Public Health Foundation of India

First comprehensive estimates of the impact of air pollution on deaths, health loss, and life expectancy reduction in each state of India

The first comprehensive estimates of deaths, disease burden, and life expectancy reduction associated with air pollution in each state of India was published by the India State-Level Disease Burden Initiative on December 06, 2018 at the Indian Council of Medical Research. The India State-Level Disease Burden Initiative is a joint initiative of the Indian Council of Medical Research (ICMR), Public Health Foundation of India (PHFI), and Institute for Health Metrics and Evaluation (IHME) in collaboration with the Ministry of Health and Family Welfare, Government of India, along with experts and stakeholders associated with over 100 Indian institutions. These research findings published in The Lancet Planetary Health.

Scientific paper published:

India State-Level Disease Burden Initiative Air Pollution Collaborators. The impact of air pollution on deaths, disease burden, and life expectancy across the states of India: the Global Burden of Disease Study 2017. Lancet Planetary Health. 6 December 2018.

http://www.thelancet.com/journals/lanplh/article/PIIS2542-5196(18)30261-4/fulltext

First author:  Prof. Kalpana Balakrishnan
Senior author: Prof. Lalit Dandona
Total authors: 76

Press Release Lancet Research Paper

Key findings from the paper:

• First comprehensive estimates of deaths, disease burden, and life expectancy reduction associated with air pollution in each state of India.
• One in eight deaths in India was attributable to air pollution in India in 2017, making it a leading risk factor for death in India.
• 4 lakh deaths in India in 2017 were due to air pollution, which included 6.7 lakh deaths due to outdoor particulate matter air pollution and 4.8 lakh deaths due to household air pollution.
• Over half of the deaths due to air pollution were in persons less than 70 years of age.
• With 18% of the global population, India suffered 26% of premature mortality and health loss attributable to air pollution globally.
• In 2017, 77% population of India was exposed to ambient particulate matter PM₅ above 40 μg/m³, the recommended limit by the National Ambient Air Quality Standards.
• The mean ambient particulate matter PM₅ annual exposure of 90 μg/m³ in India in 2017 was one of the highest in the world. The highest PM_2.5 exposure level was in Delhi, followed by the other north Indian states of Uttar Pradesh, Bihar and Haryana.
• While the proportion of households using solid fuels has been improving in India, 56% of the population still used solid fuels in 2017; this proportion was higher in the less developed states with over two-thirds of the population in most EAG states using solid fuels for cooking.
• The DALY rates due to household air pollution varied 145-fold among the states of India in 2017, and it varied 6-fold for outdoor particulate matter air pollution.
• The DALYs attributable to air pollution in India in 2017 for major non-communicable diseases, which included chronic obstructive lung disease, ischemic heart disease, stroke, diabetes and lung cancer, were at least as high as those attributable to tobacco use.
• The average life expectancy in India would have been 1.7 years higher if the air pollution level were less than the minimal level causing health loss, with the highest increases in the northern states of Rajasthan (2.5 years), Uttar Pradesh (2.2 years), and Haryana (2.1 years).
• Increasing public and policy attention to the control of air pollution in India is encouraging, which needs to be sustained for effective interventions. The Pradhan Mantri Ujjwala Yojana launched in May 2016 has achieved its target of distributing LPG to 50 million poor households in August 2018, the target that was originally set for March 2019. The target has now been increased to reach 80 million households through this scheme.
• Systematic and sustained efforts are needed to address the variety of sources contributing to air pollution, which include transport vehicles, construction activity, industry and thermal power emissions, residential and commercial solid fuel use, waste and agriculture burning, diesel generators, and manual road dust sweeping.
• Variations between the states in the exposure to outdoor and indoor air pollution should be taken into account while planning policies and interventions to reduce this exposure and its health impact.

About the India State-Level Disease Burden Initiative:

The first set of findings by the India State-Level Disease Burden Initiative on the variations in epidemiological transition across the states of India were presented in a Report released by the Vice-President and Health Minister of India and in a scientific paper published in The Lancet in November 2017:

https://icmr.nic.in/reports?title=&page=1
https://phfi.org/the-work/research/the-india-state-level-disease-burden-initiative/
http://www.healthdata.org/disease-burden-India
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)32804-0/fulltext

Five detailed topic-specific papers were published in the Lancet journals in September 2018 on state-level trends of cardiovascular diseases, diabetes, chronic respiratory diseases, cancer, and suicide along with a commentary in The Lancet on the relevance of these findings for Ayushman Bharat:

https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(18)30407-8/fulltext
https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(18)30387-5/fulltext
https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(18)30409-1/fulltext
https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(18)30447-9/fulltext
https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(18)30138-5/fulltext
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)32172-X/fulltext