Take a Deep Breath and Die

OVERNIGHT, PM 2.5 and PM 10 have become household names in the national capital and adjoining states, and the doomsday scenario of dystopian fiction and films appears to be coming to life. Pulmonologists say the prevailing air pollution levels puts patients suffering from chronic obstructive pulmonary disorder (COPD), stroke and heart ailments in great jeopardy. Vulnerable groups such as former smokers, the healthy elderly and those with respiratory conditions are also at an abnormally high risk. And suddenly reports have begun to surface about how unhealthy it is to live in most cities of India, especially Delhi.

According to a report by the Lancet Commission on Pollution and Health, more people die in India than any other country due to pollution. The situation is worse than in China, which has long been featured for its injudicious development and housing of hazardous industries to generate jobs for its working-age population. Of the total 9.5 million pollution-related deaths in 2015, 2.5 million were in India alone. The study also points out that many of the killer chemical pollutants are yet to be identified. PM 2.5 are fine particles that create a dangerous haze in the air and sky. According to the United States Environmental Protection Agency, these are 30 times smaller than a strand of human hair and made up of hundreds of different chemicals emitted mostly from construction sites, unpaved roads, smokestacks and so on. PM10 are similar inhalable particles, with diameters of 10 micrometers. Both can be viewed only with the help of an electron microscope. It is bits of such particulate matter that wreak havoc, getting deep into the lungs and even the bloodstream.

The Air Quality Index (AQI) is a yardstick for measuring air pollution levels on a scale of 0 to 500. While 0 to 50 is the ideal of good air, 300 to 500 is considered hazardous. In New York, the figure as on November 9th was 22, in Toronto 34, in Bengaluru 93, and in Beijing, seen as one of the world’s most polluted national capitals, it was 117. In Delhi, the average was recorded as 316, but inching closer to 1,000 near RK Puram and Punjabi Bagh.

A public health emergency warning has gone off in Delhi with the AQI going above 500 in some parts and off the charts in areas such as Rohini, which is closer to regions in Haryana and Punjab where farmers burn their post-harvest crop stubble this time of the year, which is said to contribute hugely to the suffocation. Multiple pulmonologists have come out with warnings asking people to stay indoors. “Merely breathing Delhi air is equivalent to smoking 30-40 cigarettes a day,” says Delhi-based chest specialist Dr Hemant Kalra. As the air worsens, the Delhi government has shut schools and halted construction work.

While stubble burning adds to air pollution woes, road dust, often a by-product of rampant construction, has been identified by an IIT Kanpur study as the biggest source of suspended particulate matter in Delhi. Last month, the chief of the Environment Pollution (Prevention and Control) Authority asked the government to identify ‘high-impact’ roads that needed repair. Besides, city planners have often decried lack of any effective regulation of construction in the city. No specific hours are fixed for construction work, transportation and storage of construction material. Most often such materials, including sand, are whimsically loaded on the roads and in residential areas without meeting any safety norms. “Such insensitivity that builders often show in the absence of any effective implementation of even existing rules have thrown life out of gear even in other months of the year, not just in winter when particles tend to collect more in the air,” says a city planner.

In the NCR, tourism has been badly hit, cases of COPD and other lifestyle-related diseases have spiked. An AIIMS doctor has said the use of N95 respirators (masks are widely believed to be efficient in the filtration of airborne particles) and air purifiers isn’t enough to fight off the high pollution levels in Delhi. Dr Kalra warns that masks should be used only after consultation with pulmonologists, especially in the case of patients with a long history of respiratory diseases. Some experts have compared the plight of Delhi residents to the dreaded 1952 Great Smog of London, when cold and windless conditions in December killed close to 4,000 unsuspecting Londoners in four days. AIIMS Director Randeep Guleria, also a renowned pulmonologist, while acknowledging the rise in awareness among people, has said the situation in Delhi could be life-threatening for even healthy people.

Hospitals in the national capital have seen a surge in patient admissions with respiratory illnesses, but to compare the current situation to the Great Smog may create unnecessary panic. Yet, there are lessons Delhi can learn from how cities such as London, Brussels, Beijing and Paris successfully grappled with similar man-made disasters accompanying large-scale manufacturing and construction. They have translated words into deeds to become cleaner and healthier at a fast clip. As the Delhi government said in a health advisory, the smog in Delhi is a mixture of carbon monoxide, particulate matter such as PM2.5, PM10, ground level ozone and oxides of nitrogen and sulphur dioxide, and this health hazard has to be fought with the ruthless implementation of clean air laws.

Though pollution levels are always acute, a combination of factors around this time of the year turns north India into a poisonous smokehouse. More studies are in order to understand the key contributors to this phenomenon. The festive and wedding season leads to much more vehicles on the roads and bad traffic management results in engines idling at long signals. Others believe bursting of crackers also has a role to play. Anuj Guglani, CEO of World Auto Forum which connects auto vendors, auto makers and dealers in 125 countries, believes scientists need to probe the role of diesel fuel in vehicular pollution. Some scientists have asserted that most diesel fuel used in India is adulterated and therefore responsible for high PM2.5 levels. Guglani says, “We need all vehicles and diesel generator sets to be connected to a Central Pollution Control Board control room for real-time emission data monitoring and corrective action. It can be done by getting data through a GSM chip from oxygen sensors in the engine.” He is of the view that the anti-air pollution drive gets defeated at the level of PUC (Pollution Under Control) networks. “They need better analysers, maintenance and trained manpower. They too should transmit data of each tested vehicle to a CPCB control room for the corroboration of results. Additionally, we need a comprehensive, neutral study on the impact of all pollution sources, specifically the diesel particulate matter. Petrol and diesel prices should be the same for personal vehicle users,” he says, emphasising that the Government needs to promote gasoline vehicles for personal use.

The Government will have to offer incentives to farmers dispose of their excess straw through ways other than burning. It was unable to curb the bursting of firecrackers during Diwali despite a Supreme Court order, but needs to realise that desperate times call for desperate measures. In the US, authorities even took on the mighty automobile industry to ensure that people have the right to breathe pure and clean air. A comprehensive Clean Air Act and stringent implementation of such laws are the way forward to save residents of most parts of north India from the short- and long-term effects of this scourge.

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