How Mumbai's air pollution is sending people to respiratory ICU

Mumbai’s deteriorating air quality, which has been overlooked amid soaring pollution levels in Delhi, but it is equally upsetting. On Sunday, the financial capital was ranked among the world’s most polluted cities. The worsening situation has even prompted a hospital to set up a special Intensive Respiratory Care Unit (IRCU) to treat patients with respiratory problems. Let’s take a closer look. How bad is Mumbai’s pollution? Like Delhi, Mumbai has been flying under India’s radar. The air quality index (AQI) in Mumbai on Wednesday morning was in the “moderate” category, with a reading of 149, according to the System of Air Quality and Weather Forecasting and Research (SAFAR). Notably, an AQI between 0 and 50 is considered “good,” 51 to 100 is “satisfactory,” 101 to 200 is “moderate,” 201 to 300 “poor,” 301 to 400 “very poor,” and 401 to 500 “severe.” The coastal city was largely free of pollution related problems like haze or smog, due to its geographical advantage of being located on the coast and being surrounded by water on three sides. The strong sea wind eliminates most of the pollutants from Mumbai’s air, saving it from severe conditions like in the National Capital or Kolkata. However, this advantage isn’t helping anymore.

The dream city is choking, with air quality being worse than in Delhi several days this year. According to News18, Mumbai witnessed the longest spell of toxic air quality from November to January last year. How it is affecting patients? The pollution is now taking a serious toll on Mumbaikars, with a significant rise in respiratory conditions like Chronic Obstructive Pulmonary Disease (COPD), asthma, inflammation, bronchitis, pneumonia, and tuberculosis across all age brackets. There are common complaints presented by people, such as breathlessness, chest infections, coughing up blood, wheezing, persistent coughing, episodes of fatigue, weight loss, and sputum production. Dr Prashant Borade, Director, Department of Critical Care, Mumbai’s Global Hospitals, told NDTV, “Apart from COVID-19, the other cause is air pollution. The AQI is increasing every day and so is particulate matter of less than 10 microns. These particles enter the lungs. If they are over 10 microns, they may get filtered at the nose level or airway level, but those under 10 microns don’t, and cause these problems,” he said. The doctor said the hospital in Parel has seen a 100 per cent increase in patients with respiratory illnesses. “The symptoms of such airway diseases are breathlessness, wheezing and chronic cough, which doesn’t go away even when they are given antibiotics. It looks like asthma but it may or may not be asthma… We have to give inhalers and some patients even need steroids. Pollution reduces the immunity of the lungs,” he told the news channel. Dr Borade added, “Inhaling this polluted air is like smoking 1,000 cigarettes in a short span of time. This is going to get worse after Diwali. This is despite the government taking several measures to curb the bursting of firecrackers. Air pollution also goes up during the winter and that is one of the reasons we have opened this special ICU.” Also read: In Graphics | The masks you must wear to combat air pollution Why is an IRCU set up in a hospital? According to NDTV, nearly 50 per cent or one in two, of all patients with the aforementioned symptoms who are visiting the Outpatient Department are having to be admitted for at least one or two days; and almost 30 per cent need ICU admission. To provide proper treatment to patients dealing with respiratory issues, Global Hospitals has unveiled an IRCU facility featuring eightbeds equipped with cutting-edge technology, as per Mid-Day. According to the report, this unit is especially designed for the comprehensive management of complex respiratory conditions and will greatly help patients struggling with impaired lung function. Economic Times quoted Dr Borade as saying, “Respiratory infections are a common and serious concern in the ICU, as they can significantly impact the health and recovery of patients. By promoting a holistic approach that combines proper infection control practices with individualised patient care strategies designed to enhance lung function, respiratory infections can be managed more successfully in ICUs.” “The newly launched facility promises to provide the highest level of care to patients facing respiratory challenges. The ICU’s ventilation systems can adapt to individual patient needs. This ensures that each patient receives personalised and optimal treatment, improving their chances of recovery. The unit is outfitted with cutting-edge monitoring tools that allow experts to closely track and analyse a patient’s breathing patterns, oxygen levels, and other vital signs in real time.” Mid-Day quoted Dr Vivek Talaulikar, COO, IHH Healthcare India, as saying. What are the other measures taken? To address this issue, the Maharashtra health department has also initiated a “health action plan,” which will monitor air pollution-relation conditions and ensure prompt treatment, reported Indian Express. On Sunday, it issued an order instructing to implement sentinel surveillance for acute air pollution-related illnesses in 17 cities, tracking respiratory and coronary cases at city hospitals and comparing them to daily AQI levels, the report said. They have also instructed the development of a District Action Plan with a section focusing on air pollution and health-related activities. Notably, this also comes after the BMC announced plans for such advisories in its budget and in the Mumbai Air Pollution Mitigation Plan (MAPMP) to inform citizens during worsening air quality. Moreover, the Bombay High Court asked the civic body and the state government to take action to curb the deteriorating pollution. What are Delhi hospitals doing? The National Capital is also witnessing a growing number of people with numerous health issues due to toxic air they are breathing. Considering this, Ram Manohar Lohia (RML) Hospital has established a weekly “pollution” OPD, according to another Indian Express report. The multi-disciplinary OPD will function on Mondays from 2 pm to 4 pm, which may be later extended. According to the report, doctors from five departments, namely – Respiratory medicine, Ear Nose Throat (ENT), Eye, Dermatology and Psychiatric Department – will attend to patients visiting the OPD. Indian Express quoted RML medical superintendent Dr Amit Shukla as saying, “As pollution peaks around Diwali, doctors witness an increase in the number of patients suffering from illnesses due to pollution… for the first time, RML has started a multi-disciplinary, dedicated and comprehensive OPD exclusively meant for medical consultations of patients suffering from pollution-related illnesses.” With inputs from agencies