Docs slam Centre’s denial of lung disease, pollution link

Pulmonologists and cardiologists working in heavily polluted cities such as Delhi said the effects are visible in daily clinical practice.

Medical experts have cited multiple recent international studies to challenge the Union government’s assertion in Parliament that there is no conclusive evidence establishing a direct link between higher air pollution levels and lung disease, calling the statement misleading and based on a “play of words”.

Visibility reduces as fog, paired with pollution, engulfs the city on Monday. (Arvind Yadav/HT Photo)

On December 18, the government told Parliament that there was no definitive data proving a direct correlation between air quality index (AQI) levels and lung-related illnesses or deaths. However, doctors pointed to a study published on April 25 in the British Journal of Cancer (Nature) titled “Particulate matter air pollution as a cause of lung cancer: epidemiological and experimental evidence”, which concludes that long-term exposure to fine particulate matter (PM2.5) is strongly associated with increased lung cancer incidence and mortality.

The study collated epidemiological evidence from multiple regions across the world and examined biological mechanisms through which PM2.5 causes harm. It found that toxic components of fine particulate matter, including polycyclic aromatic hydrocarbons and heavy metals, can damage DNA, trigger chronic inflammation and promote carcinogenesis.

Former AIIMS director and current chairman of department of international medicine and respiratory at Medanta, Dr Randeep Guleria said the government’s response echoed arguments historically made by the tobacco industry. “Saying air pollution has no direct link to lung disease or death is like saying smoking is not harmful because there is no test that proves this particular cancer occurred due to smoking,” he said. “Years ago, the smoking lobby argued that since non-smokers also get cancer, smoking could not be conclusively blamed. But accumulated scientific evidence showed otherwise.”

Dr Guleria said air pollution works in a similar way, worsening underlying chronic conditions and increasing mortality risk. “We may not be able to say this individual died because of air pollution, but there is overwhelming evidence that pollutants aggravate heart disease, respiratory illness and cancers, leading to premature deaths,” he said.

Cardiologist Dr Ashok Seth said the impact of poor air quality on cardiovascular health is well-documented. “There is clear data showing that air pollution causes inflammation of blood vessels and increases clot formation. During periods of severe pollution, heart attack rates rise sharply. That directly translates into increased deaths, which establishes a clear link between air quality and mortality,” he said.

Dr Seth, added, “Stating that there is no air pollution link to lung cancer or mortality is only play of words and as no direct data will ever will prove that, as mortality is based on different variables.”

Pulmonologists and cardiologists working in heavily polluted cities such as Delhi said the effects are visible in daily clinical practice. Doctors report a sharp rise in patient loads during pollution peaks, with not only chronic obstructive pulmonary disease (COPD) patients affected but also younger people with no prior respiratory illness. They said air pollution impacts multiple organs, including the heart, brain and even mental health.

Dr Anant Mohan, professor and head of pulmonary medicine and sleep disorders at AIIMS, said the evidence has moved far beyond debate. “Air pollution harms people before they are born and affects those at the end of life. It reduces life expectancy and increases mortality. The science is clear,” he said.

Earlier this month, around 80 Padma Bhushan awardee doctors wrote to the government, describing India’s air pollution crisis as “medically unacceptable” and urging urgent action. They stressed that air pollution is no longer merely an environmental or seasonal issue, but a persistent public health emergency with direct consequences for human survival.