NEW DELHI: The centre, on Friday, urged the governments of Delhi and its neighbouring states to prepare for potential healthcare challenges as air pollution poses a serious threat, especially with the upcoming festive season.
The Union Health Ministry also issued an updated advisory to all states on air pollution and asked them to expand the network of sentinel hospitals for air pollution-related illness surveillance.
It also asked them to increase public awareness of activities that could prevent further deterioration of air quality, such as curbing stubble and waste burning, avoiding firecrackers during festivities, and using mass public transport systems.
It has also recommended that states consider city- and district-level plans for schoolchildren and households.
"School health authorities, along with principals, teachers, and parents, have been asked to develop mechanisms in order to create awareness and motivation for adopting better practices among students to mitigate and adapt to air pollution," said the updated advisory.
They recommended wet mopping of school floors, using markers instead of chalk, and encouraging school transport to drop students in order to reduce vehicular emissions. It advised avoiding outdoor sports and exercise, especially for the elderly, pregnant women, and those with comorbidities, especially respiratory and cardiovascular.
In a letter to the health departments of Delhi, Haryana, Punjab, Uttar Pradesh, and Rajasthan this week, Director General of Health Services Atul Goel said air pollution not only accounts for acute illnesses but also precipitates the exacerbation of chronic illnesses of the respiratory, cardiovascular, and cerebrovascular systems.
"The consequences are grave for vulnerable populations such as children, pregnant women, older people, those with pre-existing illnesses, and those exposed due to their occupations, such as those involved in traffic policing and municipality work, etc.," he said.
The states were also requested to issue advisories to hospitals in regard to making necessary patient care preparations anticipating increased attendance in emergencies, outdoor and indoor patient departments of medicine, and paediatric specialities.
"This would require an increased allocation of beds and stock updates on medicines and equipment related to case management," the letter said.
Vulnerable people should seek medical help when they first develop a worsening of their illness or feel discomfort and symptoms due to poor air quality, the letter stated.
In a separate advisory to all states and union territories last month, Union Health Secretary Sudhansh Pant had asked them to establish and expand sentinel surveillance on air pollution-related illnesses, analyse statistics of such illnesses, and share them at the state and central levels for timely action.
The advisory said that the state health departments and healthcare facilities should strictly monitor daily AQI levels during such high air pollution days and months as reported by pollution control boards. Health facilities may provide a daily AQI value to inform people of measures to protect, prevent, and control themselves from air pollution.
"Particulate matter (PM) may potentially serve as a vehicle for airborne transmission of the SARS COV-2 virus. Short-term and long-term exposures to PM2.5 and long-term exposures to NO2 appear to be correlated with increased susceptibility to COVID-19 infection and higher mortality among those infected," it added.
It has also been said that schools should limit outdoor activities during days of higher pollution levels, and physical activities like running, jogging, and playing may be avoided or postponed. Also, school activities, functions, celebrations, and even birthday celebrations should be postponed.
The advisory cited a recent ICMR study on the disease burden and deaths attributed to air pollution among Indians. The study showed that 1.7 million deaths, or 18 per cent of the total deaths in India, in 2019 were attributable to air pollution.
It said that short-term high-level exposures can result in acute health reactions with involvement of various human organs, and patients may present with certain suggestive symptoms like irritation of the eyes, nose, throat, and skin, cough, breathing difficulty, wheezing, chest discomfort, chest pain, headache, giddiness, limb weakness, facial deviation, etc.
Vulnerable groups can experience more severe effects such as lower respiratory tract inflammation and infection, exacerbation of asthma, bronchitis, or exacerbation of chronic illnesses such as chronic obstructive pulmonary disease (respiratory system), ischemic heart diseases, and cerebrovascular strokes, it added.
Long-term exposures to even lower levels of air pollution can result in chronic illnesses of the respiratory and cardiovascular systems, lung cancer, and premature deaths, it stated.