‘Ultimately, everyone’s health is going to be affected due to pollution’

The situation seems to be getting worse, we have to tackle it on a war footing rather than taking small steps, says AIIMS doctor

Dr. Anant Mohan, head of Department of Pulmonology at AIIMS, Delhi, told The Hindu in an interview that they see a spike in patients every year when pollution levels are high and the future challenge for hospitals will be to deal with patients with both long-term complications and short-term problems.

What are the health impacts of air pollution?

It affects several organs. The respiratory tract is the most affected as it is in contact with the airway. In the upper respiratory tract, problems such as nose irritation, inflammation, infection of the sinuses, sore throats, shortness of breath, cough with phlegm occur — these are short-term effects.

People, especially those with already diseased lungs, will notice more serious impact like chest infections. And the implications of this will be seen not just short-term, but also long-term.

Even though you can’t see it right now, there are long-term impacts such as damage to lungs. Also, life expectancy is highly likely to be shortened by a few years due to air pollution. If children are exposed to this level of air pollution, their lungs would not grow to the normal level. All this will show the effect when they are adults.

What changes do you observe in patients over the years?

I have been working at AIIMS for more than 20 years and the number of cases of respiratory problems are definitely on the rise. The rate of asthma in children is rising, the rate of COPD (chronic obstructive pulmonary disease) in adults is rising, and the rate of lung cancer is also rising. All these are in some ways environment-related. Air pollution is definitely contributing to all these.

What do you observe in your long-term patients when pollution spikes?

Some of them, who were doing fine, suddenly come back to us saying that for the last one week their symptoms have worsened. The only reason could be environmental factors. These patients have been coming to us in the last 15 days. In the last two weeks, we have seen a 20-25% rise in cases as pollution increased and we see the same pattern almost every year.

Do you see a spike in patients coming from other States also when pollution increases?

To some extent, yes. But they might be coming in the next couple of weeks. But we see a spike in people from outside Delhi too.

What would you suggest people do in terms of precautions?

People should keep a close watch on the air quality and be outdoors on the good days and indoors on bad days. They should avoid morning and evening walks. They should go for a walk between 11 a.m. and 4 p.m. Wear a mask when you step out. Usually, we don’t suggest people to wear masks indoors as practically it is very difficult. If it’s practical for you, then do it.

Does staying indoors actually help?

The indoor air is also polluted. But pollution is likely to be more outdoors. There will be dust and pollution from vehicles outside and that can be avoided to an extent if you don’t step out. But even people who are working from offices, they might not be out on the streets the whole day, but exposure to such polluted environment even for a short time is bad enough to cause problems.

Do purifiers help?

We don’t really suggest people to buy air purifiers as we don’t have that level of evidence right now to prove its benefits. But for people who have significant respiratory diseases and are likely to be indoors, we suggest they use air purifiers as an interim measure as it might help. There is no proven benefit, but due to lack of evidence we suggest it only to ones who need it the most.

What precautions do you take at your house?

I too have school-going children. At home, we keep the doors and windows closed and keep a close watch on the air quality index. Whenever we go out, we make it a point to wear masks. We also avoid going out at a time when the air quality is the worst.

What challenges lie in the future?

In the future, hospitals will be dealing with patients who develop long-term complications and also people with short-term problems and it will be more difficult to deal with that situation. A polluted environment is likely to compound problems in those with pre-existing lung diseases, both in the short-term and long-term.

Is the situation getting better or is it getting worse?

The situation seems to be getting worse, no doubt. It is a sorry situation. Year after year, the same situation [high pollution] is happening and ultimately it is going to really affect everyone’s health in a bad way. We have to tackle the situation on a war footing rather than taking small steps.

We have to work together at every level from individual to the community to the legislation to get results. It is an emergency situation. We have run out of time to just talk about it.

Time has come not just to do something, but to see what we have done in the past five years and analyse whether we did anything or not. Else, it is going to impact the children, specially, in a very bad way. It has already started to happen.

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