Rate of asthma within Kolkata teenagers highest among Indian major cities, first generation asthmatic children soaring
Photo: iStock Kolkata’s children have been affected by air pollution since the time the city was still called Calcutta, more than two decades back, and the situation has gone from bad to worse.
In 2000, a study carried out by the Chittaranjan National Cancer Institute demonstrated that “children inhaling grossly polluted air of Calcutta (Kolkata) suffer from adverse lung reactions and genetic abnormality in the exposed tissues”.
A recent, yet-to-be-published study anchored by pulmonologist Alok Gopal Ghoshal of the National Allergy Asthma Bronchitis Institute, has found that Kolkata had the highest proportion of asthma patients within major cities among the children in the age group of 13-14 years, though younger groups are also suffering.
A study by Umemura and four other Japanese scientists, published in the European Journal of Public Health in 2020, showed that urban children may be affected by air pollution more than those in the rural areas in Bengal due to comparative higher exposure; while indoor air pollution may have a greater influence on children of the poor than outdoor air pollution.
This reporter has spoken to a series of paediatrics in the city, and almost all pointed out that the number of patients have increased at least 3-4 times since the 90s.
One out of every two children in Kolkata suffers from some kind of respiratory disorders triggered by air pollution, pointed out pulmonologists in a recent national conference of Indian Academy of Paediatrics (IAP) held in the city. Experts pointed out that even newborns and babies in nurseries are not being spared from the impact of air pollution.
Soon the proportion will increase as Kolkata’s air quality continues to worsen over the last one week; and ensuing Diwali and bursting of crackers is likely to add more toxic pollutants to the existing load.
Patients suffering from respiratory ailments, including children, are already making a bee line for the doctor’s chambers; which is also likely to increase post Diwali as the city is expected to have high intensity of firework bursting this year after the state government dropped hints to become relaxed on firework norms.
“We expect at least a 30 per cent increase in the number of children coming to hospitals post Diwali, and the admission will also increase. There may be long-term effects as well. I am advising the parents to continue with the inhalers at least for a weak post-Diwali,” observed Apurba Ghosh, head of Institute of Child Health.
Senior officials of both government and private hospitals pointed out that they are also getting prepared to receive more patients, including children, suffering from respiratory distress.
“You can already see that the air is quite polluted; bursting of firecrackers in Diwali is likely to add to it,” said a doctor and administrator in a government hospital.
Data is also vindicating the rapidly rising air pollution in the city. Kolkata's Air Quality Index (AQI) has been rising sharply over the last few days turning from ‘poor’ to even worse as the winter sets in. On November 10, 2023, all the city-based air pollution stations recorded ‘very poor’ — AQI levels more than 300 — air quality during night time.
Overall, even the day’s AQI average has turned from ‘moderate’ to ‘poor’ within a span of five days; actually, it doubled within five days. On November 5, the day India and South Africa match was played, the AQI was 133 — moderate — while it had jumped up to 282 — poor — on November 10.
Poor air quality, according to the Central Pollution Control Board (CPCB), may lead to “breathing discomfort to most people on prolonged exposure”.
A scientist in Bose Institute, through modelling analysis, predicted that overall city’s air quality is likely to “remain around 200-230 (poor)” during Diwali. “Though overall the city's AQI is likely to remain poor during Diwali, various regions within the city may turn very poor,” said Abhijit Chatterjee, the scientist.
Anumita Roy Choudhury, air pollution expert with the Center for Science and Environment (CSE), earlier explained that the sobering effect on city’s pollution level has already being neutralised; and Kolkata, along with most metro cities, were on course to achieve pre-COVID-19 pollution status, or, get even poorer.
“The air pollution impact on children’s lungs is magnifying of late as children were confined to homes during COVID-19 period as the schools were closed, and the immunity level has gone down. The impact is huge but we do not have adequate data to pinpoint the scenario” opined Pallab Chatterjee, a paediatrician.
“The air pollution impact on the children is increasing both quantitatively and qualitatively; not only the lungs are choking, almost all organs particularly the gastrointestinal tracts and skin are also getting affected,” observed Goutam Ghosh, a paediatrician.
Ghosh pointed out that, as a consequence to continuing exposure to air pollution, viral infections are on the rise compared to allergic infections. “Either the immunity level gets hindered in affected children or, they are becoming hyper-immune triggering inflammation and prolonging the ordeal; and in both ways the children are suffering,” explained the physician.
Chatterjee explained that the children are falling prey to rising pollution most, especially the most toxic Particulate Matter 2.5 level, as due to their less height they remain closer to the ground and hence get more exposed to the pollutants as they settle on ground.
The physician pointed out that the smaller the particulate, higher the damage, as the pollutants penetrate in the deeper crevices of lungs and can even get mixed with the blood stream and even affect the cardiac tissues.
“Pollution seems to be exaggerating several diseases; earlier the common cold and cough were usually cured within a few days, but now often such children are required to be put under c-pap or get admitted in ICUs,” added another.
“I treat children in northern fringe of city and can safely vouch that the number of patients has increased several times in last few decades, but the actual impact, both long and short term, is difficult to be spelt out as there is inadequate data,” explained Subhamoy Mukherjee, a paediatric working more than three decades.
Another noted pulmonologist Arup Haldar explained that the first-generation asthma patients among children is on the rise. “Overall, the respiratory problems are increasing especially in winter when the air pollution surges… earlier in case of asthma patients we usually used to get family history, but now a sizable affected children are found without family history, and seemed to be affected by air pollution exposure,” explained Haldar.
The physician observed that the timing of early morning schools need to be changed as the children get exposed to maximum pollution during that period.
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