Mongabay-India

The disease burden of Delhi’s smog is among the highest in the world

  • The Delhi National Capital Region and surrounding states have been facing severe air pollution this winter, registering very poor and severe Air Quality Index figures.
  • This part of the country is among the regions that have the worst air pollution globally, according to the State of Global Air 2017 Report.
  • The Global Burden of Disease Report notes that the severe pollution in the region has led to very high rates of health problems.

If the residents of New Delhi and the National Capital Region believed that there would be a respite in the new year from the suffocating smog that was hovering over their lives for the past few weeks, they were in for a rude shock when the new year dawned on January 1. The blanket of dust and haze was so thick that the international airport did not function for the entire forenoon. More than 300 flights got delayed, and at least eight cancelled. It was no better for those travelling by trains – more than 400 were delayed.

According to the Central Pollution Control Board (CPCB), on January 1 the 24-hour average of the Air Quality Index (AQI) was 400, which was constituted mainly by particulate matter with a diameter less than 2.5 micrometres (PM2.5). At an AQI of 400, Delhi hit the ‘very poor’ category, while some of the neighbouring urban centres such as Faridabad, Ghaziabad and NOIDA crossed into ‘severe’ category.

The CPCB categorises AQI values into good (0-50), satisfactory (51-100), moderately polluted (101-200), poor (201-300), very poor (301-400) and severe (401-500). While poor AQI can give breathing discomfort to most people on prolonged exposure, very poor causes respiratory illnesses, and severe affects healthy people and seriously impacts those with existing diseases.

Smog over Gurgaon area, New Delhi. Photo by Saurabh Kumar / Wikimedia Commons.

Being a major centre for national and international media presence, the air quality in the national capital makes news. However, the problem of the smog had spread over much larger region across the northern and north-western part of the country. The story is a repeat of what has been happening over many winters.

Steepest increase in air pollution

After the monsoon winds retreat and the air movement slows down over the northern plains, the winter air sits heavily, trapping the warm, pollution-bearing air closer to the streets. Into this chamber comes smoke from fields in the neighbouring states where farmers burn crop stubble, vehicular emissions, smoke from thermal power plants and diesel generator sets, and smoke from the burning of waste. Together, this combination turns Delhi into a gas chamber.

Bursting of fireworks during Diwali adds to this cocktail. In 2017, the Supreme Court had banned the sale of crackers in Delhi during Diwali. However, a report submitted by the CPCB to the Supreme Court stated that even though the air quality worsened during Diwali, there was no marked change in the health impacts because of this.

The heavy load of particulate matter – especially PM2.5 – makes northern India amongst the second worst regions in the world, according to the State of Global Air 2017 Report published by the Institute for Health Metrics and Evaluation’s Global Burden of Disease Project (GBD Project) and the Health Effects Institute based at Boston in the USA. The countries of South Asia such as Bangladesh, Nepal, China and India (especially the northern parts), are second to North Africa and the Middle East only because of the high levels of wind-blown mineral dust in the latter region. That means South Asia has the highest load of human-induced particulate matter concentrations in the air. The report notes that Bangladesh and India have experienced the steepest increases in air pollution levels since 2010 and have the highest PM2.5 concentrations globally.

How countries fare on air pollution. Source: SOGA 2017 Report.

Affects the heart, lung and brain

Assessing the impact of high concentration of pollutants to health through an extensive literature analysis, “the GBD project concluded that certain diseases could be causally linked with exposure to ambient PM2.5 — ischemic heart disease, cerebrovascular disease (ischemic stroke and hemorrhagic stroke), lung cancer, chronic obstructive pulmonary disease (COPD), and lower respiratory infections (LRIs).” Also, studies have suggested associations between long-term and acute exposure to asthma, various adverse birth outcomes, diabetes and neurological disorders.

The GBD report has other disturbing observations. “In 2015, long-term exposures to ambient PM2.5 contributed to 4.2 million deaths and a loss of 103 million years of healthy life (disability-adjusted life years or DALYs), making PM2.5 exposure responsible for 7.6% of all global deaths and 4.2% of all global DALYs. China and India each had the highest absolute numbers of deaths attributable to PM2.5. Together, these two countries accounted for 52% of the total global PM2.5-attributable deaths and 50% of the DALYs.”

Ischemic heart disease, cerebrovascular disease, lower respiratory infection and COPD were among the top 10 causes of death in India during 2016, according to the GBD project report. When compared with the situation in 2005, ischemic heart disease remained on the top slot, whereas COPD moved from the third to second position. While lower respiratory infections moved from the fourth to fifth place, cerebrovascular diseases moved from the sixth to the fourth spot.

Smog-filled Delhi skyline. Photo by Ville Miettinen / Wikimedia Commons.

In combination, the illnesses that are impacted by poor air condition were among the top causes of death in the country. While it does not mean that air pollution caused all deaths in this category, the winter smog in north India would have certainly contributed to it.

India among the worst

Compared to other countries with similar development parameters, the country’s death and illness figures due to air pollution-related causes are high. For instance, in the case of ischemic heart disease, India had an age-standardised rate of 4111.3 per 100,000 in 2016, while the group average was 3,370.1. The similar figures for COPD were 2,432.1 and 1,868.5 respectively.

Fog and smog have been a constant every winter in Delhi and the adjoining north Indian plains. However, the situation was so severe in 2017 that just before the year ended the High Level Task Force constituted to deal with the situation announced a 12-point action programme. With the principal secretary to the prime minister chairing this Task Force, the national government was signalling its intent of dealing with the issue comprehensively.

View over West Delhi on a smog filled day. Photo by Jean-Etienne Minh-Duy Poirrier / Flickr.

The Task Force recommended creating an information technology platform for obtaining real-time data on crop residue burning in the states neighbouring New Delhi so that the national and state governments can take coordinated action to mitigate this cause. Other recommendations include ensuring adequate facilities for air quality monitoring and source attribution; reducing pollution from power plants and polluting industries; reducing air pollution from waste management and disposal; improving public transport; encouraging electric vehicles and shared transportation; and reducing traffic congestion.

There is nothing new about these recommendations though. These have been an integral part of all state and national environmental action plans. The need is for action so that the smog level decreases in the coming years and in turn the negative health impacts are also reduced.

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