Former AIIMS Director and currently Chairman of Respiratory & Sleep Medicine at Medanta Hospital, Dr Randeep Guleria, speaks to Ashish Srivastava on how pollution impacts human health, especially vulnerable groups—children and the elderly.
Excerpts
We spoke last year as well on the same topic. Did you notice any improvement this time?
Given the measures put in place to address the emission source, one would have expected that the AQI would be better this year. Unfortunately, the air quality started to deteriorate even earlier than anticipated. The AQI may not be as dangerous as a reading of 800, but we can’t be sure that it won’t reach there as the climatic conditions would not favour the dispersion of pollutants as winter deepens.
How are chronic respiratory patients affected?
Such patients are increasingly ending up in emergencies with severe breathing problems. The use of nebulizers and inhalers has increased significantly. Even healthy individuals are complaining of chest congestion and breathlessness.
What is the impact of long-term exposure to a vulnerable population?
It is akin to constant smoking. Data now shows that prolonged exposure to pollutants, particularly PM 2.5, is linked to the progressive worsening of respiratory and cardiac problems in people with underlying health issues. Some studies also suggest a heightened cancer risk.
Any impact on those without medical history?
New research on long-term exposure shows that high pollution levels impact the entire body. We now know PM 2.5 causes persistent inflammation and changes in autoimmune responses, which are linked to cancer development. People in highly polluted areas report higher rates of strokes and dementia. Diseases like diabetes and arthritis are also associated with ongoing exposure to poor air quality. Additionally, children born in such regions often have reduced lung capacity and face a higher risk of respiratory illnesses. A New York study found Covid death rates were higher in heavily polluted areas.
Given severe health impacts, could it lead to overwhelming the healthcare system?
Air pollution has become the second most common cause of morbidity and mortality after conditions like diabetes and heart disease. The latest State of Global Air 2024 report links air pollution to 8.1 million deaths—a staggering figure, even higher than the death toll from Covid that year. This rising toll will likely increase non-communicable diseases, leading to more hospitalizations and further straining the healthcare system.
There has been debate on the immediate measures and long-term solutions to address pollution. Your comments?
We need to look at this holisticly. A preventive approach should be taken to guard the vulnerable population who are more susceptible. We need to explore scientific solutions and ensure their on-the-ground implementation. The mere announcement would not work. One thing that has worked is monitoring the air quality. It has been limited to metro cities so far and should be expanded to Tier-III and IV towns.
Your say on temporary measures like odd-even rules, crackers and construction bans?
These measures have been in place for nearly a decade. However, their effect is not visible. We need to work more on sustainable solutions. For example, Delhi’s air quality was terrible in the late 90s, but the introduction of CNG in the early 2000s led to significant improvement. Unfortunately, we lost those gains with the rise of diesel vehicles due to a lack of a long-term strategy.