World Health Day 2019: India accounts for quarter of the world's air pollution deaths

Every second person in the world lives in areas that don't fall into even the least stringent WHO targets.

Every year, more people die from air pollution-related illnesses in the world than road traffic injuries or malaria. It trumps better-known risk factors like malnutrition, alcohol use, and physical inactivity in terms of the ill-health effects associated with it. In India, over 1.2 million people lost their lives due to air pollution in 2017, according to a global report on air pollution released on Wednesday.

The State of the Global Air 2019 report looks at air pollution caused by three of the most problematic pollutants: fine particles (PM2.5), ozone and household (indoor) air pollution. It was compiled and released by the US-based Health Effects Institute (HEI). As per the report, over 90 percent of people in the world live in areas with unhealthy levels of air pollutants as per guidelines set by the World Health Organisation.

Half of these areas don't qualify even for the least-stringent targets for air quality as per the guidelines.

The (deadly) state of India's air

The State of Global Air 2019 report looks at how long-term exposure to outdoor and indoor air pollution has affected health.

Five million cases of death from stroke, diabetes, heart attack, lung cancer, and chronic lung disease the world over were linked with air pollution in 2017, according to the report. Of these, 1.5 million were in India and China, directly related to PM 2.5 levels.

China and India come up very often in the report and are together responsible for over half the global deaths. Among Indians, air pollution was the third highest cause of death in 2017, costing more lives than smoking did. Children born in South Asia will live 26 months fewer than they would in an area with better air quality, while globally, life expectancy is lower by 20 months.

Unlike India, China's PM2.5 pollution levels have seen a marked drop in recent years, which the report attributes to extensive government efforts to control emissions from power plants, traffic, household burning of coal, among other sources.

In India, government schemes launched to address air pollution like the Pradhan Mantri Ujjwala Yojana, Household LPG program, accelerated Bharat Stage 6 clean vehicle standards, and the new National Clean Air Programme can have significant health benefits in the coming years.

China's and global levels of PM2.5 pollutants vs targets set by WHO. Image: HEI

China's and global levels of PM2.5 pollutants vs targets set by WHO. Image: HEI

"These and future initiatives have the potential, if fully implemented as part of a sustained commitment to air quality, to result in significant health benefits in coming years," Robert O'Keefe, Vice-president of HEI, told Press Trust of India. 

Air quality changes: 1990 to 2007

Not all countries have seen similar changes in air quality indices over the years. There have been wide disparities in air quality globally from 1990 to 2017, the report says.

Russia, the European Union, Japan, Brazil, and the United States saw the most improvements in air quality during the 18-year period. But the bulk of the population in Bangladesh, Pakistan, Nigeria, India, and China have been exposed to levels of PM2.5 that are well above the WHO's warning levels — the "Interim target" of 35 ug/m^3.

And while the quality of it has been poor over the years, India and China appear to be particularly susceptible to its disease burden, as is clearly visible in the relative pollution levels and disease burden in countries neighbouring India (see slider below).

Tracking tiny air-borne agents of doom

An important precursor to PM2.5 pollution is sulfur dioxide gas, the levels of which have dramatically dropped in China from 2005 to 2017, as can be seen in this animation from NASA. Coal-fired power plants are an important source of sulfur dioxide and remains something India struggles with today.

Ozone pollution is another challenge in more-developed countries. It is increasingly starting to affect developing countries too, adding to the existing air quality concerns. These levels are on a slow but steady rise from warming temperatures and a rise in the emissions of ozone precursors from industries.

Here's what ozone levels from around the world look like as of 2017.

Global ozone concentrations in 2017 (shown as population-weighted seasonal averages). Image: State of the Global Air Report 2019/HEI

Global ozone concentrations in 2017 (shown as population-weighted seasonal averages). Image: State of the Global Air Report 2019/HEI

Household and Indoor Air Pollution

India has another unique concern with regard to air pollution — a large population in the country still uses the old-school method of burning solid fuels like coal, wood, charcoal, dung, and other forms of biomass to cook food, and heat and light their houses. This is a big contributor to PM2.5 levels in and around homes. Fine particles in ambient air from household air pollution also eats away at health. 846 million Indians (that's ~60 percent of the country) live with a household air pollution problem.

The many effects that air pollution has on health are also reflected in a loss of life expectancy. Another global study by Greenpeace released on 5 March this year cited Delhi-NCR as the most polluted capital city in the world, and Gurugram, the most polluted city.

"(The report) is a reminder to us indicating that our efforts and actions to reduce the invisible killer, i.e., air pollution are not enough, and we need to do much more than already planned and done," Pujarini Sen, a Climate and Energy Campaigner at Greenpeace India, said. "Beijing is showing us that it can be done, as have many other cities in Europe and the US over past decades... The question which remains to be answered is whether there is enough political will to aggressively fight the health emergency India faces today and move away from polluting fuels and practices of the past?"

With elections looming, there appears to be more traction in space and defence than in strategies to address the dire pollution problem. Could a report titled "State of the Global Air" with 21 mentions of India in the text of a 24-page report turn some heads, draw attention to the alarming health crisis brewing in the country? Let's hope so, because something needs to be done, and now.

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