Delhi’s air quality worsens, doctors say cases of lung problems expected to rise

Children, the elderly, pregnant, and those with other medical conditions like diabetes and hypertension are at a higher risk to develop complications due to pollution. Cases also spike in the week after Diwali, usually one of the most polluted days of the year due to bursting of firecrackers.

Every year around October, Doctors in Delhi report a spike in cases of people coming with respiratory problems, aggravated asthma and chronic obstructive pulmonary disease . It is around this time of the year that Delhi’s air quality starts deteriorating with the adverse weather conditions facilitating the concentration of toxic gases and ultra fine particles.

A patient gets tested for lung problems at a city hospital. Last year, spirometry tests conducted by the Delhi government on citizens to check lung function, found that more than 34% of the people checked had impaired lung function.(Sushil Kumar/HT file photo)

“We usually see a threefold rise in the number of patients between October and February, especially at the onset of winter. Some reach hospital with symptoms so severe that they need ICU care. This rise in numbers and aggravation of symptoms is because the temperature dip results in denser air and concentrated levels of pollution in lower atmosphere, which people breathe,” said Dr Sandeep Nayyar, head, department of respiratory medicine, allergy and sleep disorders, BL Kapur Super Speciality Hospital.

Last year, spirometry tests conducted by the Delhi government on citizens to check lung function, found that more than 34% of the people checked had impaired lung function.

Children, the elderly, pregnant, and those with other medical conditions like diabetes and hypertension are at a higher risk to develop complications due to pollution.

A study commissioned by the Central Pollution Control Board, which was conducted by Chittaranjan National Cancer Institute, found that more than two of five school-going children in Delhi have reduced lung function. The study, published in 2012, said that the lung function of 43.5% Delhi children was impaired, as compared to 25.7% in students from rural West Bengal and Uttarakhand.

It also found that the sputum (mixture of saliva and mucus coughed up from respiratory tract) samples of children from Delhi had four times more iron-laden macrophages, indicating bleeding in the lungs. The scientists also found that the changes in the sputum correlated with the ambient air pollution.

Doctos said the cases also spike in the week after Diwali, usually one of the most polluted days of the year due to bursting of firecrackers. “The numbers shoot up in the week after Diwali, corresponding with the increase in pollution levels because of crackers,” said Dr Srikant Sharma, senior consultant of medicine at Moolchand Medicity.

A study by the Chest Research Foundation, Pune, looked at the level of pollution an individual is exposed to when they light common crackers. A single snake tablet produces nearly 64500 µg/m3 of PM 2.5 within 3 minutes. The accepted level is 60 µg/m3.

This is 40 to 400 times the amount of harmful substances from a cigarette, said Dr GC Khilnani, head of the department of pulmonary medicine and sleep disorders at All India Institute of Medical Sciences (AIIMS).

“It has also been scientifically proven that the particulate matter produced by burning firecrackers weakens our immunity and causes much more inflammation than what is triggered by pollutants produced by automobile and other sources,” said Dr Khilnani.

Particulate matter is the principal pollutant in Delhi’s air. Particles as fine as 2.5 microns and 10 microns, referred to as PM2.5 and PM10, cause immense damage to human lungs by embedding deep into the tissues and causing severe diseases.

Vehicular pollution is known to increase the risk of asthma, according to a nation-wide study on which AIIMS had collaborated. The study showed a nearly 2 fold increase in the number of children with asthma in moderate to high pollution areas near roads that have heavy vehicular traffic throughout the day.

The major contributors of PM 2.5 in Delhi are road dust (38%), vehicular pollution (20%), domestic fuel burning (12%) and industrial sources (11%), according to the Centre for Science and Environment (CSE). Fireworks are also a major contributors.

More than 55% of Delhi’s 19 million people live within the highly exposed, toxic zones, according to a 2015 CSE report.

Constant monitoring of the level of pollution in the air done by Vallabhai Patel Chest Institute (VPCI) has found that the level of pollen in the air goes up during the winter. Data showed that the pollen count increased in the months of September, October and November, and started declining again from December.

“Pollens are allergens and whenever there is pollen in the air; people with pollen sensitivity will start showing symptoms. In fact, 70% of the population faces respiratory problems due to pollution,” said Dr Raj Kumar, Head of National Centre of Respiratory Allergy, Asthma & Immunology and Department of Respiratory Allergy & Applied Immunology, VPCI.

Pollen can also aggravate symptoms of people living with chronic respiratory problems. “And, till the pollution levels are high, we think that is the sole reason for adverse respiratory health. But, we will not know how much of the problem is due to the pollens,” said Dr Kumar.