We are blessed in the valley that despite several hazards to daily life in various forms, which includes spurts of violence, intense cold, inadequate electricity distribution, and all kinds of stresses, our air quality is very good. The air quality index (AQI) being less than 100.
Jammu is not as good with AQI of 120 to 150, indicating unhealthy air for sensitive groups. As one travels more South, towards Punjab and Haryana, it starts deteriorating to values between 150 and 250, unhealthy to severe. As we come down to NCR the index becomes increasingly high. This is important from our perspective because during the winter months a large population from Kashmir moves to warmer places in Jammu, NCR, Mumbai and Bangalore etc.
Air pollution is at its worst in Delhi and NCR having the distinction of being the most polluted city of the world with AQI being close to 450-500. AQI is a measure of pollution used by government agencies to communicate to the public, how severe the pollution is? The values more than 450 by the Indian authorities is severe pollution of the highest grade. Other Indian cities which come in the top 10 are Kolkata and Mumbai with recorded AQI of 177 and 169 respectively bringing them to 4th and 6th positions.
It is the very small and minute particles circulating in air which are the main culprits. These are termed PM2 (atmospheric particulate matter) and are found in smoke, dust, haze and the exhausts emanating from factory outlets and vehicles. They contain toxins like nitrogen oxide, carbon monoxide, sulphur dioxide, ozone and second-hand cigarette smoke. This part of the year is the time for the capital city to become badly air polluted. Fire crackers, stubble burning, vehicular and industrial wastes, including fumes and dust all contribute towards it, year after year. The fine and tiny particles pass through the filters of the lung and enter blood and lead to excessive clotting and damage to the vessel walls of the arteries supplying the heart and brain. This can lead to unstable angina, heart attacks and brain strokes with their catastrophic consequences.
The association of pollution and heart disease first came to light when in 1930 there was a sudden upsurge of mortality during extreme pollution in Meuse Valley in Belgium and in the well-known London fog incident of 1952. This initiated clinical research and finally after several decades of intense work led to efforts in reducing and minimizing the pollution and finally an Act of clean air regulation was brought in the year 1970.
The first large, prospective cohort study that demonstrated an adverse health impact of long-term air pollution exposure was the Harvard Six Cities study by Dockery and colleagues, in 2012. This study demonstrated that chronic exposure to air pollutants is independently related to cardiovascular mortality which is increased significantly and leads to shortening of life by at least 2.3 years.
Vulnerable Population:
The worst affected population is relatively older individuals, persons suffering from high blood pressure, diabetes, smokers, obese and physically inactive persons. People with an existing heart disease and strokes, those having undergone angioplasty and bypass surgery, and also people with chronic lung disease.
How to reduce pollution?
The example of our neighbour China should be a lesson. As far back as 2012 the authorities there prohibited new coal fired plants and shut down a number of old plants in their most polluted cities. The number of cars in cities like Shanghai, Shenzhen, and Guangzhou were drastically reduced and all electric bus fleets introduced. Aggressive afforestation and reforestation programs were introduced and planted more than 35 billion trees across 12 provinces. It helped the nation to make significant improvements in its air quality between 2013 and 2017, reducing PM2.5 levels (atmospheric particulate matter) by 33% in Beijing. The city achieved an annual average PM2.5 level of 58µg/m³– a drop of 35%.
The Supreme court of India on the plea by a 17 year old student Aditya Dubey, who alleged the “Non-Seriousness and Inaction” of the government has directed the Centre to take necessary steps to control pollution and sought a response from the Delhi Government on steps taken by it. To add to the woes the air is full of micro (PM 2.5) as well as macro particles (PM10). This leads to very severe threat to the lives of the public in both short and long term.
Exercise in Polluted Atmosphere:
Regular exercise, an important part of prevention of heart disease becomes a challenge with high levels of pollution lasting for long periods. It is possible to find out when and where the particle pollution levels are high by meteorological reports. Particle levels are always high near busy roads, high ways especially during the busy hours and in Industrial areas.
Avoid exercises in environments polluted with smoke in the air, burning vegetation and forest fires in the hilly areas. Pollution levels are lower in early mornings and in areas surrounded by green trees. When particle levels are high with haze, smog etc., activities should be delayed until air is cleaner, or move to activities indoors. Reduce the level of activities if air is not clean. Go for a walk instead of a jog, so that the number of pollutants breathed in are reduced.
It is also important to know warning symptoms during exercise, even if they go away a note of them must be taken. Chest discomfort, breathing difficulty, cold sweat, nausea or giddiness can be the initial symptoms of a pending serious problem.
Tail Piece:
We talk about air pollution every year during this period and authorities reassure that stringent action is being taken. Nothing is visible on ground except the announcement of short-term cosmetic measures. It is very unfortunate that the central government along with the Delhi state only blame neighbouring states in producing this, and plead helplessness. This is playing with the lives of millions of our citizen, which is unpardonable.
Prof Upendra Kaul is an eminent Cardiologist, Recipient of Padma Shri and Dr B C Roy
Disclaimer: The views and opinions expressed in this article are the personal opinions of the author. The facts, analysis, assumptions and perspective appearing in the article do not reflect the views of GK.