The global mortality data associated with air pollution is staggering. The World Health Organization says air pollution is linked to one in nine deaths and 7 million premature deaths every year. According to the State of Global Air 2024 report, air pollution caused 8.1 million deaths in 2021, making it the second most important risk for mortality, especially among children under five. Every year, 6.7 million people lose their lives prematurely due to the combined impact of poor indoor and outdoor air. Outdoor pollution accounted for 4.2 million of these deaths, primarily from cancer, respiratory infections and cardiovascular disorders.
Almost 90 percent of these deaths occur in low- and middle-income countries like India, which are disproportionately affected. In 2023, India was the second-most polluted country in the world. One of the key indices is particulate matter (PM), which is not a single pollutant, but a dangerous concoction of solids and aerosols. It contains inorganic ions, metallic and organic compounds and carbon. PM with a diameter of 10 microns or less (PM10) are inhalable and thus have serious health implications. Emissions from vehicles produce much of the PM2.5 found in outdoor air, as well as a significant proportion of PM10. Both of these induce tissue damage, lung inflammation and trigger DNA mutations leading to cancer.
Though it’s not the only cause, vehicular emissions play a significant role in escalating air pollution. In the national capital, vehicular pollution accounted for 40 percent of PM2.5 emissions. In 2024, Delhi recorded an annual average PM2.5 level of 107 micrograms per cubic metre (µg/m3)—over two-and-a-half times the safe limit of 40µg/m3.
The rising levels of PM2.5, which penetrate deep into our lungs and bloodstream, pose a grave health risk, especially for children, elderly and other vulnerable groups with existing conditions. In children, PM2.5 has also been linked to sub-optimal cognitive development and other mental health issues like anxiety.
As a pulmonologist practising for 25 years, I have witnessed a distressing rise in the number of respiratory and other issues, likely linked to air pollution in the last few years, across the board in children, adults and the elderly. There is a rise in air pollution-related life-threatening health issues such as severe asthma and other pulmonary diseases, cancer and several cardiovascular issues.
About 1.1 billion Indians currently live in areas where the PM2.5 levels exceed the National Ambient Air Quality Standards. It will, therefore, not be an exaggeration to say that the rising air pollution is not just a regulatory or governance issue. It is a public health emergency of grave significance, as it hampers the overall quality of life of billions, causing endless human suffering and lowering our productivity and contribution to the society.
On the economic front, air pollution has a debilitating impact on GDP growth and per-capita income levels. The problem manifests itself in myriad ways: lower labour productivity, lower consumer footfall, premature mortality, lower asset productivity, higher health expenses and welfare losses. According to a 2019 report by Dalberg, air pollution costs Indian businesses about $95 billion every year, around 3 percent of GDP.
By 2040, an estimated 270 million people are likely to be added to India’s urban population. Transport is currently one of the fastest-growing sectors in terms of energy demand, with urbanisation catalysing this growth. The ownership of private vehicles is skyrocketing amid stagnant public transport use. Now, only about 39 percent of the population has access to public transport. We must urgently develop and upgrade our mobility infrastructure to cater to the rising urban population adequately and prioritise investing in low-carbon and sustainable solutions like electric buses.
Another urban lifeline, the metro rail system, currently carries about 1 crore passengers daily. The government should also prioritise investments to ramp up the last-mile connectivity to metros across cities to improve ridership. Enabling systemic changes that can make public transport solutions accessible and efficient for citizens will go a long way in improving our mobility patterns and have a lasting positive impact on the overall quality of life.
Imposing stringent norms on vehicular emissions is another high-impact intervention for air quality improvement. There are ample global case studies from American and European cities that clearly demonstrate how enforcement of strict emission norms drastically improves air quality and public health. Implementing the Corporate Average Fuel Efficiency or CAFE III and IV norms, released last year by the government, can be a highly impactful approach. By shifting to zero emission vehicles, our children and society can breathe and live in a better, more sustainable world.
As things stand now, the exponentially rising menace of hazardous air is nothing short of a rapidly rising pandemic. While India has set an ambitious 40 percent air pollution reduction target by 2026, the ground reality is grim, and the target is distant. Time is running out to save millions of lives. We must act decisively—and the time for that is now.
(Views are personal)
Dr Ravindra Mehta | Head of integrated pulmonology department, Apollo Hospitals