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Patralekha Chatterjee | Toxic air: Get serious on avoiding death by breath

Health must be the prism through which we view and address air pollution.

If you live in a city with clean air, cycling is good for your health. Not so, however, in cities with toxic air. A cyclist inhales more air, and when the air is severely polluted, it means inhaling more toxic air. Which means cycling is not advisable in Delhi right now. Ditto for brisk walking or any kind of vigorous outdoor activity. In an all-too-familiar scenario, the city, home to more than 20 million people, as well as its neighbourhood, is once again making headlines because of its toxic air even amid all the news about looming Assembly elections in several states, Israel’s attacks on Gaza and the ongoing humanitarian catastrophe.

At the time of writing, pollution levels in Delhi have slightly improved. From “severe” for five consecutive days, it had moved up to the “very poor” category. As if on cue, on November 6, Facebook tossed up a photo I had clicked last year on the same date -- it was about sunset, smog and the city.

Many among the upper middle classes and rich are seeking a reprieve by installing air purifiers at home, travelling in air-conditioned cars and spending as much time indoors as possible. But it is still a wafer-thin minority that has all these options.

What about the rest?

All schools in Delhi have been ordered to remain shut till November 10; construction is banned, as is non-essential truck movement. Water sprinklers are being used to settle the dust. Doctors are asking people to wear masks, stay indoors as long as possible. And the “odd-even” car restrictions are set to return after Diwali.

Year after year, it is the same story.

How does one talk about India’s terrifying air pollution when the discourse around it seems repetitive and bordering on hopeless?

What are we missing in the conversation about air pollution? How do we overcome hopelessness?

To start with, there is a need to separate the official talking points from the national conversation about toxic air. Official India does not like global benchmarks; it is hesitant to see a correlation between air pollution and deaths and diseases. But the national conversation is shaped not just by official statements. It must take on board what scientists and experts are saying and citizens’ voices.

Despite the mounting scientific data, we are not taking the devastating health effects of toxic air seriously. A scientific paper published by the India State-Level Disease Burden Initiative in December 2020 on the health and economic impact of air pollution in Lancet Planetary Health noted that 1.7 million deaths in India were attributable to air pollution in 2019, 18 per cent of the deaths in the country. It said that while household air pollution is decreasing in India, resulting in 64 per cent reduction in the death rate attributable to it from 1990 to 2019, the death rate from outdoor ambient air pollution has increased during this period by 115 per cent.

Health must be the prism through which we view and address air pollution. Official strategies to deal with air pollution do not centre-stage the health effects. Many experts say that, typically, all governments in India opt to deal with low-hanging fruits. They look for quick fixes, silver bullets, like smog towers and spraying water. These can improve things a little in the short term, but they will not solve India’s smog problem.

“The problem with the national conversation on air pollution is that it is fixated on specific times of the year and on extremes. So, the official strategy to deal with air pollution also largely pivots around winter, ignoring what happens the rest of the year. The discussion is also Delhi-centric. But air pollution now is a pan-India problem, also prevalent in smaller cities”, says Bhargav Krishna, environmental health and policy researcher and fellow, Sustainable Futures Collaborative.

On November 5, Fatehabad in Haryana topped the “most polluted city” list in India, with PM2.5 concentration at 338 µg/m3 (microgrammes per cubic metre), as Sunil Dahiya, analyst, Centre for Research on Energy and Clean Air (CREA), pointed out on X (formerly Twitter). Delhi was second, with a PM2.5 concentration of 334 µg/m3. Mumbai’s air is also raising concerns though it is not as bad as Delhi.

Arguably, winter is the worst, pollution sits in the air, but, as Krishna points out, we cannot deal with India’s air pollution problem “if we ignore what happens for the rest of the year”.

There are multiple reasons for toxic air in many parts of India -- construction, vehicular pollution, stubble burning, industrial emissions and others. We need to talk about all the factors which cumulatively contribute to toxic air, and not just a few. We need to ask questions. For example, why is there so little focus on the contribution of power plants to foul air? Only five per cent of India's coal-fired power stations have installed flue gas desulphurisation systems, that are air pollution control mechanisms for sulphur dioxide emissions, according to a recent study by environmental think tank Centre for Science and Environment.

And we need to talk about regulation. “We have emissions guidelines, but they are not enforced. The regulatory capacity and will are not there,” says Krishna.

We need hyper-local data on health impacts of air pollution. “Currently, we do not have data about respiratory infections from primary health centres or at the block level. The other source of health data would be from outpatient visits. There is no centralised database on this currently. A state profile will not give us the necessary micro picture,” Krishna adds.

In January 2019, India launched its National Clean Air Programme. Key goals included reduction of PM2.5 levels by 20-30 per cent by 2024 relative to 2017 levels in 132 cities. A recent report by CREA points to sluggish progress -- only 37 of the cities have completed even the source apportionment studies which were supposed to be completed in 2020. And that would be just the first step. Almost all these reports still lack public availability and no city action plan has been updated with new findings of the report as envisaged in the NCAP. The National Emission Inventory is also yet to be formalised, which was to be completed by 2020, says CREA. India will also have to install many more air quality monitoring stations to reach its own goals by 2024.

That might seem like a tall order. But it is not, if we are serious about avoiding death by breath. We must address the toxic air problem across the country, through the year, not just in winter.

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