The continuously deteriorating air quality in Delhi has built a lot of fear among its residents. Media outlets reporting that breathing in Delhi is akin to smoking around 40-50 cigarettes in a day adds to the ever-growing panic. Research, however, backs the finding that air quality can be compared to the number of cigarettes smoked by individuals. A digital app also measures this relationship.
Doctors specialised in chest and lung medicine (pulmonologists) have observed a surge in the number of patients with ailments which are commonly known to be related to changes in air quality.
The Cigarette and Air Quality Saga
Delhi's air quality dipped to severe deterioration in the months of October and beginning of November, affecting people's breathing abilities and leading to the Supreme Court intervening and suggesting amendments to both the Central and State Governments. Read our story here.
BOOM spoke to Dr. Vikas Maurya, Additional Director, and HOD, Pulmonology and Chest Medicine, Fortis Hospital, Shalimarbagh, Delhi to comprehend whether media reports about how breathing in Delhi felt similar to smoking about 40 cigarettes daily could be validated.
"Studies have devised a formula on the basis of Air Quality Index (AQI) levels. According to the formula, a 400 AQI, would definitely mean smoking around 25-40 cigarettes daily. Many other countries diligently follow these formulas", stated Dr. Maurya.
The studies that Dr. Maurya refers to have been conducted by Arden Pope, economics professor at Brigham University discussing air quality and just cigarette smoke, while the other study was conducted by Richard Muller, physics professor at University of California, Berkeley with his daughter Eliabeth Muller, where they have researched the overall health impacts of air quality and compared it to smoking.
The Mullers' study takes into consideration the ratio of deaths caused by smoking in a particular year to the number of cigarettes purchased in a year. This constant is 1.37 x10-6. Further, the air pollution, this constant and the deaths caused due to smoking, were used to determine the number of cigarettes. This final figure was divided by the population of the specific area to determine the number of cigarettes per person per year, further divided by 365 to determine per day.
The final thumb rule is that 22 μg/m3 of pollutant PM2.5 is equivalent to smoking one cigarette. This implies that even people who do not smoke are at the risk of suffering from smoking related diseases. The US EPA estimates that for every smoking death, there are 30 other people who suffer significant smoking- related health impairment.
On the basis of this study, designer Marcelo Celho, and developer Amaury Martiny developed an app "Sh**t I Smoke" which measures the existing air quality levels and converts that into cigarette smoke. It provides a daily, weekly, and monthly review. It even allows users to view the air quality and cigarette comparison in areas across the world.
Siobhan Heanue, Australian correspondent for ABC news tweeted about Delhi's situation on November 3, when the air quality was severe and the app showed an equivalence of smoking 33.2 cigarettes. She used the "Sh**t I Smoke" app for the same.
I use an app that converts the air quality to an equivalent number of cigarettes. Anyone in Delhi now might as well be smoking 33 cigarettes a day. Imagine knowing your children are smoking more than a pack a day. Cos here, they are. #DelhiAirEmergency pic.twitter.com/9aumGokBo0— Siobhan Heanue (@siobhanheanue) November 3, 2019
The application considers the location and the air quality and converts it into the number of cigarettes. Mumbai's air quality for 30th November is equivalent to smoking 4.3 cigarettes.
Long Term and Short Term Effects of Air Pollution
Dr. Maurya states that he has witnessed an increase in the number of cases with bronchitis, infections, persistent coughs and asthamatic symptoms. "We tend to see this trend, as soon as the winter sets in. The gases cannot expand, leading to pollutants being present in the air."
He held the industrial gas emissions, the rampant stubble burning and the bursting of firecrackers responsible for the increasing deterioration of air quality in Delhi.
BOOM also spoke to Dr Jai Mullerpattan, Consultant Pulmonologist, Hinduja Hospital, Mumbai and Dr. Preyas Vaidya, Consultant Pulmonologist at Fortis Hospitals, Mumbai to understand the impact of changing air quality.
"Air pollution is harmful for both people with pre-existing health conditions and also in people who are not particularly vulnerable to changes in air quality. Asthma, an increase in infectious diseases have been observed in the clinics", stated Dr. Mullerpattan. He also informed that Constructive Obsessive Pulmonary Disorder (COPD) which constricts breathing, is on the rise.
Dr. Vaidya has also witnessed an increase in the number of patients suffering from various respiratory disorders due to the winter setting in. "I cannot attribute the increase specifically to air pollution as there is no current statistically significant study stating the same."
For the long term effects, all the three specialists agree that pregnant women, foetuses, young children, and the geriatric population are vulnerable to the effects of air pollution. Continuous exposure to air pollution could lead to developmental issues in the foetus.
The doctors also believe that neurological, and cardiovascular diseases can arise in the long run because of the impact that air pollution has on the human body.
"It has been observed that there is a spike in mood related disorders due to the winter coupled with the increasing pollutants", emphasized Dr. Maurya.
Individually, the doctors believe that people can bring about a change which could improve their chances of not suffering from air pollution related disorders. Doctors emphasize on people cutting down on cigarettes if they are smoking.
"Using a N95 or a N99 mask to prevent air pollution is a good mechanism", said Dr. Vaidya. "We also suggest that people avoid exercising in the early mornings and wait till the sun is out."
Dr. Mullerpattan states that controlling indoor pollution is also important. "Keeping the windows shut, ventilation when the sun is out are other important measures."
In a Delhi like situation, Dr. Maurya believes that people should avoid going outside for exercising and also avoid outside food. "Using plants which detoxify the air, and keeping the house dust free are good ways to prevent indoor transfer of pollutants."