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Hi, I'm Shashank Bhargav and you're listening to Three Things,
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the Indian Express news show.
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Dr.
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Khilani, you have been in the city for a while now.
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Do you recall a time when the air quality in
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Delhi was actually good?
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Of course, we all know that the air quality in
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Delhi was amazing during COVID times.
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When there was.
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No traffic on the road, there was no movement, there
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was no factories running, the schools were closed, and you
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could see the blue sky which you see in New York,
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San Francisco.
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Or Europe.
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That was the time, and I have a picture of it,
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which I keep showing, and I show the India Gate,
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which is so clearly visible.
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Besides that, Delhi.
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Always had a very bad air pollution, especially in winter season.
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That's Dr.
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G.C.
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Khilani. He's the chairman of the Pulmonary Critical Care and
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Sleep Medicine at the PSRI Hospital in Delhi. And he's
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also a member of the Technical Advisory Group on Air
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Pollution and Health at WHO. And in today's episode, we
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are dedicating the conversation to speaking to him about everything
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related to air pollution. What AQI levels actually indicate, how
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air pollution affects our bodies, the steps individuals can take,
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and what the government can do to reduce a city's
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pollution by half. And while this conversation is centered around Delhi,
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it has important lessons no matter where you are in
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the country. So here's Dr. Khilani telling us the reasons
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why the capital's pollution is so bad.
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So Delhi's air quality is bad, one, because of the geography,
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because the low-lying area is a part of the gigantic
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region where the air pollution is high, but.
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Delhi is highest. As you know, it is the.
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worst polluted city in the world. And there are so
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many reasons. So one of the reasons is the transport,
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that is vehicles. The number of vehicles in Delhi are
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more than Calcutta, Chennai and Mumbai combined. So the numbers
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are too large. Although everything is there, that pollution check
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is there and certificates are there, but there are issues
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about engine quality in city of Delhi also.
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So that is transport is one.
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And is that the biggest contributor?
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More or less, yes.
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That is the biggest contributor on an average.
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It depends upon season.
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But if you take annual average, then transport is the
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number one cause of air pollution. Besides this, the road
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dust and the construction dust, that's a very big contributor
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which is less talked about. You would have seen that,
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you know, big trucks moving and if you are, you know,
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or buses for that matter, if you are driving behind,
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you can see actually dust coming up, and every fourth
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house is being reconstructed or constructed, and demolition is going on,
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and the norms are not followed. So the construction and
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demolition is another cause of air pollution. Beside this, 3-5%
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of the air pollution comes from the burning of the waste,
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municipal waste, which is done by the government, not by
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the people, and which is actually preventable. And if you
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talk about tandoors, there are 9,000 tandoors in this city,
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you know, for making chicken tikka and paneer tikka, and
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they all run on coal and wood. So they are
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also a big source of air pollution.
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And besides this, what is also highlighted when it comes
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to Delhi are outside factors, right? Can you talk about
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how much they contribute to the city's air pollution?
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So one important thing that we need to understand that
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Delhi pollution is not only from generated in Delhi. A
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large proportion comes from outside Delhi, even from Afghanistan and Pakistan, Punjab.
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And if we talk about, say, distance of 300 kilometers
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within
Load full transcript
Delhi, there are many electricity generating plants. And except one,
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all are using coal.
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And this is a big source of air pollution as
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far as the Delhi and NCR is concerned. And this
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is exemplified if you know that 10 worst polluted cities
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in India are Delhi, Gurgaon, Faridabad. Noida, Harford, they are
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around this area only. So this coal burning for electricity
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generation is a big source of air pollution. Besides that,
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of course, stubble burning, which is a periodic thing. And
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as I said, even from Pakistan, Afghanistan. And I have
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talked about sources, but one of the reasons that air
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pollution continues to be worst in Delhi is the wind speed.
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Delhi geographically is a very low-lying area.
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So the only.
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Thing which reduces the AQI, as you must have read
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in the newspaper, that wind blow was good, the wind
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speed was good. So therefore, the air quality improved.
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Right.
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Whenever the wind speed is high or it's not cloudy,
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the air quality improves. But you mentioned stubble burning and
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that makes so many headlines. How much does stubble burning
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actually factor into Delhi's air pollution?
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So, stubble burning, anything between 5 to 18%. This is
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a rough figure and these are estimates actually. It depends
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upon the quantum of stubble burning, the area of burning
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and also wind direction. All those things matter, but the
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maximum what I have come to know with my knowledge
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is about 16 to 18% of the pollution coming from.
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But that is episodic.
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But the AQI in Delhi 12 months is much, much above.
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any acceptable limit, and if you talk about WHO standard,
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you might be shocked that the WHO average of PM2. 5
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standard is 5 micron per cubic meter, whereas we are
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living at 250, 300, and WHO daily maximum is 15 micron.
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The 5 is annual average. So we are in trouble,
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and it's not new. It has been there for decades, actually.
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And does the air quality get particularly bad during the
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winters or it's just that we can see smog in
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the air?
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So what is smog? Smog is a combination of fog
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and air pollutants. When the temperature is down, the humidity
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is high, the air pollutants get trapped and there's something
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called inversion. Inversion is that air pollutants, instead of being
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equally distributed in the sky, they In the morning time
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when it is cold, it comes down at a breathable
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surface level. With that, visibility goes down, but also the
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concentration of air pollutants is extremely high. Whereas in summer,
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despite the same vehicles and same, they go up. So
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that is why the effect is much less because the
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fog is not there. When the fog is there, winter
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is there, air pollution is there, the smog occurs.
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And you mentioned a couple of factors that contribute to
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air pollution. You mentioned vehicles, you mentioned construction, garbage burning,
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stubble burning. Are they emitting different kinds of pollutants? And
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if that's the case, then how do those pollutants affect
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us differently?
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Yeah, so that's an amazing question. PM2.
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5 from the petrol engine would be different from PM2. 5
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from the diesel engine. Because diesel engine will emit lot
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of what we call it polyaromatic hydrocarbons which are carcinogenic.
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Whereas the petrol emission would cause more of asthma. Similarly,
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the PM2. 0 from firecrackers would have arsenic, thallium, potassium, very
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toxic substances which gets deposited.
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PM2.
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5 from the road dust would be different. PM2. 5 from
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the construction and demolition will contain lot of fungi like this. So, PM2. 5
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It's only something that we can measure and say.
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And for those who might not know already, can you
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tell us what exactly PM2. 5 is? Because that's all we
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hear about these days.
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So, you should understand
that why these figures are quoted
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all the time. Because this is called aerodynamic diameter. How
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they are formed? They are formed by complex chemical reaction
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of noxious gases and other particles in the air.
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So, PM10.
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Why don't we talk about PM 15 or PM 20?
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You know, after all, they are also small particles.
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And this is the size of the pollutant.
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Size of the aerodynamic diameter of the particle. The particles
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which are more than 10 micron are filtered by our nose.
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The God has provided with that filter so that foreign
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particles do.
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Not go in.
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So they cause cough and sore throat and blah, blah, blah.
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But the particles which are smaller than 2.5 micron, that
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is called PM2. 5, they go to the lowest part of
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the lung where gas exchange takes place. And they cause
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short-term as well as long-term diseases in the lung. But
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I would also like you to know there is something
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that we don't talk about, is ultra-fine particulate matter. This
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is PM0. 1 particle which are smaller than 2.5. 0.1 micron.
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These are the particles which penetrate the lung and go
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into the blood vessel.
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What is lung?
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Lung is a filter through which the oxygen goes into
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the blood and carbon dioxide comes out. And with that
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other things also come out. But the particles which are
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less than 0.1 micron, they pass through that, what we
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call as allulose, go into the bloodstream and go into
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every part of our system. Like it may be brain,
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it may be eyes, it may be heart, it may
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be blood vessels, it may be kidney, intestine and everything.
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That is why... The air pollution.
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Affects every organ of the body and it is affecting
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our longevity as well as the quality of life.
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And so when we look up the air quality index,
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the AQI of a place, and it shows us 200
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or 500, what
exactly is that number telling us? What
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does that number mean?
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So the AQI that you hear is actually not made
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of one parameter.
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AQI was... Sort of formulated.
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In year 2012, there was a committee under the chairmanship
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of Dr. Mukesh Sharma, who is a professor of civil
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engineering in IIT. There was a 10 or 11 member
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committee and I was part of that and we sat
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down and discussed the health effects. So AQI is made
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of six parameters. One is of course PM2. 5, other is
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nitric oxide, other is sulfur dioxide, ozone and lead. Lead
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is no more very serious issue because it has been
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taken off. So each parameter is given certain strength in
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that calculation. The final thing which comes out is one
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parameter AQI. So AQI should not be equated to PM2. 5.
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It is a.
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Mixture of all the six air pollutants. But while PM2. 5
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affects the lung, Nitric oxide, sulfur dioxide, carbon monoxide, these
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gases will easily pass through the lung and go into
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the blood and they also cause their own harms and
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there are various adverse effects.
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And so right now, are we measuring all these different
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kinds of pollutants?
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Yes, the Central Pollution and Control Board measuring all the
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components except ozone. Ozone is not easy to measure, but
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they are measuring it for research purposes. But on a
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daily basis, ozone is not published. The rest of the
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parameters regularly are monitored at various stations by Central Pollution
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Control Board.
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And, you know, we all know that pollution is bad
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for us. And we hear all the time that breathing
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in bad air is like smoking cigarettes and it reduces
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life expectancy. And in fact, some people react to that
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by saying, you know, I'm fine losing five years of life.
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I don't care that much about air pollution. But can
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you stress on how air pollution affects our quality of
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life and what are its long and short term effects?
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So I'll talk about first the short-term effects of air
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pollution on us. And if you talk to any Delhiite today,
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you tell him that, look, I have some very bad throat,
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you know, my throat is so scratchy, I have running nose,
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I have got headache, and I'm coughing. Sometime I have
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to cough through the night. You will never get a
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sympathy because everybody has it. So they will say, okay,
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you have it, I also have it. So it's what
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we in French phrase you call fait accompli. This has
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to happen every year. But this is not the only thing.
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Besides this, your feeling of well-being is affected. You feel
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more tired in the evening. Your appetite may go down.
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Quite importantly, slight heaviness of head is there. And what
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is lesser talked about, our sleep gets affected. If you
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are in a cleaner environment, you are more likely to
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sleep peacefully. But even without cough, that sleep quality gets affected.
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And as someone who sees patients regularly, can you talk
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about the kind of problems you come across on a
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daily basis?
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So about a month back, when I was sitting in
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my OPD, the AQI was Still in the 200 round category,
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but the pollution had started setting in. I got five
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consecutive patients who were my old patients who were happily
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living their life on inhalers or whatever treatment.
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Consecutively, five patients came.
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That we have increased cough, we have increased breathlessness, and
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we are unable to sleep. We have to sit up
246
00:14:24.740 --> 00:14:27.340
through the night. And when I asked the ST, they
247
00:14:27.360 --> 00:14:30.740
said we have no fever whatsoever. I do their x-ray,
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that is normal. And then I do their one test
249
00:14:33.929 --> 00:14:38.169
called fraction of exhaled nitric oxide. That is one exhales
250
00:14:38.250 --> 00:14:41.389
into a machine and we measure the nitric oxide, which
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00:14:41.470 --> 00:14:45.159
is the measure of airway inflammation. All these patients have
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00:14:48.539
a high level of exhaled nitric oxide, which told me
253
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that they have airway inflammation. So that means that there
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00:14:52.759 --> 00:14:57.009
was increased inflammation there. due to the air pollution which
255
00:14:57.090 --> 00:15:01.600
led to exacerbation of their asthma or bronchitis or other
256
00:15:01.909 --> 00:15:06.440
respiratory ailments, some of them also landed up into the ICU.
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And not only that, those patients who were admitted with
258
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respiratory ailments during the high level of air pollution, their.
259
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Response to treatment was very poor.
260
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Instead of improving, despite the treatment which we thought giving
261
00:15:20.269 --> 00:15:24.000
was appropriate, they were not responding. At least two of
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my chronic patients with respiratory diseases, they got admitted. They
263
00:15:29.980 --> 00:15:33.679
knew it was because of the air pollution, and one
264
00:15:33.720 --> 00:15:36.529
knew that it was because of firecrackers, and he was
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unwilling to go home. and his response to the treatment
266
00:15:40.159 --> 00:15:43.570
was extremely poor. And this we know that even a
267
00:15:43.610 --> 00:15:47.570
viral infection, which should be trivial, at the time of
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air pollution, it may take a serious turn and person
269
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may land into the ICU. There I also would like
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to tell you that children, young children, less than 5
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years of age, and the elderly more than 60 or
272
00:15:59.649 --> 00:16:05.019
65 years of age, And those who are having heart
273
00:16:05.059 --> 00:16:09.159
diseases or previous lung diseases or those who are immunocompromised
274
00:16:09.200 --> 00:16:13.759
because of diseases or chemotherapy or cancers, they are the
275
00:16:13.820 --> 00:16:16.830
people who are worst affected during this time.
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00:16:17.710 --> 00:16:19.090
And you know, there are a lot of people who
277
00:16:19.169 --> 00:16:22.029
claim that, you know, they are not being affected by
278
00:16:22.190 --> 00:16:24.970
any of this. So are they just not noticing some
279
00:16:25.009 --> 00:16:27.320
of these symptoms or have they just sort of got
280
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used to it?
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No.
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00:16:29.230 --> 00:16:32.990
Those people who have allergic tendencies, those who are what
283
00:16:33.049 --> 00:16:37.460
we call technically as bronchial hyperreactivity, they are more likely
284
00:16:37.500 --> 00:16:40.759
to be affected. After all, if you give insult to
285
00:16:40.799 --> 00:16:44.279
five people, they react differently. So this is an insult
286
00:16:44.320 --> 00:16:48.940
to our lung. And everybody's
lung will react differently and
287
00:16:49.000 --> 00:16:53.159
with different severity. And there are so many people who
288
00:16:53.220 --> 00:16:57.230
are traveling abroad and... They tell me and I also
289
00:16:57.309 --> 00:17:00.450
keep going. When I go to the Western world, I
290
00:17:00.490 --> 00:17:04.690
go for morning walk, same person, same age, me. I
291
00:17:04.710 --> 00:17:09.549
walk for hour together, I don't get tired. And whereas here,
292
00:17:09.750 --> 00:17:13.319
I don't have that much energies or whatever you call it.
293
00:17:13.839 --> 00:17:16.759
One gets used to it, you stop complaining because it
294
00:17:16.819 --> 00:17:21.109
has been the visibility for that matter. If you land
295
00:17:21.470 --> 00:17:24.849
in the developed worlds and come out of the aircraft,
296
00:17:24.869 --> 00:17:28.819
you feel their vision has improved. And I would also
297
00:17:28.880 --> 00:17:32.059
like to tell you what is the evidence from India,
298
00:17:32.480 --> 00:17:37.480
scientific evidence, that there are short-term implications. About 30 years back,
299
00:17:37.809 --> 00:17:40.210
There was a study conducted at the All India Institute
300
00:17:40.289 --> 00:17:43.569
of Medical Sciences, which I was part of that. That's
301
00:17:43.589 --> 00:17:48.579
a published study where we collected the emergency visits of
302
00:17:48.660 --> 00:17:53.759
patients with asthma, COPD, and heart attacks over a period
303
00:17:53.839 --> 00:17:57.119
of one year and correlated with the level of air pollution.
304
00:17:57.700 --> 00:18:00.490
What was the conclusion was that there was 22 to
305
00:18:00.490 --> 00:18:02.250
25 percent increase in the.
306
00:18:05.069 --> 00:18:06.369
Rate of heart attacks.
307
00:18:06.450 --> 00:18:11.359
Bronchitis and asthma attacks in response to the air pollution
308
00:18:11.440 --> 00:18:14.960
in last 48 hours. And actually that was the study
309
00:18:14.980 --> 00:18:20.250
which led to the vulnerable code taking cognizance and that
310
00:18:20.309 --> 00:18:23.869
time the CNG came and all the industries were asked
311
00:18:23.910 --> 00:18:27.089
to go 50 kilometers away from and that's how the
312
00:18:27.130 --> 00:18:29.599
daily air quality somehow improved in late 90s.
313
00:18:30.670 --> 00:18:32.769
Okay, so, so far we have been talking about how
314
00:18:33.210 --> 00:18:37.960
our body gets affected immediately. What are the long-term effects
315
00:18:38.059 --> 00:18:38.920
of air pollution?
316
00:18:39.720 --> 00:18:44.809
So, first I will talk about the respiratory effects. And
317
00:18:45.130 --> 00:18:48.269
if you talk about asthma, and today every third child
318
00:18:48.670 --> 00:18:52.789
has asthma. And Every other house where young children have
319
00:18:52.849 --> 00:18:58.430
nebulization machine. Whereas the incidence, prevalence of asthma in Indian
320
00:18:58.470 --> 00:19:00.809
children is about 5% or 10%.
321
00:19:00.809 --> 00:19:03.089
But the daily children have.
322
00:19:03.509 --> 00:19:07.559
The lung capacity of daily children as done by a
323
00:19:07.710 --> 00:19:11.180
study at All India Institute of Medical Sciences is much
324
00:19:11.299 --> 00:19:14.299
less than the lung capacity of Tirupati.
325
00:19:14.400 --> 00:19:17.779
This study also is a published study long time back.
326
00:19:18.160 --> 00:19:23.789
The COPD, chronic obstructive pulmonary disease, commonly causes bronchitis. And
327
00:19:23.829 --> 00:19:27.250
when we were studying, it was 90% was caused by
328
00:19:27.369 --> 00:19:33.049
tobacco smoking. And in India today, that COPD, 50% is
329
00:19:33.130 --> 00:19:36.769
caused by outdoor and indoor air pollution. And COPD is
330
00:19:36.890 --> 00:19:40.529
third leading cause of death all over the world. Talking
331
00:19:40.569 --> 00:19:45.849
about lung cancer, lung cancer is number one cancer killer
332
00:19:45.930 --> 00:19:46.690
all over the world.
333
00:19:47.160 --> 00:19:49.589
More than prostate, breast, colon.
334
00:19:50.640 --> 00:19:54.720
So lung cancer in the western world, 90% is caused
335
00:19:54.819 --> 00:20:00.700
by tobacco smoking. Whereas in India, 40% it occurs in non-smokers.
336
00:20:01.140 --> 00:20:05.279
And it is attributed to indoor and outdoor air pollution.
337
00:20:05.799 --> 00:20:09.470
And of course, we have already talked about acute exacerbation
338
00:20:09.549 --> 00:20:14.170
of asthma and COPD, which is caused by air pollution. So,
339
00:20:14.670 --> 00:20:17.309
as I talked in the beginning, that air pollution does
340
00:20:17.349 --> 00:20:23.059
not confine itself to lung. It percolates from lung to
341
00:20:23.440 --> 00:20:27.940
all parts of the body. Almost every cancer, starting from
342
00:20:28.039 --> 00:20:34.000
intestine to urinary system to even uterus, ovary, the Incidence
343
00:20:34.099 --> 00:20:36.619
of cancer is higher if you are living in a
344
00:20:36.940 --> 00:20:43.539
polluted environment. Besides that, heart disease also occurs more because
345
00:20:43.599 --> 00:20:49.430
of obvious reasons. And everything culminates into quality of life
346
00:20:49.509 --> 00:20:54.329
and quantity of life. So India got, at the time
347
00:20:54.410 --> 00:20:57.880
of independence, their life expectancy at birth in India was
348
00:20:57.880 --> 00:21:02.200
32 years. Now we are at about 72 years. And
349
00:21:02.240 --> 00:21:09.940
the Chicago study, which was published in October 2023, estimated
350
00:21:10.359 --> 00:21:15.359
that because of the air pollution, that average life expectancy
351
00:21:15.440 --> 00:21:20.920
of Indian at birth is reduced by 5.3 years and 11.9
352
00:21:20.920 --> 00:21:22.720
years for Delhiites.
353
00:21:23.160 --> 00:21:26.140
So, this is very important for all of us to
354
00:21:26.180 --> 00:21:28.509
know that it's not about Delhi.
355
00:21:28.509 --> 00:21:33.640
99% of the Indians are living in the area
where
356
00:21:33.700 --> 00:21:38.589
their pollution is more than what WHO standards.
357
00:21:39.690 --> 00:21:43.630
Yeah, but WHO standards are like 5 and 15. So,
358
00:21:44.009 --> 00:21:48.380
do we know how badly our bodies get affected at
359
00:21:48.390 --> 00:21:50.140
say 200 AQI versus 500 or 800? So, more the
360
00:21:50.160 --> 00:21:50.900
level of AQI versus the.
361
00:21:58.019 --> 00:22:00.940
I don't have the quantification of this. I'm not aware
362
00:22:00.980 --> 00:22:05.849
of any study. But the longitudinal study is done. There's
363
00:22:05.910 --> 00:22:11.650
something called Boston City Study. And the best evidence of
364
00:22:12.150 --> 00:22:20.059
effect of air pollution was documented during COVID. Where in Italy,
365
00:22:20.519 --> 00:22:23.839
you would recollect that initially Italy was worst affected. There
366
00:22:23.880 --> 00:22:28.759
was very high mortality. And the mortality in the North
367
00:22:28.819 --> 00:22:34.009
Italy was four times higher than Southern Italy because the
368
00:22:34.049 --> 00:22:38.049
air pollution in North Italy was much higher. Similarly, the
369
00:22:38.109 --> 00:22:42.490
mortality in Germany and other parts of Europe, it was
370
00:22:43.109 --> 00:22:47.009
found out that if the NO2 levels were more than 100,
371
00:22:46.990 --> 00:22:51.430
the mortality was much higher as compared to the, if
372
00:22:51.509 --> 00:22:54.509
it was between 50 and 100. And if they're less
373
00:22:54.549 --> 00:22:59.089
than 50, the mortality was much, Similarly, in the United States,
374
00:22:59.529 --> 00:23:05.230
each microgram increase in PM2. 5 led to higher mortality with COVID.
375
00:23:05.269 --> 00:23:10.079
So any infection that only exemplifies that any infection, be
376
00:23:10.150 --> 00:23:13.519
it any viral infection, if the pollution is high, it
377
00:23:13.559 --> 00:23:16.359
becomes worse and the outcome also becomes worse.
378
00:23:17.160 --> 00:23:20.180
And you were talking about vulnerable people earlier and I
379
00:23:20.200 --> 00:23:24.220
was thinking about pregnant women. Does air pollution affect the fetus?
380
00:23:25.039 --> 00:23:30.029
Definitely. Excellent question. So, before the pregnancy, it affects the
381
00:23:30.089 --> 00:23:34.970
fertility also. Air pollution also affects fertility. It also affects
382
00:23:35.029 --> 00:23:40.220
sperm count. But the fetus, yes, there is more incidence
383
00:23:40.359 --> 00:23:45.039
of what we call as intrauterine growth retardation, IUJR, more
384
00:23:45.099 --> 00:23:49.119
incidence of miscarriage. Also, the child which grows in the
385
00:23:49.180 --> 00:23:54.609
womb when the mother is exposed to poor air quality,
386
00:23:55.009 --> 00:24:01.240
his onward growth, even after taking birth, their growth is affected.
387
00:24:01.539 --> 00:24:02.859
It's quite serious actually.
388
00:24:03.859 --> 00:24:07.019
And so considering this and considering you see patients
who
389
00:24:07.039 --> 00:24:10.339
get admitted to the ICU because of this, do you
390
00:24:10.380 --> 00:24:12.500
recommend people moving out of the city? And I know
391
00:24:12.519 --> 00:24:15.400
very few people can actually do that, but have you
392
00:24:15.720 --> 00:24:16.809
recommended that to people?
393
00:24:17.549 --> 00:24:18.009
All the time.
394
00:24:18.329 --> 00:24:22.390
And actually it is happening that my patients who are
395
00:24:22.430 --> 00:24:27.009
chronically ill, Those who have chronic lung disease, severe asthma,
396
00:24:27.049 --> 00:24:30.109
those who are on oxygen or who get repeated attacks,
397
00:24:30.589 --> 00:24:33.490
or those who can afford to leave city for two
398
00:24:33.569 --> 00:24:36.569
months or three months or even one month for that matter,
399
00:24:36.609 --> 00:24:40.960
I advise them to leave city. And the young people,
400
00:24:41.420 --> 00:24:45.099
young technocrats who are based in developed world and want
401
00:24:45.140 --> 00:24:47.700
to come back to India and they have small children,
402
00:24:48.059 --> 00:24:50.960
Delhi is not a preferred place for them. They prefer
403
00:24:51.009 --> 00:24:53.819
to go to other cities. Because of this, because they
404
00:24:53.859 --> 00:24:57.900
are aware that their children's health will be jeopardized if
405
00:24:57.940 --> 00:24:58.859
they come to Delhi.
406
00:24:59.640 --> 00:25:01.339
And which place do you recommend they go?
407
00:25:02.079 --> 00:25:03.839
So, everything is relative.
408
00:25:04.180 --> 00:25:07.559
If there is a technocrat is there, even Bangalore or
409
00:25:07.640 --> 00:25:12.309
Hyderabad or Mumbai will also be better. But Mumbai, I
410
00:25:12.329 --> 00:25:15.009
will see, so their air pollution is better.
411
00:25:15.410 --> 00:25:16.930
So, that is how it is.
412
00:25:17.920 --> 00:25:20.910
And for perhaps the 99% who can't leave the city,
413
00:25:21.490 --> 00:25:23.690
what are the things that they can do? And maybe
414
00:25:23.730 --> 00:25:27.369
we can start talking about masks. Does wearing a mask help?
415
00:25:28.089 --> 00:25:32.329
So during COVID time, there was not a channel, TV
416
00:25:32.369 --> 00:25:36.720
channel where I didn't go saying that please use simple mask,
417
00:25:36.900 --> 00:25:43.279
cloth mask, three-ply mask and protect yourself and protect others. Unfortunately,
418
00:25:43.339 --> 00:25:47.000
for air pollution, WHO doesn't agree that any kind of
419
00:25:47.039 --> 00:25:47.660
mask works.
420
00:25:48.400 --> 00:25:52.200
So WHO is saying that masks will not protect you
421
00:25:52.480 --> 00:25:53.319
against air pollution.
422
00:25:53.440 --> 00:25:54.119
Air pollution.
423
00:25:54.619 --> 00:25:59.240
WHO said that. But my thinking is that since WHO
424
00:25:59.279 --> 00:26:01.869
has got studies which are done on AQI of 25,
425
00:26:01.859 --> 00:26:08.480
they haven't studied the AQI of 300, 400, 500. So
426
00:26:08.980 --> 00:26:13.369
certainly the cloth mask or simple mask or three-ply mask
427
00:26:13.410 --> 00:26:14.130
does not help.
428
00:26:14.630 --> 00:26:15.509
If something helps.
429
00:26:16.390 --> 00:26:21.230
is N95 or there is something called KN99 mask. So
430
00:26:21.269 --> 00:26:24.309
if somebody is susceptible and he has to go to
431
00:26:24.349 --> 00:26:27.950
crowded market or he has to move out in a
432
00:26:27.990 --> 00:26:31.529
crowded place or air quality is very poor on that
433
00:26:31.630 --> 00:26:34.990
particular day and he must go out, then he should
434
00:26:35.150 --> 00:26:39.400
use N95 mask and not a simple mask. That is
435
00:26:39.460 --> 00:26:43.960
about the mask. And of course, initially you do feel claustrophobic.
436
00:26:43.980 --> 00:26:48.119
You find the breathing out is Only one thing is
437
00:26:48.180 --> 00:26:50.920
that COVID time we said don't use mask with a
438
00:26:50.960 --> 00:26:55.920
valve because you will be emitting virus into the system
439
00:26:56.140 --> 00:26:59.890
if you are infected. Because the breathing becomes better when
440
00:26:59.930 --> 00:27:04.509
you use a valve mask. But pollution you are infecting nobody.
441
00:27:04.549 --> 00:27:07.029
So you can use a mask with a valve if
442
00:27:07.049 --> 00:27:09.170
you feel more comfortable using that.
443
00:27:09.910 --> 00:27:12.250
What about air purifiers? Do they help at all?
444
00:27:13.009 --> 00:27:17.309
So what is air purifier? Air purifier has got two components.
445
00:27:17.750 --> 00:27:22.700
One is a filter which filters 2.5, PM 2.5.
446
00:27:22.700 --> 00:27:25.019
Another is adsorbitant, AD.
447
00:27:25.380 --> 00:27:30.779
Adsorbitant that adsorbs the gases like nitric oxide, sulfur dioxide,
448
00:27:31.099 --> 00:27:34.940
carbon monoxide. And the air which comes out is purer.
449
00:27:35.039 --> 00:27:39.829
And nowadays the air purifiers will demonstrate whether it's pink or,
450
00:27:39.849 --> 00:27:43.140
you know, blue or, you know, whether it's 30 or
451
00:27:43.140 --> 00:27:47.579
200 or whatever. So, presumably, the air that you breathe
452
00:27:47.700 --> 00:27:52.589
is better. But one thing, that there is a way
453
00:27:52.650 --> 00:27:56.309
that you should use your air purifier. Number one is
454
00:27:56.369 --> 00:27:59.829
that air purifier should be of the capacity which is
455
00:27:59.890 --> 00:28:02.900
commensurate with the volume of your room. It is not
456
00:28:02.960 --> 00:28:05.980
that you procure one air purifier and keep it in
457
00:28:06.059 --> 00:28:09.329
the Living room and thing that your house is purified,
458
00:28:09.549 --> 00:28:12.109
that is not there. Second is the room has to
459
00:28:12.130 --> 00:28:15.650
be completely closed. All windows and doors should be closed.
460
00:28:16.119 --> 00:28:19.880
Third thing is that the flow of air from the
461
00:28:19.900 --> 00:28:23.440
air purifier preferably should be an area where you
are there.
462
00:28:23.619 --> 00:28:26.279
So if you are sleeping, then it should be in
463
00:28:26.339 --> 00:28:30.720
that direction. Fourth thing is that the filter should be
464
00:28:31.079 --> 00:28:35.019
replaced as per the recommendation. It can become a source
465
00:28:35.059 --> 00:28:40.099
of fungal infections if the air filters are not. Windows
466
00:28:40.279 --> 00:28:43.519
and doors, if you keep opening for tea, coffee, food,
467
00:28:43.599 --> 00:28:47.519
somebody coming, coming out, it becomes useless. And lastly, the
468
00:28:47.660 --> 00:28:52.289
WHO doesn't agree that air purifier leads to improved health.
469
00:28:52.410 --> 00:28:55.329
But my thinking is that, because I was in Geneva
470
00:28:55.369 --> 00:28:58.150
in a meeting as a member of expert committee, and
471
00:28:58.509 --> 00:29:01.190
I sort of argued that your.
472
00:29:01.029 --> 00:29:04.029
Studies are at 2.
473
00:29:04.190 --> 00:29:08.609
AQI of 50 or PM 2.5 of 30 or 20,
474
00:29:08.609 --> 00:29:12.250
but we are breathing at PM 2.5 of 200. So
475
00:29:12.269 --> 00:29:15.750
same recommendation cannot apply. So they said we have no
476
00:29:15.829 --> 00:29:18.809
evidence that it helps in the health. But I think
477
00:29:19.230 --> 00:29:22.490
the air purifiers are good. And one thing which I
478
00:29:22.559 --> 00:29:26.640
must emphasize that it should not be used like air conditioner,
479
00:29:26.680 --> 00:29:29.200
that when you enter the room, you put on the AC.
480
00:29:29.700 --> 00:29:31.460
It should be on all the time.
481
00:29:32.430 --> 00:29:35.579
And you mentioned keeping doors and windows closed. But one
482
00:29:35.619 --> 00:29:39.630
thing we have heard often in the past regarding indoor
483
00:29:39.809 --> 00:29:43.220
airport is that there should be proper ventilation so what
484
00:29:43.279 --> 00:29:45.279
is a good time to actually ventilate your house no.
485
00:29:45.940 --> 00:29:49.160
No but the thing is that that good windows is
486
00:29:49.220 --> 00:29:52.500
there if you are cooking in that room or you
487
00:29:52.519 --> 00:29:55.819
know you are doing some activity which which generates some
488
00:29:56.079 --> 00:30:00.039
fumes then the windows should be open otherwise it doesn't.
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00:29:59.779 --> 00:30:02.589
Matter And any other tips for people who want to
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00:30:02.609 --> 00:30:05.619
step out? Any places that they should avoid? And also,
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00:30:05.720 --> 00:30:08.019
what is the best time to exercise?
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00:30:08.680 --> 00:30:12.519
So, few tips I would like to give. Those people
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00:30:12.539 --> 00:30:16.309
who are susceptible, and I've already said elderly and with diseases,
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00:30:16.589 --> 00:30:20.420
they must not go to crowded markets. Because air pollution,
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00:30:20.460 --> 00:30:24.250
when you say AQI is 300 or 400 or.
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00:30:23.970 --> 00:30:25.150
200, it's not uniform.
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00:30:25.369 --> 00:30:28.230
Like if you measure the air pollution at the intersection,
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00:30:28.289 --> 00:30:31.589
a busy intersection, which may be ITO or Chirag Delhi
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00:30:31.650 --> 00:30:34.430
or whatever, it will be very high. And if you
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00:30:34.579 --> 00:30:37.980
go from there 20 meters, 50 meters, it will keep
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00:30:38.140 --> 00:30:41.799
on reducing till the time a plateau comes. Similarly, if
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00:30:41.839 --> 00:30:44.440
you go to the crowded market, and I need not
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00:30:44.500 --> 00:30:48.559
recite those names, it's not good. Those kind of markets,
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00:30:48.880 --> 00:30:52.559
you feel choked actually, where actually the air pollution is
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00:30:52.599 --> 00:30:55.960
very high. So those things should be avoided. And of course,
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00:30:55.980 --> 00:31:00.099
when the AQI is bad, one should not think of exercising.
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00:31:00.500 --> 00:31:04.440
Early morning exercise in city of Delhi during winter is
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00:31:04.559 --> 00:31:07.920
big no-no. As I told at the beginning that because
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00:31:07.960 --> 00:31:11.180
of the inversion, the air pollutants are at the breathable level.
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00:31:11.559 --> 00:31:16.180
So we breathe about 500 milliliters of air with every breath.
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00:31:16.839 --> 00:31:21.089
And when you exercise, then you breathe, especially when you jog,
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00:31:21.269 --> 00:31:25.630
this quantum becomes five types. And inevitably your mouth will
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00:31:25.730 --> 00:31:28.849
open and you will breathe more through the mouth than
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00:31:28.930 --> 00:31:29.569
your nose.
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00:31:29.730 --> 00:31:31.410
So that filter gets bypassed.
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00:31:31.539 --> 00:31:35.019
The whole air which you are breathing directly goes without
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00:31:35.099 --> 00:31:39.720
filtration in the lungs. So the adverse effects of pollutants
518
00:31:39.779 --> 00:31:43.359
are much more in the morning. So therefore, big no-no for...
519
00:31:44.029 --> 00:31:47.980
early morning when the smog is there. However, if you
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00:31:48.000 --> 00:31:51.299
have time when the sun is bright, which is uncommon
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00:31:51.400 --> 00:31:53.920
in Delhi, that is a better time to go for
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00:31:53.940 --> 00:31:58.700
a walk and stepping out and doing some exercises. And
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00:31:58.740 --> 00:32:01.160
there is an evidence for that. I should not be
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00:32:01.200 --> 00:32:04.940
talking without evidence. There was a very elegant study conducted
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00:32:05.049 --> 00:32:09.869
in London. What they did was people above 60 years
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00:32:09.970 --> 00:32:13.740
of age They made them walk in the Oxford Street,
527
00:32:13.900 --> 00:32:17.299
where a lot of diesel buses run, and did their
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00:32:17.359 --> 00:32:21.940
lung functions before and after the walk. And they documented
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00:32:21.980 --> 00:32:26.180
that their lung functions diminished after the walk. And they
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00:32:26.240 --> 00:32:30.269
also did some inflammatory markers, which are actually highly technical,
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00:32:30.750 --> 00:32:33.849
before and after, in
their blood. So there was a
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00:32:34.170 --> 00:32:38.670
definite increase in their inflammation in the system in response
533
00:32:38.710 --> 00:32:42.500
to walking on Oxford Street. Same people, then they made
534
00:32:42.559 --> 00:32:43.200
them walk in.
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00:32:43.160 --> 00:32:43.839
The Hyde Park.
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00:32:44.059 --> 00:32:47.779
Hyde Park is a large park in London, and their
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00:32:47.819 --> 00:32:51.519
lung function improved. So, this is the best evidence that
538
00:32:51.559 --> 00:32:55.319
we have, that walking in the polytrate area reduces your
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00:32:55.359 --> 00:32:58.910
lung function. There is more inflammation in your blood, which
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00:32:58.950 --> 00:33:02.430
will affect all the systems of the body. So, therefore,
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00:33:02.609 --> 00:33:06.329
reiterating that it is better to do indoor exercises than
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00:33:06.390 --> 00:33:06.799
to go out.
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00:33:07.589 --> 00:33:10.170
And lastly, you mentioned that Delhi's air pollution is because
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00:33:10.210 --> 00:33:14.329
of many factors. There is the weather, there are external factors,
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00:33:14.730 --> 00:33:17.750
you have dust coming in from the Middle East. But
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00:33:17.769 --> 00:33:21.490
the other major factors are vehicles and garbage burning and construction.
547
00:33:22.059 --> 00:33:24.420
How is it that the government, you know, after all
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00:33:24.480 --> 00:33:27.900
these years still struggles to tackle these issues?
549
00:33:28.519 --> 00:33:30.940
So this is a political question, but I would tell
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00:33:30.960 --> 00:33:33.849
you the science. There was a very elegant study done
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00:33:33.930 --> 00:33:37.259
by the same Dr. Mukesh Sharma and Dr. Divedi from
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00:33:37.420 --> 00:33:41.299
IIT Kanpur. They did a study in India, in the
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00:33:41.420 --> 00:33:46.039
city of Delhi. And they documented that if you do
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00:33:46.140 --> 00:33:50.029
following things, your air pollution would be much less.
555
00:33:50.990 --> 00:33:53.509
And I will just narrate briefly.
556
00:33:54.109 --> 00:33:57.990
If you vacuum clean the roads four times in a
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00:33:58.069 --> 00:34:02.430
month and wash them also, If you carpet the sides
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00:34:02.509 --> 00:34:06.319
of the road with some kind of greenery, if you
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00:34:06.619 --> 00:34:11.420
follow the demolition and construction activities with the norms which
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00:34:11.480 --> 00:34:15.619
are well known, I need not narrate that. If you
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00:34:15.760 --> 00:34:19.800
deshock and denox the electricity generation plant, and there are
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00:34:19.889 --> 00:34:23.630
machines which can do that, that same electricity would be
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00:34:23.650 --> 00:34:28.090
generated without emission of NO2 and SO2, which are the
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00:34:28.150 --> 00:34:32.519
main sources. Outcomes of this, if you stop the municipal
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00:34:32.639 --> 00:34:38.260
burning completely, and if you convert all the 9,000 tandoors
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00:34:38.320 --> 00:34:42.449
from coal to wood into the LPG or electrical, and
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00:34:42.530 --> 00:34:45.809
if you do what you call as carpooling, if you
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00:34:45.829 --> 00:34:48.909
do all this, there will be at least 50% reduction
569
00:34:48.989 --> 00:34:51.929
in the air pollution. And this is a published study
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00:34:52.289 --> 00:34:55.789
in the year 2016. So that is where we are.
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00:34:56.289 --> 00:34:58.329
And are there any lessons we can take from other
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00:34:58.369 --> 00:35:00.809
countries or cities that have managed to do this?
573
00:35:01.469 --> 00:35:06.059
That's an excellent question. So as a documented Chicago study,
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00:35:06.400 --> 00:35:09.519
so that same study also says that China in 2014
575
00:35:09.519 --> 00:35:16.280
had Beijing, especially China, had similar air pollution that we
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00:35:16.320 --> 00:35:19.760
have in Delhi. And they took it on war footing.
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00:35:20.179 --> 00:35:24.730
And their life expectancy has improved by 2.2 years. So
578
00:35:24.769 --> 00:35:28.909
there is solid evidence that if you, long-term evidence, that
579
00:35:28.969 --> 00:35:33.110
if you improve your air quality, your health quality improves. So,
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00:35:33.510 --> 00:35:37.269
and if you talk about California, 100 years back, they
581
00:35:37.309 --> 00:35:41.699
had pollution something like what we have in Delhi. 100
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00:35:41.699 --> 00:35:44.500
years down the line, their number of cars have gone
583
00:35:44.579 --> 00:35:47.780
up by 10 times. And their air pollution has gone
584
00:35:47.840 --> 00:35:50.900
down by 10 times. It is only because of good
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00:35:51.000 --> 00:35:53.699
practices including engine quality.
586
00:35:53.300 --> 00:35:54.119
And fuel quality.
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00:35:54.889 --> 00:35:58.409
Evidence is there. We have to follow it. There should
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00:35:58.449 --> 00:36:00.070
be will on the part of policymakers.
589
00:36:00.090 --> 00:36:00.929
Share it with.
590
00:36:03.739 --> 00:36:05.420
A friend or someone in your family. It's the best
591
00:36:05.440 --> 00:36:23.010
way for people to get to know about us. You
592
00:36:23.030 --> 00:36:26.019
can tweet us at Express Podcast and write to us
593
00:36:26.219 --> 00:36:27.989
at podcast at IndianExpress.com.