Pollution the internal enemy

JYOTI PANDE LAVAKARE

First, let’s get this straight. There are no safe levels of air pollution. Experts speak in one voice when they say this, whether it is the World Health Organization (WHO), the National Institutes of Health, the American Journal of Respiratory and Critical Care Medicine or others. Episodic high pollution levels like what happens in north India during peak stubble burning or Diwali may dramatically increase visits to hospital emergency rooms, but even lower pollution levels also cause disease, disability and death.

Nearly 1.7 million people die from air pollution each year — which is more than three times the deaths Covid-19 caused in one year, a disease the government took seriously in its public messaging, something it has never done with equal intensity for pollution.

Second, and equally important, air pollution is not a seasonal problem, it is an invisible, year-round problem in all of India, that usually becomes most visible in the winter. On average, the country’s pollution load is usually 10 times higher than the WHO guidelines’ safe threshold all year through. It is just insanely — almost 50 times — higher in the winter months in North India, which leads to international headlines and increased attention. However, that doesn’t alter the fact that year-round pollution levels are also high; but, sadly, they have been normalized by over a billion people torn between helplessness, resignation and apathy.

Third, over 90 percent of India breathes dirty air, not just northern India or Delhi, though these regions are the most polluted. The Indo-Gangetic plain is home to 40 percent of India’s population, which means more than 500 million people are sickening by just breathing. But Mumbai has shown us in three consecutive years that it can beat Delhi’s AQI levels, this year even a month before Diwali.

As for southern India, although its geography (high altitude) and weather (rain and wind) ensure most of its particulate matter is washed or blown away, Bengaluru still had the dubious distinction of topping the State of Global Air’s list of polluted cities for nitrous oxides in September 2023, followed by neighbouring Hyderabad. NOx exacerbates respiratory diseases, and a recent AIIMS study found it can lead to an increase in the number of emergency room visits by 53 percent.

Another coastal city, Chennai, in the south has had its moments, with AQI levels crossing Delhi’s. And if you thought that only urban India was suffering, not only does research show that pollution is increasing faster in southern and eastern India, it is also increasing faster in rural areas where indoor air pollution (caused by burning biomass for cooking and heating) already contributes nearly 30 percent of outdoor air pollution.

Air pollution doesn’t just harm the human respiratory system, it damages every organ in the human body, especially the heart. Peer-reviewed journal Neurology’s September issue published research that showed a strong and significant correlation between air pollutants and death from strokes.

In fact, Bengaluru has the youngest population of heart patients. The city’s Jayadeva Institute of Cardiovascular Science and Research treated 2,200 heart attacks in patients under 40 in two years, the youngest being 16 years old. These were mostly software professionals and auto/cab drivers who spent longer than an hour in traffic — but is 16 any age to have a heart attack triggered by just the involuntary act of breathing?

None of this harm is short-term, it is long-term and irreversible damage, which means that you can arrest the harm once you start breathing clean air (like when you stop smoking cigarettes) but you can’t reverse it. Those microscopic particles of PM2.5 will remain in your body until you die.

The University of Chicago has created an Air Quality of Life Index tool that calculates how much longer people of a certain region would live on average if that region met WHO guideline limits. A Delhi resident would live nearly 12 years longer, a North India resident nearly seven years. And let me not even get started about how air pollution is a social inequity, because this column just doesn’t have enough words for that. But when you are working from home with your air purifier on during a high pollution day, just spare a thought for the waste-picker or construction worker who won’t get her daily wage if she decides to protect her health and stay home, or the traffic policeman who stands among vehicular fumes at intersections, directing traffic, or the autorickshaw driver who won’t earn if he doesn’t drive that day. These are also people who have less access to healthcare and are often also undernourished.

India’s air has been getting filthier over the years. Politicians bring up economic growth as the bogey when urged to act strongly and decisively on pollution. But there is a difference between growth and development — with the latter including a better quality of life through focus on basic needs for all, healthcare, education and well-being. That is the kind of sustainable growth I’d like to see in my country, a place I chose to return to, despite other international options.

Solutions aren’t rocket science and instead of wasting precious tax money on unscientific, ineffectual and performative red herrings such as anti-smog towers (the Delhi government recently spent `44 crore on setting up two large outdoor air filters, which it admitted in Parliament just months later were useless), the government would do well to focus on a proactive bouquet of medium- and long-term solutions that address all the top sources of pollution.

There is only one way to reduce pollution: reduce emissions at source. Nothing else works. Air pollution is nothing but what we burn. India is working on its liquid fuels policy and has frogleaped to BS-6 fuels but it burns two billion tonnes of solid material. Of this 1.1 billion tonnes are coal. Another 600 million tonnes are crop residue burnt by farmers — and biomass for cooking. There is simply no cogent action on solid fuel. No country has been able to address pollution without addressing the issue of pollution from solid fuels. As for useless burning like crackers, frankly, that shouldn’t even cross our minds.

Covid came from outside, but air pollution is an internal enemy. Both need a war room set-up to fight back. But, unlike Covid, where people could see a direct link between the virus and the disease it caused, air pollution is an invisible enemy. Air pollution in India kills nearly 1.7 million each year. Covid killed less than one-third of that number in one year.

For the Covid pandemic, at least the world got together and discovered a vaccine that limited it. For the hidden pandemic of air pollution, we need a social vaccine. ν

Jyoti Pande Lavakare is a co-founder of clean air non-profit Care For Air and author of Breathing Here is Injurious to Your Health: The Human Cost of Air Pollution