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Air Pollution, Diwali And COVID 19 – A Deadly Combination ?

By Dr. Vivek Nangia in Pulmonology

Nov 09 , 2021 | 3 min read

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Air pollution is the Single Largest, Invisible, environmental risk hazardous to human health. According to the State of Global Air 2020 report, it resulted in 6.7 million deaths globally out of which 1.6 million deaths were in India alone. While these deaths occurred due to stroke, heart attack, diabetes, lung cancer, chronic lung diseases and neonatal diseases but they were all attributable to poor air quality.

Its time again for the “Great North Indian Winter Smog” to envelope our city. Stubble burning in the northern part of the country contributes 15-20% to the pollution. It is just the start of the season and the AQI levels are in the hazardous range (i.e between 300 and 500). Increased vehicular movement and bursting of firecrackers during Diwali only worsen the situation making the air even more poisonous for us to breathe. 6 popular firecrackers the snake tablet, ladhi (string of 1,000 crackers), fuljhadi (sparkler), pul-pul (string sparkler), anar (flower-pot) and chakri (spinning firecracker) emit particulate matter 200 to 2,000 times more than the safe limits as designated by the World Health Organisation. Although the government has advised against bursting firecrackers on Diwali and even recommended “green” crackers, past experience shows that people continue to burst crackers despite repeated appeals by the government.

Poor quality air causes inflammation in the lungs, making people more vulnerable to breathing-related ailments. We see a rise of about 15-20 % in the cases both in OPD and emergency due to respiratory and cardiac ailments. Associated allergic problems like nasal discharge/sneezing, headache, eye burning, sore throat etc have also been observed, especially in children. This is also the time when the number of cases of Influenza, H1N1 and pneumonias rise due to change in weather conditions. Many people encounter acute exacerbations of their asthma and COPDs. This year the situation is compounded by the ongoing COVID pandemic.

Due to low temperatures and increased air pollution particulate matters remain suspended in the air for a longer period increase transmissibility of the novel coronavirus, making people more vulnerable to the disease. The second mechanism linking increased covid cases and mortality due to air pollution is that exposure to polluted air is known to cause inflammation and cellular damage, making it easy for the virus or any other pathogenic microbe to invade our lungs and also that this process of inflammation may suppress early immune response to infection, making an individual more susceptible. It has been observed that In areas with poor quality air, not only does the number of people developing covid increase but so does the death rate. With every 1 micron/cubic meter increase in PM 2.5 particle, the mortality rate increases by 8%. A direct relationship exists between air pollution and COVID-19 infection. There is a positive association of PM2.5, PM10, CO, NO2 and O3 with COVID-19 confirmed cases observed.

The most at risk people are those at the extreme of ages (< 5 yrs and >60 yrs), those suffering from heart disease, chronic lung disease (asthma, COPD, Interstitial lung disease etc), diabetes, obesity and pregnant ladies.

Hence it is strongly recommended that all people especially those belonging to the highly vulnerable group follow certain precautions :

  • Stay indoors or at least restrict their outdoor movements to only essential activities - Minimize outdoor activities
  • Totally avoid strenuous physical work/exercise outdoors
  • Avoid going for morning walks until its bright and sunny outside.
  • Say no to bursting crackers
  • Avoid traveling during peak hours
  • Wear a mask especially N95 mask at all times when outside
  • if you are at risk of attack of asthma or COPD due to pollution, visit your doctor before start of the season, understand drugs to be used in emergency, and avoid smoking areas. Vaccinations against flu and pneumonia may help in reducing these particular infections.
  • Maintain social distancing norms and other precautions during the festive season
  • Wash eyes and face with clean water regularly to minimise irritation
  • Stop smoking