Wake up and smell the air

By Sunita Narain
Last Updated: Monday 17 August 2015

imageOur health is not on anybody’s agenda. Or, we just don’t seem to make the connections between the growing burden of disease and the deteriorating condition of our environment. We don’t really believe the science, which tells us each passing day how toxins affect our bodies, leading to high rates of both morbidity and mortality. It is true that it is difficult to establish cause and effect, but we know more than enough to say that air pollution is today a leading cause of both disease and death in India and other parts of South Asia.

The Global Burden of Disease is an initiative involving WHO that tracks the causes of disability-adjusted life years lost—the number of productive years lost to diseases—and human death. In other words, it assesses a large number of risk factors responsible for the global burden of disease. Why are we ill? The initiative’s decadal 2010 assessment should make us angry.

In South Asia the top cause of disease and death is particulate pollution—inside homes because of the poor quality cook stoves and biomass fuel burnt by poor households, and outside homes because of growing numbers of vehicles and use of dirty diesel fuel. What is more worrying is that ambient and household-level air pollution has a correlation with ischemic heart disease, stroke, lung cancer and lower respiratory infections. According to this assessment, some 627,000 deaths in 2010 are attributable to ambient air pollution alone in India, of which heart disease caused almost 50 per cent deaths and stroke and hypertension another 25 per cent. In all, over 1.6 million deaths happened in India because of indoor and outdoor air pollution in 2010, finds the global assessment. It is not mocking numbers.

What is clear is that we have run out of air and time. Rural India suffers badly because it still burns biomass for cooking its food. Commercial fuel is expensive, while kerosene does not reach the very people for whom it is subsidised. There is no option for the poor but to burn leaves, twigs, wood or cow dung in inefficient chulhas in poorly ventilated conditions. Women suffer the highest exposure to toxins, which is equivalent to smoking many cigarettes every day. The answer is to improve the combustion efficiency of the stove, the quality of material being burnt and ventilation. But till date, government programmes—and there have been many—have failed to get this done. As a result, indoor air pollution is the top cause of morbidity and mortality in India.

In fact, air does not differentiate between rich and poor; rural and urban. Biomass burnt inside houses also contributes to ambient air pollution; everyone in an airshed is affected.

Then pollution takes new forms which makes it difficult for us to find protection even if we are rich and capable. The ground-level ozone is found to be a key pollutant adding to the death burden in South Asia. This is a gas, which is not necessarily found in the most polluted parts of the city. Instead, it drifts away from the source of pollution to greener and less congested regions. Thus, it hits and hurts even where one cannot smell or see pollution.

All in all, this is bad news. This is when we know that half of India’s urban population lives in cities where particulate pollution levels exceed the standards considered safe. And as much as one-third of this population breathes air having critical levels of particulate pollution, which is considered to be extremely harmful. We are also running out of “clean” places. Small and big cities are now enjoined in the pain of pollution. Of the 180 cities monitored by different pollution control agencies, only two—unknown cities in Kerala—meet the criteria of low pollution. In other words, they have pollution levels 50 per cent below the standard. Rest have foul air.

But we don’t make the connection. Current policies on containing air pollution, particularly in cities, are regressive and border on the criminal. We know that diesel particulates are indicted as known carcinogens. Use of diesel in vehicles needs to be contained. We also know that the price differential between petrol and diesel has pushed up sales of inefficient SUV-type vehicles. This hurts oil companies and kills us, literally. There has been pressure on government, mostly fiscal, to contain the use of diesel in private vehicles.

So what does it do? It raises the price of diesel for retail buyers by Rs 0.50 per litre. It also raises the price of diesel for bulk buyers by Rs 10 per litre. What it does not explain is that bulk users of diesel are mainly railways and public-sector bus transport agencies. Therefore, what government does is deliberately hit the more efficient forms of transport, which carry more people using less fuel. It also hits the poor and not the rich who travel in cars.

Health is not on the agenda. That is pretty much clear.

Workshop on Global Burden of Disease: Air Pollution amongst top killers in India

The global burden of disease: generating evidence, guiding policy - South Asia

Epidemiological study on effect of air pollution on human health (adults) in Delhi

Alarm over air pollution & public health, languishing vehicle technology & mobility crisis in South Asian cities

Seeking solutions to air pollution, health and congestion in South Asian cities

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  • Yes, to control particulate

    Yes, to control particulate pollution in metro cities in India, people should move to clean fuels, but unfortunately in our country, everytime clean fuels get the short shrift in the budget. CNG and petrol are cleaner than diesel, but still diesel is sold at more subsidized rate. I don't buy the government logic that diesel is subsidized due to farmers and transport sector, but we do understand that real benefit is going somewhere else. When govt planned the cash subsidy for all other schemes, why they does it not go for the same in diesel sector.
    In Delhi, no road is available to drive cycles and even in BRT, cyclist way is always captured by motorist. One time tax on diesel cars will put control on diesel cars and can see some positive results. Others incentives for clean fuels vehicles, like free parking to bicycles, reduced parking to CNG and petrol cars, separate bay for cycles etc should be given and I could find no reason to believe that people will go for alternate means of transportation like mass transport systems in my country as well.

    Posted by: Anonymous | 7 years ago | Reply
  • I like Ms Sunita's article.

    I like Ms Sunita's article. Politically, it makes sense and also as a quick short-term policy. Typically, a distorted economic concept is being used by the government.

    However, as a short- and long-term policy and with a will to implement on priority, emphasis needs to shift to electricity generation in excess of requirement. Then give abundant support to the railway system for promoting cheap and speedy inter-city trains both for passengers and freight.

    In this respect we do not need to look at new lines for 300/350 kmph trains. On the existing tracks , with DFC in place this can be done at a much lesser cost. No additional land and other assets are really needed.

    Thus demand and consumption of diesel goes down, pollution levels fall, lesser congestion on roads will be there and, transport will be comparatively cheaper.

    Posted by: Anonymous | 7 years ago | Reply
  • Dear Ms. Sunita Narian: Thank

    Dear Ms. Sunita Narian:

    Thank you for your article, which actually reminds me of the same old issue of air pollution causing cancer and serious health problems that I learnt while pursuing my Masters degree in environmental engineering way back in very early Nineties.

    I am, and actually we all are, looking for solutions and innovative ideas how our policy makers and chiefs of pollution control agencies can be sensitized to take collective and effective actions.

    Shall I request CSE to announce on its website giving cash awards of significantly higher amount to senior most policy makers and chief of pollution boards to spend few nights in homes in rural areas where they use cook stoves and biomass!

    Shall I request CSE to announce on its website giving cash awards of significantly high amount to senior most policy makers and chief of pollution boards to spend few hours for a week in areas with high level of particulate pollution!

    In china, they announced for pollution chiefs USD48,000 for 30 minutes swim in a polluted river.


    I request CSE to come up with ideas and solutions that help eradicate/mitigate urban air pollution by drawing highest level of attention of the government and industries.

    Sincerely yours,

    K D Bhardwaj

    Posted by: Anonymous | 7 years ago | Reply
  • Its not the burning of

    Its not the burning of biomass that is the problem. It is the poor ventilation only. Burning biomass is the lowest entropy fuel available. The carbon it generates is easily absorbed by the forests around. Yes improving combustion efficiency is a challenge. The other side- that is our urban population is slowly ghettoing itself and policy makers simply couldn't care. We have isolated our rural areas and laid emphasis on building infrastructure in our cities at the cost of both.

    Posted by: Anonymous | 7 years ago | Reply
  • Dear Ms. Sunita Narain: If

    Dear Ms. Sunita Narain:

    If CSE goes ahead with what I suggested by getting sponsors, title of your article needs to be changed to:

    Wake up, smell the air, and get paid !!!!


    K D Bhardwaj

    Posted by: Anonymous | 7 years ago | Reply
  • The cause and effects of air

    The cause and effects of air pollution and disease is proven beyond doubt. What is astonishing is its effect on diverse human systems. Till date we were aware that Respiratory system and the Lungs in particular are the target organs for risk from air pollution. Now we know that every system gets affected in differing measures.
    Chronic Obstructive Pulmonary Disease is moving up as a predominant cause of death worldwide. Although Cigarette smoke is the major known culprit, all types of smoke cause it, for it is seen even in non-smokers in rural settings due to burning of biomass easily available in the vicinity of households.
    Two interventions are worthwhile. 1) Health monitoring by professional or trained teams in Primary Health Centres who would visit every household and educate and measure health effects by questionnaire based instruments and respirometry and co-oximetry 2) Design initiative by various rural improvement agencies which would survey design and carry out simple changes to improve indoor ventilation to reduce SPM per cubic foot of indoor air.

    Posted by: Anonymous | 7 years ago | Reply
  • The article poses a problem

    The article poses a problem of health but does not suggest any solution. If health is the priority, then cheapest solution available to tackle air pollution is to ask the enlightened individual to take preventive measures. This includes yoga pranayam and sticking to simple non-processed non-additive non-preservative diet. This needs to be taught in schools at the elementary level since we have a huge infrastructure of teachers as compared to health staff in India.Such education will also help create pressure groups like CSE whose initiative helped raise the issue in courts and at policy level.
    The PHC's are overloaded and they have their own problems of lack of doctors and staff and multiplicity of schemes to implement at the ground level.Hence their ability to deliver result in this respect will be limited.
    In the rural context, as suggested , improving ventilation, improving combustion efficiency are some issues that can be thought of through the Gram sevaks , specially in areas where health problems due to smoked chullas is more in women.
    In the urban context, many things have gone wrong and all suggested mitigation measures like taxing diesel vehicles, ensuring that diesel goes to public transport and not to divert diesel to SUV and diesel cars are a eyewash. The transport system has falied. Trains are the best and train charges should be increased so that more railway infrastructure is created. There has to be systemic EIA for the city which looks into population density, load on basic infrastructure , water supply , sewerage and only then will we realise that the cities have gone beyond their limits. But political system demands that and this trend appears irreversible and hence there is only one way, each citizen must guard his health and take preventive measures ( which may include going to less polluting cities).

    Posted by: Anonymous | 7 years ago | Reply
  • Dear Ms. Sunita

    Dear Ms. Sunita Narain,
    Thanks for the wake up call. It is high time we did some thing to cut down the pollution and use of fossil fuels.
    we have come up with Pongamia VayuSap based sustainable bio-energy programme. Pongamia pinntata (known as Karanj in Hindi, Indian beech & Pongam in English) is energy rich non-edible oil yielding tree with several desirable attributes of environmental (including soil) amelioration. It is estimated that 10 year old Pongamia trees planted in one acre sequester as much as 15 to 20 tonnes of Carbon /year. We in Vayugrid have developed genetically elite grafted saplings of Pongamia (VayuSaps) that yield one tonne of oil /hectare by the fourth year of planting. VayuSaps can be planted on waste lands and degraded soils which are not suitable for regular high input crop production and grown totally under rainfed conditions without any need for extraneous irrigation.
    Pongamia oil can be used for running tractors, pump sets and as source of energy for rural electrification. The oil can also form a good feed stock for bio-diesel production.
    Corporate sector may take initiative to grow large scale plantations of Pogamia VayuSaps to enhance soil and air quality as well as to produce feed stocks for sustainable clean and green energy. We are installing Pongamia VayuSap plantations on large scale in Ethiopia, Kuwait and parts of USA. Please visit our website www.vayugrid.com for more details.

    Posted by: Anonymous | 7 years ago | Reply
  • I am from chennai and living

    I am from chennai and living now in Bhubaneswar, a city much cleaner and less congested than my native. But what I have seen here in the past 4 years is a drastic change. No later than 10 years this city is going to become like bangalore, with roads crowded by cars and no poor people still fighting for autos and share autos. We dont learn from our mistakes. Since childhood I have taken a oath not to buy a two/four wheeler and use public transport as much as possible. But I am one of the victims of respiratory diseases. People want to be in their comfortable zones and get things done. But hey folks, this is a cancerous behavior and getting passed on to the gen Y and Z!
    All this imported technology has ruined us beyond imagination, made us lazy, and now curbed us of our common sense. We humans always have to learn the hard way! pity.

    Posted by: Anonymous | 7 years ago | Reply
  • They can also improve the

    They can also improve the quality of sidewalks and availability of public transportation. I can only speak for Chennai and Bangalore, while the metros are being built - slowly - there is no parallel effort to make the streets/roads pedestrian friendly.

    The point about raising diesel prices and affecting trains and public transport is very valid - nothing is done to disincentive people from using their cars, such as raising oil prices.

    Another issue is simply the lack of regular waste collection. In Denmark, apparently all the garbage (not the recyclable plastics and metal, just the garbage) is burned to generate energy - for the amount of waste produced here, surely it is a worthy idea to check into? Parenthetically, some cremation homes in the UK use the heat produced from cremations to provide heating - can't imagine there is a country better suited than India to creatively exploit these ideas.

    From your article to the politician's brains! Rather than learning from the consumer culture of the west, we might do well to learn from their sanitation and infrastructure practices!

    Posted by: Anonymous | 7 years ago | Reply
  • We should promote industries

    We should promote industries which are clean and green. Polluting industries should be punitively taxed so that they will shut shop or switch to greem. Carbon foot print should be assessed and carbon neutrality should be achieved for each industry.

    Posted by: Anonymous | 6 years ago | Reply