The Poison in Our Air: Why It’s Killing More Than Just Our Lungs
By Arunima Rajan
Air pollution isn’t just choking our cities—it’s silently attacking our hearts. The World Health Organization estimates that nine out of ten people globally are exposed to polluted air, causing seven million premature deaths each year. India, home to some of the most polluted cities, is at the heart of this crisis. The connection between air quality and cardiovascular diseases has become impossible to ignore. In an interview with Arunima Rajan, Dr. Ravi Dosi, consultant in pulmonary medicine at Kokilaben Dhirubhai Ambani Hospital, Indore, unpacks how polluted air is leaving a deep scar on public health.
Air pollution is often discussed in the context of respiratory health, but its connection to heart disease is less commonly addressed. Could you explain how polluted air contributes to cardiovascular problems?
Air pollution not only affects the respiratory system but also impacts cardiovascular health. The pollutants include particulate matter (PM2.5 and PM10), nitrogen dioxide (NO₂), ozone (O₃), and carbon monoxide (CO), which are inhaled into the lungs, thereby entering the bloodstream. These pollutants cause:
Inflammation: Irritants inflame lung tissue, which extends to the cardiovascular system
Oxidative Stress: Pollutants generate free radicals that damage heart tissue
Endothelial Dysfunction: Exposure reduces the ability of blood vessels to expand and contract, increasing blood pressure
Atherosclerosis Acceleration: Long-term exposure contributes to plaque build-up in arteries that leads to heart attacks and stroke
Understanding this connection highlights the broader health implications of air pollution.
A recent study indicates that 30% of air pollution-related deaths in India are linked to heart disease. What does this reveal about the scale and severity of the problem in a country like ours?
The study underscores the critical impact of air pollution on public health in India. With 2.18 million deaths annually attributed to air pollution, 30% linked to heart disease translates to over 650,000 lives lost. This figure illustrates:
Widespread exposure: India’s rapid urbanisation has intensified pollution levels across cities and rural areas
Healthcare challenges: Rising cardiovascular cases strain an already overburdened healthcare system
Socioeconomic inequalities: Vulnerable groups in the low-income areas are most affected because of poor living conditions and access to health care
Data indicates the need for policy on pollution as well as its health effects.
Given that Delhi’s air quality frequently reaches hazardous levels, what are the immediate and long-term cardiovascular risks faced by its residents?
Delhi’s residents are exposed to some of the highest pollution levels in the world, leading to a range of cardiovascular risks:
Immediate Risks: Short-term exposure can trigger heart attacks, arrhythmias, and hypertension episodes. Individuals with pre-existing heart conditions are at higher risk of complications.
Long-term Risks: Prolonged exposure contributes to chronic diseases such as coronary artery disease, strokes, and heart failure. The cumulative damage from inhaling polluted air also increases mortality rates.
Residents experience a year-round assault on their cardiovascular systems, especially during pollution peaks in winter
What are the most vulnerable groups when it comes to air pollution-induced heart disease? Are children and the elderly disproportionately affected?
Certain groups are considered especially vulnerable to air pollution-induced cardiovascular disease:
Children: With the only developing lungs and cardiovascular systems, they are the most vulnerable to any damage done by pollutants
Elderly: Age-associated decline in heart function and pre-existing ill health renders them susceptible
Low-Income Communities: Poor housing, higher exposure to pollutants, and limited access to healthcare further amplify risks
People with Pre-existing Conditions: Those with diabetes, hypertension, or pre-existing cardiovascular diseases suffer compounded health risks
The groups highlighted above must be given special priority in any public health plans.
From a public health perspective, what specific interventions or policy measures are needed to mitigate the cardiovascular impacts of air pollution in India?
Collaborative efforts between government, private sectors, and civil society are crucial to mitigate the issue.
India requires a multi-faceted approach for the mitigation of air pollution and cardiovascular impacts:
·Regulatory Measures: Enforcement of emission limits for industries and automobiles
·Food and Clean Energy: Development of solar, wind, and other clean energy technologies
·Urbanization: Creation of green spaces and sustainable development of infrastructure
· Access to Healthcare: Timely treatment at affordable costs for marginalized populations
Public Awareness: Provide citizens with adequate education on air pollution risks and measures that can be undertaken to reduce exposure
Collaborative efforts between government, private sector, and civil society members are of vital importance to counteract this problem.
Emergency responses like shutting schools or halting construction provide temporary relief. What sustainable solutions could help in significantly reducing air pollution levels and their impact on health?
While emergency measures deal with short-term adjustments, sustainable solutions are essential for a long-term upside:
·Electric Vehicles: Incentives for electric and hybrid cars to cut emissions
·Green Energy: Investment in solar, wind, and any clean energy technologies
Public Transport Improvement: Create and enhance public transport systems so that reliance on automobiles is reduced
Alternative Agricultural Practices: Promotion of alternatives for stubble burning, a major cause of seasonal pollution
Waste Disposal Systems: Bring in the necessary changes to avoid open burning of garbage
Commitment to these measures will provide major benefits to enhance the health of the population and the environment.
With 2.18 million deaths annually in India attributed to air pollution, how can the healthcare system better prepare to address the rising burden of heart disease linked to environmental factors?
The healthcare system must adopt a proactive approach to manage the cardiovascular impacts of air pollution:
Infrastructure Development: Increase the number of hospitals and specialised cardiovascular care centres.
Screening Programs: Implement regular cardiovascular health screenings in high-pollution areas.
Training for Healthcare Professionals: Equip medical staff with skills to address pollution-related diseases.
Public Health Campaigns: Raise awareness about symptoms and preventive measures for cardiovascular conditions.
Research and Data Collection: Enhance understanding of the pollution-CVD link through localized studies.
Building resilience in healthcare can help manage the growing burden effectively.
Are there preventive steps individuals can take to protect themselves from the cardiovascular effects of air pollution, especially in highly polluted cities like Delhi?
Those are some of the self-protective measures one may take to lower the risks:
Decrease Indoor Pollution Levels: Install Air Purifiers inside one's house
Stay Away from Open Public Areas at Peak Pollution Times: Limited outdoor exposure within hours of extremely high pollutants in the environment
Use Protective Masks: Go for N95 protective masks whenever stepping outside
Healthy Lifestyle: Eating a balanced diet, exercising regularly, and avoiding smoking strengthens the heart by adding in lifestyle-related healthy interventions
Monitoring the Air Quality: To organize activities based on pollution levels, download apps and harness resources available
Individual preventive measures complement wider policy action towards risk mitigation..
What role do advancements in research and technology play in both understanding and combating the link between air pollution and heart disease?
Research and technology are critical in addressing the air pollution-CVD connection:
Proactive Air Quality Monitoring: With advanced sensors, real-time data on pollution are made available for informed decision making
Predictive Analytics: AI and machine learning identify populations vulnerable to health impacts and offer weather-analogue predictions of pollution
Novel Treatment: Research on antioxidants and anti-inflammatory drugs aims to mitigate damage arising from pollution
Renewable Technologies: Innovations in energy storage and distribution accelerate the transition to cleaner energy
Modern technological innovations will empower policymakers, health care personnel, and individuals to work more efficiently on the issue.
Looking at global examples, are there any successful models or policies from other countries that India could adapt to address the dual challenge of air pollution and public health?
India can draw from the successful international examples:
China’s Air Pollution Control Plan: Through setting up an air quality management system covering industry regulations, the case for clean energy, and improvement in public transport, the PM2.5 levels show a significant decline there from 76 to 30 micrograms per cubic metre
London's ULEZ: The imposition of fees for high-emission vehicles offers health benefits that include improved air quality and decreased cardiovascular risks
California's Clean Air Act: The stringent regulations of emissions from industry and vehicular pollution provide a worldwide standard
The Scandinavian Sustainable Practices: These countries indeed combine urban planning and the green effort to minimize pollution's adverse impact on health
Adjusting these lessons to Indian context could pave way for sustainable change.