One in 8 deaths in India caused by air pollution

The first comprehensive estimates of deaths, disease burden, and life expectancy reduction associated with air pollution in each state of India was published on December 6, 2018 in the British on-line journal, The Lancet Planetary Health.

The findings are from the India State-Level Disease Burden Initiative, a joint research of the Indian Council of Medical Research, Public Health Foundation of India, and Institute for Health Metrics and Evaluation (US) in collaboration with the Union Ministry of Health and Family Welfare.

The key findings of the report are:

·      One out of every eight deaths in India is attributable to air pollution.

·      over half of the 12.4 lakh deaths in India attributable to air pollution in 2017 were in persons younger than 70 years.

·      The average life expectancy in India would have been 1.7 years higher if the air pollution level were less than the minimal level causing health loss.

·      Air pollution now contributes to more disease burden in India than tobacco use, primarily through causing lower respiratory infections, chronic obstructive lung disease, heart attacks, stroke, diabetes, and lung cancer.

·      77% of India’s population is exposed to outdoor air pollution levels above the National Ambient Air Quality Standards safe limit, with the northern states having particularly high levels.

·      Exposure to household air pollution due to solid fuel use for cooking is decreasing in India with the increasing provision of clean cooking fuel; this effort needs to be sustained to address the still high levels of this exposure in several less developed states.

·      Systematic efforts are necessary to address the multiple sources of air pollution in India: transport vehicles, construction activity, industry and thermal power emissions, residential and commercial solid fuel use, waste and agriculture burning, diesel generators, and manual road dust sweeping.

·      India has one of the highest annual average ambient particulate matter PM2.5 exposure levels in the world. In 2017, no state in India had an annual population weighted ambient particulate matter mean PM2.5 less than the WHO recommended level of 10 μg/m³. (PM 2.5 particles are those that are suspended in air and have a diameter lesser than 2.5 microns.)

·      In 2017, 77% of India’s population was exposed to mean PM2.5 more than 40 μg/m³, which is the recommended limit set by the National Ambient Air Quality Standards of India.

Variation across states

There was a marked variation between the states with regard to ambient particulate matter pollution and household air pollution. States in north India had some of the highest levels of both ambient particulate matter and household air pollution, especially Bihar, Uttar Pradesh, Rajasthan, and Jharkhand; and Delhi, Haryana, and Punjab in north India had some of the highest ambient particulate matter pollution exposure in the country.

A contiguous group of states in central, western and northern India has emerged with the highest death-rates attributable to air pollution. Rajasthan tops the list with 112 deaths per lakh population, followed by Uttar Pradesh (111), Uttarakhand (106) and Haryana (100), while Himachal Pradesh, Madhya Pradesh and Chhattisgarh each had 97-100 such deaths per lakh in 2017.

At the lower end of the scale are several of the Northeastern states — including Arunachal Pradesh (36), Meghalaya (43), Nagaland (49) – while Union territories other than Delhi show a pollution-related death rate of 48.5. While Manipur and Mizoram too figure on the lower side of the list, Tripura had a high rate (91) and Assam’s rate was 72 per lakh, higher than Delhi’s 65. Death rates in the southern states ranged between a high of 95 in Karnataka and a low of 66 in Telangana. Among other larger states, the death rate was 93 in West Bengal and in the 80s in Maharashtra and Gujarat.

WHO/COP24 Special report: Health & Climate Change

A WHO (World Health Organization) report launched on December 5, 2018 at the UNFCCC COP24 Meeting in Katowice, Poland, highlighted why health considerations are critical to the advancement of climate action and outlines key recommendations for policy makers.

Some Key Findings of the Report:

·      The same human activities that are destabilizing the Earth’s climate also contribute directly to poor health. The main driver of climate change is fossil fuel combustion which is also a major contributor to air pollution.

·      Exposure to air pollution causes 7 million deaths worldwide every year and costs an estimated US$ 5.11 trillion in welfare losses globally.

·      In the 15 countries that emit the most greenhouse gas emissions, the health impacts of air pollution are estimated to cost more than 4% of their GDP.

·      Switching to low-carbon energy sources will not only improve air quality but provide additional opportunities for immediate health benefits.

·      Actions to meet the Paris goals would cost around 1% of global GDP.

·      If the mitigation commitments in the Paris Agreement are met, millions of lives could be saved through reduced air pollution, by the middle of the century.

·      The most recent evidence indicates that the health gains from energy scenarios to meet the Paris climate goals would more than meet the financial cost of mitigation at global level and would exceed that in countries such as China and India by several times.

The Report includes the following recommendations:

1.   Identify and promote actions to reduce both carbon emissions and air pollution, with specific commitments to reduce emissions of short-lived climate pollutants in Nationally Determined Contributions (NDCs) to the Paris Agreement.

2.   Include the health implications of mitigation and adaptation measures in the design of economic and fiscal policies, including carbon pricing and the reform of fossil fuel subsidies.

3.   Include the commitments to safeguard health from the UNFCCC and Paris Agreement, in the rulebook for the Paris Agreement; and systematically include health in NDCs, National Adaptation Plans and National Communications to the UNFCCC.

4.   Remove existing barriers to investment in health adaptation to climate change, especially for climate-resilient health systems and “climate-smart” health care facilities.

5.   Facilitate and promote the engagement of the health community as trusted, connected and committed advocates for climate action.

6.   Mobilize city Mayors and other subnational leaders, as champions of intersectoral action to cut carbon emissions, increase resilience, and promote health.  

7.   Systematically track progress in health resulting from climate change mitigation and adaption, and report to the UN Framework Convention on Climate Change, global health governance processes and the monitoring system for the SDGs.