Global Burden of Disease ranks air pollution as a top killer

Killer outdoor air contributes to 1.2 million deaths in East Asia which is in throes of high level of economic growth and motorization and 712,000 deaths in South Asia which is at the take-off stage
Global Burden of Disease ranks air pollution as a top killer

The findings of the new Global Burden of Disease (GBD) count, a global initiative involving the World Health Organisation, says air pollution has become one of the top 10 killers in the world. GBD tracks deaths and illnesses from all causes across the world. According to it, in South Asia, air pollution is ranked as the sixth most dangerous killer. It is now three places behind indoor air pollution, which is the second highest killer in this region.

The latest GBD results have been produced through a rigorous scientific process involving over 450 global experts and partner institutions, including the Institute of Health Metrics and Evaluation, the World Health Organization, the University of Queensland in Australia, Johns Hopkins University and Harvard University. The Health Effects Institute has played a leading role in the expert group conducting the air pollution analysis

This GBD count on air pollution and its health risks must trigger urgent, aggressive and most stringent action in India to curb air pollution to protect public health. India cannot afford to enhance health risk at a time when much of its economic growth and motorization are yet to happen.

Alarming facts about killer breath

There has been shocking increase in global death toll due to outdoor air pollution. According to the latest tally, air pollution causes 3.2 million deaths each year worldwide. This has increased from 800,000, last estimated by GBD in 2000—a whopping 300 per cent increase. In 2000, GBD assessments had reported a much smaller air pollution-related burden of disease. The new estimates of particulate air pollution are based on ground-level measurements, satellite remote sensing and global chemical transport models to capture population exposure.

Air pollution is amongst the top 10 killers in the world. In South Asia, air pollution has been ranked just below blood pressure, tobacco smoking, indoor air pollution, poor intake of fruits and diabetes. This is scary as outdoor air pollution is a leveller that makes everyone—rich and the poor—vulnerable.

Two-thirds of the death burden from outdoor air pollution occurs in developing Asia, including India. The new GBD estimates over 2.1 million premature deaths and 52 million years of healthy life lost in 2010 due to fine particle air pollution in Asia, which is two-thirds of the burden worldwide. Killer outdoor air contributes to 1.2 million deaths in East Asia which is in throes of high level of economic growth and motorization and 712,000 deaths in South Asia (including India) which is at the take-off stage. This is much higher than the combined toll of 400,000 in the 27 EU countries, Eastern Europe, and Russia.

India cannot afford to ignore numbers anymore

There is hard evidence now to act urgently to reduce the public health risks to all, particularly children, elderly, and the poor. No one can escape toxic air. India will have to take aggressive action to reverse the trend of short-term respiratory and cardiac effects as well as the long-term cancer and other metabolic and cellular effects. Toxic effects like cancer surface after a long latency period. Therefore, exposure to air pollution will have to be reduced today to reduce the burden of diseases.

The government must account for health cost in decision making. Valuation of acute and chronic illnesses must be linked to decision on air pollution control measures.

The time has come to make national ambient air quality standards legally binding in all regions. The national air quality planning and city action plans need a road map for each source of pollution and aggressive measures. Impose penalty on cities if air quality standards are violated. Critically polluted areas need stringent implementation plans. At the same time install public information system on daily air quality with health advisories and implement smog alert and pollution emergencies measures

The government must not delay in framing of the vehicle technology and fuel quality road map to get to Euro VI levels as quickly as possible and also put in place a robust in-use vehicle management to cut toxic vehicular fume.

But the air quality gains from the technology improvement can be nullified if the explosive increase in vehicle numbers is not contained. Cities need to scale up public transport, non-motorised transport and promote compact city planning to reduce travel distances.

GBD report findings
The Global Burden of Diseases (GBD), 2010 is a systematic effort of scientists and researchers from around the world to describe the global distribution and causes of various diseases, injuries and health risk factors.

The study shows that although the scenario has improved in a lot of areas like lower neonatal mortality and mother and child sickness, deaths among young and middle aged adults are increasing due to non communicable diseases especially cancer and heart diseases.

The year of 2010 saw 52.8 million deaths globally. In 2010, the three leading risk factors for global disease burden were high blood pressure, tobacco smoking, including second-hand smoke and alcohol use. Hypertension caused 9.4 million deaths, tobacco smoking caused 6.3 million deaths and alcohol use led to 5 million deaths. Dietary risk factors and physical inactivity collectively accounted for 10% of global DALYs in 2010, with the most prominent dietary risks being diets low in fruits and those high in sodium.

In 1990, the leading risks were childhood underweight, household air pollution from solid fuels and tobacco smoking, including second-hand smoke. The decline in deaths due to communicable, maternal, neonatal and nutritional causes was because of decrease in diarrhoeal mortality (from 2•5 to 1•4 million), lower respiratory infections (from 3•4 to 2•8 million), and reduction in neonatal disorders (from 3•1 to 2•2 million). This has led to fewer children dying. However, “deaths from HIV/AIDS increased from 0•30 million in 1990 to 1•5 million in 2010, reaching a peak of 1•7 million in 2006. Deaths from non-communicable diseases rose by just under 8 million between 1990 and 2010, accounting for two of every three deaths (34•5 million) worldwide by 2010”.

Although the life expectancy years have grown by 10 years since 1990, the Healthy Life Expectancy years (HALE) have grown very slowly. In 2010, global male HALE at birth was 58•3 years and global female HALE at birth was 61•8 years. The much smaller improvements in male mortality are largely due to the greater impact of tobacco use in men.

- input by Ratnika Sharma

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