Respiratory diseases like Asthma, Chronic Obstructive Pulmonary Disease (COPD), Tuberculosis, Bronchiectasis and Lung Cancer are a major cause of morbidity and mortality in India. Chronic respiratory diseases account for 4% of the global and 8.3% of the overall burden of chronic diseases, having a major adverse impact on sufferer’s quality of life (QoL), disability and productivity and resulting in an increased economic burden for both the individual and community. An estimated 12.6 million people died as a result of living or working in an unhealthy environment in 2012 – nearly 1 in 4 of total global deaths, according to WHO.
South-East Asia region has witnessed rapid urbanisation, industrialisation, booming population, changing lifestyle and increasing number of vehicles that led to a rise in environmental and health diseases. The Global Burden of Diseases, Injuries and Risk Factors Study 2015 (GBD 2015) identified air pollution as a leading cause of global disease burden, especially in low income and middle-income countries.
Air pollution is the contamination of the indoor or outdoor environment by any chemical, physical or biological agent that modifies the natural characteristics of the atmosphere. Household combustion devices, motor vehicles, industrial facilities and forest fires are common sources of air pollution.
In India especially in rural settings use of biomass fuel like solid wood, cow dung and coal produce high levels of indoor air pollutants, including small soot particles that penetrate deep into the lungs. These inefficient cooking practices are a major cause of chronic respiratory illnesses including cancer among women and non-smokers in India. A WHO study shows that more than 50% of premature deaths due to pneumonia among children under 5 are caused by the particulate matter (soot) inhaled from household air pollution.
Most Indian metro cities are among the world’s most polluted ones when it comes to the quality of air. There has been a steady rise in acute respiratory illnesses which is related to worsening ambient air pollution. According to India’s National Health Profile 2015, there were almost 3.5 million reported cases of acute respiratory infection, a 30% increase since 2010.
This pollution disease burden is preventable for which the environment and health and other sectors need to work together. Strategies like reducing traffic congestion, using more public transport than personal vehicles can reduce ambient air pollution. Introduce clean fuels for cooking and heating and lighting for example Govt. of India in May 2016 launched ‘Pradhan Mantri Ujjwala Yojana’ where they provide free cooking gas connections to women from extremely poor households, to reduce the use of polluting fuels such as wood and dried cow dung with target of increasing LPG usage to cover 80% of the households by March 2019.
China and India combined had the largest numbers of attributable deaths and disability-adjusted life years (DALY): 52% and 50% of the respective global totals. Pakistan, India and Bangladesh had the highest age-adjusted mortality rates, more than seven times higher than those of Japan and the USA.
About the doctor:
Dr Bornali Datta
Respiratory and Sleep Medicine
Dr Bornali Datta is a highly qualified Respiratory Physician with a cumulative experience in India and the UK of about 15 years since qualification from medical school. She has been exposed to and has gained experience in all aspects of General and Respiratory Medicine in this period. This specifically involved the management of interstitial lung disease, sarcoidosis, lung cancer, airways disease, sleep disorders, TB, bronchiectasis, difficult asthma (including new biologic therapies) and all forms of pleural disease. She is competent in the management of critically ill patients with acute respiratory failure in an intensive care / high dependency setting with non-invasive ventilation (BiPAP / CPAP). She is also competent in various aspects of interventional respiratory medicine namely bronchoscopy, transbronchial biopsy and transbronchial fine needle aspiration (having performed 400 procedures), chest drain insertion (Seldinger and Argyll), thoracic ultrasound and medical thoracoscopy.
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