In this most populous country in the world, almost every citizen is exposed to deadly pollution while performing the most basic existential activity: breathing. And it adds to their disease burden. The notion that air pollution is a ‘big city problem’ is rapidly crumbling. Data indicates that smaller towns and industrial hubs are now at the frontline of India’s air pollution crisis. Rural areas are also reporting high levels of air pollution. Indians are indeed losing on life expectancy due to foul air
This series is an account of India’s biggest public health threat: air pollution.
Delhi’s battle against air pollution, which began with CSE’s 1996 Slow Murder campaign, led to landmark Supreme Court interventions, cleaner fuels and tighter vehicle emission standards. However, rising private vehicle ownership, congestion and dependence on polluting fuels are eroding these gains. Growing congestion also increases vehicular emissions, with studies showing pollution levels can be three to seven times higher in congested traffic than in free-flowing conditions.
Right to clean air is about inter-generational equity. Traditionally, the health impacts of air pollution have been understood in terms of the relation between dose and response at an undifferentiated population scale. But over the years, more nuanced approaches have evolved to investigate the modifiers and specific impacts on groups differentiated by age, gender, socio-economic and nutritional status, and a range of other factors that define the vulnerabilities and underpin marginalisation.
Air pollution was the second largest killer globally after blood pressure, recording a dubious tally of 8.1 million deaths in 2021. Of this, a staggering 2.6 million deaths occurred in South Asia alone. To this is added debilitating chronic diseases and a range of ill health. With a population over 1 billion, India recorded 2.1 million deaths, including 237,000 ozone-pollution related deaths.
Every breath in India kills, slowly but certainly. In the 2009-19 decade, about 3.8 million deaths were attributed to air pollution above the country’s air quality guidelines of 40 micrograms per cubic metre (μg/m³). ‘Compared to the stricter guidelines recommended by the World Health Organization (WHO)—only 5 micrograms per cubic metre—the figure rises to 16.6 million deaths.
The toxic journey begins in the womb. When mothers are exposed to polluted air during pregnancy, the foetus is at serious risk. The risk escalates into a massive disease burden for infants, children and adolescents, lasting a lifetime. The problem has reached alarming proportions in the Global South, with India bearing the infamy of accounting for a quarter of the global infant deaths— within the first month of birth.