One in every eight deaths in India is attributable to air pollution which now contributes to more disease burden than smoking. The first comprehensive estimates of deaths, disease burden, and life expectancy reduction associated with air pollution in each state of India by the India State-Level Disease Burden Initiative has been published in The Lancet Planetary Health.
The estimates show that India with 18 per cent of the global population has a disproportionately high 26 per cent of the global premature deaths and disease burden due to air pollution. Over half of the 12.4 lakh deaths in India attributable to air pollution in 2017 were in persons younger than 70 years. The average life expectancy in India would have been 1.7 years higher if the air pollution level were less than the minimal level causing health loss.
“India has one of the highest annual average ambient particulate matter PM2·5 exposure levels in the world. In 2017, no state in India had an annual population weighted ambient particulate matter mean PM2·5 less than the WHO recommended level of 10 μg/m³, 45 and 77% of India’s population was exposed to mean PM2·5 more than 40 μg/m³, which is the recommended limit set by the National Ambient Air Quality Standards of India,” reads the article in The Lancet Planetary Health. PM 2.5 particles are those that are suspended in air and have a diameter lesser than 2.5 microns. There is a marked variation between the states, with a 12 times difference for ambient particulate matter pollution and 43 times difference for household air pollution. States in north India had some of the highest levels of both ambient particulate matter and household air pollution, especially Bihar, Uttar Pradesh, Rajasthan, and Jharkhand; and the states Delhi, Haryana, and Punjab in north India had some of the highest ambient particulate matter pollution exposure in the country.
Releasing the report, Dr Balram Bhargava, secretary health research said “It is important to have robust estimates of the health impact of air pollution in every state of India in order to have a reference for improving the situation. Household air pollution is reducing in India, facilitated by the Pradhan Mantri Ujjwala Yojana. There is increasing political momentum in India to address air pollution. The findings reported today systematically document the variations among states, which would serve as a useful guide for making further progress in reducing the adverse impact of air pollution in the country.”
The India State-Level Disease Burden Initiative is a joint initiative of the Indian Council of Medical Research (ICMR), Public Health Foundation of India (PHFI), and Institute for Health Metrics and Evaluation (IHME) in collaboration with the Ministry of Health and Family Welfare, Government of India, along with experts and stakeholders associated with over 100 Indian institutions. Lauding India’s achievements in cutting down smoking, the study noted that contrary to the popular association of air pollution only with respiratory diseases, in India, the disease burden because of air pollution also includes ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lung cancer, commonly associated with smoking. Prof.
Christopher Murray, Director, IHME, said”Air pollution in India causes not just lung disease, but also is a substantial contributing factor in cardiovascular disease and diabetes. As a result, there is enormous potential to reduce the burden of these non-communicable diseases by curbing air pollution across the country.”
According to the WHO database of air pollution, 14 of the 15 cities with the worst air pollution in the world are in India. The study notes that the experience in controlling air pollution in Mexico City and Beijing could be “instructive” for dealing with the extremely high pollution levels in New Delhi and other cities of India. Mexico and China have been making long-term efforts to switch to cleaner energy options, improve the application of emission-controlling technologies, promote public transport systems, promulgate policies to reduce total energy consumption, and promote environmental education and research, which attempt to address all major sources of air pollution through coordinated air quality management.
Prof. Randeep Guleria, Director, All India Institute of Medical Sciences added, “The upsurge in respiratory problems in the winter months with peak air pollution is well known, but what is now also becoming better understood is that air pollution is a year-round phenomenon particularly in north India which causes health impacts far beyond the seasonal rise of respiratory illnesses. Air pollution is now the leading risk factor for chronic obstructive lung disease in India, and a major contributor to pneumonia and lung cancer. This study provides the most comprehensive estimates of the adverse health impact of outdoor and indoor air pollution in each state of India so far, which would serve as a valuable resource for planning air pollution reduction in all parts of India.”