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Indoor pollution kills

Deccan Herald
By Professor  

It is that time of the year again to think about clean earth, clear water, and pure breath. Each year, Diwali brings along this good citizen-bad citizen feeling. Our eco-friendly genes awaken and we embark on heated debates on what’s to be done, how nice the air used to be.

During the rest of the year, though, we care about nothing - not about landfills nor about roadside plastic dumps. Nor do we care about diesel generators that shoot up loads of breath-chokers. But it aches to think: have we been really reduced to this?

It aches to think that about 6.5 million people died in 2015 due to diseases caused by air pollution. About 92% of the world’s population presently dwell in places where air pollution levels far exceed safe limits. It aches that nearly 90% of such pollution-related deaths occur in low and middle-income countries, with nearly two out of three occurring in the South-East Asia and Western Pacific regions. It aches to realise that India has the world’s highest mortality rate from respiratory diseases related to air pollution, with 159 deaths per 1 lakh population, about double that of China.

According to General Flavia Bustero, assistant director at World Health Organisation, women, children and the elderly are the ones most vulnerable to fluctuations in ambient air quality, which frequently leads to disastrous ends. Children are particularly vulnerable.

According to the UN statistic, about six lakh deaths each year among children under five are due to air pollution. It affects through multiple pathways - stunted brain development, reduced pulmonary function and asthma. At chronic levels, it raises risk of cardiac attacks, stroke, even cancer. Apparently, children are more susceptible than adults because of higher breathing rates.

People already suffering from pulmonary or cardiac affliction will have increased shocks at times of spikes in air pollution. To make things worse, the effects on the body ultimately spill over to the brain, elevating levels of depression and anxiety, even to the extent of aggravating suicidal tendencies among older people.

A wealth of literature from around the world suggests how helplessness, ensuing from the body-mind nexus, eats away at the human spirit, without getting noticed until too late. It is often termed "eco-anxiety” - helplessness to stop environmental damage. Is it not what happens during Diwali? Elderly folk crumbling to helplessness when the crackers bust the eardrums?

But even during Diwali, the air pollution that we talk about is just the outdoor stuff. There’s another thing that is practically deadlier. Firstly, because we are not aware of it and, secondly, we are exposed to it daily within the confines of home.

Technically, it is called household air pollution (HAP). The major reasons why HAP goes unnoticed most of the times is, there is still a lack of global standards regarding concentrations of household air pollutants above permissible limits and feasibility of indoor monitoring. Therefore, a majority of the policies still focus solely on outdoor air pollutants.

Recent findings reveal, however, that the health effects of HAP is no less lethal than that of its outdoor counterpart. According to WHO, 4.3 million people die annually from HAP. In 2015, an estimated 6.5 million deaths (11.6% of all global deaths) were associated with indoor and outdoor air pollution together.

The dominant causes of death, ensuing from HAP, include stroke (34%), ischaemic heart disease (26%) and chronic obstructive pulmonary disease (22%). Pneumonia and lung cancer account for 12% and 6% of deaths, respectively. Also, over 50% of pneumonia deaths among children under five are frequently linked to HAP.

For the most part, HAP is tied to fuel types used for cooking, heating and lighting. In the low and lower-middle income nations, still a large fraction of the population rely on solid fuel (wood/straw/charcoal, etc), which aggravates health hazards.

However, we are still pretty ignorant of it and hence fail to take necessary precautions. In poorly ventilated dwellings (typical for peri-urban and rural areas of India), smoke in and around the home can accentuate levels of airborne particles by over 100-fold. Women and young children, who spend most time near the kitchen, bear the brunt of it.

WHO relates this to a variety of ailments, such as low birth-weight and perinatal mortality, cancer (cervical, laryngeal, nasopharyngeal, etc), cataract, burns, besides a range of cardiac and pulmonary disorders such as asthma, TB, otitis media (middle ear infection) etc.

What can we do?
The WHO’s Programme on Household Air Pollution came up with several interventions, especially for lower income nations, broadly comprising (a) research and evaluation, (b) capacity building, (c) database creation, and (d) recommendations for policy-makers. Specific facets of regulatory actions include staying within WHO emission rate targets (ERT) for household fuel emissions - for PM2.5 less than 0.23 mg/minute for dwellings without chimneys/hoods while less than 0.80 mg/minute when vented). One of the immediate actions will be to stop the use of unprocessed coal or even kerosene for cooking.

The path isn’t easy as it calls for drastic changes in age-old lifestyles in low and lower-middle income nations. Also associated are questions of affordability. But no matter what it takes, the transition to "clean” fuel at home (such as biomass stoves) should be a priority. It is time we realised that nearly 18% of global CO2 emissions actually come from inefficient energy/fuel use in the residential sector. Which can be cut back substantially by switching to cleaner technologies.

Michael Jackson once sang the Gandhi-like line, "if you want to change the world, take a look at yourself and make a change”. We keep talking about the Paris Accord or Kyoto Protocol, without really understanding the gravity of our actions. To be honest, efforts for a global clean-up should actually start at home.

(The writers are faculty, Centre for Environment, Sustainability and Human Development, OP Jindal Global University, Haryana)