‘Pollution-related’: Pvt hospital in Delhi’s diagnosis for respiratory problems

Doctors at Holy Family hospital in Okhla will diagnose people coming in with respiratory symptoms with ‘pollution-related’ or ‘triggered by pollution’ diagnosis. Clinicians have for years been pointing out that increase in pollution levels drive up cases of respiratory conditions

New Delhi: With high levels of pollution driving up cases of respiratory problems and aggravation of chronic conditions like asthma, a private hospital in the Capital plans to write “pollution-related” as diagnosis for such patients.

With temperatures and air quality dipping in Delhi, hospitals across the city have seen a 20-30% increase in the number of such, doctors said. (AP)

“We have decided to write ‘pollution-related’ or ‘triggered by pollution’ as a diagnosis for people who come in with respiratory symptoms to the hospital this time of the year. It should become a diagnostic criterion,” said Dr Sumit Ray, head of the department of critical care at Holy Family hospital in Okhla.

Clinicians have for years been pointing out that increase in pollution levels drive up cases of respiratory conditions.

“Respiratory symptoms can be clearly connected to increasing levels of pollution. Usually symptoms in people with asthma or COPD (chronic obstructive pulmonary disease) are triggered either by infection or due to exposure to pollution. So, what we need to do is, check for an acute exacerbation, a spike in the number of such cases, and rule out infection,” said Dr Ray.

With temperatures and air quality dipping in Delhi, hospitals across the city have seen a 20-30% increase in the number of patients coming in with respiratory symptoms in the last 10 days, doctors said.

“Exacerbation in symptoms of those who have conditions like asthma and COPD is usually triggered by three things – viral infections that are common during the change in season, high levels of pollution and exposure to certain gases that are usually released in the atmosphere during Diwali,” said Dr Neeraj Gupta, a professor in the department of pulmonary medicine at Safdarjung hospital. He, however, did not want to comment on whether “pollution” should be used as a separate diagnostic criteria.

Dr Karan Madan, associate professor in the department of pulmonary medicine at the All India Institute of Medical Sciences (AIIMS), said that experts should come together to set a criteria for what can qualify as a “pollution-related” diagnosis.

“One can say that certain conditions are triggered and exacerbated by pollution. But labelling is a challenge. All of us know that pollution is leading to an increase in respiratory symptoms, but establishing cause and effect in one particular case is difficult. The experts should come together and define the symptoms or behaviours that happen due to pollution. Once that comes in the medical literature, then we can have a criteria for such a diagnosis,” he said.

Dr Ray added that even though there is an increase in cases of heart attack and stroke when the pollution levels are high, determining the role of pollution in individual cases is difficult.

“Unlike the acute respiratory symptoms, it takes years for pollution to cause a heart attack or a stroke. We know that the incidence (of respiratory symptoms) goes up in winter – and it cannot be only due to the cold because earlier the numbers used to go up during the really cold months of December and January. Now, we have already started seeing an increase,” said Dr Ray.