Whether at the Asian Games held in Indonesia last year, 2019 Singapore Grand Prix,or the ongoing Rugby World Cup in Japan, the alarming levels of air pollution have kept everyone on tenterhooks. Counted among the top five causes of death, air pollution in Asia is a public health crisis that demands immediate action. Is staying indoors the best solution? asks Jisha Krishnan
By Jisha Krishnan
“The air is pure,” says Kanchana Prasad, quite a few times, as she talks about her 11-year-old’s move to a boarding school, in the lap of nature, more than three years ago. “We could see the difference within a month. His wheezing had reduced, lung capacity had gone up, allergies were gone…you know, he actually plays outdoor sports now,” affirms the corporate communications professional from Bengaluru.
According to the World Health Organization (WHO), 90 per cent of the global population breathes air containing high levels of pollutants. Air pollution is the fourth-highest cause of death in the world – after smoking, high blood pressure and poor diet. The latest report by the Air Quality Life Index (AQLI) shows that particulate air pollution can reduce life expectancy by an average of two years. Another report from India’s Centre for Science and Environment has a concurring finding: Life expectancy for South Asians has reduced by about 2.6 years because of poor air quality.
Expectedly, the effects are worse in the more polluted parts of the world. Over 90 per cent of air pollution-related deaths occur in low- and middle-income countries, mainly in Africa and Asia. 15 Indian cities feature in the notorious ‘20 most polluted cities in the world’ list. As per the Global Burden of Disease Study, 1.2 million Indians died in 2017 due to unhealthy air. And nearly 38 million years of healthy life were lost due to air pollution. The air we breathe presents one of the biggest global health crises today.
Changing contexts
Whether at the Asian Games held in Indonesia last year or the ongoing Rugby World Cup in Japan, the worrisome levels of air pollution have kept everyone on tenterhooks. At the recently-concluded Singapore Grand Prix, organisers were busy keeping tabs on haze readings. In Malaysia, the Youth and Sports Ministry is said to be working on its first-ever ‘work from home’ policy, in the wake of worsening air pollution levels.
“Air pollution increases disease risk largely through particulate matter, particularly PM 2.5,” says Dr Shivaraj A L, Consultant Pulmonologist, Columbia Asia Hospital, Bengaluru. “Blame it on industrialisation, surge in vehicular traffic, or unsystematic urban development, the growing incidence of asthma cases in our cities bears testament to the heavy price that our lungs are paying,” he maintains.
Persistent coughs, runny nose, irritation in the throat, watery eyes, wheezing and chronic fatigue are often tell-tale signs of unhealthy air quality. Studies show that prolonged exposure to air pollution increases an individual’s risk of cardiovascular diseases (CVDs), neurological disorders, strokes, chronic respiratory diseases, lung cancer and even premature death. In children, it can impair cognitive development as well as weaken immunity.
A thought-provoking study, published in the New England Journal of Medicine, used data from 652 cities in 24 countries to find that as the concentration of particulate matter (PM 2.5 and PM 10) increased, so did the number of deaths. Another research finds that air pollution exposure increases the risk of infertility, metabolic syndrome and polycystic ovary syndrome. Recently, Belgian scientists found that air pollution can reach the placenta during pregnancy. While conclusive evidence of the damage caused is yet to be established, the possibilities are perturbing.
Mental health matters
In the meanwhile, there are several studies that have found strong links between air pollution and mental health. People who grow up in areas with poor air quality are more likely to develop depression and bipolar disorder later in life, suggests a study by researchers at the University of Chicago. In collaboration with Denmark’s Aarhus University, the team found that there was a 29 per cent increase in mental health disorders for people living in the most polluted areas. Similar studies in the US, London, China and South Korea have also found links between poor air quality and poor mental health.
Researchers at the King’s College London have established that people living in heavily-trafficked areas are 40 per cent more likely to develop dementia. A later study by the University of New South Wales supports the finding: People with long-term exposure to PM 2.5 and nitrous oxide (NO2) are more likely to develop dementia later in life.
From impaired judgement and poor academic performance to growing anxiety and higher levels of crime, scientific studies link air pollution to a whole gamut of issues. In a recent paper published in the journal Nature Human Behaviour, researchers at MIT note that air pollution has a broader impact on people’s social lives and behaviour. On days when air pollution levels in Chinese cities were higher, the scientists noted, people were more likely to engage in impulsive and risky behaviour, possibly as a result of short-term depression and anxiety. Air pollution, the research infers, is a major contributing factor to urban unhappiness.
Catch-22 situation
As people are increasingly advised to avoid outdoor activities to protect themselves from the harmful effects of air pollution, will we all just eventually have to stay indoors for good? How will that impact the obesity epidemic, considered to be the greatest risk factor for lifestyle diseases?
“Given our sedentary lifestyles, obesity has become a chronic health condition that increases the likelihood of developing a host of ailments, such as heart diseases, diabetes, strokes and even asthma. We cannot afford to forgo daily physical activity because of poor air quality. I recommend indoor games, especially for older patients and those with lower immunity,” states Dr Shivaraj.
However, indoor air pollution is also a matter of concern. Studies say that it is a leading contributing factor to CVDs in middle and low-income countries in Asia. “Contrary to popular perception, it’s not just the biomass fuels in rural households that cause air pollution. Poorly-maintained AC systems and humidifiers, indoor smoking, pets, etc., are shown to mar the air quality in most city homes. Yet, we live in blissful ignorance, seeking short-term relief for recurring health issues. We simply don’t realise the magnitude of the problem,” rues Dr Shobha Sharma, who is currently working on a thesis on air pollution at a government hospital in Mumbai.
In his deeply insightful book, The Invisible Killer, Dr Gary Fuller, an air pollution scientist at the Analytical and Environmental Sciences Department, King’s College London, UK, notes that there has been a reluctance to acknowledge air pollution because it is – for the most part – invisible. It’s only in the recent past that athletes have started complaining about poor air quality.
Although studies about the hazards of air pollution have existed for some time, it’s just over the last decade or so that the majority of humanity has woken up to this health threat. But beyond ozone alerts, stocking up on disposable face masks, and unscheduled holidays for schools, what else are we doing to fight air pollution?
Learning from China
The 2008 Summer Olympics in Beijing was a turning point for China. The mega-sports event prompted the country – recording an average of 1.1 million premature deaths annually due to air pollution – to make air pollution an integral part of its development policy and an economic agenda. After all, poor air quality was costing the Chinese economy $38 billion, noted researchers at The Chinese University of Hong Kong.
Within a year, the environmental regulation recorded a 30 per cent improvement, resulting in a corresponding drop in cardio and respiratory diseases among Beijing residents. Soon, heavy-polluting plants were shut down, while other factories relocated away from populated areas. Farmers were given government subsidies to encourage recycling. Targets were set to reduce air pollution year on year.
In a persistent endeavour to move on from its coal-burning past, China has been investing in clean energy-generating sources like solar power, wind farms, hydro and bio-energy. Today, as the world’s largest consumer of solar power, China has come a long way in its fight against air pollution. However, there are still miles to go.
Unquestionably, the Asian neighbours have valuable lessons to learn from China. Earlier this year, the Indian government introduced the country’s first National Clean Air Programme that aims to bring down the pollution levels in about 122 cities by 20-30 per cent by 2024. Without strict legislation and government intervention to curb air pollution and embrace clean energy, India’s dream of hosting the 2032 Summer Olympics, will remain a pipedream.
And children will have to live in boarding schools, far away from the toxic waste of cities, to breathe pure air and play outdoor sports.
