India faces some of the gravest public health risks from environmental pollution, warns New Delhi-based environmental advocacy group, Centre for Science and Environment (CSE).
In the first-ever report on environmental linkages with health, CSE noted air pollution is one of the top 10 killers in the world and it is the fifth leading cause of death in India. The report called for revamping transportation systems and cleaner technologies to save the population in the country, particularly in urban areas.
Body Burden 2015: State of India’s Health report on public health threats notes forest degradation has helped pathogens that were restricted to animals, jump the species barrier and infect humans.
“It is very clear if we do not have very good epidemiological studies, if we do not have good research, making the connection between health and environment, it becomes even more difficult for us to justify it,” said Sunita Narain, Director General of CSE releasing the report in New Delhi.
Some of the main findings of the report include:
Air pollution is one of the top 10 killers in the world and is the fifth leading cause of death in India. It results in about 620,000 premature deaths which are caused by stroke, chronic obstructive pulmonary disease, ischemic heart disease, lower respiratory infections and trachea, bronchus and lung cancer, among others.
“Death toll due to uncontrolled air pollution-related illnesses alone has increased worldwide by a whopping 300 per cent in the last decade: from 800,000 in year 2000 to 3.2 million in 2012… In Delhi, which was named as the most polluted city of the world by WHO in 2014, air pollution is responsible for 10,000 to 30,000 annual deaths,” says the Report.
Water and sanitation
About 37.7 million Indians are affected by water-borne diseases annually. Around 1.5 million children die due to diarrhoea alone, and 73 million working days are lost due to water-borne illnesses each year. Estimates suggest India loses Rs. 36,600 crore every year due to water-borne diseases.
The Report says by 2015, the figure of malnutrition should have dropped to 26 per cent as per the Millennium Development Goals (MDG). But, the country fell short of the goal by seven per cent. Notwithstanding the progress, India still cannot answer why the malnutrition rate among its children is so high. The country’s economy has doubled since 1991, when the government started counting the malnourished children. The world’s largest programme to tackle child malnutrition, the Integrated Child Development Services (ICDS), has been in force in the country since 1975, much before any other country, save the US, introduced measures to tackle the problem.
India loses over US $12 billion in gross domestic product (GDP) due to vitamin and mineral deficiencies among its population. Malnutrition is not just about access to food. Children who are constantly exposed to faecal microorganisms demonstrate environmental enteric dysfunction or EED, where the gut becomes permeable and brings microbial products in contact with blood. This leads to activation of the immune system which down-regulates the growth factors in the body and leads to stunting.
States like Odisha, Chhattisgarh, Jharkhand where more people defecate in open, have more malnourished children, comparatively.
“Open defecation will lead to perpetuation of infection, causing intestinal helminths in children, which is a primary cause of malnutrition,” commented Dr. K.N. Panicker, a community medicine expert and adviser to World Health Organisation, based at Kochi, Kerala
Climate change is leading to greater frequency and intensity of extreme weather events. Simultaneously, India has seen an increase in vector-borne diseases such as dengue and malaria. The report states that the potential period of spread of malaria has increased to 10-12 months (almost the whole year) which is up from 4 to 6 months. In Kolkata, dengue transmission takes place for 44 weeks in a year. With a 2.4 degree C rise in temperature, transmission may continue for 53 weeks, increasing the risk of more people getting affected. Around 600 people died due to heat waves in Andhra Pradesh and Odisha in 2015.
The diseases of animals that were confined to forests are now affecting humans, says the report. These include zoonotic diseases – as many as 2.7 million people die of these diseases every year. These diseases cause illnesses among 2.5 billion humans every year.
“The reduction in the wild animals make many parasites and pathogens to resort to human beings. Just an example, when so many wild animals were slaughtered and trees were felled to control tsetse fly in Africa, to control sleeping sickness, it boomeranged, making the situation worse,” commented Dr. Panicker.
Ebola, the killer virus, is one such disease-causing virus. It was first reported in 1976 and has exploded into a public health emergency. Loss of forests is linked to these diseases finding their way into human society.
WHO estimates that say that 13.1 million people in India will die of cancer by 2030. This is 20 times than the current death toll in the country.
“Increasing numbers of studies are establishing that the risk of getting cancer has more do with the state of one’s environment than his or her genetic makeup,” says the report, drawing a connection between cancer and pesticides and other factors. It states that five top five states for pesticide use in the country are Maharashtra, Uttar Pradesh, Punjab, Andhra Pradesh and Haryana. It also cites data which show that cancer is on the increase in urban areas.
“Since no doctor will issue a death certificate saying that the cause is an unknown trigger, the industry is safe,” said Narain. “Globally, the maximum residue limits (MRLs) of pesticides are reviewed periodically to incorporate changes in dietary pattern and agricultural practices. But in India, MRLs for registered pesticides are incomplete and have not been reviewed periodically.”
“There is a very tangible link between our environment and our health. In fact, environmental degradation’s first assault is on our bodies and this is one of the biggest reasons why we try to protect the environment. But the linkage is complex and is often disputed. We need to join the dots. We are often not able to take crucial decisions as we really do not know what is happening to our health and how is it linked to the environment. We don’t know and so we don’t care. There is a conspiracy of silence,” said Narain.
Photo Courtesy: CSE