Sunday, March 3, 2019

Top health concerns of 2019

Air pollution

Nine out of ten people now breathe polluted air, which kills 7 million people every year, according to the World Health Organization (WHO). And it’s just not outdoor air pollution; household (indoor) air pollution also causes 4 million deaths annually.

Air pollution has now emerged as a major environmental risk factor for health; particulate matter (PM 2.5/10), ozone (O3), nitrogen dioxide (NO2) and sulfur dioxide (SO2) are pollutants with the strongest evidence for public health concern. It not only contributes to chronic illnesses but also acute cardiovascular and respiratory events such as stroke, heart attack, acute asthma attack and acute exacerbation of COPD. The WHO further says, “The health effects of air pollution are serious – one third of deaths from stroke, lung cancer and heart disease are due to air pollution. This is having an equivalent effect to that of smoking tobacco, and much higher than, say, the effects of eating too much salt.”

As per WHO data, in terms of PM2.5, 14 Indian cities figured in the list of 20 most polluted cities in the world in 2016; in terms of PM10 levels, 13 cities in India were among the 20 most-polluted cities of the world in the same year. Air pollution in Delhi, the national capital, is now perennial and persists in the severe category. There seems to be no answer to this conundrum.

In addition, air pollution is a major contributor to climate change (global warming), which also affects health in different ways.

Global influenza pandemic

The world will face another influenza pandemic as predicted by the WHO. This occurs when a new influenza virus hits the world and affects people who are not immune to it. Flu is widespread in the US; so far there have been more than 20 million flu illnesses and more than 25,000 flu deaths since the season began in October last year (CDC).

India, particularly Rajasthan, Delhi, Gujarat is in the midst of its flu season; H1N1 (swine flu) is the predominant strain that is causing 70%-90% of seasonal flu infections. The National Centre for Disease Control has reported 14,803 confirmed H1N1cases across states till February 24, with 448 deaths.

Antimicrobial resistance

Easy over the counter availability of antibiotics and lack of awareness about correct usage of antibiotic drugs are among factors that have contributed to antibiotic resistance in the country. Also, the prevalence of multi-drug resistant infections is rising in the country. As per Global TB report 2017, estimated number of multi drug resistant (MDR) TB patients are 6,01,000 globally, of which 147000 (1/4th) are estimated from India. Treatment of MDR-TB or rifampicin-resistant-TB is prolonged and entails use of more expensive drugs.


India is no stranger to Dengue and the disease is endemic in almost all states. Every year, mostly during monsoons, dengue affects thousands of people across the country. Dengue outbreaks in India have become more frequent, especially in the urban areas. Delhi is hyperendemic for dengue. What is of more concern is that it has spread to new regions, such as Orissa, Arunachal Pradesh and Mizoram, where dengue was historically non-existent (Emerg Microbes Infect. 2017 Aug; 6(8): e70).

Cricket World Cup anxiety

ICC Cricket World Cup 2019 is scheduled to be held in England in May this year. Cricket is not just a sport; it is a religion in India, where billions watch their team play, as one. It’s also a huge business now. And every match that India plays is likely to cause many anxious moments to the viewers.


In May last year, Nipah virus disease was reported from in Kerala. The Government said that “this was not a major outbreak. It is only a local occurrence” (PIB). Nipah is a potentially life-threatening illness. It is an emerging zoonotic disease of public health importance. Will Nipah strike again?

Hearing aid from ear phone use

Constant exposure to loud noise can cause high frequency sensory neural hearing loss. Ear phone users are at risk of developing hearing loss and be candidates for hearing aids. This is especially true for young people who constantly use headphones and earphones for listening to high decibel music. Listening to music at 110-120 dB damages the hearing in less than an hour and a half.

An exposure of 90 dB (which is equivalent to the noise made by a power lawn mower or passing motorcycle) is allowed for 8 hours, 95 dB for 4 hours, 100 dB only for 2 hours, 105 dB ( power mower) for one hour and 130 dB for (live rock music) 20 minutes.

Ayushman Bharat

Around 14 lakh people have reportedly benefitted from Ayushman Bharat or Pradhan Mantri Jan Aryogya Yojana (PMJAY) scheme since it was launched in September 2018. And, the government has spent Rs 1800 cr for this.  The future of this scheme may depend on the parliamentary elections. If BJP returns to power, the scheme may emerge even bigger; but if it does not return to power, will Ayushman Bharat be repealed and replaced?

Digital illnesses

The constant of smartphones, tablets, and computers has spawned a whole new set of diseases. Terms like “text claw,” “Blackberry thumb,” “cellphone elbow”, “tech neck” are becoming common and represent medical conditions arising out of overuse of mobile phones. Fauxcellarm (“Phantom Ringing”), “Technoference” (digital interference in relationships) are few more such conditions.

Prolonged use of mobile phone can also cause neck pain, dry eyes, computer vision syndrome, and insomnia. About 60% of youth between 20 and 30 years of age fear losing their mobile phone, a condition called nomophobia ((“No-Mobile-Phobia”). Dependence on technology is adversely affecting our memory, attention span.

The World Health Organization (WHO) has now included video game addictions as “Internet Gaming Disorder” in its latest revision of the International Classification of Diseases (ICD-11). It described the addiction as a ‘pattern of persistent or recurrent gaming behavior’ that becomes so extensive it ‘takes precedence over other life interests’.


Recent events have placed India at the brink of war. A further escalation in hostilities is envisaged. But will there be a full-blown war? We hope not.

War causes tremendous destruction. Economy is negatively affected, infrastructure is damaged, there is scarcity of food and other resources, people lose their homes and become “refugees” in their own countries. Besides physical health, psychological trauma due to war has long-lasting effects.

Fake news

Fake news is a word in vogue today. It was also named word of the year in 2017. Fake news is deliberate misinformation and disinformation not only in the social media but also in the regular mainstream media. The intent is to mislead. There should be a law against fake news as it can generate social unrest in the community and polarize society into groups. Agitations may be an unwanted consequence of fake news.

Dr KK Aggarwal
Padma Shri Awardee
President Elect Confederation of Medical Associations in Asia and Oceania   (CMAAO)
Group Editor-in-Chief IJCP Publications
President Heart Care Foundation of India
Past National President IMA

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