Doctors blame air pollution for sharp rise in respiratory diseases in India
A sharp rise in cases
of chest and throat disease in India is being blamed by doctors on worsening
air pollution in the country, which is now home to 13 of the 20 most polluted
cities in the world.
According to India’s
National Health Profile 2015, there were almost 3.5m reported cases of acute
respiratory infection (ARI) last year, a 140,000 increase on the previous year
and a 30% increase since 2010.
The number of ARI cases
has risen steadily in India over the last 15 years, even when population growth
is taken into account. In 2001, less than 2,000 cases per 100,000 people had an
ARI. In 2012 the number was 2,600 per 100,000, statistics show.
The rise has occurred
despite steady improvements in medical care and nutrition, as well as a shift
away from using wood as fuel in rural areas. Together this has mitigated many
factors long blamed for the high levels of respiratory diseases in India.
Doctors are blaming the
increasing severity of the problem on unprecedented decline in air quality
across India. “Due to the awareness drives conducted about diseases like swine
flu and influenza, people have become more aware ... Yet air pollution is
playing a major role in increasing the numbers of such diseases,” Dr Jugal
Kishore, head of community medicine at Delhi’s Safdarjung hospital, told the
local India Today news magazine.
Attention to the
problem of air pollution in India has so far focused almost exclusively on the
capital. One study found that half of Delhi’s 4.4 million schoolchildren would
never recover full lung capacity.
But the rest of India
has received less attention, though in many cases the problem is almost as
acute, or possibly worse. The latest government figures show high numbers of
lung and throat infections in the eastern state of West Bengal, the central
state of Andhara Pradesh, as well as in tourist favourites Kerala and
Mumbai also has
pollution levels which, though lower than in Delhi, exceed safe limits set by
the Indian government many times. Those limits are significantly higher than
those set by international experts and western governments.
This summer, some
reports suggested that Chennai experience worse pollution than anywhere else in
India. Though the data has been challenged, it is clear that the levels of
hazardous gases such as carbon monoxide, nitrogen dioxide and ozone, as well as
of deadly fine particulates, in the southern city have consistently breached
the World Health Organisation’s maximum safe limit.
“I always thought there
was some washing off of pollution here due to the coastal breeze. But that
seems to be wishful thinking,” said Prof Sudhir Chella Rajan, a specialist in
urban air pollution at the Indian Institute of Technology Chennai.
Campaigners point out
that the focus on Delhi has distracted from problems elsewhere. “Some reports
are alarmist but in general, for sure, parts of Chennai are definitely worse
than Delhi,” said Shweta Narayan, an activist.
Other major regional
centres, such as Mumbai, Bangalore, or Bhopal are also badly affected.
“The older parts [of
the Bhopal] have horrendous air. There’s no mass transit system, lots of very
old substandard vehicles, open fires. It’s very serious,” said Nityanand
Jayaraman, an environmental campaigner who regularly visits the Madhya Pradesh
individual cities around India are rarely identified by official figures,
either on the prevalence of respiratory illness or air quality.
The worst affected
areas of Chennai, which has a population of around 4 million people, lie on its
northern rim, where petrochemical works, car factories and coal-burning power
stations exist close to residential areas. In July, levels of deadly PM2.5
particulates in the Manali neighbourhood were four times the WHO safe limit.
These particulates lodge in the lungs and allow heavy metals to enter the
In other cities across
the country the problem was even worse. In Ahmedabad, in the west, levels of
PM2.5s peaked at eight times the WHO limit for a 24-hour average. In Lucknow,
in the north, levels reached seven times the limit. Levels of CO2, nitrogen
dioxide and ozone in less known cities have also regularly exceeded WHO
guidelines by huge margins.
India has the highest
rate of death from respiratory disease in the world, according to the WHO,. The
rate was 159 per 100,000 in 2012, about 10 times that of Italy, five times that
of the UK and twice that of China.
Officials in Chennai
say they are aware of the problem, and point to measures from the new $3bn
(£2bn) metro to the construction of traffic islands as evidence of their intent
to tackle it.
But similar mass
transit systems across India do not have a significant immediate impact on
pollution, experts say. Most are too small and have been built too late.
Studies show that Delhi’s metro users previously travelled on buses, by
bicycles or on foot, not in cars.
One effective, and
considerably cheaper, scheme in Chennai has been the introduction of minibuses
on smaller roads between the major bus routes. “It has worked and been very
popular,” said Narayan.
The problem has a
broader cultural aspect too. In India, as in the west in the 1950s and 1960s,
cars bring not just mobility and convenience but are tangible symbols of social
On a sheet of paper
pinned to a wall of the spotless Alandar station, contented passengers have
scrawled their impressions of Chennai’s month-old metro. “Very wonderful,
fantastic, unforgettable,” they gush.
Natarajan Ramesh, an
off duty policeman buying a ticket in the station’s cavernous entry hall, was
also impressed. “It is very nice. It is the need of the hour. It will help
commuters travel in such a quick span of time and is very clean too,” he said.
However, Ramesh’s own
ambitions are less environmentally sensitive. “My dream is to have a car,” he
said. “Trains are all nice and useful but not the same as a car. I would like a
Honda, or maybe a Volkswagen.”
The number of vehicles,
including motorbikes, on Chennai’s roads has more than trebled in 15 years. In
Delhi and many other cities the increase has been even greater. Hundreds of
smaller towns, for which there are no reliable air quality figures available,
have horrific congestion and pollution from ageing power stations and poorly
There is still hope for
improvement, though only in the long term. Officials in India no longer deny
there is a problem and air pollution is fast becoming a significant political
issue for many wealthier urban residents.
On Tuesday, a joint
initiative by police and local businesses led to a “car free day” in Gurgaon, a
satellite city of Delhi. Though only a limited number of roads were shut,
pollution levels dropped dramatically, local newspapers reported.
Pollution expert Raja
worked for five years at the Californian Air Resources Board. The air in the US
state, once infamous for its smoggy cities, is now cleaner than in decades,
even though problems remain.
“They have done an enormous amount … but it
took 40 years. Here [in India] air pollution is probably going to be very
severe for a couple of decades before it gets any better,” he said.