Delhi’s high pollution levels pose health risk, experts suggest precautions
The continued bad air run in the capital entails health hazards for its citizens, doctors and health experts said on Tuesday, suggesting a series of precautions such as not venturing out early in the morning, wearing a mask and avoid construction sites.
Doctors with at least three city hospitals said they have been getting more patients with exacerbation of respiratory conditions such as asthma, respiratory infections, heart attacks and stroke.
Delhi’s air quality has stayed in the poor or worse zone since October 27. It stayed in the severe zone for three consecutive days since November 5, improved slightly to very poor on Monday, but worsened to return into the severe category on Tuesday.
Experts say long term exposure to the toxic air can lead to several health problems to people of all age groups, including increase in blood pressure, under-development of lungs in infants, chronic lung conditions in adults, cancers, low immunity, and depression.
Air pollution was the top risk factor for death in India in 2019, killing an estimated 1.67 million people, according to the Global Burden of Disease report.
Over half the cases of chronic obstructive pulmonary disease (COPD) in India is attributable to ambient and household air pollution, according to a 2018 Lancet Global Health research paper. In developed countries, 80% of COPD is caused by smoking.
“I don’t think there is exact data for Delhi, but it appears reasonably certain that this level of exposure for this duration is associated with significant damage. There will be earlier onset of COPD, more asthma exacerbations, and more lung fibrosis. Ageing will be faster,” said Dr Anurag Agarwal, director of the Institute of Genomics and Integrative Biology who has worked on asthma and lung health. He is himself an asthmatic.
A study from the All India Institute of Medical Sciences (AIIMS) shows that there is a nearly 20% increase in the number of patients seeking emergency care for acute respiratory symptoms even when the air quality is slightly bad with PM2.5 levels recorded between 50 and 100 micrograms. At its peak -- between October and January when Delhi records a PM2.5 levels of around 400 micrograms – this number goes up to 40%, according to the study.
The highest risk from air pollution is to those whose lungs are already compromised, and people in jobs such as the traffic police, street vendors, and delivery personnel who have very high level of exposure. High levels of pollution have also been linked to pre-mature births and deaths due to pneumonia in children.
Over 116,000 infants in India died within a month after birth in 2019 because of exposure to high levels of pollution, estimates the State of Global Air report. When it comes to the death of children below the age of five, pneumonia is the most common cause after malnutrition, killing an estimated 126, 535 children in India in 2017. Of this, 27% of the deaths were attributable to outdoor air pollution and 22% to indoor air pollution, according to the report titled Fighting for Breath – Call to Action.
How to keep yourself safe
Not only might those with chronic conditions, even seemingly healthy people start experiencing symptoms when the pollution levels shoot up, experts say.
“Even those without any history of chronic condition may experience symptoms such as dryness of throat, itching in the eyes, cough, feeling tired and disturbed sleep with such high levels of pollution. Those who already have lung disease may land up in the emergency department. Some of them in our experience, respond to only cortico-steroids,” said Dr GC Khilnani, former head of the department of pulmonology at AIIMS and chairman of PSRI Institute of Pulmonary and Critical Care.
“Everybody should take precautions. Healthy people should not go for walks or jogs early in the morning; the pollutants are at the breathable height at this time. Go for an exercise only when there is bright sunlight, when the temperature goes up, the pollutants also rise up. The masks that we use for Covid-19, has little or no value against Covid-19. If at all, people have to use an N95 mask,” he said.
Dr Khilnani added, “Those who already have a history of respiratory conditions should avoid going out at all. They should also ensure that they take their medicine regularly to avoid emergency episodes. Those with severe asthma or COPD may consider the use of air purifiers; there is no conclusive evidence that they help but they do reduce the levels of PM2.5 etc.”
He said that people should consult their doctor if they get fever, start coughing up phlegm, get breathless, or experience moderate to severe chest pain.
Pollution and Covid-19
Doctors said the high levels of pollution can be bad news for those who have recently recovered from Covid-19.
“If we see the post-Covid-19 scenario, there is a large proportion of people who have post-pneumonic pulmonary fibrosis and long Covid-19. These people are more likely to get cough, breathlessness, chest discomfort, lung infection just like those with other chronic respiratory conditions when the pollution levels shoot up,” said Dr Khilnani.