Sunday, January 02, 2022

Doctors say breathing toxic air in Delhi is like smoking 10 cigarettes a day and urgent solutions are needed

By Charmaine Manuel
abc.net.au
1/1/2022
During December, Delhi's daily PM2.5 levels were, on average, nearly 14 times higher than the World Health Organization recommends.
(Reuters: Adnan Abidi)

Months after the Delta variant ravaged India's capital, Delhi, the city's residents are taking refuge indoors once more.

Key points:

Air pollution is a health concern for children and adults in Delhi

Experts say breathing toxic air is equivalent to smoking multiple cigarettes a day

Clean air activists say urgent solutions are needed



But this time, they aren't just shielding themselves from a dangerous virus. They're also protecting themselves from the city's toxic air.

Schools, construction sites and some workplaces were closed briefly in November due to heavy air pollution and the country's chief justice has asked the central government to take urgent action on the "very serious" problem in Delhi.

Delhi's air quality has been steadily deteriorating for years, and it is particularly bad during winter when the cool weather traps pollution and smoke, shrouding the city in a thick layer of smog.

This seasonal phenomenon has huge health costs for Delhi's residents, many of whom are now agitating for change.
No one knows what 'real blue skies' and 'real clean air' feels like

Jyoti Pande Lavakare has personally experienced the human cost of Delhi's air pollution crisis.

In 2017, her mother, Kamala, died from lung cancer which, she said, doctors told her was triggered by air pollution.

Jyoti Pande Lavakare's mother, Kamala, died from lung cancer in 2017. (Supplied)

"She got diagnosed and, in three months, she had passed on and that was a very traumatic time," she said.

Ms Lavakare, a clean-air activist and author, always knew that Delhi suffered from poor air quality, but it was only when she returned from years of living in California that she realised just how bad it was.

"I realised that people who were born and raised in India didn't really know what real blue skies looked like and what real clean air smelled and felt like," she said.

Worried about the impact on her young children, Ms Lavakare, a former journalist, threw herself into researching the health consequences of living in a polluted city.

Concerned by what she learned, she founded a not-for-profit called Care for Air to raise awareness of the health impacts of Delhi's dismal air, activism that became more personal after her mother's death.

"Although I knew myself about air pollution, it was all intellectualised in my head," she said.

"But to see her struggle to breathe and to die in that horrific way was something I felt in my heart."

Farmers in India traditionally burn their fields to improve soil fertility. 
(Reuters: Danish Siddiqui)

Why is Delhi's air quality so bad?

There are multiple contributing factors.

Siddharth Singh, an air pollution researcher and the author of The Great Smog of India, noted that while air pollution is a common problem in cities around the world, the kind of pollution seen in Delhi is "unique to India".

Delhi's air quality worsens when farmers in the neighbouring states of Punjab and Haryana burn their fields in the winter months after the harvest to prepare for the next agricultural cycle.

Siddharth Singh says there are several factors that contribute to India's "unique" air pollution. (Supplied)

Mr Singh explained that changing wind directions and slower wind speeds in winter mean that smoke gets trapped instead of being blown towards the sea.

Another factor was pollution emitted from road vehicles and a dependence on coal to generate electricity — India relies heavily on coal because it's readily available and cheap, Mr Singh said.

Northern India also has thousands of small-scale brick manufacturing businesses — which use fire, coal and simple chimneys — that release emissions and dust into the atmosphere and are a "major contributor to the problem", Mr Singh added.

On top of this, the burning of garbage and biomass such as leaves combine to create a "cocktail of air pollutants", Mr Singh said.
Toxic air means no one is a 'true non-smoker' in Delhi
India's government is changing the way it manages pollution by moving to an "airshed" approach.(Reuters: Adnan Abidi)

Breathing in the toxic air of New Delhi has dire consequences for the city's inhabitants.

It can lead to lower life expectancy and an increased chance of lung cancer, among other illnesses, according to professor and medical doctor Arvind Kumar.

As a chest surgeon at Medanta Hospital in Gurugram — a satellite city of Delhi — and founding trustee of the Lung Care Foundation, Dr Kumar has noticed a significant change in the profile of his patients over the past 30 years.

In 1988, 90 per cent of his patients were cigarette smokers and they were mostly men in their 50s and 60s, he said.

But, by 2018, 50 per cent of his lung cancer patients were non-smokers and from a younger demographic: Most were in their 40s, with some in their 30s and a few in their late 20s.

"When I used to operate on patients, I used to see black deposits on the lungs of known smokers. But, when I used to operate on patients for other chest diseases, in non-smokers, it was a rarity to see black lungs," he said.

These days, when he operated on people, finding a normal pink lung was "a rarity", he said.

Dr Arvind Kumar has witnessed a change in the profile of his patients over the past 30 years. (Supplied)

In a city as polluted as Delhi, "there is no true non-smoker", Dr Kumar added.

This is due to the tiny particulate matter known as PM2.5 (with a diameter of 2.5 micrometres or less), air pollution that is so small it can be inhaled into the lungs and enter the bloodstream.

"So, if today the level of PM2.5 is 220 — which is equal to 10 cigarettes — every newborn today will be smoking 10 cigarettes on day one of his or her life," he said.

Over December 2021, Delhi's daily levels of PM2.5 averaged around 205 micrograms per cubic metre, nearly 14 times higher than the threshold prescribed by the World Health Organization's air quality guidelines.

Ms Lavakare was particularly concerned about the impact on Delhi's children, saying the air is so polluted that "every newborn is a smoker from the day they're born".

"You're setting up your young and your youth for failure," she said.

A boom in air purifiers and oxygen bars

People are paying to breathe in fresh oxygen at oxygen bars in Delhi.
 (Reuters: Anushree Fadnavis)

One of the offshoots of the air pollution crisis is the rise in products and businesses catering to the need for clean, fresh air.

"Air purifiers are a booming industry today," Dr Kumar said.

Cities like Delhi have also seen a rise in oxygen bars, where customers can pay to breathe in pure oxygen.

At one oxygen bar in Delhi, customers can pay 700–1300 rupees ($13–$24) to breathe in flavoured oxygen for around 15 minutes.

Dr Kumar described these ventures as "opportunistic industries" that are trying to "cash in on this health crisis".

Mr Singh noted that, while wealthier residents have the option of staying indoors or purchasing air purifiers, lower socio-economic groups are more exposed to air pollution.

"The poor tend to work closer to the roads. They tend to work closer to the brick-manufacturing units. They tend to work at construction sites, so their exposure to pollution is obviously much, much higher," he said.
Solutions to avoid 'a dystopian future'

In response to the country's air pollution problem, India's central government launched the National Clean Air Program (NCAP) in 2019.

The NCAP targets air pollution in around 132 cities in India and aims to reduce pollution concentrations by 2024.

Mr Singh was not optimistic about NCAP's success because air pollution "is not just an urban problem".

Some experts say "smog towers", which are basically 20-metre-tall air purifiers, are ineffective.
(Reuters: Adnan Abidi)

The ABC contacted the Environment Minister in the Delhi government, Gopal Rai, as well as pollution control entities at the state and central government level but did not receive a response.

What was needed, Mr Singh said, was "a shift from an urban approach to an airshed approach".

An airshed, he explained, was a region with "common geographical and meteorological traits that make air pollution in that region very similar".

India's Environment Minister, Bhupender Yadav, recently announced the government would revise its approach to air pollution and would focus on airsheds instead of urban centres.

The Delhi government has also attempted to tackle air pollution in the city by building smog towers, which are designed to purify the air around them.

Both Dr Kumar and Ms Lavakare consider this solution to be ineffectual and a waste of money.

Dr Kumar said air pollution could not be solved by allowing the air to be polluted and then cleaning it.

It was the sources of pollution that needed to be controlled, he stressed.

But there was also the question of political will.

Air pollution was "not a major electoral issue", Mr Singh said, because there were more-pressing developmental challenges such as "poverty, economic growth, jobs, inflation" along with other political and cultural issues.

Jyoti Pande Lavakare became a clean-air activist and is worried about the impact of air pollution on her family. (Supplied)

Air pollution is the second crisis Delhi's residents have lived through in 2021 after the pandemic.

However, Ms Lavakare said that its government was not taking air pollution as seriously as COVID-19 and that it had fallen to civil society groups such as hers to do the government's job in spreading awareness.

"It's really a dystopian future unless the government gets its act together," she said.

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