Lin December, a Delhi man convicted of rape and murder appeared before the Indian Supreme Court and argued that in light of the city’s staggering pollution problem, he should be spared the death penalty. Air quality is “like a gas chamber,” he said in a petition. The water is “full of poison”. Why condemn him to death, he argued, when pollution was already killing him?
The argument was both absurd and ineffective. But it does reflect an underlying truth: in India and around the world, people are increasingly concerned about the health effects of worsening pollution in cities.
Delhi air quality levels achieved “Severe” levels twice last December, just a month after the deterioration in the air quality index that led doctors to declare a public health emergency in the city and schools were closed. The smog-filled air at that time was as damaging to the lungs as smoking more than a pack of cigarettes a day, according to a study by the nonprofit climate research organization. Berkeley Land.
Similar crises have been unfolding since Beijing at Baltimore. According to the World Health Organization (WHO), more than 80 percent of people living in urban areas where the air is monitored experience dangerous levels of pollutionand 98 percent of cities in low- and middle-income countries do not meet WHO air quality guidelines. A 2017 report of the Lancet Commission on Pollution and Health found that pollution is responsible for nine million premature deaths per year – about 16% of the number of deaths worldwide and more than the number of deaths from war or hunger.
The astonishing impact of pollution on health was confirmed this year by a study published in the New England Journal of Medicine which examined particulate air pollution in 652 cities around the world. He found that particulate pollution was associated with increases in cardiovascular and respiratory mortality and overall mortality. Other studies have linked pollution to conditions ranging from Diabetes at renal dysfunction. Pollution is not only the main environmental cause of disease, but it is also linked to climate change and the health of the planet. The Lancet Commission estimated that the annual economic costs of pollution are $ 4.6 trillion worldwide.
New search also suggest that people living in areas with poorer air quality may be more susceptible to the impacts of Covid-19, the disease caused by the new coronavirus.
Yet the pollution problem remains largely neglected by policy makers, funding agencies and the media. Globally, the pollution control program attracts only a fraction of the hundreds of millions of dollars in annual funding that goes to other public health threats like HIV / AIDS and malaria, a highlighted Richard Fuller, co-author of the Lancet report and president of the pollution-focused nonprofit Pure land. Why is pollution not on our radar?
Part of the answer is that environmental regulations in the United States and other wealthy countries have already led to progress. After the Lancet report was published, Philip Landrigan, co-author and physician epidemiologist at the Mount Sinai School of Medicine in New York, explained, “I was a medical intern at Cleveland Metropolitan General Hospital in the late 1960s. You couldn’t see the air pollution from the steelworks along the corridor. You don’t see pollution like that in Cleveland anymore. But you see it in New Delhi.
Another factor is that the pollution problem is complicated and insidious. We tend to pay attention to it only in times of crisis, such as when drinking water in Flint, Michigan is discovered contaminated with lead and other pollutants. “The water crisis in Flint caught people’s attention as something important and unacceptable,” said Gary Adamkiewicz, assistant professor at Harvard TH Chan School of Public Health. “He showed gaps in public policy, revealed which communities had power and voice, and how these things can go unnoticed without proper testing.”
But even when no health emergency makes headlines in local and national newspapers, pollution continues to threaten our well-being. Polluted water leads to diarrheal disease and other infections in the gastrointestinal tract. Soil polluted with toxic chemicals causes heart disease, stroke, and brain damage in developing children. Polluted air not only leads to asthma, lung cancer and diabetes, but also to low birth weight in infants. There is even cognitive effects: Recent studies have shown that chess players make more mistakes in more polluted environments and that high levels of air pollution are linked to higher rates of attention deficit hyperactivity disorder and dementia.
A September 2019 study published in Nature Communications examined the placentas of 28 new mothers and found that soot-like carbon black had accumulated on the fetal side of the placental walls, suggesting that particulate air pollution may directly affect a fetus by development. A recent study of pregnant women in Boston showed that women exposed to higher levels of air pollution during pregnancy gave birth to newborns with lower fetal heart rate variability, indicating better cardiovascular health bad.
Some might argue that pollution is an inevitable part of a growing economy and a necessary by-product of developing economies’ steps towards industrialization. This idea, an extension of the so-called environmental hypothesis of the Kuznets curve, has become conventional wisdom in economic circles. However, the Lancet Commission showed that the hypothesis is nothing more than an urban legend, based on weakly extrapolated statistics. It does not take into account the effects of pollution on health or the availability of solar or wind energy. “Countries can embrace clean energy sources and embark on development,” says Landrigan.
Policymakers can take clear and achievable action to tackle pollution. The first is to ensure that pollution is a priority at local, state and national levels, and that pollution control efforts are adequately funded. Another step is to encourage countries like the United States, which have been successful in tackling pollution in many areas, to export their expertise to countries which still struggle with air quality issues, water and soil. Meanwhile, countries that have achieved success must fight attacks on their existing regulations.
As a global community, we must act collectively and urgently to reduce the problem of pollution. Our health depends on it.
Pranav Reddy, MD, MPA, is a medical resident in Obstetrics and Gynecology at the Yale School of Medicine. His research examines the impact of social and health policies on perinatal outcomes. Follow him on Twitter @born_reddy.