India is not much better than China when it comes to air pollution, say experts

Air pollution kills at least 21 lakh people every year in Asia. In China the count of particulate matter 10 (a hazardous pollutant ) is 60 while the safe limit set by WHO is 20. India fares no better at 58. Polluted air has become the fifth largest killer in India. These shocking figures were revealed by the recent Global Burden of Disease report. Robert O'Keefe, vice president of US-based Health Effects Institute and Chair of Clean Air Asia, who analysed the Global Burden of Disease (GBD) study shares with TOI-Crest how disease patterns in India are seeing dramatic shift due to increased levels of air pollution

How is India faring compared to China?

The unfortunate message here is that both India and China have severe air pollution problems that routinely exceed both national and World Health Organisation standards, often by wide margins. Whether it is Ludhiana and Delhi or Beijing and Huaibei the high levels of air pollution that occur cause extensive damage to the health of their respective populations. While overall the burden of disease from air pollution is higher in China (due in part to China's larger population and other factors), in any given city or region levels of air pollution are all too similar.

Your study concludes that non-communicable diseases have overtaken communicable diseases in India, what does that mean? In India, and throughout developing

Asia, there is a shift from communicable diseases that spread among a population, such as waterborne viruses and bacteria, to non-communicable diseases such as heart disease, stroke and chronic obstructive pulmonary disease (COPD). These diseases, many of which are found in the ageing population of India, include heart disease, stroke, respiratory disease and cancer, and are strongly associated with exposure to air pollution.

Your study has revealed that ambient air pollution is the fifth largest killer in India. What are the major sources of this pollution in India?

Largest health impacts in the GBD study are from particulate matter (PM). Combustion source PM is emitted from mobile (transportation) sources, such as older diesel trucks and vehicles, coal-fired power plants and brick kilns, biomass combustion, including emissions from household cooking, and also some non-combustion windblown dusts.

In your study, a diet low in nuts and seeds also feature as leading risk factors for death in India. Why?

Nuts and seeds along with fruits and vegetables are critical suppliers of key vitamins, minerals, and other nutrients that can help strengthen the body and fight off disease.

Which place in India has recorded the highest deaths due to ambient air pollution?

I often hesitate to target the places with the worst levels of air pollution because the problem is widespread and differences, while significant, can mask the need for broader interventions. However, in India as reported by WHO too, Ludhiana, Kanpur, Delhi and Lucknow are among the most highly polluted locations relative to PM.

How is indoor air pollution or household combustion affecting India?

Household combustion of fuel for cooking and heat contributes to over 1 million premature deaths in India each year, as well as contributing up to 25-30 per cent of the outdoor air pollution in the rural areas of the country. Air pollution, whether from indoor sources or outdoor sources, is a major public health risk in India

Is there any particular pollutant which is more responsible for the deaths in India?

There are many pollutants of concern in India, including PM, ozone, nitrogen dioxide, sulphur dioxide and a range of toxic air pollutants (eg benzene). While all of these pollutants are damaging to health in different ways and should be reduced, studies have found the strongest associations to be with particulate matter and its impact on cardiovascular disease, respiratory disease and the over 6, 20, 000 premature deaths that were identified in the global burden of disease.

Is there a certain age group that is more vulnerable to complications due to air pollution?

Air Pollution can affect people of any age group if they have pre-existing heart or lung disease, but two groups are especially vulnerable - older adults (who may already have underlying disease) and young children (less than 5 years) who are especially susceptible to acute lower respiratory infection (or pneumonia) which can be severely aggravated by exposure to air pollution.

What solutions do you recommend?

Measures can vary from place to place. In urban regions reducing emissions from transport, including vehicles and older high emitting diesel vehicles, is important. To enable this, especially for old vehicles, fuel with very low sulphur content is essential. Effects of air pollution on humans - whether measured as illness or premature death - can be avoided by following these pollution control norms. Worldwide the costs of these measures have been proven to be cheaper than the costs of treating health impacts of air pollution.