The rising intensity of air pollution is wreaking havoc on our health. On November 18, 2024, New Delhi recorded the highest air quality index (AQI) that has been recorded in India—a staggering 1,081. With this, the city infamously earned the distinction of being the most polluted in the world that day. What is particularly disturbing in that New Delhi isn’t just any other city—it, along with parts of the National Capital Region (NCR), is home to 33 million people.
The crisis is nothing short of a curse for the residents of the Indo-Gangetic plains—a region that houses nearly half of India’s population. According to a 2019 study by the Energy Policy Institute at the University of Chicago, individuals living here are expected to lose up to seven years of life expectancy as compared to those in less polluted regions. The major culprits here are vehicular emissions, industrial and construction activities, and the widespread use of biomass for heating and cooking—all of which release fine particulate matter and toxic gases into the atmosphere.
It’s not just the air pollution—water, soil and occupational pollution are also causing irreversible harm—not only threatening present and future generations but also weakening the potential of human resources to contribute meaningfully to nation-building.
How does pollution cause such damage?
Pollution induces DNA mutations, causes epigenetic changes that alter gene expression, and triggers chronic inflammation—all of which promote cancer development and progression.
The numbers are mind-boggling. According to The Lancet, pollution was responsible for approximately nine million premature deaths in 2019. Of these, 6.7 million were due to air pollution, while water pollution led to 1.4 million deaths. Likewise, toxic occupational hazards, excluding workplace fatalities due to safety hazards, accounted for 8.7 lakh deaths. Here, it is important to reinforce that the total effects of pollution on health would undoubtedly be larger if more comprehensive health data could be generated, especially if all pathways for chemicals in the environment were identified and analysed.
The Lancet Planetary Health Study found that long-term exposure to air pollution results in 1.5 million excess deaths annually in India. PM2.5—fine particles smaller than 2.5 micrometers—penetrate deep into the lungs and bloodstream, posing several health risks. The study, which analysed data across every 1x1x1km in India from 2009 to 2019, provides the most comprehensive view yet of the deadly impact of the polluted air.
While a strong connection between pollution and cancer is well-documented and established, here are some other diseases that are attached to this scourge—asthma, chronic obstructive pulmonary disease. Water pollution causes cholera, typhoid, hepatitis A, and dysentery. Soil contamination contributes to kidney and liver damage, neurological and gastrointestinal disorders, and weakened immune systems.
The crisis is intensifying and it is spreading. If corrective and concrete measures are not put in place, it is only a matter of time before other parts of the country (besides the Indo-Gangetic plains) become equally impacted. It has been seen that over the years a concerted effort against tobacco products has led to a decline in their consumption. Governments across the world, and specially in India, need to be complimented for their aggressive measures against such products; these have yielded positive results and the industry is in a downward spiral.
The impact of air pollution on the health of the people is much more severe than ever before. It requires robust and collective efforts on a war-footing. That is, if we sincerely want to protect the health of our people, and reduce the overall health care costs which are rising at a steep rate of 14 per cent annually.
Dr Rawal is medical director and chief of genitourinary oncology services at Rajiv Gandhi Cancer Institute & Research Centre, Delhi.