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Health Cost Of Smog And State’s Responsibility

By Dr. Arun Mitra

The dense smog, which has engulfed large part of north India, including Punjab, Haryana, western UP, parts of Rajasthan and NCR Delhi is a matter of serious concern. It is a result of polluting material mixed with vapours. The pollutants mainly come from vehicular emissions, industrial effluents and smoke coming out of burning of paddy straw in the fields. With fall in atmospheric temperature these get suspended near to the ground level. Low wind speed and no rain have aggravated the problem.

As a result, the air quality has dropped to dangerous levels. Air quality is measured as Air Quality Index (AQI). As per the Environmental Protection Agency (US), the AQI is calculated on the basis of five major pollutants – the ground level ozone, particulate matter, carbon monoxide, sulfur dioxide and nitrogen dioxide. The AQI levels have been graded in the range of 0-500. AQI level from 0-50 are satisfactory and pose little or no risk. Moderate AQI is from 51-100. This poses risk to a very small number of people, particularly those who are sensitive to ozone. The levels from 101-150 can be harmful to persons who are already suffering from respiratory problems or heart diseases; children and elderly are at higher risk. From 151-200, are unhealthy levels for every citizen while the sensitive groups may experience more serious effects. Levels between 201-300 are health alert for more serious effects. AQI levels beyond 300 are an emergency situation. In this context, the levels which went up to 999 in the Punjabi Bagh area of Delhi on 8th November 2017, is a definite cause of extreme concern.

Smog causes a feeling of suffocation, which occurs due to relative lowering of oxygen level in the surrounding air. The pollutants in the smog can irritate respiratory system, causing coughing, feeling of irritation in throat and one may experience an uncomfortable sensation in chest. The ozone in the smog can reduce lung functions and make it more difficult to breathe deeply and vigorously. There is aggravation of asthma, which may require medication. Ozone makes people more sensitive to allergens, which are the most common triggers for asthma attacks.

Ozone may aggravate chronic lung diseases such as emphysema and bronchitis and reduce the immune system’s ability to fight off bacterial infections in the respiratory system. Repeated short-term ozone damage to children’s developing lungs may lead to reduced lung function in adulthood.

Particulate matter includes microscopic particles and tiny droplets of liquid. Because of their small size, these particles are not stopped in the nose and upper lungs by the body’s natural defenses but go deep into the lungs, where they may become trapped and cause irritation. Exposure to particulate matter can cause wheezing and similar symptoms in people with asthma or sensitive airways. Particulate matter can serve as a vector for toxic air pollutants. Carbon monoxide affects oxygenation of Haemoglobin by forming Carboxy Haemoglobin.

As a result of all these there is loss of man days because the working capacity of the person goes down. Children are not able to attend school. Since the medical advisory is to avoid outdoor activity, productivity falls. In addition, health problems are aggravated as a result of accidents.

Every year when the smog level goes high, there is debate on the issue but it dies down after some time. Urgent remedial measures have to be taken. The industry needs to be regulated firmly to reduce effluents. Vehicular emissions have to be brought down, paddy straw burning needs to be checked. It is not correct to put the whole blame on farmers without addressing their grievances.

The time gap between harvesting of paddy and sowing of wheat crop is less. Therefore, the easiest method the farmers find is to burn the straw and then plough the field for the next crop even though the high temperature over the soil because of burning of straw residue destroys useful microorganisms, causing huge loss of nitrogen, phosphorous, potash and many beneficial micro nutrients. As per estimates, there is loss of macro and micro nutrients to the tune of Rs.1000 crores in the state of Punjab per year due to burning of wheat and paddy straw. The paddy cultivable area in Punjab is about 65 lakh acres. On an average, there is 30 quintal of yield per acre, which means 19.50 crore quintal of paddy is produced in the state. As per the NGT guidelines, different agricultural machinery required for management of straw costs around Rs 1600 crores for Punjab. It is not possible for small and marginal farmers to purchase such machinery. The Punjab government has submitted a demand for this amount to the Central government. But the Centre has so far not accepted it saying that agriculture is a state subject. But it is to be noted here that pollution is a central subject. Air pollution has no boundaries. So the Centre should come forward to fund this amount.

Moreover, the farmers have a feeling that by delaying the sowing of next crop they are losing money due to reduced yields. Therefore, if farmers are given a bonus of Rs.100 per quintal, which will cost the government around 2000 crores rupees, there is a possibility that they could be convinced to shun this practice. Many young farmers are now concerned about the fertility of the soil as well as the health effects of smoke. The state and the Central governments should share this responsibility. The overall cost has to be evaluated with the health cost borne by the people, which could be much higher because it involves cost on disease, loss of man days, loss of production, loss of schooling and mental stress.
(IPA Service)

The writer is senior vice President Indian Doctors for Peace and Development, Former Chairman Ethical Committee Punjab Medical Council & Member core committee ADEH (Alliance of Doctors on Ethical Healthcare).

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