Delhi air pollution: Every breath you take

The Indian Express , Monday, November 13, 2017
Correspondent : Kaunain Sheriff M
Between 2007 and 2012, a study examined 10,565 births at Sir Ganga Ram Hospital (SGRH) to assess the link between air pollution and birth outcomes in the capital. For this, maternal and neonatal data was gathered and linked to air pollution data — based on distance to the nearest air quality monitoring station.

The study was conducted to assess if there were any gaps in the information maintained by city hospitals for environmental public health tracking. It concluded that information related to the mother’s socio-economic position, substance abuse, exposure to second-hand tobacco smoke and nutritional status were crucial to identifying environmental factors, and were linked to the health of the baby and the mother.

But the study threw up another unexpected — and alarming — trend: Delhi’s toxic air is shrinking newborns; with the air not only adversely affecting the growth of the foetus, but also resulting in premature births.

The hospital, in collaboration with the Public Health Foundation of India, the Indian Meteorological Department and the London School of Hygiene, published the trend in 2015. Two years later, in October 2017, a Lancet study echoed what the 2015 study had pointed out: More than half a million Indians are estimated to have died prematurely in 2015 due to particulate matter (PM) 2.5.

The recent smog in the city has led to a sudden spike in the number of people lining up at OPDs — complaining of sore throat, burning eyes and a smoker’s cough — even if they don’t smoke. But there’s another section of the population that’s suffering in silence: the newborns. “It’s alarming. You are building a future that is totally dark. You are looking at short-term effects, look at the long-term ones,” said Dr Neelam Kler, chairperson of the department of neonatology, Institute of Child Health, at SGRH.

The principal investigator of the 2015 study, Dr Kler said, “We linked birth outcomes with the historical data of pollution, and looked at data related to birth rate and foetal growth. The key findings were that the birth rate had come down when the air quality worsened. This is the same trend that has been seen in industrial countries such as the UK during industrialisation. It also showed that in most cases, poor air quality affected the weight of newborns.”

She added, “This is the long-term effect of air pollution — it adds to the burden of an already high rate of premature births in the country. This is like a nuclear disaster. These babies have high morbidity and an increased risk of death. There is also an increased risk of respiratory diseases that can cause neurological damage. In the long-term, these babies risk contracting hypertension and cardiovascular diseases.”

About 20% of approximately 15 million global premature births every year are in India, and Dr Kler pointed out that rising pollution levels will further increase the burden.

“Foetal growth depends on three factors. One is the genetic growth factor; the second is the nutritional milieu — and malnutrition of the mother continues to be great concern for India. The third is that certain things can have a deleterious effect on foetal growth and result in adverse stimulus. This can cause foetal malformation. If there is an increase in the quantity of lead or any other pollutant, it will act as a deterrent for foetal growth. This is the long-term effect,” Dr Kler explained.

Lasting damage

Days after Diwali, when the city witnessed a spike in pollution levels, one particular OPD in AIIMS saw 155 cases on October 25. And on November 8, when the capital was engulfed by smog, it saw 263 cases. But this OPD does not deal with respiratory diseases; it sees patients suffering from autoimmune diseases.

Particulate matter is one of the deadliest components of air pollution, which can settle deep in the lungs and get absorbed into the blood stream. The most visible effect is respiratory problems and cardiovascular diseases.

But the trend at the rheumatology OPD at AIIMS suggested that PM is taking a toll on the autoimmune system too. In fact, the rheumatology department at AIIMS, following a three-year investigation, recently concluded that rheumatoid arthritis flares up with increase in PM levels.

The study, which involved 1,000 patients, showed another worrying trend: 30% of them were “healthy” but showed presence of “inflammatory markers” — which meant the disease could be triggered in the future.

The study also revealed that 18% of patients tested positive for auto antibodies, which trigger autoimmune diseases — that can have pathological effects like tissue damage, altered organ growth and altered organ functions.

Dr Uma Kumar, head of the rheumatology department at AIIMS and the principal investigator of the study, said: “Our OPD has witnessed a spike in the number of patients. These are follow-up cases — patients who already had arthritis and autoimmune diseases. The study had found that autoimmunity is linked to pollution levels. In these diseases, the consequences are long-term. It can start from childhood and manifest decades later. When someone is exposed to such pollution levels for years, they are at risk of developing autoimmune diseases. In such cases, disability is higher. Today, children are exposed to bad air quality — after 30 years they might get arthritis.”

Dr Kumar added, “During the smog, we saw a flare-up of diseases. Our study found that autoimmunity is connected to pollution levels. We now have scientific data to prove it. When PM levels are very high, it enters the blood. These foreign particles not only increase inflammation but also bring changes in the body’s cellular proteins.”

 
SOURCE : http://indianexpress.com/article/india/delhi-air-pollution-smog-odd-even-scheme-delhi-winter-respiratory-infections-burning-of-crops-stubble-burning-pollution-4934733/
 


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