Javadekar Doesn't Think Bad Air Affects Mortality. Bad Air Does Much Worse.

Air pollution has been linked to depression, reduced cognitive function, dementia, brain cancer, chronic obstructive pulmonary disease and many, many other diseases.

The evidence is chilling. The time for blame-games is long past. There is also no need to point fingers because we’re likely past the point of no return. According to the latest WHO data, the world’s highest PM2.5 levels are to be found in India. We currently have 16 of the world’s 30 most polluted cities. These are remarkable figures that should surely be discussed fiercely on all TV channels every night.

Granted, the reading-down of Article 370 and the Supreme Court’s verdict on the Ayodhya title case merit serious debate – but the air around us is a killer. More people will die in this country each year than all wars put together as a result. Yet one does not see a proportionate outcry, even by the citizens of Delhi. Union environment minister Prakash Javadekar is in fact in denial, when he said on December 6 that there is no link between air pollution and mortality.

Mercifully, also according to the WHO, the most polluted city on the planet is in Nigeria, a port-city named Onitsha. But Delhi cannot be far behind. The national capital recently bore the brunt of crop-burning in its neighbouring states. The air quality was horrendous then but is still potentially carcinogenic today. One doubts there will be a single day in Delhi when we will all be safe from bad air in the future. The population is rapidly climbing, construction work continues unabated, and there appears to be no solution on the horizon for vehicular pollution. Ironically, the slash in car and two-wheeler sales could not have come at a better time, but the streets of Delhi are infested with traffic that churns out toxic air every minute of every day.

Somehow, the consequences of bad air don’t appear to sink in. We are indeed a stoic people, with the Mahabharata marvelling at the fact that we carry on living without the slightest acknowledgement of our imminent death. It has become a stale cliché to enumerate the horrible ways one can suffer by breathing the toxic air. We now know that just about every cancer in the body can be caused by PM2.5 particles because they can affect every cell of the body. Doctors also know that bad air causes asthma, bronchitis and, of course, lung cancer. When PM2.5 particles enter the blood, they affect the entire cardiovascular system and could create a chronic inflammatory condition. The person concerned becomes acutely vulnerable to high blood pressure, heart attack, heart failure and stroke.

We are therefore looking at astronomical mortality figures, despite what Javadekar might think.

The biggest killer in the world continues to be cardiovascular disease, responsible for over 15 million deaths a year, but a significant fraction is due to air pollution. The WHO is clear that air pollution kills around 7 million people each year. More than 80% of people living in cities around the world that monitor air quality are exposed to toxic air. The numbers are as staggering as our apparent lack of interest in fighting this scourge. while the response of people who matter in this country continues to be jaw dropping.

In August this year, scientists published a study of people from 652 cities showing independent associations between short-term exposure, of only two days, to PM2.5 and PM10 matter daily – and cardiovascular and respiratory mortality. A mere increase of 10 micrograms per cubic meter of PM2.5 and PM10 levels in the air was associated with a 36% increase in cardiovascular death and 47% increase in respiratory mortality. These figures are from regions across the Northern Hemisphere; the particular situation in India is bound to be more dire.

Scientists recorded the connection between particulate air pollution and mortality around 70 years ago. There was clear evidence even then that the number of deaths increased with higher levels of particulate matter (or PM) in the air. The Dutch Environmental Longitudinal Study reaffirmed this conclusion in 2015 with a study of seven million people. The Chinese have very elegantly shown that bringing down particulate air pollution reduces stroke mortality. Air pollution ranked as the 11th most important risk factor of death and disability in the US, while chronic obstructive pulmonary disease (COPD) is the third-most common cause of death and disability.

Crucially, half of all COPD patients have the disease because of poor lung growth rather than due to declining lung function. Every child in Delhi breathing toxic fumes is susceptible to developing chronic lung disease later on, apart from having suboptimal lung function (there goes your future Olympic champion). Delhi’s air quality index was higher than 500 on November 1, 2019 – which is 10-times more than the safe limit. Bad air also adversely affects the human brain by inducing depression, reducing intelligence and promoting dementia. Brain cancer is also on the list. It’s a moot point as to which condition is worse.

We should be scrambling to tackle the mess we have created. This is not only a serious matter, it is downright deadly. Lakhs of lives are at stake besides increasing the incidence of disabling diseases as well. The problem is that the people refuse to appreciate the looming danger. But then again so does the minister they elected, so what more can be done, eh?

Deepak Natarajan is a cardiologist based in New Delhi.