitoring from 1,600 cities in 91 countries, covering the period from 2008 to 2013, found the annual average PM2.5 (particulate matter smaller than 2.5 <br />microns) level in Delhi to be as high as 153 µg/m3, which is six times the WHO’s recommended maximum and 12 times the US standards. The Indian government, however, rejected WHO’s report, but environmentalists issued strong warnings against the polluted air.<br /><br />“This database confirms our worst fears about how hazardous air pollution is in our region. Last year, the Global Burden of Disease study pinned outdoor air pollution as the fifth largest killer in India after high blood pressure, indoor air pollution, tobacco smoking, and poor nutrition,” Sunita Narain, director general of New Delhi-based Centre for Science and Environment (CSE) said in a statement. <br /><br />In the past, serious efforts by environmentalists and the intervention of the Supreme Court of India had lead to a cleaner air in the capital. In 1998, the apex court ordered all public transport in the city to switch to compressed natural gas (CNG), a cleaner fuel as compared to petrol and diesel. This not only brought down pollution levels in the city, but also helped register a decline in respiratory illness cases in the city. From a high of 409 µg/m3 in 1995, the RSPM went down to 191 µg/m3 in 2000, and then further to 161 µg/m3 in 2007. At VPCI, the number of OPD cases dipped from 51,694 in 2003-04 to 47,887 in 2006-07. However, 2008 onwards, things started to change and have now reached a stage when RSPM levels in Delhi rose again to 316 µg/m3. <br /><br />CSE, which fought a long and difficult battle to switch city’s public transport to CNG and implement other reforms, feels the advantage of CNG-switch has been lost due to the sheer number of vehicles that are added to Delhi’s roads every day. “The most reduction in emissions between 1998 and 2012 occurred as a result of implementation of four sets of vehicular emission standards, removal of lead [in fuels], reduction of sulphur content, mandatory retirement of older commercial vehicles, and conversion of diesel and petrol run public transport vehicles to compressed natural gas,” reads a scientific study by Rahul Goel of IIT Delhi and Sarath K Guttikunda of IIT Mumbai. <br /><br />Apart from the private cars, another source of pollution in Delhi is the daily exhaust of 80,000 trucks that keep moving in and out of the city during the night time. Most of these trucks are 10 to 20 years old and run on a mixture of diesel and kerosene, spewing toxins into the air. <br /><br />Death by breath<br />Delhi is not the only highly polluted city in India. According to WHO, there are 12 more Indian cities which make to the top-20 list of polluted cities around the world. And, air pollution has huge health costs. A recent study published in Economic & Political Weekly has calculated that 660 million people in India now live in areas where PM2.5 levels exceed the country’s national ambient air-quality standards. This is reducing people’s life expectancy by 3.2 years. Another study has revealed that air pollution in Delhi kills approximately 20,000 to 30,000 people annually. This means 80 deaths every day due to pollution. And, majority of these are due to heart attacks and strokes, and not respiratory disorders. About 45 per cent of these premature deaths could be controlled if Delhi meets the national ambient air quality standard of 60 µg/m3 for PM2.5. <br /><br />Air pollution is taking a toll on children’s health, as shown in a landmark study by Kolkata-based Chittaranjan National Cancer Institute. This study, which spanned over three years and tracked 11,000 school children in Delhi region, has found that key indicators of respiratory health, lung function to palpitation, vision to blood pressure were worse off in children of Delhi (between four and 17 years of age) than their counterparts elsewhere because of high air pollution. <br /><br />Rather than debunking the scientific reports, the government needs to take proactive action against growing air pollution, which may unleash a public health disaster in the country. There is also a need to improve and scale up public transport and last mile connectivity. <br /><br />The Delhi government has already started working in that direction. It has recently decided to apply ‘polluter pays’ principle and impose a congestion tax on incoming trucks and the revenue generated will be used to augment city’s public transport system. Some other green measures are also in the offing. But, controlling the rising levels of air pollution in the Indian cities will require some hard decisions and strict <br />implementation. <br /> </p>