Spike in bad air in Delhi but government not sure if pollution kills

Officials said the air is expected to remain in the “severe” category – a classification when AQI is above 400 – till Saturday.

Can India’s bad air crisis lead to fatalities? There are two different answers, depending on which Union government ministry has been asked the question.

The government’s response comes at a time when Delhi recorded the second-worst air quality of this year.(Biplov Bhuyan/HT PHOTO)

The environment ministry told Parliament this month that there is no direct link between pollution and deaths or diseases even though a health ministry report published in a leading peer-reviewed journal last month estimated that one in eight deaths in the country are linked to air quality.

The environment ministry’s response to a question in Lok Sabha comes at a time when the national capital is shrouded in “severe” pollution – Thursday recorded the second-worst air quality of this year with the air quality index (AQI) at 440. This was the third-worst reading this winter, attributed by experts to low temperature and slow wind speeds at the surface level that were militating against the dispersal of suspended pollutants.

Officials said the air is expected to remain in the “severe” category – a classification when AQI is above 400 – till Saturday.

“There is no conclusive data available in the country to establish direct correlation of death or disease exclusively due to air pollution. However, air pollution is one of the triggering factors for respiratory ailments and associated diseases,” the environment ministry said in the January 4 response which first reported by Scroll.in on Wednesday. In 2017, environment minister Harsh Vardhan said: “No death certificate has the cause of death as pollution.”

This sentiment is contradicted by findings by the Indian Council for Medical Research (ICMR), published on December 6 in Lancet Planetary Health, that 1.24 million deaths in 2017 were due to exposure to air pollution, and that bad air reduces life expectancy in India by 1.7 years on an average. ICMR is India’s premier research body under the Union ministry of health and family welfare.

Prior to that ICMR report, the health ministry released another study in 2015 that said air pollution exposure impact was no longer limited to chronic and acute respiratory disorders. “It is generally accepted there are also impacts on ischemic heart disease, stroke, cataracts, and lung cancer. In addition, there is increasing evidence of adverse pregnancy outcomes, TB, asthma exacerbation, other cancers, and cognitive impairments,” said the report drafted by health experts such as Dr K Srinath Reddy, president of the Public Health Foundation of India (PHFI), Dr Kalpana Balakrishnan of the department of environment health engineering, Sri Ramachandra Medical College and Research Institute; and Dr Kirk R Smith, professor of global environment health, School of Public Health, University of California, Berkeley.

“Just as with tobacco smoking, which produces the same set of impacts, air pollution needs now to be considered within public health programs concerning non-communicable and communicable diseases,” the report added.

The environment ministry, however, will launch its own assessment of the health impact of bad air. A National Environmental Health Profile has been commissioned to assess “human health impact in consequence of exposure to outdoor air pollution” in 20 selected cities across the country, the ministry told Parliament.

“Yes, we have no data linking air pollution with death. It can definitely aggravate existing conditions. Obviously air pollution impacts health but it cannot be the cause of death. If you have morbidity, air pollution will aggravate it,” CK Mishra, secretary, environment ministry, said on Thursday. Mishra added that he was aware of the ICMR and health ministry’s steering committee reports.

Balakrishnan, who was also the lead author of the ICMR study, said: “We have observed that people exposed to high level of air pollution suffer tissue ageing and inflammatory responses alongside other risk factors. In areas with high air pollution there is higher premature mortality.”

She added that while India doesn’t have long-term cohort studies on premature mortality related to air pollution, there are short-term studies. “So, there is no reason to doubt the relationship between premature mortality and air pollution. Long term cohort studies will take a very long time to roll out,” she added.

The Lok Sabha query answered on January 4 also says that “there is no increasing trend in air pollution which reflects the air becoming more toxic in the country”.

Emergency measures such as a ban on entry of trucks in city limits and stopping of construction and industrial activities come into effect in case air quality remains in the same zone for more than 48 hours as per the Graded Response Action Plan (Grap) enforced by a Supreme Court-appointed committee to fight against Delhi’s annual public health emergency due to winter pollution.

The measures include radical steps such as shutting schools and curtailing private vehicles if the high pollution levels persist.

(With inputs from Vatsala Shrangi)