This month public health issues became policy for once. The Supreme Court in its judgement
on moving public vehicles to compressed natural gas (CNG) in Delhi made it clear that the
concern of the court in passing various orders on combating air pollution has been only
one, "namely to protect the health of the people." Unusual also was that
scientific research was considered to decide policy. I call this unusual because a key
failure in our country is that government decision-making and policy setting is never
based on recent scientific evidence. But this time the court looked at studies from the US
to Kolkata to understand the impact of air toxins on human health.
A key consideration was the recent study published in the Journal of American Medical
Association (JAMA) on tiny particles. The JAMA study an amazing epidemiological
journey taking 16 years, covering 116 cities and research on 500,000 people
presents stunning evidence that exposure to fine particles leads to lung cancer and other
related diseases and deaths. According to the study a mere increase of 10 microgramme per
cubic metre (µg/cum) of fine particles smaller than 2.5 microns or PM 2.5
can increase the risk of lung cancer by 8 per cent, cardiopulmonary deaths by 6 per cent
and all deaths by 4 per cent.
Co-author Arden Pope, who has been working on particulates and pollution for many years
now, says that the findings of this study provide the strongest evidence to date that
long-term exposure to air pollution is an important risk factor for cardiopulmonary and
lung cancer mortality.Consider also that the US annual average standard for fine
particulates is 15 µg/cum while in India the annual average standard for
PM 10 is 60 µg/cum and most cities, where this pollutant is
monitored, record anywhere between 100-200 µg/cum on an average in a year. What then
would be the risk of breathing air in our cities?
In the JAMA study, analysis was based on data collected by the American Cancer Society,
which is working on a massive study involving over 1.2 million adults to look at cancer
prevention. I believe this is all about what we should be doing in our country
working with medical professionals to study exposure and impact studies on vulnerable
populations children, women and people living in polluted areas. Such studies give
us confidence in knowing what needs to be done and then policy prescription can follow.
This is good research and good politics.
The judges also discussed studies, however limited, done by Indian medical
professionals by H Paramesh of the Bangalore based Lakeside Medical Centre on
20,000 children under the age of 18 years which shows that asthma incidence increased from
9 per cent in 1979, to 29.5 per cent in 1999. By J N Pande of the All India Institute of
Medical Sciences, by S K Chhabra of the Vallabhai Patel Chest Institute and by the
Chittaranjan National Cancer Institute and Environmental Biology Laboratory of the
Department of Zoology of Kolkata University. All showing similar trends of growing risk.
The court then concluded that the increase in respiratory diseases, especially in
children should normally be a cause of concern for any responsible government. But, the
wise judges say, "children do not agitate or hold rallies and, therefore, their sound
is not heard and the only concern of government appears to be to protect the financial
health of polluters, including oil companies, at the cost of public health."
Need I say anymore?
Sunita Narain
Director