Air Pollution : a mass poisoning. . Each minute 2 people die due to air pollution

Air pollution is an increase in harmful quantities of substances such as gases(carbon dioxide, carbon monoxide, sulphur dioxide, nitrogen dioxide, methane, chloro fluoro carbon etc.), particulates(organic and inorganic) and biological molecules in the atmosphere. Air pollution in India is estimated to kill 1.5 million people(around a quarter of global) every year, being the fifth largest killer in India. One out of 9 die due to air pollution in the world as per WHO. One out of three children in Delhi has reduced lung function. India accounts for the highest number of premature deaths due to ozone pollution amounting to 1.1 million. Chronic obstructive lung disease deaths which are ozone-related, are highest in India. As per WHO, 7 million premature death worldwide due to air pollution is there, which amounting to all combined deaths due to war, murder, tuberculosis, malaria and HIV.

The estimated cost of air pollution was 8.5 % of GDP in 2013 in India, an exorbitant economic burden.

Air pollution increased by 13% in the 5 years between 2010 to 2015. In 2001, 25 lakhs vehicles were present in Delhi, which gradually increased to 80 lakhs in 2015, and 1.05 crores in May 2017. Number of vehicles in Delhi is more than the combined number in Kolkata, Mumbai and Chennai.

Stubble burning spikes air pollution every year during October- November months in Delhi. Five hundred million tonnes of crop waste generated every year in India.

Pollution is a significant risk factor for:

Elderly, less than 5 years children, pregnant women are the high-risk population for pollution. People with Immune deficient, organ transplant, asthma, chronic obstructive lung disease, heart disease, and kidney disease are more prone to the detrimental effects of pollution. Pollution may lead to irritability, depression, lack of sleep, tiredness, respiratory tract (infection and irritation) involvement, stroke and lung cancer. An association between air pollution and cervical cancer and brain cancer have been observed.

The health effects may include difficulty in breathing, wheezing, coughing, nasal irritation. Itchy eyes, nose and skin may be present. Asthma, existing respiratory and cardiac conditions may worsen. Pollution can lower children's immune system and also increase the risks of cancer, epilepsy, obesity, diabetes. Early exposure to air pollution causes autism and schizophrenia. Also affects short-term memory, learning ability, and impulsivity(irritable, aggressive) of children. Air pollution increases the risk of dementia in people over 50 years old. In pregnant, it may cause growth retardation of the baby and intrauterine death of the newborn.

Air quality index:

Air quality( air pollution)is represented by the annual mean concentration of particulate matter PM10 (particles smaller than 10 microns) and PM2.5 (particles smaller than 2.5 microns, ie., about 40 times thinner than a human hair). The ultrafine PM is smaller than 0.1 microns. Safe levels for India, PM10 and PM2.5 levels (at any time) of <100 and <60 are satisfactory, respectively.
More than this is implied to get bad effects of pollution. Air quality index more than 200 prohibits
all kinds of group running or marathon. Similarly, air quality index more than 300 stops people
going for a morning walk or exercises. Particulate matter (PM), originates from volcanoes, dust storms, forest, agricultural stubble and grassland fires, burning fossil fuels in vehicles, power plants and various industrial processes. Ultrafine particles can spread to 300 metres and can increase mortality. It reaches to the last part of the lung that is alveoli and gets absorbed in blood to move in our body throughout. Polyaromatic hydrocarbons from Diesel and kerosene are ultra-fine particulate which can lead to lung cancer, which is one of the most common cancer-causing death.

AQI (depending on pm2.5,pm10,so2,no2,o3, co, co2, and On) is acceptable below 100; but >100 is moderate, >200 is poor, >300 is very poor, >400 is severe poor.

Components of air pollution:

Sulfur dioxides – particularly sulphur dioxide is produced by various industrial processes, volcano and Coal/petroleum combustion. In Delhi, only about 20% of the industrial units are set up in the approved industrial areas whereas the rest of them are in residential and commercial areas. There has also been reported that the number of vehicles plying on the roads of Delhi is more than that of the three metropolitan cities of Mumbai, Kolkata and Chennai taken together. This decreases lung function. Indians have around 15% lesser lung functions compared to Europeans.

Nitrogen oxides are expelled from high-temperature combustion and are also produced during thunderstorms by electric discharge. This reddish-brown toxic gas has a characteristic sharp, biting odour. This causes inflammation to the respiratory tract.

Diesel exhaust has been linked to acute vascular dysfunction and increased thrombus formation. Also, this being a cancer-producing substance.

Carbon monoxide is a product of combustion of fuel such as natural gas, coal or wood. Vehicular exhaust contributes to the majority of carbon monoxide into our atmosphere, creating smog formation. Modern smog acted on by ultraviolet light from the sun to form photochemical smog(dangerous pollutant). Since this is a heavy white layer over the ground and affects during respiration. Only when there is rainfall or there is a strong wind which takes it away.

Chlorofluorocarbons are released from air conditioners, refrigerators, aerosol sprays, and then rise to the stratosphere, where they damage the ozone layer. This allows harmful ultraviolet rays to reach the earth's surface. This can lead to skin cancer, eye disease and can even cause damage to plants. In India in 2014, it was reported that air pollution has reduced crop yields in the most affected areas by almost half.

Volatile organic compounds (VOC) – They are categorized as either methane or non- methane (NMVOCs). The aromatic NMVOCs are suspected carcinogens and may lead to leukemia(blood cancer) with prolonged exposure.

Dioxins and furans are created by burning of plastics. These compounds are also endocrine disruptors(may cause obesity, diabetes) and can mutate the human genes.

Indoor pollution

Building materials including carpeting and plywood emit formaldehyde gas. Fumes from paint, hair spray, varnish, aerosol sprays and other solvents, are indoor pollution from volatile organic compounds. Lead paint can degenerate into dust and may be inhaled. Indoor air pollution maybe because of the use of air fresheners, incense, and scented items. Indoor

pollution fatalities may be caused by pesticides sprays used without proper ventilation. Clothing emits tetrachloroethylene, for days after dry cleaning. Pets produce dander, mites in bedding, carpeting. Mould forms on walls may generate mycotoxins. If lack of indoor air ventilation, then these airborne pollutants accumulate more.

Prevention action:

A Mass Rapid Transport System is useful to transport for long distances. Every individual should keep a proper check on the pollution level of their vehicles. Keep car, boat, and other engines properly tuned. Follow gasoline refuelling instructions for efficient vapour recovery, being careful not to spill fuel and always tighten your gas cap securely. Making more use of CNG.

Be sure your tires are properly inflated. Do not speed up or drive aggressively because that only produces more emissions, as well as tire rubbing, may produce fine pollution particles. Avoid driving during rush hours. More pollution is produced during stagnant traffic. During red light car, the engine should be stopped. Replace car air filters in stipulated time.

Bicycles and Solar power plants are a good eco-friendly option for a long term plan. N95 or N99 mask(ordinary surgical masks are of less use) should be used for all public coming out from their houses. Three-layer velvet cloth can be put on the nose in place of a mask to prevent pollution.

In California over the last decade, the number of vehicles became 10 times more but the pollution decreased to one-tenth, this is because of good fuel use. Hence better quality of vehicular fuel is to be used. Biodigesters can be utilized where slash and burn of yard waste/leaves are prevalent.

Poster coated with microscopic, pollution-eating nanoparticles of titanium dioxide, placed on a building, can absorb the toxic emission from around. EPCA(environment protection and control authority) has directed Graded response action plan (GRAP) for daily emergency action from Oct 15, 2019, including targeting pollution hotspots for improving AQI.

If AQI is moderate to poor, then garbage/landfill burning is punishable; if very poor(>300),then Diesel generators prohibited, parking fees are hiked, increased metro and bus services(so that private vehicles can be decreased); if severely poor or emergency category, then sprinkling water on road, stop construction, stop truck entry in city, school shutting etc are done.

Control devices

Electrostatic precipitator (ESP), or electrostatic air cleaner is a particulate device that removes particles from flowing air, using the force of an electrostatic charge. Electrostatic precipitators are highly efficient filtration devices that minimally impede the flow of air through the device, and can easily remove fine particles such as dust and smoke from the air stream.

Baghouses Designed to handle heavy dust loads, a dust collector consists of a blower, dust filter, a filter-cleaning system, and a dust receptacle or dust removal system.

Trees around your house have the unique ability to clean the air of gaseous pollutants, such as carbon dioxide, nitrogen dioxide, carbon monoxide, sulfur dioxide.
Ro-Ro(Rollon-Rolloff) on roads: Indian railways should carry loaded trucks on a goods train to decongest the Delhi roads.

Reduce Pollution Indoor :

Use natural instead of conventional chemical-filled products to clean utensils and house. Use natural cleaning methods such as baking soda, vinegar and lemon juice.

Perfumes consist of a number of synthetic chemicals that when being sprayed in the air, break down into harmful compounds. Instead of using them, use essential oils, herbs and flowers to make your home smell nice.

Keep Air-conditioning temperature not be lesser than 25 °C.
Consider using air filters and getting your HVAC (heating, ventilation and air conditioning systems) checked regularly. Also, aromatherapy can often make air quality worse unless they have HEPA (high-efficiency particulate arresting) air filters.

Cigarette smoke contains up to 70 carcinogenic substances and more than 6000 chemicals that remain in the indoor air for a long time.

Keep air-cleaning houseplants: Some plants have the ability to remove air pollutants. Such plants are Peace Lily (Spathiphyllum), Areca Palm (Chrysalidocarpus lutescens), Chinese Evergreen, English Ivy (Hedera helix), Golden Pothos (Epipremnum aureum), and Bamboo Palm (Chamaedorea seifrizii).

Dr Srikant Sharma, author of the article is a Senior Consultant Physician at Moolchand Medcity, New Delhi.