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Opinion: Breathing The Unknown – Measuring The Health And Economic Impact Of Air Pollution

The health impact that air pollution has on development and growth of infants and children is concerning – it reduces life expectancy, overall brain growth, and productivity in the long run, writes Suresh Kotla, Director – Energy & Environment at Institute for Sustainable Communities (ISC)

Breathing The Unknown - Measuring The Health And Economic Impact Of Air Pollution

Mumbai: Winter is here, and so is the discourse on air pollution. As soon as the winter subsides, and the air quality improves, the topic of debates will shift. The season has become synonymous with air pollution, which poses the question – can we do something about the air we are breathing? We like to choose what we wear, eat or drink, but can we choose the quality of air we breathe? Probably the time is near when clean air will be on sale in India, like packaged drinking water. Driven by our concern for the health of our families, we will soon pay for clean air. Does that sound bizarre?

Also Read: 1.7 Million Deaths In India Were Attributable To Air Pollution In 2019, Says Scientific Paper

Up For Grabs, At A Price – Clean Air

The sale and purchase of clean air is already a reality, and will soon become commonplace. There are companies that capture fresh mountain air and sell it in bottles as pure premium oxygen to countries like China, and the US. There are real estate developers in the west, selling residential projects on the promise of clean air. Air filtration technology is used to pump fresh, filtered, conditioned air that has gone through multiple layers of treatment. People are already paying for clean air as an amenity; apart from swimming pools, gyms, boutique kitchenettes and bathtubs.

Also Read: New Delhi’s Poisonous Air A Perennial Crisis Of Its Own Making: Experts

Air Pollution And Public Health Concerns

The COVID-19 pandemic brought public health to the forefront of the collective priorities of the government, and the community. It also drew our attention to air quality with clear skies in Delhi. The government announced a large relief package of Rs.20 lakh crore to revive the economy earlier this year, with a view to march towards self-reliance. Apart from the relief package, the government announced investments to the tune of Rs.15,000 crore towards ‘India COVID-19 Emergency Response and Health System Preparedness Package’. The main objective of this package includes an emergency response to curb the spread of COVID-19 and building treatment facilities, centralized procurement of essential medical equipment and drugs required for COVID relief work. The PM Cares Fund was created to channelise CSR funds towards COVID relief and several other subsidies have been announced. This needs to be seen in the context of COVID-19 being a national emergency that warranted the size of expenditure.

Also Read: Air Pollution: What Is Air Quality Index, How Is It Measured And Its Health Impact

Comparing this with air pollution which took 1.67 million lives in India in 2019; got a conditional allocation of Rs.4,400 crore in the Union Budget 2020-21. Air pollution continues to exacerbate the risk of heart diseases, stroke, acute respiratory illnesses, chronic obstructive pulmonary disease, and lung cancer in infants, children, elderly, and vulnerable citizens of our country. Coupled with the widespread pandemic, this puts air pollution in perspective, when looking at grave public health concerns that India contends with. According to the NCAP, India has 122 cities that don’t meet the National Ambient Air Quality Standards. If we rank Indian cities on WHO air quality standards, the number of cities would probably exceed 200 cities.

The health impact that air pollution has on the development and growth of infants and children is concerning – it reduces life expectancy, overall brain growth, and productivity in the long run.

Also Read: US Study Links Air Pollution To Increased COVID-19 Mortality, Indian Experts Say Causal Link Not Established

PM10 (particulate matter 10), PM2.5, NO2 (nitrogen dioxide), SO2 (sulphur dioxide), CO (carbon monoxide), O3 (ozone), NH3 (ammonia), and Lead (Pb) are the indicators considered in deriving the Air Quality Index (AQI) value of a city region. While a layman doesn’t understand the difference between these pollutants, PM2.5 refers to fine particles of diameter less than 2.5 micrometers (more than 100 times thinner than a human hair) that remain suspended in the air for long durations. The PM2.5 in the air comes from various point and non-point sources, and can contain a range of toxic substances including Arsenic, Lead, Nickel, Chromium, and Cadmium. A recent study conducted by IIT Delhi confirmed the presence of these heavy metals in varying concentrations in the air. Exposure to PM2.5 pollutants occurs through nasal inhalation, absorption through skin, and ingestion through food consumed on the roadside. Even N95 masks may not completely safeguard one from the possibility of exposure. This poses a few questions for us to introspect – first, should air pollution be addressed as a national emergency; what is being done, and what should be done about improving the quality of the air we breathe.

Also Read: Air Pollution: What Is Particulate Matter And How Does It Affect The Human Body

An Effort To Tackle – Knowledge, Acknowledgement And Measurement

The Government of India (GOI) has been striving to reduce air pollution. Starting with the Air (Prevention and Control of Pollution) Act, 1981, which was enacted as a response to the decisions taken at the United Nations Conference on Human Environment held at Stockholm in June 1972. It contained a comprehensive set of directions for the implementation of 42 action points to mitigate air pollution. Although this act raised accountability and limited industries from polluting the atmosphere, it alone could not be a blanket solution to the issue. Since then the GoI has launched various initiatives like the National Air Monitoring Programme (NAMP), the National Ambient Air Quality Standards (NAAQS) and, the Air Quality Index (AQI) with the aim of determining the status and trends of ambient air quality, to ascertain whether the prescribed ambient air quality standards are violated, to identify non-attainment cities, to obtain the knowledge and understanding necessary for developing preventive and corrective measures, to provide a uniform yardstick for the assessment of air quality at the national level and effectively communicate the status of air quality to the people by collating various pollutants into a single color-coded index value.

Also Read: Air Pollution And COVID-19: Is It About Time To Shift From Cloth Mask To Pollution Safe N95 Or N99 Mask?

While these programs and initiatives shed some light on the severity and scale of the issue, they did not manage to effectively reduce air pollution. In 2019, the government launched the National Clean Air Programme (NCAP) that seeks to reduce levels of PM10 and PM2.5 in non-attainment cities by 20 per cent to 30 per cent by 2024, over 2017 levels. The source apportionment studies to identify emission sources are currently underway in different cities, and city action plans are under different stages of implementation. Apart from what’s being done by the central and state governments, there are measures that would enhance India’s capacity to address the problem.

Also Read: How Effective Are Masks To Take On Air Pollution?

First, there is a need to measure the true impact of air pollution, because we can’t control what we can’t measure. Arguably, India has 200 continuous air quality monitoring stations operating in 20 states and covering 116 districts. The current monitoring capacity of India is severely inadequate. As per the Central Pollution Control Board of India’s (CPCB) thumb rule, based on parameters such as traffic density, industrial growth, population density, public complaints, and land use patterns – an estimated 4000 continuous monitoring stations are needed to monitor air quality at city and district levels. However, there are two key socio-economic parameters missing from air pollution monitoring, mitigation, and policy – Public health data to corroborate its impact on the health of citizens, and economic value of the lost lives and earnings due to health issues.

Second, once we start measuring health and economic impacts of air pollution, the budget allocations for air pollution mitigation, and public health infrastructure should be commensurate with the health and equivalent economic losses.

Third, there is a need for capacity enhancement in government institutions, civil society, research, and development.


As India emerges from the multifaceted crisis forced by the pandemic, the country should also strive hard to emerge from the smog of polluted air that blurs our future. This will require a political and economic commitment from the government, and cross-sectoral collaboration between public, private, academic, and civil society institutions, along with the community. It is time we treat air pollution as a national health emergency that poses risks to the present, and future of our country; create a framework that enhances enforcement of pollution regulations in the industrial and transportation sector, and mobilize finances for accelerating clean air solutions. Just as we demonstrated unity, solidarity, and resilience in our fight against COVID-19, let’s win this battle against air pollution. If we don’t feel the urgency for ourselves, let’s do it for our children – for they hold the future of our nation in their hands.

Also Read: Five Easy Ways To Protect Yourself From Air Pollution

Breathing The Unknown - Measuring The Health And Economic Impact Of Air Pollution

Suresh Kotla


Suresh Kotla is the Director – Energy & Environment at Institute for Sustainable Communities (ISC). In his current role at ISC, he leads the overall implementation and management of projects on sustainable development.


Disclaimer: The opinions expressed within this article are the personal opinions of the author. The facts and opinions appearing in the article do not reflect the views of NDTV and NDTV does not assume any responsibility or liability for the same.

NDTV – Dettol Banega Swasth India campaign is an extension of the five-year-old Banega Swachh India initiative helmed by Campaign Ambassador Amitabh Bachchan. It aims to spread awareness about critical health issues facing the country. In wake of the current COVID-19 pandemic, the need for WASH (WaterSanitation and Hygiene) is reaffirmed as handwashing is one of the ways to prevent Coronavirus infection and other diseases. The campaign highlights the importance of nutrition and healthcare for women and children to prevent maternal and child mortality, fight malnutrition, stunting, wasting, anaemia and disease prevention through vaccines. Importance of programmes like Public Distribution System (PDS), Mid-day Meal Scheme, POSHAN Abhiyan and the role of Aganwadis and ASHA workers are also covered. Only a Swachh or clean India where toilets are used and open defecation free (ODF) status achieved as part of the Swachh Bharat Abhiyan launched by Prime Minister Narendra Modi in 2014, can eradicate diseases like diahorrea and become a Swasth or healthy India. The campaign will continue to cover issues like air pollutionwaste managementplastic banmanual scavenging and sanitation workers and menstrual hygiene

1 Comment

1 Comment

  1. Vamsi Sai Krishna Paluvadi

    January 23, 2021 at 1:27 am

    The one concern that always haunts India is that the Dose Response Curves we use does not belong to India. We rub US’s or European casestudies on India and we don’t even have concrete evidence on how Air Pollution impacts Indian Population. The one thing we know is that Indian pollution is majorly dependent on PM2.5 and US’s pollution is predominantly dependent on Ozone or SO2 or NOx. We cannot use their Dose Response Curves, we cannot use their Realtive Risk graphs. It’s high time that we contribute some money on researching the impacts of air pollution on the health of Indian population and stop calculating the GBD(Global Burden of Diesease) based on US’s dose response Curves. We have sophisticated methods to estimate the imapct of air pollution like GIS and satellite monitoring and we have ground level monitors at district level and we do not need more monitors to acknowledge the fact that India is polluted with toxic air. What we need to do is to accept that Air Pollution is a critical factor in the productivity of human! Based on research, we can hardly point out to air pollution as a source of death, but we definitely could not prove it in court that the reason of death of a specific individual is due to Air pollution. We need robust systems and own research to determine whether the impact of air pollution is limited to newspapers or is it actually impacting the health of local population.

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