The Hindu Business Line - - PULSE - PT JYOTHI DATTA Air pock­ets

As State gov­ern­ments wring their hands over how to solve a prob­lem like air pol­lu­tion, the grim truth is that pol­lu­tion is not just at our doorsteps, but in­side our homes as well.

Res­pi­ra­tory com­pli­ca­tions are the sin­gle most com­mon com­plaint that doc­tors across the coun­try are see­ing dur­ing their con­sul­ta­tions, and this is re­gard­less of age, be it new-borns or adults. So, while high-deci­bel dis­cus­sions dom­i­nate an­other sea­son of fes­tiv­i­ties on the right to fire a cracker ver­sus the right to breathe clean air, mem­bers of the med­i­cal fra­ter­nity are of the opin­ion that Delhi’s state of air emer­gency should sound a warn­ing bell for the rest of the coun­try as well. And a key part of the so­lu­tion lies in the hands of the peo­ple, say doc­tors, as pol­i­cy­mak­ers seem to speak more for their re­spec­tive States and less from the point of view of what’s good for the en­tire coun­try.

“Delhi should have been made cracker-free this Di­wali,” says Dr KK Ag­gar­wal, se­nior con­sul­tant physi­cian and car­di­ol­o­gist and a key voice on air pol­lu­tion, who has been send­ing recorded pub­lic health mes­sages on the dos and dont’s on a bad air day. Pol­lu­tion fluc­tu­ates over days and out­door pol­lu­tion from ve­hi­cles, ir­re­spon­si­ble con­struc­tion ac­tiv­ity, stub­ble burn­ing, etc, con­trib­utes to health prob­lems, just as in­door pol­lu­tion in­volv­ing dust­ing, light­ing can­dles or agar­bat­tis (in­cense sticks), he says, adding that there re­ally is no more time for never-end­ing dis­cus­sions. “A 28year-old-boy died, sud­denly, some days ago,” he says, warn­ing that cases of sud­den heart at­tacks can be pre­cip­i­tated by pol­lu­tion.

“It has been a rain of pol­lu­tion, or a flood of pol­lu­tion. And the same level of ac­tion is re­quired to tackle it as there was when the floods hit Ker­ala,” he says. “Delhi has to be treated like a model, as it is the most pol­luted,” stresses Ag­gar­wal, for­mer head of the In­dian Med­i­cal As­so­ci­a­tion, call­ing for guide­lines on all com­bustible and pol­lut­ing ac­tiv­ity. It needs a com­pre­hen­sive ap­proach to tackle pol­lu­tion at ev­ery level — from agar­bat­tis to the cre­ma­to­rium, he says, pulling no punches. Lay­ing the re­spon­si­bil­ity at the doorstep of cit­i­zens, he says, “Peo­ple need to see what the pol­lu­tion level is and au­to­mat­i­cally act by tak­ing a car pool or pub­lic trans­port, for ex­am­ple,” he says, call­ing for re­spon­si­ble be­hav­iour, un­like the de­fi­ance some­times shown by cit­i­zens. Air pol­lu­tion is hard to es­cape, no mat­ter how af­flu­ent the area you live in. Mi­cro­scopic pol­lu­tants in the air can slip past our body’s de­fences, pen­e­trat­ing deep into our res­pi­ra­tory and cir­cu­la­tory sys­tem, dam­ag­ing our lungs, heart and brain.

Nine out of 10 peo­ple breathe pol­luted air, which kills 7 mil­lion peo­ple ev­ery year.

One-third of deaths from stroke, lung cancer and heart dis­ease are due to air pol­lu­tion. The health ef­fects are equiv­a­lent to smok­ing to­bacco and higher than, say, the ef­fects of eat­ing too much salt.

Ambient air pol­lu­tion im­poses enor­mous costs on the global econ­omy, at over $5 tril­lion in to­tal wel­fare losses in 2013. For in­stance, ini­tia­tives like al­low­ing cars with odd and even num­bers on al­ter­nate days are cir­cum­vented by peo­ple keep­ing mul­ti­ple cars, miss­ing the rea­son be­hind the ini­tia­tive. Or the more re­cent fire-cracker ban, where peo­ple de­fied both air and noise pol­lu­tion warn­ings and con­tributed in­stead to the over­all health emer­gen­cies that doc­tors are hav­ing to deal with.

Why do we ig­nore air?

Su­jeet Ra­jan, a con­sul­tant res­pi­ra­tory physi­cian with Bom­bay Hos­pi­tal, says In­dia has a high bur­den of res­pi­ra­tory dis­eases. The num­ber of early deaths caused by toxic air in In­dia is ex­pected to ex­ceed 6 lakh a year.

When the air qual­ity in­dex shows high pol­lu­tion, the ef­fect is im­me­di­ate, says Ra­jan, in terms of in­creased mes­sages from his pa­tients. “The lungs are ex­tremely vul­ner­a­ble,” he says, re­fer­ring to the sweep of ill­nesses, from asthma to COPD (chronic ob­struc­tive pul­monary dis­ease) to struc­tural lung dis­eases and hy­per­sen­si­tiv­ity pneu­moni­tis, where the lungs be­come in­flamed as an al­ler­gic re­ac­tion to in­haled dust, fun­gus, moulds or chem­i­cals. “We eat 2-3 kg of food and drink 2-5 litres of wa­ter a day and take great care of what we eat and drink. But we breathe 10,000 litres of air ev­ery­day and don’t bother about the air we breathe, ” he says. Ra­jan too feels the power lies with peo­ple, to ex­er­cise re­spon­si­ble be­hav­iour in tak­ing pub­lic trans­port or en­sur­ing more green spa­ces. The day is not far when peo­ple go be­yond masks and wear nasal de­vices, fil­ters, etc, he says.

In the ab­sence of a na­tional pol­icy to tackle air pol­lu­tion, Ag­gar­wal sug­gests a Supreme Court­mon­i­tored com­mit­tee em­pow­ered to di­rect across min­istries and States, for a co­her­ent ap­proach on is­sues from au­to­mo­biles to realty, crack­ers to stub­ble burn­ing, be­sides pro­tec­tion of the coun­try’s green spa­ces — all of which af­fect the air we breathe.

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