New Delhi, Nov 11 (IANS): Shutting down schools, implementing the odd-even vehicle rule, using water sprinklers and artificial rain to boost air quality levels has become a norm every year, when the winter season sets in, these are all knee-jerk reactions, says top pulmonologist Dr Randeep Guleria.

Speaking to IANS, Dr. Guleria, Chairman, Institute of Internal Medicine, Respiratory and Sleep Medicine, Medanta Gurugram, said these measures have specifically been taken since the last 10 years.

However, the need is to have a sustainable plan for better air that runs all year long, he said, and noted although the winter pollution levels get more talked about, air quality in India during most time of the year is generally poor.

“Air pollution has now become an annual event actually for the last almost, I would say 10 years. And it's something which has happened because of a combination of factors,” Dr Guleria said, pointing at increased load of vehicles, unplanned construction, use of diesel generators, burning of crackers during Diwali, and burning of crops in the nearby states. He calls these as “man-made effects”.

On the other hand are natural reasons.

“One of them of course being that the Indo-Gangetic plain is a landlocked area. And therefore during this time of the year, there is very little wind and whatever pollution is created actually tends to settle at ground level because of the change in temperature,” the health expert said, adding: “It becomes colder and there is hardly any wind”.

“The combination of these factors leads to what we see in the winter months”.

During these times “we always have knee jerk reactions like water sprinklers, artificial rain, stopping schools. But there needs to be a sustainable plan”, Dr Guleria said.

He said that poor air quality, which is when the air that we breathe is increasingly filled with nitrogen dioxide, sulphur dioxide, ground level ozone, lead and particulate matter, can do serious harm to the human body both in “short-and long term”.

Right from the unborn baby, pregnant women, young children, to people with underlying chronic respiratory and heart problems, elderly and even the seemingly fit can be significantly affected when the levels of pollution go into the severe or very severe range.

“They tend to have worsening of the underlying diseases, breathing difficulty, cough, chest tightness, wheezing, and because of that, many of them have to increase the medicine and they land up in the emergency,” Dr Guleria told IANS.

Whenever the Air Quality Index (AQI) is high, the emergency visits in children and adults because of respiratory problems go up significantly over the next four to six days, he said, citing a recent study done with the support of the ICMR on hospitals in Delhi.

High AQI levels, “lead to more hospitalisation, more ICU admissions and therefore indirectly a higher chance of mortality”, the doctor said.

Further, he stated that being exposed to high levels of air pollution for long-term can have “chronic effects”.

“Living in an area with high levels of air pollution is as much a risk of heart disease as high cholesterol or smoking. It's also linked with chronic respiratory diseases, and strokes”.

In addition, he said that there is good data to show that chronic exposure to bad air is also linked with the risk of developing dementia, diabetes, and lung cancer. Studies also suggest that in pregnant women, air pollution has an effect not only in the women leading to premature birth, but it also leads to what we call intrauterine growth retardation (IUGR), the pulmonologist told IANS.

Dr Guleria also noted that to make the AQI better, we should “have milestones that over a period of time we will be able to have people breathe better air. It's not something that cannot be done”.

He cited the examples of other cities like London, Los Angeles, and New Mexico which all once had bad air quality levels, but with “good actions” they have better air quality levels now.

“Even if you look at Delhi, in the late 90s the air quality was very bad. But then CNG came in and then had people who had better quality air for some time.

“But then again because of diesel vehicles, increasing construction, not making the city more green and not planning for environmentally friendly ways of travel has led again to high levels of pollution,” the doctor told IANS.

He called for developing a “practical” and “sustainable plan”, by targeting the source of emission, increasing the public awareness for decreasing the carbon footprint, and adopting more environment friendly practices.

“There has to be a sustainable multi-pronged attack against air pollution. Environment isn't a medical emergency; we'd have this every year. And then we make a lot of noise during the winter months, but then forget about it,” Dr Guleria lamented.

“A plan has to be in place which is practical and also takes all stakeholders on board”.

(Rachel V Thomas can be contacted atrachel.t@ians.in)