Air pollution claimed around 21 lakh Indian lives in 2021 alone. Not just asthma, bad air is increasing the risk of heart attacks, stroke and even high BMI in children. Dr Sundeep Salvi, Pune-based pulmonologist and head of the Indian Chest Society, speaks to Malathy Iyer about air pollution’s link to diseases and how we can protect ourselves
Why is air pollution described as a slow killer?
Air is a vital nutrient as we get 90% of our energy from it. One breathes around 10,000 litres of air every day. Our lungs, if spread out as a flat surface, would be like a 100-sqm tennis court. They are designed for clean air (comprising nitrogen, oxygen, argon and a little carbon dioxide) but instead encounter harmful elements such as nitrogen dioxide, sulphur dioxide, ozone and microscopic particulate matter (PM), which eventually get absorbed into our bloodstream. Over time, PM2.5 (2.5 microns in size) get deposited in various organs, increasing the risk of respiratory, cardiovascular and neurological complications. We blame sudden heart attacks and strokes on what we eat and lack of exercise, but air pollution plays a crucial role as well.
How widespread is air pollution in India?
Around 98% of Indians live in areas where air pollution levels are higher than WHO standards. While Delhi gets a bad name as one of the most polluted cities in the world, there are 15 to 16 Indian cities, including Mumbai, that are equally bad. Most of these cities are in the northern belt.
Are Diwali firecrackers the only reason for the worsening air quality?
Certainly not. Day-to-day activities like driving, construction work and burning of waste, among others, contribute significantly to air pollutants. Diwali fireworks further deteriorate the situation as the festival coincides with winter’s onset, when denser air causes pollutants to remain suspended at ground level for longer durations. Over the years, the number of patients visiting doctors with respiratory problems in Delhi has increased two- to three-fold immediately after Diwali.
One of your studies published in Lung India journal says prolonged exposure to high levels of outdoor air pollution could increase BMI among urban adolescents. Can we link air pollution to obesity?
The study — jointly done by the Pulmocare Research and Education Foundation in Pune, and Lung Care Foundation and CSIR Institute of Genomics and Integrative Biology from Delhi in 2021 — looked at over 4,000 children from 12 private schools in Delhi, Mysore and Kottayam. We found a higher prevalence of asthma among adolescents in Delhi (30%) than among those in the relatively cleaner cities of Kottayam and Mysore (18%). Also, Delhi’s students were significantly more overweight. We believe air pollutants can directly lead to asthma by damaging the lungs or acting as obesogens (endocrine-disrupters) that affect the body’s normal processes and lead to obesity, which affects the physiology in such a way that it causes asthma.
What can people do to protect themselves from air pollution?
Just like the Covid-19 awareness drives about wearing a mask, we need to bring about a similar behavioural change for air pollution. We must wear a mask to protect ourselves from the polluted air outside. Research has shown that two layers of cotton with a chiffon or silk layer in between is as good as an N95 mask. Schoolchildren, motorcyclists, hawkers, autorickshaw drivers and others constantly on the road should wear a mask. Just as we brush our teeth twice a day, we should do nasal washes twice a day. One needs to improve hydration and provide the body with antioxidants found in fresh fruits and green vegetables. Exercises should be done when pollution levels are low, and we could put up indoor air plants that absorb pollutants.
Why is air pollution described as a slow killer?
Air is a vital nutrient as we get 90% of our energy from it. One breathes around 10,000 litres of air every day. Our lungs, if spread out as a flat surface, would be like a 100-sqm tennis court. They are designed for clean air (comprising nitrogen, oxygen, argon and a little carbon dioxide) but instead encounter harmful elements such as nitrogen dioxide, sulphur dioxide, ozone and microscopic particulate matter (PM), which eventually get absorbed into our bloodstream. Over time, PM2.5 (2.5 microns in size) get deposited in various organs, increasing the risk of respiratory, cardiovascular and neurological complications. We blame sudden heart attacks and strokes on what we eat and lack of exercise, but air pollution plays a crucial role as well.
How widespread is air pollution in India?
Around 98% of Indians live in areas where air pollution levels are higher than WHO standards. While Delhi gets a bad name as one of the most polluted cities in the world, there are 15 to 16 Indian cities, including Mumbai, that are equally bad. Most of these cities are in the northern belt.
Are Diwali firecrackers the only reason for the worsening air quality?
Certainly not. Day-to-day activities like driving, construction work and burning of waste, among others, contribute significantly to air pollutants. Diwali fireworks further deteriorate the situation as the festival coincides with winter’s onset, when denser air causes pollutants to remain suspended at ground level for longer durations. Over the years, the number of patients visiting doctors with respiratory problems in Delhi has increased two- to three-fold immediately after Diwali.
One of your studies published in Lung India journal says prolonged exposure to high levels of outdoor air pollution could increase BMI among urban adolescents. Can we link air pollution to obesity?
The study — jointly done by the Pulmocare Research and Education Foundation in Pune, and Lung Care Foundation and CSIR Institute of Genomics and Integrative Biology from Delhi in 2021 — looked at over 4,000 children from 12 private schools in Delhi, Mysore and Kottayam. We found a higher prevalence of asthma among adolescents in Delhi (30%) than among those in the relatively cleaner cities of Kottayam and Mysore (18%). Also, Delhi’s students were significantly more overweight. We believe air pollutants can directly lead to asthma by damaging the lungs or acting as obesogens (endocrine-disrupters) that affect the body’s normal processes and lead to obesity, which affects the physiology in such a way that it causes asthma.
What can people do to protect themselves from air pollution?
Just like the Covid-19 awareness drives about wearing a mask, we need to bring about a similar behavioural change for air pollution. We must wear a mask to protect ourselves from the polluted air outside. Research has shown that two layers of cotton with a chiffon or silk layer in between is as good as an N95 mask. Schoolchildren, motorcyclists, hawkers, autorickshaw drivers and others constantly on the road should wear a mask. Just as we brush our teeth twice a day, we should do nasal washes twice a day. One needs to improve hydration and provide the body with antioxidants found in fresh fruits and green vegetables. Exercises should be done when pollution levels are low, and we could put up indoor air plants that absorb pollutants.
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