India has undergone an industrial revolution in the last few decades. This has made the country one of the world’s largest economies. It has also had disastrous effects on the environment – and on public health.
Highlighting this issue, recent World Health Organization (WHO) data showed that of the fifteen most highly polluted cities in the world, fourteen are in India. In fact, Indian cities were found to exclusively comprise the top fourteen entries. This leaves India as the most polluted nation on earth.
Such high levels of pollution nationwide mean negative health effects on the population are inevitable. Some, like lung disease, are commonly known to result from high levels of pollution. However, there are myriad of health conditions that are less well-known as being either aggravated or caused by pollution.
Particulate matter – India tops global lists
Particulate matter refers to microscopic airborne particles. These commonly result from human activity such as combustion of fuel, in car engines and power plants. These particles can be inhaled and directly enter the lungs. In some cases, particles are so small they enter the bloodstream. Due to this a number of health concerns can arise from high levels of these pollutants in the atmosphere.
The WHO study analysed the concentration of both PM2.5 and PM10 in the air in a number of major cities. PM10 refers to coarse particles with a diameter between 2.5 and 10 micrometres. PM2.5, on the other hand, is fine particles with a diameter of less than 2.5 micrometres. PM2.5 is considered to be far more dangerous to humans. Due to its smaller size it is capable of lingering in the air for longer periods of time and has a greater chance of entering the bloodstream.
Kanpur, in Uttar Pradesh, is at the top of the list. It has the world’s highest atmospheric concentration of PM2.5, at 173 micrograms per cubic metre. Faridabad takes second place on the list. Varanasi comes in third.
India does not fare much better in lists based on PM10 pollution. Delhi is the world’s most polluted megacity in this regard, with Mumbai (India’s most populous city) in fourth place. Delhi also places sixth on the list of most polluted cities in terms of PM2.5 pollution.
Exposure of children to PM2.5 particulate matter
Around 93 percent of children globally are regularly exposed to air pollution levels considered dangerous to their health. This is according to a report published by the World Health Organization (WHO).
India may be facing the brunt of the negative effects due to air pollution. The WHO claims that India faced 60,987 deaths of children under five years of age in 2016 that could be linked to their exposure to PM2.5.
India is the country with the highest number of recorded deaths due to PM2.5 exposure in this age bracket. Nigeria fell short of India with 47,674 deaths, followed by Pakistan with 21,136 deaths and Democratic Republic of Congo with 12,890 deaths.
Heart and lung disease: The most prominent results of pollution
Non-communicable diseases (NCDs) are on the rise in India. Heart disease accounted for 28.1 percent of all deaths in India in 2016. Pollution is a considerable risk factor for many NCDs. As such, it may — at least in part — be driving India’s NCD rates higher every year.
Fine particulate matter in particular may be a cause for concern for India’s cardiac health. “Breathing in fine particles can cause death by harming the heart and blood vessels….which can lead to heart attacks, stroke, cardiac arrest, and/or congestive heart failure,” according to the US Environmental Protection Agency (EPA).
Lung disease is the most obvious condition resulting from the inhalation of pollutants. Air pollution has the potential to both cause these conditions, as well as worsen the symptoms of those already with some form of respiratory disease, including conditions such as asthma and chronic obstructive pulmonary disease (COPD). Lung cancer can also result from consistent exposure to high levels of pollution.
Last year on November 7 in Delhi when smog levels hit extreme heights the volume of PM 2.5 in the atmosphere across the National Capital Region (NCR) hit 728. The following afternoon, levels reached 833. The World Health Organization (WHO) says that exposure to levels above 100 is unhealthy. Exposure above 300 is ‘hazardous.’
PM2.5 is a known carcinogen, acting as a risk factor to cancers such as lung cancer. Dr Arvind Kumar likened breathing the air in Delhi during the smog crisis to smoking fifty cigarettes a day. The Chief Minister of Delhi Arvind Kejriwal called the city “a gas chamber.”
A less obvious effect was implicated in a study published in The Lancet Planetary Health. The study suggests that India’s high levels of air pollution have a hand to play in the country’s rising diabetes levels. The research attributes 3.2 million cases of diabetes a year to air pollution worldwide. The biological mechanism is currently unknown, though the study has uncovered clear correlations on a global basis that show higher levels of diabetes in areas with pollution.
Less obvious effects: Could pollution contribute to rising infertility levels?
Infertility affects ten to fourteen percent of Indians according to the Indian Society of Assisted Reproduction (ISAR). The ISAR warns that these figures are beginning to rise rapidly as infertility becomes more common in urban environments. Could pollution be playing a role in this?
Sperm count in an average Indian male three decades ago averaged at around sixty million per milliliter of sperm, says the All India Institute of Medical Sciences (AIIMS). Currently this figured has reduced by two thirds, with the average sperm count just twenty million per milliliter. Correlation does not equal causation. However, the simultaneous rise in pollution levels and drop in male fertility may be related.
Recent studies indicate that pollution may be a contributing factor towards infertility in both males and females. Constant exposure to air pollution takes a toll on a person’s health in general and can cause a number of health conditions predominantly related to lung function. This, combined with poor diet and a lack of exercise, can cause hormone levels such as testosterone to fall, resulting in lower fertility levels.
It may be possible that pollution is playing a more direct role in causing infertility. A process known as gametogenesis may be the pathway by which this occurs. Gametogenesis is where stem cells are differentiated into sperm and egg cells. Pollution is believed to cause genetic damage during this process, which can render the affected sperm or egg unviable. This can then result in either pregnancy not being possible, or increase the possibility of miscarriage.
Depression among farmers, linked to climate change and pollution?
In the words of Dr. Vikram Patel, an influential Indian psychiatrist and mental health expert with Harvard Medical School, “farming is an inherently risky occupation, with annual incomes often held hostage to the weather, and it’s getting riskier in the era of climate change.”
The increase in suicide rates that were correlated with the temperature increase were not observed outside of the growing season. This would indicate that the increase in temperature is linked with events such as droughts and failing crops. These factors may lead to lack of food availability, or reduced pay for farmers and farm workers. This, in turn, may lead to suicide – especially when coupled with other factors such as high rates of alcoholism in rural farming communities.
Pollution and dementia?
Recent evidence is emerging linking high levels of pollutants to dementia and Alzheimer’s disease. This recent finding is by no means limited to the pollution commonly found in cities; India’s rural population may also be at risk due to a similar correlation found between pesticide fumes and dementia.
Findings of a study conducted in Taiwan suggest long-term exposure to O3 (ozone) and PM2.5 above the current US EPA standards are associated with increased the risk of AD. India now tops the list of cities with high levels of PM2.5, and so may face considerable issues with dementia in the coming years.
Climate change: a combination of gradual and extreme changes
Previous studies have shown a gradual rise in temperature in India. Over the period of 1960 to 2009 average temperatures have risen by just over 0.5°C. This is accompanied by an increased prevalence of heatwaves. These factors combined have lead to a 146 percent increase in probability of heat related mortality.
A UN report from 2018 has predicted a 1.5 °C temperature rise globally by 2040 – with potentially devastating implications for India’s water supply. As temperatures rise they do not do so in an even manner. The figure is simply an average. In reality such a rise implies that heatwaves and more drastic cold temperatures are likely to be more common. Both of these issues can have devastating effects on water supply, in turn affecting the ability to grow crops.
The rising prevalence of heatwaves and overall higher temperatures have led to droughts becoming more common. This can have a severe impact on groundwater supplies and so reduce the capacity of farmed land to produce food. This in turn can lead to food and water shortages that could exacerbate India’s issues with malnutrition.
Violent weather phenomenon such as the dust storms at the beginning of May in 2018 are becoming both more common and more severe. The incident in may left a trail of death and devastation across the northern Indian states of Rajasthan and Uttar Pradesh. More than 127 people were killed. Dust storms are a normal part of India’s climate in the summer months. They usually pass with comparatively little incident. The death toll rarely exceeds a dozen or so.
The flooding in Kerala is another example of extreme weather effects. By the time the floods had receded hundreds had died and hundreds of thousands had been displaced. The mass displacement and disruption to services opened opportunities for infectious disease to spread.
“All over India, temperatures are abnormally high,” Indian Institute of Tropical Meteorology climate scientist Roxy Mathew Koll told The Hindustan Times. “Even if they are not the drivers, they will aggravate the situation by causing the atmosphere to become more unstable.”
Climate change and the mosquito vector
Recent studies suggest changing climates also play a role in dengue fever distribution.
The theory states that as temperatures rise, more and more areas of the globe become potential breeding areas for mosquito populations. In turn, this puts populations at risk that would previously not be exposed to mosquitoes, leaving them prone to diseases such as malaria and dengue fever.
By limiting the effects of climate change, millions of dengue fever cases could be prevented. This mindset also applies to any other diseases spread via a mosquito vector.
Climate change may be playing a role in depleting water sources
Water shortages are being seen as more of a common occurrences as temperatures and weather patterns change. Summers of recent years have been exceptionally hot, with heatwaves becoming more frequent across the country. In mid-March of 2018, 91 major reservoirs were at just 32 percent of their capacity.
Ground water, a depleting resource
India will face severe shortages of water by 2050, a UNESCO report warns. This finding was backed up by a report published in The Lancet, which suggests that by 2050 India could be facing the very real threat of regular famine due to lack of groundwater.
Rivers and groundwater resources are becoming increasingly heavily polluted across the country. The Central Pollution Control Board identifies 275 Indian rivers as polluted – more than double the figure five years ago. The high levels of contamination across the country mean 19 percent of the world’s people who lack access to clean water live in India.
In the short term, this could result in situations similar to that seen in Cape Town, in which a “day zero” situation was approached where drinking water would no longer be available within the city. With dwindling supplies of unpolluted water available, this could become a regular occurrence within India if the situations is not resolved.
Desertification, the degradation of arable land
The Indian Institute of Meteorology has issued warnings that the duration of dry spells in the country are set to increase. While the average annual rainfall will remain the same, it is predicted to come in short, heavy periods. Such changes to the weather could make it far more difficult to make use of India’s rainfall, depleting reservoirs and groundwater reserves.
Factors such as this can lead to desertification. This is the process by which otherwise arable land is transformed into deserts and barren land, typically through depletion of water or nutrients in the soil. Such a process could severely impact India’s farmable land. With an ever growing population, this could potentially be devastating.
Sanitation in Indian Cities: A neglected issue
A survey, published by the Urban Development ministry shows how basic infrastructure, especially sanitation, cannot keep up with the fast growth of Indian cities. The survey examined 1405 cities in twelve different states and found out that around fifty percent of these cities don’t have a proper water supply system. Even if the households have access to piped water in around eighty percent of these households the average supply is less than five hours per day.
Concerning sanitation the numbers are even worse: Over seventy percent of the households in the analyzed cities don’t have access to toilets or a sewerage system. Almost sixty percent of the world’s population who has to rely on open defecation lives in India, but this number also includes many people in rural areas.
Poor handling of India’s industrial waste as well as commonly practised open defecation all contribute to the pollution of India’s water supplies. The rapid expansion of the Indian population, coupled with ever increasing numbers of individuals flocking to the already overcrowded metropolises is also exacerbating the issue.
From smog cannons to more effective strategies
In its attempts to cut down pollution rates, India has attempted some odd strategies. The most bizarre of which was the government’s investment in $40,000 smog cannons. These cannons would fire vast amounts of water in the air which, in theory, would capture at least some of the pollution and so reduce smog levels in the capital. The plan was ridiculed and was noted as being unsuccessful.
In more reasonable and effective attempts at cutting down pollution, the Ujwala Scheme, for example, was set out to encourage families to use cleaner methods of cooking by providing free LPG connections. Burning of biomatter and coal within Indian homes is a notable cause of pollution within the country. Due to the confined areas in which this takes place, the smoke produced can be harmful to occupants of the home. The scheme has been praised by the WHO.
The cost of pollution
The World Bank Disaster Management and Climate Change Unit has prepared a report estimating the costs to the Indian economy incurred by the excess of pollution, with an estimate totalling 3 percent of India’s GDP in health care costs. This comes alongside cost estimates for environmental damage consisting of Rs 3.75 trillion, or 5.7 percent of the Indian GDP.
Symbolic of the crisis, the Taj Mahal
Perhaps India’s most iconic landmark, the Taj Mahal is demonstrating the effect pollution is having on India. The Taj Mahal is famous for its ivory white complexion. However, in recent years pollution has discoloured the building. According to a petition filed in the Supreme Court, “yellow pallor pervades the entire monument. In places the yellow hue is magnified by ugly brown and black spots.”
Representing the crisis, the Taj Mahal reflects India’s current polluted state. Major change is needed to address the situation. While historical monuments may reflect the change in the nation, the figures are far more damning. There were an estimated 2.51 million fatalities stemming from pollution related afflictions in 2015.