It is a shocking statistic, it kills more infants in a year than Covid-19 has killed across the country, yet we are not talking about the silent killer. The first-ever comprehensive analysis of air pollution’s global impact on newborns finds that outdoor and household particulate matter pollution contributed to the deaths of more than 1,16,000 Indian infants in their first month of life in 2019, a new global study on Wednesday. However, the study found progress in reducing household air pollution exposures but levels stagnant for outdoor PM2.5. The report, State of Global Air 2020, said more than half of these deaths were associated with outdoor PM2.5 and others were linked to use of solid fuels such as charcoal, wood, and animal dung for cooking instead of a clean source of fuel.
Long-term exposure to outdoor and household air pollution contributed to over 1.67 million annual deaths from stroke, heart attack, diabetes, lung cancer, chronic lung diseases, and neonatal diseases in India in 2019. For the youngest infants, most deaths were related to complications from low birth weight and preterm birth and overall, air pollution was now the largest risk factor for death among all health risks, according to the annual State of Global Air 2020 report published by the Health Effects Institute (HEI). The HEI is an independent, nonprofit research institute funded jointly by the US Environmental Protection Agency, industry, foundations, and development banks.
The government has claimed that average pollution levels in India are declining over the last three years but these have been marginal, particularly in the Indo-Gangetic plains, which see extremely high particulate matter pollution exposure particularly during winter. After the abrupt lockdown, which brought the country to a standstill, India did see a decline in pollution which led to blue skies, and fresh air after ages, with pollution so less that the Himalayan Ranges were visible from places that earlier did not allow the view of even the tip of the mountains. At one point during the lockdown, India had reached the levels of some of the cleanest European countries in terms of PM2.5. However, pollution levels are again rising and air quality has already dipped to ‘very poor’ category in several cities.
The report highlights the ongoing challenge of high outdoor air pollution in South Asian countries. India faced the highest per capita pollution exposure—or 83.2 μg/cubic metre — in the world, followed by Nepal at 83.1 μg/cubic metre and Niger at 80.1, according to the report, which sources its data from publicly available sources. Countries with the least population exposure are below 8 micrograms (μg) per cubic metre. India, Bangladesh, Pakistan and Nepal feature among the top 10 countries with the highest PM2.5 exposures in 2019; all of these countries experienced increases in outdoor PM2.5 levels between 2010 and 2019.
Use of solid fuels for cooking, however, presents a pattern of moderate success. Since 2010, more than 50 million fewer people have been exposed to household air pollution. The Pradhan Mantri Ujjwala Yojana Household LPG program and other schemes have helped to dramatically expand access to clean energy, especially for rural households. More recently, the National Clean Air Programme has spurred action on major air pollution sources in cities and states around the country.
This report comes as Covid-19, a disease for which people with heart and lung disease are particularly at risk of infection and death, has claimed more than 110,000 lives in India. Although the full links between air pollution and Covid-19 are not yet known, there is clear evidence linking air pollution and increased heart and lung disease creating a growing concern that exposures to high levels of air pollution, during winter months in South Asian countries and East Asia, could exacerbate the effects of Covid-19, scientists all over the world have cautioned.
“An infant’s health is critical to the future of every society, and this newest evidence suggests an especially high risk for infants born in South Asia and sub-Saharan Africa,” said HEI President Dan Greenbaum. “Although there has been a slow and steady reduction in household reliance on poor-quality fuels, the air pollution from these fuels continues to be a key factor in the deaths of these youngest infants,” he said, to The Hindu.
Infants in the first month of life are already at a vulnerable stage. But a growing body of scientific evidence from multiple countries, including recent ICMR-supported studies in India, indicates that particulate air pollution exposure during pregnancy is linked to low birth weight and pre-term birth.
These latter conditions, both of which are associated with serious complications, already account for the vast majority of deaths in the neonatal period (4,55,000 in 2019). The new analysis reported in the State of Global Air this year estimates that nearly 21 per cent of neonatal deaths from all causes are attributable to ambient and household air pollution.
“Addressing impacts of air pollution on adverse pregnancy outcomes and newborn health is really important for low- and middle-income countries, not only because of the high prevalence of low birth weight, preterm birth, and child growth deficits but because it allows the design of strategic interventions that can be directed at these vulnerable groups,” said Kalpana Balakrishna, an air pollution and health expert who was not involved with the study, according to The Tribune.
The battle to tackle air pollution in a poor country like India is a environmentalists and policymakers nightmare. With a population of 130 crore, out of which 70% of the population resides in rural India, and a large chunk of the population below the poverty line or barely above it – it is unrealistic to expect them to be concerned with environment-related health issues when their day to day survival itself is at stake. For people at the margin, the fight against hunger is a much more serious issue than fight against pollution. The solution to this problem is two-fold and a lengthy process. The government needs to ensure that marginalized people can be brought up to a basic standard of living via subsidies and employment opportunities, and then it can provide a clean source of energy to all. Only then can we truly dream of an India where death doesn’t linger in the air.