Nine out of ten people now breathe polluted air, which
kills 7 million people every year, says the World Health Organization (WHO).
Air pollution has now emerged as a major environmental
risk factor for health. “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” (WHO).
In 2016, as per WHO, ambient or outdoor air pollution
caused an estimated 4.2 million premature deaths worldwide in both cities and
rural areas; 58% of outdoor air pollution-related premature deaths were due to
ischemic heart disease and strokes, while 18% of deaths were due to chronic
obstructive pulmonary disease (COPD) and acute lower respiratory infections
respectively, and 6% of deaths were due to lung cancer. More than 90% of these
deaths occurred in low- and middle-income countries.
And it’s just not outdoor air pollution; household
(indoor) air pollution also causes 4 million deaths annually.
Pollutants with the strongest evidence for public health
concern include particulate matter (PM), ozone (O3), nitrogen dioxide (NO2) and
sulfur dioxide (SO2).
Air pollution has been identified as a trigger of acute
cardiovascular events (myocardial infarction and stroke). A recent study
presented at Heart Rhythm 2018, the Heart Rhythm Society's 39th Annual
Scientific Sessions, which evaluated 112,700 women
in the ongoing Nurses' Health Study showed that
lower-risk women exposed
to particular matter (PM) for even a short amount of time are at an increased
risk of sudden cardiac death. This association was significant on cold days -
at low temperatures below 13°C.
In a report published by the ICMR in The Lancet Planetary
Health in December 2017, ICMR clearly stated that 1.24 million deaths in 2017
were caused by exposure to air pollution; one in eight deaths was due to the
constantly deteriorating air quality. ICMR also observed that life
expectancy in India is reduced by 1.7 years on an average due to bad air
quality.
This report was considered devoid of merit by the Environment
ministry.
But, prior to the ICMR report, in 2015, the health
ministry had released a report saying that air pollution causes impacts similar
to that of tobacco smoking. The report also said that there was evidence of
adverse pregnancy outcomes, tuberculosis, asthma exacerbation, cancer and thus,
air pollution needs to be addressed during public health programs.
The environment ministry maintains that
since no death certificates have pollution listed as the reason of
death there is no correlation between air quality and deaths due to
the same.
Doctors do not mention pollution as a cause of death,
because pollution is not recognized as a cause of death and has no insurance
cover. Natural disasters are generally not covered in routine insurance.
However, these statistics only serve to emphasize that
perhaps the time has come to declare pollution as one of the causes of all
sudden deaths, particularly when the pollution levels in the city are high.
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
