As State governments wring their hands over how to solve a problem like air pollution, the grim truth is that pollution is not just at our doorsteps, but inside our homes as well.

Respiratory complications are the single most common complaint that doctors across the country are seeing during their consultations, and this is regardless of age, be it new-borns or adults. So, while high-decibel discussions dominate another season of festivities on the right to fire a cracker versus the right to breathe clean air, members of the medical fraternity are of the opinion that Delhi’s state of air emergency should sound a warning bell for the rest of the country as well. And a key part of the solution lies in the hands of the people, say doctors, as policymakers seem to speak more for their respective States and less from the point of view of what’s good for the entire country.

“Delhi should have been made cracker-free this Diwali,” says Dr KK Aggarwal, senior consultant physician and cardiologist and a key voice on air pollution, who has been sending recorded public health messages on the dos and dont’s on a bad air day. Pollution fluctuates over days and outdoor pollution from vehicles, irresponsible construction activity, stubble burning, etc, contributes to health problems, just as indoor pollution involving dusting, lighting candles or agarbattis (incense sticks), he says, adding that there really is no more time for never-ending discussions. “A 28-year-old-boy died, suddenly, some days ago,” he says, warning that cases of sudden heart attacks can be precipitated by pollution.

“It has been a rain of pollution, or a flood of pollution. And the same level of action is required to tackle it as there was when the floods hit Kerala,” he says. “Delhi has to be treated like a model, as it is the most polluted,” stresses Aggarwal, former head of the Indian Medical Association, calling for guidelines on all combustible and polluting activity. It needs a comprehensive approach to tackle pollution at every level — from agarbattis to the crematorium, he says, pulling no punches. Laying the responsibility at the doorstep of citizens, he says, “People need to see what the pollution level is and automatically act by taking a car pool or public transport, for example,” he says, calling for responsible behaviour, unlike the defiance sometimes shown by citizens. For instance, initiatives like allowing cars with odd and even numbers on alternate days are circumvented by people keeping multiple cars, missing the reason behind the initiative. Or the more recent fire-cracker ban, where people defied both air and noise pollution warnings and contributed instead to the overall health emergencies that doctors are having to deal with.

Why do we ignore air?

Sujeet Rajan, a consultant respiratory physician with Bombay Hospital, says India has a high burden of respiratory diseases. The number of early deaths caused by toxic air in India is expected to exceed 6 lakh a year.

When the air quality index shows high pollution, the effect is immediate, says Rajan, in terms of increased messages from his patients. “The lungs are extremely vulnerable,” he says, referring to the sweep of illnesses, from asthma to COPD (chronic obstructive pulmonary disease) to structural lung diseases and hypersensitivity pneumonitis, where the lungs become inflamed as an allergic reaction to inhaled dust, fungus, moulds or chemicals. “We eat 2-3 kg of food and drink 2-5 litres of water a day and take great care of what we eat and drink. But we breathe 10,000 litres of air everyday and don’t bother about the air we breathe, ” he says. Rajan too feels the power lies with people, to exercise responsible behaviour in taking public transport or ensuring more green spaces. The day is not far when people go beyond masks and wear nasal devices, filters, etc, he says.

In the absence of a national policy to tackle air pollution, Aggarwal suggests a Supreme Court-monitored committee empowered to direct across ministries and States, for a coherent approach on issues from automobiles to realty, crackers to stubble burning, besides protection of the country’s green spaces — all of which affect the air we breathe.

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