While all discussion around pollution is pivoted around lung health, there are far-reaching consequences beyond the physical, especially among the generation that’s growing up with masks and indoor confinement. Apart from battling infections each season, continued exposure to pollutants means the asthmatic condition of the likes of six-year-old Arjun Shrivastava turns chronic and their immunity dips sharply. Besides, forced to stay indoors, with schools shut down, they miss the peer culture that develops connectedness and creates a healthy social environment. Worried that their children will become sicker by the day and be denied a season’s worth of school work, most parents are thinking of relocating to a cleaner air city and taking up new jobs. Arjun’s mother Ananya Shrivastava, a 36-year old PR professional who lives in Dwarka, Delhi, is looking for a job opportunity in Canada that will give her permanent residency and the clean air that Arjun needs desperately. “Both my husband Gaurav and I are determined to get the job that will justify our relocation outside Delhi. We have to save Arjun,” she says. Gaurav, a sales professional, is already looking for a backup option in relatively cleaner cities like Pune and Bengaluru. They have reasons to be worried. An asthmatic, Arjun’s condition has deteriorated every year since he was born in 2017 during the severely polluted months of October and November. He needs a combined power of nasal spray, steaming, and nebulisation to get rid of his rather stubborn nose block. Come October Ananya shuts the door and windows in his room, keeps him in front of an air purifier, creates an air-conditioned environment, makes sure he gargles up to four times a day, and drinks warm water. For years, she has administered a course of anti-allergic medicine like Maxtra or cetirizin for about five months. Her harshest preventive measure has been to not send her son to school for weeks during Diwali. Last year, Arjun could attend only 150 of the 200 school days. “If he goes out for just one day, he will lose a week in treatment and recovery,” says Ananya, who has signed him up for online classes with the support of his teachers. “Kids of his class have started reading thoroughly and speak fluently in English but he is still behind because of his ill health,” she adds. Arjun wonders why he can’t play outdoors like his classmates and though Ananya tries to divert his attention, saying he is better off with his Lego blocks, she knows he is missing out on a host of extracurricular activities like horse riding and swimming at school. “That lack of competence has had an impact on his mind. He is now rebellious and asks us why should he go back to school when he is mostly out of it,” she says. The family keeps the humidifier on, uses the kitchen chimney every time they cook and doesn't prepare any dish which needs to be smoked, like a paratha for instance. According to Arjun’s consulting doctor, Dr Vibhu Kawatra, Paediatrician Pulmonologist and Allergy Specialist practising in Delhi’s Malviya Nagar, pollution was holding back his full recovery and making him dependent on nebulisation. “As part of a recovery protocol, we removed the inhalers/nebulisation he was on and started with standard home remedies like steaming. He had major nasal allergy issues and we started taking adequate precautions like eliminating junk food. Gradually his condition improved and in a few months, we were able to reduce his medications to almost zero drugs. He was basically on steam from June onwards. But since Navratri his condition has deteriorated yet again,” says Dr Kawatra. She had put him through many tests to diagnose the nature of his problem, ascertaining whether he had Cow Milk Protein Allergy (CMPA). She later found out that Arjun, though born an asthmatic, had also developed bronchitis. The last was the reason for his many coughing bouts. According to Dr Rajesh Sagar, Professor of Psychiatry, All India Institute of Medical Sciences (AIIMS), New Delhi, a child in a confined environment becomes frustrated and irritable. And negative emotions fuel asthma. “We have published a paper linking behaviour patterns and symptoms of asthma in a child. It is important that they go out, meet new people, and learn to interact because at that stage our social skills and cognitive abilities are developing. Socialisation is a kind of stimulation that we all need while growing up. One of our studies at AIIMS Delhi has also concluded that children and adolescents with bronchial asthma have comorbid psychiatric morbidities and behavioural problems,” he says. Dr Kawatra says that long-term effects of pollution can be deadly for anyone who is suffering from any respiratory ailment and living in a polluted city like Delhi. “The particulate matter 2.5 can irritate the airways, making them swell and tighten up, and cause breathing problems because of which the asthmatic children can generate COPD changes. They may have obstructive airway disease later on in their lives if they continue to breathe this kind of air. Pollution is a major cause of hypertension as these particles get deposited in your arteries. Overall all the organs of your body get impacted because of this,” he adds.
