Air Quality Monitoring

Interview: India could see ‘epidemic of lung cancer from air pollution’, ‘no organ system’ spared

Thoracic surgeon Arvind Kumar says if you’re breathing, there’s no way you can escape the ill effects of air pollution.

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On November 19, as many as 22 of the 35 air quality monitoring stations in Delhi recorded an air quality index (AQI) reading of 500, which is the maximum value that the scale can register. The actual pollution is likely much worse.

Two days before, on November 17, the Commission for Air Quality Monitoring announced measures that included restrictions on the entry of vehicles with outdated diesel engines, asking schools to switch to online classes and banning construction activities, among others. These measures fall under the most stringent category of steps of the Graded Response Action Plan and were also invoked at the same time last year, as we had reported.

The crisis continued, with a 24-hour AQI of 349, which translates to “very poor” air quality in Delhi on November 25. Other parts of India were similarly affected: 89 of 252 cities had air capable of causing breathing discomfort, as per the Central Pollution Control Board bulletin.

India committed to reducing air pollution by 40 percent (compared to 2017 levels) before 2026, as per the National Clean Air Programme, IndiaSpend reported in August 2023. In a decade to 2021, pollution robbed an average Indian resident of 3.6 years of life, found a University of Chicago study. In 2021, 148 of every 100,000 deaths in India were attributable to polluted air, as per the State of Global Air report.

Air pollution, like cigarette smoke, contains 70 class-1 carcinogens, or chemicals known without doubt to cause cancer, and it is the reason why lung cancer is increasing in incidence among non-smokers, explains Arvind Kumar, a thoracic surgeon and chairman of the lung transplant division at Medanta Medicity in Gurugram. He is also founder and managing trustee of Lung Care Foundation. No organ system is spared from the effects of air pollution, he tells us in this interview.

Who are the people most susceptible to air pollution?

The only people who are not affected by the ill effects of air pollution are those who are not breathing. If you are breathing, there is no way that you can escape the ill effects of air pollution. Having said that, there are some groups who are affected more than others.

Pregnant women are badly affected, children from the ages of 0-14 – which is the group of growing children – are badly affected, and so are the elderly. The fourth group is people with comorbidities, which means they have pre-existing conditions like diseases of the heart, lung or kidneys or are on steroids. These are the four groups which have much worse effects than the average population.

How does polluted air affect the body?

Having set its feet in the lungs, the chemicals from the polluted particles and the gases pass the barrier in the lung and enter the blood and reach every organ in the body from brain to toe, and they have their ill effects on every organ

Air pollution affects lungs badly, but it also affects brain, heart, kidneys, liver, intestines, bones, reproductive system, endocrine system. There is no system in the body which is not affected by air pollution...

What are the most common diseases caused by air pollution that you observe?

Common diseases are in the chest like breathing difficulties, asthma, COPD (chronic obstructive pulmonary disorder), emphysema, lung cancer, interstitial lung disease, tuberculosis, allergies, etc. These are the range of chest diseases which occur with much higher frequency in people who are exposed to air pollution.

People, including children, exposed to air pollution also get premature hypertension. There are rhythm disorders of the heart in children. Adults get heart disorders, heart failure and heart attacks.

It also affects the nervous system and brain. Children can become hyperactive or have attention deficit problems, or their intelligence does not develop to the optimum level later in life. Strokes occur with much higher incidence (among those exposed to polluted air). Dementia and Alzheimer's disease too are common among those exposed to air pollution. Sleep problems are emerging as one of the commonest problems due to exposure to air pollution.

So there are nervous system problems, cardiovascular problems. In addition, there are problems with the endocrine system, such as diabetes, obesity, and also various reproductive problems. The existence of pollutants has been demonstrated in the sperm and ova. So, probably infertility is also being caused, to some extent, by air pollution.

Then there are cancers caused by air pollution. Lung cancer is one of them, but there is also now data to show that breast cancer also is somehow related to air pollution. Intestines are affected, bones are affected, kidneys are affected. There is no organ system in the body which is not affected by air pollution.

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