Air pollution major cause of increased respiratory disease burden in India: Lancet

India, having 18% of the global population contributes to 32% of the global burden of respiratory diseases, with COPD (chronic obstructive pulmonary disease) and asthma being responsible for 75·6% and 20·0% of the chronic respiratory disease DALYs (disability-adjusted life years) respectively.

According to the Global Burden of Disease Study 1990–2016 published in The Lancet, about 55 million of the people in India suffer from COPD. The major risk factor for COPD being air pollution (53·7%), followed by tobacco use and occupational risks (16·5%).

"The increasing contribution of these diseases to the overall disease burden across India and the high rate of health loss from them, especially in the less developed low epidemiological transition level (ETL) states, highlights the need for focused policy interventions to address this significant cause of disease burden in India," write the authors.

India State-Level Disease Burden Initiative CRD Collaborators consisting of Sundeep Salvi and colleagues conducted the study with an objective to report the trends in the burden of chronic respiratory diseases and the heterogeneity in their distribution in all states of India between 1990 and 2016.

• The contribution of chronic respiratory diseases to the total DALYs in India increased from 4·5% (95% UI 4·0–4·9) in 1990 to 6·4% (5·8–7·0) in 2016.


• Of the total global DALYs due to chronic respiratory diseases in 2016, 32·0% occurred in India.


• COPD and asthma were responsible for 75·6% and 20·0% of the chronic respiratory disease DALYs, respectively, in India in 2016.


• The number of cases of COPD in India increased from 28·1 million (27·0–29·2) in 1990 to 55·3 million (53·1–57·6) in 2016, an increase in prevalence from 3·3% (3·1–3·4) to 4·2% (4·0–4·4).


• The age-standardized COPD prevalence and DALY rates in 2016 were highest in the less developed low ETL state group.


• There were 37·9 million (35·7–40·2) cases of asthma in India in 2016, with similar prevalence in the four ETL state groups, but the highest DALY rate was in the low ETL state group.


• There were 37·9 million (35·7–40·2) cases of asthma in India in 2016, with similar prevalence in the four ETL state groups, but the highest DALY rate was in the low ETL state group.


• The highest DALY rates for both COPD and asthma in 2016 were in the low ETL states of Rajasthan and Uttar Pradesh.


• The DALYs per case of COPD and asthma were 1·7 and 2·4 times higher in India than the global average in 2016, respectively; most states had higher rates compared with other locations worldwide at similar levels of Socio-demographic Index.


• Of the DALYs due to COPD in India in 2016, 53·7% (43·1–65·0) were attributable to air pollution, 25·4% (19·5–31·7) to tobacco use, and 16·5% (14·1–19·2) to occupational risks making these the leading risk factors for COPD.