In polluted Delhi, children have no place to hide from diseases

Come winter and Delhi's alarming daily air quality index figures are splashed across newspapers. This year isn't different and since October 28, 2023, the AQI of the city has slipped into the 'very poor' category, buoyed entirely by its own emissions, according to a report in The Times of India.

Things are to get worse in the coming days, experts noted, as the number of farm fires rises in neighbouring Punjab and Haryana, and the north-westerly winds transport the smoke to the city.

Seen in isolation, these numbers will give us no more information than a trend of a city getting choked up every year. They do not convey the magnitude of damage citizens are exposing themselves to with every breath they take and how the region has become unlivable. The impact is worse for certain population groups like children, elderly and the poor but is certain for all. 

Air pollution is the biggest external threat to human health, taking away more years from a person’s life than smoking cigarettes or alcohol abuse, malnutrition as well as malaria and neglected tropical diseases.

India’s national capital region, especially Delhi and the heavily built-up cities of Gurgaon and Noida, record severe air pollution many days a year, putting the lives of residents at risk.

In Delhi, the world’s most polluted city, residents lose about 12 years of their lives because the concentration of fine pollutants Particulate Matter 2.5 (PM 2.5) is so much higher than the standards set by the World Health Organization (WHO) as well as the country’s health bodies. 

WHO recommends that there should not be more than five micrograms of PM 2.5 in every cubic metre (ug / m3) of air we breathe. India’s national safe levels for the pollutant is 40 ug / m³. In 2021, Delhi’s annual PM2.5 concentration was 126 ug / m³.

The value has never been lower than 110 in more than half a decade in the city. 

Children are the most impacted by air pollution. This is because one, they breathe faster than adults and thus take in larger volumes of pollutants compared to their body weight. And two, toxins cause infections and disease that hinder normal development of lungs in children, leading to a host of health problems. 

Children growing up in an area with polluted ambient air are prone to developing respiratory ailments like asthma and bronchitis and have impaired lung function due to recurring infections. 

No wonder then, at least 2.2 million schoolchildren in Delhi have irreversible lung damage due to poor air quality, according to studies.

There was an almost 30 per cent increase in daily emergency room visits due to acute respiratory symptoms in children of Delhi on high pollution days, according  to a 2021 study published in the journal Environmental Science and Pollution Research.

In general, the number of emergency room visits of children with dry cough and breathing difficulty was observed after an “increase in daily ambient air pollution levels in Delhi”, the authors of the report noted. 

Exposure to pollutants suspended in the air can also cause cancers in children, as has been studied in several studies in the last decade. 

A study published in the journal Environmental Research in 2013 explored global data and found an association between traffic-related air pollution and childhood leukemia.

Then, a 2022 study done in Switzerland found evidence of an increased risk of childhood leukemia from exposure to traffic-related outdoor air pollution at children’s place of residence. 

Air pollution of the extent that is recorded in Delhi also impair the social development of children. Many have to miss school due to ailments caused by unhealthy air they breathe. Their outdoor playtime also gets restricted as the air quality dips, limiting their social interactions as well as scope for physical activity.

In short, being raised in Delhi is nothing short of being grounded permanently in a smoke chamber!

Forced to keep indoors and lead a sedentary lifestyle also put children at higher risks of developing non-communicable diseases. 

The city is such a health trap that people diagnosed with high cholesterol or blood sugar levels who are asked to go for morning runs to keep fit, may have to choose between having a healthy pair of lungs and healthy vital signs.

Children growing up in the city’s urban slums or the homeless face the most brutal blow because they are much more exposed to outdoor as well as indoor air pollution, have poor nutritional status and have the lowest access to affordable healthcare. 

Also, for many of them, staying indoors may not be possible. 

And the suffering is not restricted to the harsh winter months, as latest research showed that the city and much of north India experiences poor air quality throughout the year due to perennial emissions from vehicles, industries and construction. 

The picture is as ominous for the rest of the country and population groups. Nearly 1.7 million people died due to air pollution in the country in 2019, according to the State of Global Air Report (2020). This was around 17 per cent of all deaths recorded. 

Among these, exposure to PM2.5 contributed to approximately 980,000 deaths. 

In India, around 116,000 neonatal deaths were attributable to exposure to ambient PM2.5 pollution in 2019, the report estimated. 

Seasonal spikes in the air quality index keep making headlines year after year. But most states have only rolled out temporary restrictions and not permanent solutions to tackle major drivers like vehicular pollution or crop burning.

But some countries have shown that it is possible to reduce the concentration of pollutants by almost half in a matter of years, and there are technologies and policy tools waiting to be adopted to make this possible. 

Only if our heads of states would give as much importance to the health of children as they do to winning elections!

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