Explained | What the new Lancet report says about India’s pollution problem

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Pollution resulted in more than 23 lakh premature deaths in India in 2019, highest in the world, a study in The Lancet Planetary Health journal has revealed. 

Pollution resulted in more than 23 lakh premature deaths in India in 2019, highest in the world, a study in The Lancet Planetary Health journal has revealed. 

The story so far: Pollution continues to be the biggest environmental health hazard, resulting in millions of premature deaths globally every year. In 2019, nine million (90 lakhs) people died around the world due to pollution. To put it simply, pollution was responsible for every sixth death globally that year. In India, more than 23 lakh people died prematurely due to pollution in 2019. Of them, 73 per cent of deaths occurred due to air pollution, the largest number of such deaths globally,

The findings have been revealed in a recent report— ‘Pollution and health: a progress update’, published in The Lancet Planetary Health journal on May 17. The report, which is an update to The Lancet’s 2015 study, takes into account data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019. The global toll has remained unchanged since the previous analysis, which the researchers say is reflective of the “little effort” countries have put to prioritise action against pollution.

What is pollution? 

The United Nations defines pollution as the presence of substances and heat in the environment (air, water, land) whose nature, location, or quantity produces undesirable environmental effects. The new report, meanwhile, defines pollution as an unwanted waste of human origin released into air, land, water, and the ocean without regard for cost or consequence.

Pollution includes contamination of air by fine particulate matter (PM2·5); ozone; oxides of sulphur and nitrogen; freshwater pollution; contamination of the ocean by mercury, nitrogen, phosphorus, plastic, and petroleum waste; and poisoning of the land by lead, mercury, pesticides, industrial chemicals, electronic waste, and radioactive waste. The Lancet defines ‘modern forms of pollution as ambient air pollution and toxic chemical pollution.

What is a premature death?

When a fatality occurs before the average age of death in a population, it is termed as a premature death. In India, the average life expectancy at birth in 2019 was 69.5 years for men and 72 years for women. It came down to 67.5 years and 69.8 years, respectively, in 2020. 

The concept of Years of Life Lost or YLL, used for a better understanding of the cause of premature deaths, is employed for public health planning and prevention. The World Health Organisation defines YLL as a measure of premature mortality that takes into account both the frequency of deaths and the age it occurs.

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Key findings from the new Lancet report:

Global pollution

1. Pollution is responsible for 90 lakh deaths each year across the world. The number has not changed since 2015. More than 65 per cent of deaths have been caused by modern forms of pollution like ambient air pollution and toxic chemical pollution over the past 20 years. The main factors behind this substantial rise are industrialisation, urbanisation, population growth, fossil fuel combustion, and an absence of adequate national or international chemical policy, the Lancet study notes. 

2. The effect of pollution on disease and disability varies by sex, shows GBD 2019 data. The new Lancet study states that men are more likely to die from exposure to ambient air pollution, lead pollution, and occupational pollutants than women. Women and children are more likely to die from exposure to water pollution than men.

3. Over 90 per cent of pollution-related deaths occur in low-income and middle-income countries. Pollution is also responsible for more deaths, war, terrorism, malaria, HIV, tuberculosis, drugs, and alcohol. It kills almost the same number of people as smoking, according to the study. “The health impacts of pollution remain enormous, and low and middle-income countries bear the brunt of this burden,” study lead author Richard Fuller was quoted as saying by news agency PTI.

An upward trend in mortality from modern pollution in south Asia and southeast Asia, 2000–2019, as per data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019.

An upward trend in mortality from modern pollution in south Asia and southeast Asia, 2000–2019, as per data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019. | Photo Credit: Source: The Lancet Planetary Health

4. Of the 90 lakh pollution-related premature deaths in 2019, air pollution caused the maximum number of deaths, at 66.7 lakhs, while water pollution was responsible for 13.6 lakh premature deaths. Nine lakh premature deaths were caused by lead and toxic occupational hazards, excluding workplace fatalities, which were responsible for 8.7 lakh deaths. Ambient or outdoor pollution was exclusively responsible for 45 lakh deaths in 2019, which increased from 42 lakh in 2015 and 29 lakh in 2000. Researchers have attributed the increase to a rise in ambient air pollution and the incidence of non-communicable diseases linked to air pollution.

5. There has been a decline in the number of deaths due to pollution as a function of extreme poverty. These reductions in deaths from household air pollution and water pollution, however, are offset by increased deaths related to general air pollution and chemical pollution, the study notes.

An earthmover sorts garbage at the Ghazipur garbage dump in New Delhi, March 2022.

An earthmover sorts garbage at the Ghazipur garbage dump in New Delhi, March 2022. | Photo Credit: AP Photo

Pollution in India

1. India saw 16.7 lakh air pollution-related deaths in 2019. The majority of such deaths, 9.8 lakh, were caused by PM2.5 pollution. Particulate matter or PM is a general term used for a mixture of solid particles and liquid droplets found in the air. PM 2.5 refers to fine inhalable particles that are 2.5 micrometres or smaller. 

2. PM2.5 pollution is well above WHO guidelines in 93 per cent of areas in India. The world health body had recently lowered its global air quality guideline value for PM2.5 from 10 microgram per cubic metre to 5 microgram per cubic metre. 

3. The study notes that deaths due to traditional pollution, defined as household air pollution from solid fuels, unsafe water, and sanitation, have reduced by more than 50 per cent since 2000.

4. Citing researchers, a PTI report stated that the burning of biomass in households was the single largest cause of air pollution deaths in India, followed by coal combustion and crop burning.

5. Air pollution is most severe in the Indo-Gangetic Plain, located in northern India. India’s toxic air has been a major cause for concern, especially in north India where air pollution peaks during winter months. As per the 2021 World Air Quality Report by Swiss-based IQAir, 35 of the 50 cities with the most toxic air were in India. New Delhi was found to be the most polluted capital city in the world for the fourth consecutive year. 

Impact on the economic front

Lost economic output as a proportion of GDP due to deaths from modern and traditional pollution in 2000 and 2019. Traditional pollution takes into account deaths from household air pollution and modern pollution includes deaths from ambient ozone pollution, ambient particulate matter pollution, and lead exposure.

Lost economic output as a proportion of GDP due to deaths from modern and traditional pollution in 2000 and 2019. Traditional pollution takes into account deaths from household air pollution and modern pollution includes deaths from ambient ozone pollution, ambient particulate matter pollution, and lead exposure. | Photo Credit: Source: The Lancet Planetary Health

The study adds that excess deaths due to pollution have led to economic losses totalling $4.6 trillion in 2019, equivalent to 6.2 per cent of global economic output. Economic losses associated with deaths due to pollution are calculated by considering the output lost when a person dies prematurely. 

In India, economic losses due to modern forms of pollution like ambient particulate matter air pollution, and lead exposure have increased between 2000 and 2019 and are now approximately 1 per cent of its gross domestic product (GDP). 

Economic effects of air pollution are severe in east Asia and the Pacific, where losses are equivalent to 9·3 per cent of GDP and in South Asia, where losses are equivalent to 10·3 per cent of GDP, the study states.

How to prevent pollution-related deaths

Noting that responses to pollution have been weak so far, with countries overwhelmed and focused on tackling climate change and COVID-19, researchers came up with eight recommendations to reduce pollution-related deaths. They have called for better monitoring, better reporting and stronger government systems regulating industries and automobiles. Here are some of the recommendations:

1. Affected countries should focus resources on addressing air pollution, lead pollution, and chemical pollution — key issues in modern pollution. “A massive rapid transition to wind and solar energy will reduce ambient air pollution in addition to slowing down climate change,” the researchers said.

2. An increased funding for pollution control from governments and philanthropic donors.

3. An independent, Intergovernmental Panel on Climate Change (IPCC)-style science/policy panel on pollution.

4. On the situation in India, researchers said India has made efforts against household air pollution, but still accounts for the largest number of air pollution-related deaths. Much more is needed, they added.

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