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Breathless in Delhi

The story of environmental deterioration has been played out in Delhi for the past several years.  The situation seems to be going beyond control this year again, as air quality has worsened to ‘severe’ category. Every day, we wake up to see a thick blanket of haze surrounding the city. Pollution levels have crossed permissible standards.  Throughout the day, the sun appears as a pale disc and darkness descends with poor visibility.

Air pollution in Delhi has earned the dubious distinction of being among the most polluted city in the world. The major air pollutants consist of suspended particles in the air, measured by their sizes in microns as PM 2.5 and PM10, invisible individually to the eye, ozone, oxides of nitrogen, carbon monoxide, lead and sulphur dioxide. The major pollutants, especially in this weather are the suspended particulates. These particles are small enough to penetrate deep down into our lungs and from there they enter our blood streams and cause harmful effects.  The mixture of these pollutants and moisture is called “smog”.  Air Quality Index (AQI) is a tool for describing air quality status to people in simple terms. All the pollutants are measured and their levels are combined into a single index that ranges from 0 to 500.  There are six AQI categories, namely Good (0 to 50), Satisfactory (51-100), Moderately polluted (101-200), Poor (201-300), Very Poor (301-400), and Severe (401-500).  These days, the AQI in most locations in Delhi is in the severe category.

What causes Air Pollution?

The major sources of air pollution are vehicles, industrial sources, construction activity, roadside dust, and domestic fuel burning. In this season, the Central Pollution Control Board (CPCB) has identified four reasons for the sudden worsening of pollution: lower temperature with onset of winter, very low wind speed, high relative humidity and atmospheric boundary layer formation. Conditions are unlikely to improve over the next few days.

Who suffers most from Air Pollution?

All of us are exposed to the environment and therefore are threatened by the toxic air in Delhi. It is not surprising that it has been described as a “gas chamber”.  However, the young and the elderly, and those who are already suffering from chest diseases such as asthma and Chronic Obstructive Pulmonary Disease (COPD), and those with heart diseases are especially vulnerable.

How is Polluted Air Harmful?

Air pollution is a major environment-related health threat to children and a risk factor for patients with acute and chronic respiratory diseases. It is the fourth highest risk factor for premature death worldwide, with more than 5.5 million people dying each year as a result of exposure to dangerous levels of particulate matter, with more than 1.5 million dying in India alone due to diseases related to poor air quality.

  • Patients with asthma and COPD are likely to have increased symptoms of cough and breathlessness with wheezing, require more medicines, may require emergency care and even hospitalization for acute attacks.
  • Patients with heart disease may have chest pain (angina) and even heart attacks, stroke and changes in their heart rhythm.
  • The apparently healthy people are also likely to get cough, sore throat, colds, irritation in chest and heavy breathing.

Health Advisory

There are several steps that patients can take to protect themselves and take timely action if things appear to be going wrong.

  • Patients should avoid going outdoors as far as possible, especially to highly-polluted areas.
  • Exercising outdoors increases our breathing and we inhale more of the toxic air. People should avoid outdoor activities including morning and evening walks. Air quality is at its worst in the early mornings and evenings: No sports, no marathon, no outdoor matches.
  • Patients with chronic airway diseases like bronchial asthma and COPD should continue to take their inhalers regularly. If symptoms increase, they should contact their doctors for increasing the doses. Warning signs include reduced exercise capacity, waking up at night due to cough, breathing difficulty, and decreased effectiveness of inhalers.
  • Patients with heart diseases should avoid outdoor activities and take their medicines regularly. If there is chest pain, sweating or giddiness, they should immediately go to the emergency department of a hospital.
  • People should wash their eyes with water and gargle regularly.
  • A balanced diet with plenty of fluids and Vitamin C rich fruits such as oranges, lemons, is helpful.
  • Wearing a mask is advisable outdoors but is not really very effective if worn loosely and may make breathing difficult if worn too tightly.
  • Air Purifiers do not have any proven value in combating air pollution.
  • One should drive with windows rolled up and air ventilation on.

Facilities at Primus Hospital

Given its commitment to provide high-quality world-class health care at an affordable cost, and to meet the needs of the people, Primus Super Speciality Hospital provides excellent round the clock services for respiratory diseases under a team of highly qualified specialists with an internationally-acclaimed leadership of long standing academic background and experience. These services include a whole-day OPD with asthma and other chest diseases clinic, short-stay emergency services, indoor admissions and intensive care.

Dr (Prof) SK Chhabra (HOD)

Pulmonary, Sleep and Critical Care Medicine

 

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