NEW DELHI: In about seven years, Indians would know to what extent air pollution may be impacting their lung function. Dr Anurag Agrawal, principal scientist at CSIR Institute of Genomics and Integrative Biology (IGIB), would start work next month on one of the first long-term studies involving children (10-18 years) from across the study.
Agrawal is among lakhs of Delhiites directly affected by severe air pollution. He's an asthmatic, but believes air pollution is only one of the several factors affecting lungfunction. "Indians have 30% lower lung function than a white European of the same height, weight, age and gender. In the very famous Framinghan heart study (US based National Heart Institute started the study in 1948) they found if you have a low lung function, your risk of an early cardiac death increases. We know Indians die much faster of cardiac issues. We have drugs to treat cholesterol but no good drugs to treat lung function. Poor lung function is probably only a marker and not a cause of death. I think that the same things that make people die of cardiac problems, also cause them to have smaller lungs—one of which could be air pollution. We don't know yet. This study area is relatively new to our lab," Dr Agrawal said.
His team plans to measure lung function of children in classes VI, IX and XII in different parts of the country through a network of schools. "We hope to see what the biggest causes of reduced lung function are. The team will complete its first round or the baseline in the next couple of years. Two types of tests will be conducted: a lung capacity test where a child has to breathe in and breathe out; another in which multi-frequency pressure waves are fed into the lungs and the flow measured. A portable device called pulmoscan is being built for such testing and a working prototype is ready. The study will help researchers understand whether lung function starts reducing very early in childhood or much later," Agrawal said.
"By Class VI (10 years old) alveolar development is mostly done. We have to see from then if the problem becomes worse. AIIMS data suggests Indians have smaller lungs throughout their lives, but it's proportionate to their body size in early life. What I am looking for is reduction in lung size disproportionate to their body size in early life," he said.
In the 1950s, the British looked at lung function of Indians. They covered Rajput cavalrymen, South Indian civil servants and Gorkha fighters. Only Gorkhas had lungs comparable to or better than the British. They thought probably it had got to do with exercise.
But Agrawal points out another dimension of the problem: that of poor nutrition of girls and mothers. "Nutrition of mothers highlighted in the DOHaD (Developmental Origin of Health and Disease) study found that most diseases can be tracked back to the early fetal periods. Risk of diabetes comes from poor nutrition of mothers. It basically said if you want to change society, take care of the girlchild. DOHaD hypothesis is very compelling. Even with lung function, my personal bias is towards the DOHaD hypothesis," he said.
The team plans to include children in corporation schools. "Delhi's air never becomes good because there is also a lot of natural dust. It is almost certain to be bad for health but we need local research to understand better. Look at the dust near the Rani Jhansi flyover. It will be interesting to study children from civic schools in these locations," Agrawal said.
