Air Pollution: Public Health Impacts and Policy Measures

Introduction

Air pollution and its impact on human health represent a slow and ongoing public health emergency. The detrimental effects of air pollution span from respiratory and cardiovascular diseases to adverse pregnancy outcomes and developmental problems in children and contribute to premature mortality across the developed and developing world. Air pollution, including microscopic PM and gaseous pollutants, can harm lung function and affect the cardiovascular system by causing oxidative stress, inflammation, altered heart rhythms, and disruptions in blood pressure. PM2.5 (PM smaller than 2.5 microns) can also penetrate deep into the lungs and bloodstream, affecting multiple organs and systems (Izzotti et al. 2022). The International Agency for Research on Cancer (IARC) has classed PM2.5 as a cause of lung cancers, building on evidence showcasing the carcinogenic effects of both vehicular diesel pollution and coal-burning emissions (Balakrishnan et al. 2015).

The 2019 India sub-national burden of disease study estimated that exposure to ambient and household air pollution contributed to 1.67 million deaths and 53.5 million disability-adjusted life years (DALYs) lost, amounting to 17.8% of total deaths and 11.5% of total DALYs, respectively. The economic loss associated with this exposure was estimated at $36.8 billion or 1.36% of GDP (A. Pandey et al. 2020). More recent results using similar approaches indicate an increase in air pollution’s burden of death to over 2.1 million deaths annually in India (State of Global Air 2024). Death rates from various sources of air pollution have changed substantially since 1990, with death rates from ambient PM2.5 increasing by 115.3% and that from household air pollution (primarily from traditional biomass-burning cookstoves) declining by 64.2%.

While the declines in household air pollution impacts are heartening, the increases in death rates from ambient air pollution are only likely to increase in the coming years, with India rapidly urbanising and industrialising. Many of the world’s most polluted cities in the world are in India, several of them tier-2 and 3 cities (IQ Air 2023). Combined with the growing evidence base on air pollution’s health impacts and the need to capitalise on its demographic dividend, there is a greater urgency than ever to tackle the all-pervasive challenge of air pollution.