This document summarizes air quality and health issues related to air pollution in India. It finds that air quality has degraded significantly due to rapid population growth, urbanization, and increased energy consumption and vehicles. Air pollution levels exceed safety limits in many cities like Delhi and are linked to thousands of premature deaths annually from respiratory and cardiac diseases. Studies show the lung health of Indians is the worst globally and conditions like asthma and COPD are on the rise, especially in children living in highly polluted cities. Indoor air pollution from cooking fuels is also a major health concern for women in India.

1. Air Quality and Health: Indian Perspective
S.K. Satheesh1,2*, K. Krishna Moorthy1, S. Suresh Babu3
1Centre for Atmospheric and Oceanic Sciences, Indian Institute of Science, Bangalore-
560012, India.
2Divecha Centre for Climate Change, Indian Institute of Science, Bangalore-560012,
India
3Space Physics Laboratory, Vikram Sarabhai Space Centre, Thiruvananthapuram-695022,
India
*Correspondence: satheesh@caos.iisc.ernet.in

2.  Air quality degradation is an issue of major concern in India.
 This is mainly attributed to increase in population density, rapid economic
growth, unplanned urbanization and industrial growth.
 The population density of India increased from ~150 km-2 in 1975 to > 400
km-2 in 2014
 The annual energy production from 4 x 1018 J in 1980 to ~25 x 1018 J in
2014 (with coal taking the major share)
 The total automobiles from about 20 million in 1990 to over 150 million
2014 with a sustained growth annual rate of above 10%.
 As per a 2012 estimate by the WHO, India ranks among the top 20
countries with high annual mortality rate due to air pollution, with a figure
of approximately 130 deaths per 1 million population.
Air Quality Degradation in India
2

3.  The particulate air pollution in Delhi is higher than that in Beijing, according to the
New York Times, January 2014.
 All buses and taxis are using compressed natural gas (CNG), till particulate pollution
in Delhi has been increasing for the past ten years.
Why is particulate air pollution still increasing in Delhi?
 Delhi's population continues to grow rapidly.
 Construction activities, vehicular emissions, industrial activities, emissions, a
number of coal-fired thermal power plants.
 There is a dramatic increase in the number of passenger vehicles running on diesel
during the past decade.
Air Quality: Delhi versus Beijing
3

4. Levels of particulate matter finer than 2.5 micrometers (PM2.5) exceeded 900
micrograms per cubic meter in some areas, which is almost 15 times the safety limit.
Contributing factors: Transport vehicles, crop-residue burning, fire crackers and so
on.
Crop-residue burning over regions west of Delhi (Punjab & Haryana) significantly
impact Air Quality in the Ganges Valley including Delhi.
Toxic Smog in Delhi: 1 to 9 November 2016
Thick smog enveloped New Delhi during 1 to 9 November 2016
4

5. • Every year during winter, farmers
in the states of Punjab & Haryana
burn the crop residue left from
rice harvesting in order to clear
and prepare land for the next
crop.
• The results are adverse in terms
of the particulate as well as
gaseous pollutants emitted by
these fires.
The Concern
Panjab &
Haryana
Red spots are
fire spots
Image courtesy: NASA’s Worldview 5

6. Source: http://www.urbanemissions.info/cities/delhi-india/whats-polluting-delhis-air/ 6

7. SHARE OF EMISSIONS
7

8. In 2014, the World Health Organisation compiled average annual PM 2.5 numbers for over
1600 cities across the world, including 124 from India. Delhi had the worst air quality in
the world by that estimate, but 12 other Indian cities were among the world’s worst 20 –
Patna, Gwalior, Raipur, Ahmedabad, Lucknow, Firozabad, Kanpur, Amritsar, Ludhiana,
Allahabad, Agra and Khanna.
The Times of India, January 2017
8

9. The World Health Organisation (WHO) concluded that Delhi’s air was the
worst of 1600 cities in 91 countries that it measured and that only 12 per cent
of city-residents breathe safe air.
DELHI AIR POLLUTION
80,000+ Trucks plying daily
10,000+ Pollution related death toll
per year
60 283
Acceptable Current level
PM2.5 level
100 517
Acceptable Current level
PM10 level
Source: The Hindu, December 2014
9

10. ARFINET
Network of Monitoring Stations over India
35 surface monitoring stations
Moorthy and Satheesh,
UNEP Report, 2011
10

11. 2048
Buildup of Particulate Matter over India
Data from 35 surface monitoring
stations
∆Μ / year : ~ 2%
PM2.5(µgm-3)
2050 SCENARIO
PM2.5(µgm-3)
250
200
150
100
50
250
200
150
100
50
11

12. The lowest black carbon particle (mostly PM2.5) mass concentration was observed on
Sundays.
Gradual build-up to a maximum on Friday indicates the influence of anthropogenic
activities.
Around 25% reduction in the black carbon particle mass concentration was observed
between Friday and Sunday.
The increase in black carbon particle mass concentration from Sunday to Monday is
sudden and is about 16%, which rises to as around 25% by Friday.
WEEKEND EFFECT
Atmos. Res., 2010
12

13. Millions
Number of Vehicles in India Has Been Rising Steadily
1970: 2 million
1990: 12 million
2005: 65 million
Number of Vehicles (approx.)
2010: 115 million
2016: > 200 million
65
115
> 200

14. Auto rickshaw (three wheeler)
Public Bus, Bicycles and Walking
Cars (without A/C)
MODE OF TRANSPORT AND EXPOSURE TO AIR POLLUTION
Motor Bikes (two wheeler)
14
Photos: Google Images

15. Chest Research Foundation, Pune, INDIA
Dr. Sundeep Salvi, Director of CRF told in an interview that “Asthma is growing and is
growing more in children, particularly in bigger cities and towns, which we believe is
because of the growing air pollution. But apart from that, Chronic Obstructive
Pulmonary Disease (COPD) is also identified as a big problem in India. COPD is
currently the second leading cause of death. Earlier, we believed that COPD was
caused by tobacco smoking. But the research that we did at CRF clearly identified that
you do not need to be a smoker to have COPD especially the impact of air pollution
both from indoor sources and outdoor sources are contributing significantly to the
growing burden of COPD in our country”
Usually, doctors in India do not show
interest in participating in studies
involving health risk assessment of
air pollution.
Though India’s overall contribution
to world’s medical literature is low,
respiratory research in India show
good progress during the last
decade, thanks to institutions like
CRF.
15

16. World’s worst lungs are in India
- Cross-continental survey raises deeper air pollution fears than suspected
Forced expiratory volume (FEV) measures how much air a person can exhale during a forced
breath. The amount of air exhaled may be measured during the first (FEV1), second (FEV2),
and/or third seconds (FEV3) of the forced breath. Forced vital capacity (FVC) is the total
amount of air exhaled during the FEV test.
September 2011
16

17. The Telegraph, September 2011FEV1 and FVC
 Indians have the poorest lungs among 17 populations across four continents.
 The incidence of respiratory illness has gone up 10 times over the past 20 years.
17

18. ESTIMATED MORBIDITY FOR NON-COMMUNICABLE DISEASES IN INDIA
0
10
20
30
40
50
60
70
Cancer Heart
Diseases
Stroke Diabetes Chronic
Respiratory
Disease
0.6
25
1
28
65
Non-communicable diseases (NCDs) are diseases that affect individuals over an extended
period of time causing socio-economic burden to the nation.
Asthma
COPD
57 million
Millions
Source: Chest Research Foundation

19. 0
5
10
15
20
25
30
35
40
Fever Head Ache Respiratory Digestive Skin
21
11
37
12
7
COMMON SYMPTOMS FOR WHICH A PATIENT VISITS A
DOCTOR (NON-SPECIALIST) IN INDIA
Source: Chest Research Foundation19

20. Traffic density around school and prevalence of Asthma
amongst school children
0
5
10
15
20
Low Traffic High Traffic
11.5
19.3
N =6550; Bangalore, India
Source: Paramesh H., Lakeside Hospital, Bangalore
& S. Salvi, Chest Research Foundation, Pune
Percentage
2-fold increase
in prevalence
The prevalence of asthma was significantly
related to traffic flow density
20

21. Pune City
> 20,000 children
Source: Chest Research Foundation
2003 -> 2.9%
2008 -> 5.4%
2014 -> 9.8%
21

22. Two Indians die every minute due to air pollution
(according to ‘The Lancet’, a medical journal)
Highlights:
 Air pollution and climate change are intricately linked and needed to be tackled together.
 The study find that Patna and New Delhi the worst polluted cities of the world for PM 2.5
levels or the fine particulate matter that hurts the lungs and heart.
 Estimates that globally, 2.7-3.4 million pre-term births may be associated with PM2.5
exposure and South Asia is the worst hit accounting for 1.6 million pre-term births.
 According an estimate by the World Bank, this would amount to a whopping USD 38
billion per year loss in income towards labour in India and costs the global economy USD
225 billion a year in related lost labour income.
The study concludes that:
 Air pollution has emerged as the fourth leading risk factor for premature deaths
worldwide.
 An estimated 18,000 people die every day due to air pollution exposure, making it
the world’s largest single environmental health risk.
The Lancet, February, 2017The Times of India, 19 February, 2017

23. Ahmedabad
Time of India;
08 June 2016
Sachin Ghude et al., IITM, Pune: “The uncontrolled exploitation of the air we breathe and
lost green cover is reducing life expectancy in the state by between 2.9 and 3.2 years”
“The Gujarat state is ranked eighth in excess deaths caused by heart disease,
cerebrovascular disease, chronic obstructive pulmonary disease, acute lower respiratory
illness and even lung cancer because of PM 2.5 pollution”, the study claims.
PM2.5 from vehicular
emissions, factory smoke and
biomass burning as well as
ozone concentration are the
main concerns.
23

24. Air Quality in Bangalore Worse than Delhi in Summer?
During April 2016, south Bangalore experienced the worst air quality
The Hindu, National Daily; April 2016
Delhi
Population:
19 million
Vehicles: 10 million
Mumbai
Population:
18 million
Vehicles: 5 million
Bangalore
Population:
11 million
Vehicles: 7 million
24

25.  Most of the research around the world has been on out-door air pollution, but in India
we have a more serious problem of indoor air pollution.
 This is on account of the use of coal and firewood for cooking.
 In 2014, the World Health Organization (WHO) classified particulate matter as
carcinogen.
 The carcinogens released during the incomplete combustion of coal and firewood pose
a serious threat to health of women who spend a lot of time in the kitchen.
 Several attempts have been made by the Government to provide more efficient cook
stoves in rural areas, but these programmes have not been uniformly successful.
 The ideal solution would be to provide biogas or cooking gas in rural areas, but this
poses many technical challenges.
 Solar cookers have been promoted, but have failed because they demand a change in
cooking habits of the people.
 There are new cook stoves with a battery-operated fan that ensures clean combustion.
 These stoves are expensive and hence require subsidy.
 The Government has not taken this issue seriously, because the impact of smoke on
the health of women in rural India has not been fully appreciated.
INDOOR AIR POLLUTION
J. Srinivasan, Current Science, 201425

26. INDOOR AIR POLLUTION AS A RISK FACTOR FOR COPD
Forced convection stove
Free convection stove
H.S.Mukunda et al, Current Science, 2010
CO emissions (g/MJ) versus water boiling efficiency from
various studies
26

27.  Most Indians consider air pollution as a nuisance, which may cause
asthma, but will pose no threat to their life.
 This misconception persists because of their lack of awareness about
international research that has shown that particulate air pollution is
directly linked to higher mortality and reduced life span.
 The mortality caused by COPD in India is much higher than that caused by
TB, diabetes, HIV and malaria.
 We spend, however, much more money on combating TB, HIV, diabetes and
malaria than controlling particulate air pollution.
Some Issues and Inferences
(Source: J. Srinivasan, Current Science, 2014)
27

28. Prof. J. Srinivasan, a well known climate scientist in India stated in his editorial
(Current Science, 2014) that :
“During the past 67 years we ignored the impact of water pollution on our life
and today we are dependent on bottled drinking water. If we ignore the threat
of particulate air pollution, we will be forced to carry ‘bottled clean air’ in the
near future”.
A Word of Caution !
28

29. The India 2000 stage set a limit of 0.36 g/ km-hr for PM emissions from
heavy duty diesel vehicles for the first time.
This limit has been consistently brought down (with simultaneous
improvement in technology) to 0.1 g/ km-hr in 2005 under Bharat Stage –
III
The limit set for Bharat Stage – IV is: 0.02 g/ km hr.
What role did policy play?
29

30.  Studies on the impact of air pollution on health can be carried only by joint
teams involving doctors and scientists.
 In general, doctors are not keen in participating studies involving ‘air
quality and health’ due to various reasons.
 Lack of research culture among doctors
 Lack of awareness about the impact of air pollution on human health
 Lack of time
 Lack of incentives
 Lack of adequate research grants
Studies on “Air Quality and Health”: Other Hurdles
30Input from: S. Salvi, CRF, Pune

31. Thank you for your kind attention