{"id":43956,"date":"2019-01-28T10:41:32","date_gmt":"2019-01-28T09:41:32","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=43956"},"modified":"2019-02-04T10:20:12","modified_gmt":"2019-02-04T09:20:12","slug":"paul-simpson-and-anita-jain-emergency-measures-alone-wont-stop-new-delhi-from-choking","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2019\/01\/28\/paul-simpson-and-anita-jain-emergency-measures-alone-wont-stop-new-delhi-from-choking\/","title":{"rendered":"Paul Simpson and Anita Jain: Emergency measures alone won\u2019t stop New Delhi from choking"},"content":{"rendered":"<p class=\"standfirst\">Delhi\u2019s air pollution problem requires sustained and longer term solutions<\/p>\n<p><!--more--><\/p>\n<p><a href=\"https:\/\/blogs.bmj.com\/bmj\/files\/2019\/01\/delhi_smog.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-full wp-image-43957\" src=\"https:\/\/blogs.bmj.com\/bmj\/files\/2019\/01\/delhi_smog.jpg\" alt=\"\" width=\"610\" height=\"346\" srcset=\"https:\/\/blogs.bmj.com\/bmj\/files\/2019\/01\/delhi_smog.jpg 610w, https:\/\/blogs.bmj.com\/bmj\/files\/2019\/01\/delhi_smog-300x170.jpg 300w\" sizes=\"auto, (max-width: 610px) 100vw, 610px\" \/><\/a><\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p><em><span style=\"font-weight: 400\">Smog shrouds the the Ministry of Defense, Ministry of Home Affairs, and the Parliament of India in New Delhi in December 2018<\/span><\/em><\/p>\n<p><span style=\"font-weight: 400\">The average temperature during winter in New Delhi is 12-13 degrees celsius<\/span><span style=\"font-weight: 400\">. We benefited from the cooler city climes for a week last December at a conference focused on how best to improve the health of women, newborns, children, and adolescents. Yet, despite the interest in the conference, a recurring topic of conversation during coffee breaks was air quality. For those arriving in the city it was impossible to ignore a shroud of smog which hid landmarks that were barely a kilometre away.<\/span><\/p>\n<p><span style=\"font-weight: 400\">Headlines for Delhi described an <\/span><a href=\"https:\/\/www.timesnownews.com\/mirror-now\/in-focus\/article\/new-delhi-air-quality-status-pollution-aqi-severe-levels-breathing-problems-safar\/330447\"><span style=\"font-weight: 400\">\u201cairpocalypse\u201d<\/span><\/a><span style=\"font-weight: 400\"> \u00a0as the air quality index neared the upper limit of its range and reached the severe category. At this level the soaring concentration of the eight pollutants that the index measures starts to have an impact on healthy people and we felt it. Sadly, the choking air was not a one off or even limited to Delhi. India can claim <\/span><a href=\"https:\/\/timesofindia.indiatimes.com\/india\/india-tops-world-in-bad-air-quality-kanpur-delhi-among-top-15-mumbai-4th-most-polluted-megacity\/articleshow\/63997130.cms\"><span style=\"font-weight: 400\">14 of the world\u2019s 15 cities<\/span><\/a><span style=\"font-weight: 400\"> with the worst air pollution.<\/span><\/p>\n<p><span style=\"font-weight: 400\">For the 29 million residents of Delhi, air pollution is a very real and immediate health issue. A recent study estimated that ambient air pollution caused <\/span><a href=\"https:\/\/www.sciencedirect.com\/science\/article\/pii\/S2542519618302614?via%3Dihub\"><span style=\"font-weight: 400\">~11,700 deaths in Delhi in 2017<\/span><\/a><span style=\"font-weight: 400\">\u2014that\u2019s over one death in the city per hour. The air is so bad that <\/span><a href=\"https:\/\/www.sciencedirect.com\/science\/article\/pii\/S2542519618302614?via%3Dihub\"><span style=\"font-weight: 400\">an average of 1.5 years<\/span><\/a><span style=\"font-weight: 400\"> could be added to the life expectancy of Delhi\u2019s residents if it was made safe. Across India the<\/span><a href=\"https:\/\/www.sciencedirect.com\/science\/article\/pii\/S2542519618302614?via%3Dihub\"><span style=\"font-weight: 400\"> impact of air pollution on disability-adjusted life years (DALYs)<\/span><\/a><span style=\"font-weight: 400\"> for lower respiratory tract infections is greater than that of tobacco. Persistent cough over several weeks in the winter is increasingly common among children and adults across major Indian metros, and may be attributed to air pollution.<\/span><\/p>\n<p><span style=\"font-weight: 400\">Severe air quality is not an inevitable fact of living in big cities. London used to be famous for its air pollution mostly caused by coal fires. Particularly bad days, when the air was so thick that it was difficult to see, were described as \u201cpea soupers\u201d. While <\/span><a href=\"https:\/\/www.bmj.com\/content\/357\/bmj.j2842\"><span style=\"font-weight: 400\">London\u2019s air quality remains problematic<\/span><\/a><span style=\"font-weight: 400\">, pea soupers are now rare <\/span><a href=\"https:\/\/www.theguardian.com\/science\/the-h-word\/2016\/dec\/09\/pollution-air-london-smogs-fogs-pea-soupers\"><span style=\"font-weight: 400\">due to government regulation<\/span><\/a><span style=\"font-weight: 400\"> that was introduced over 60 years ago. Nevertheless, London and the UK more widely continue to have serious issues with air pollution with <\/span><a href=\"https:\/\/www.bbc.co.uk\/news\/science-environment-46823440\"><span style=\"font-weight: 400\">many cities and towns passing thresholds that are considered unsafe by the WHO<\/span><\/a><span style=\"font-weight: 400\">. This has led to the UK\u2019s recently announced <\/span><a href=\"https:\/\/www.gov.uk\/government\/publications\/clean-air-strategy-2019\"><span style=\"font-weight: 400\">Clean Air Strategy<\/span><\/a><span style=\"font-weight: 400\">.<\/span><\/p>\n<p><span style=\"font-weight: 400\">For Delhi the major causes of air pollution are traffic, industry, construction, and stubble burning. These are all compounded by the cooler winter temperatures and Delhi\u2019s geography. The wind patterns across northern India make Delhi vulnerable to the smoke generated by burning stubble after autumn crops are harvested in neighbouring Punjab and Haryana.<\/span><\/p>\n<p><span style=\"font-weight: 400\">The government has introduced a series of emergency measures (the graded response action plan) to tackle air pollution as it starts to choke the city. These include traffic controls and burning restrictions. However, <\/span><a href=\"https:\/\/www.bloombergquint.com\/politics\/as-delhi-air-quality-soars-beyond-hazardous-government-emergency-plan-failed-this-winter\"><span style=\"font-weight: 400\">a recent report shows that these were not effective in 2018<\/span><\/a><span style=\"font-weight: 400\">. Delhi\u2019s air pollution problem requires sustained and longer term solutions such as the recent <\/span><a href=\"https:\/\/timesofindia.indiatimes.com\/city\/delhi\/shutters-down-polluter-badarpur-power-plant-to-return-in-green-avatar\/articleshow\/66354869.cms\"><span style=\"font-weight: 400\">shutting down of the Badarpur coal fired power station<\/span><\/a><span style=\"font-weight: 400\"> in the city, and stronger implementation of laws that ban stubble burning. \u00a0From our own experience it\u2019s clear that there is still a long way to go to resolve the very worst of the city\u2019s winter air pollution. Unfortunately, India\u2019s recently announced long-term <\/span><a href=\"https:\/\/economictimes.indiatimes.com\/news\/politics-and-nation\/government-launches-national-clean-air-programme\/articleshow\/67474160.cms\"><span style=\"font-weight: 400\">National Clean Air Programme<\/span><\/a><span style=\"font-weight: 400\"> has been <\/span><a href=\"https:\/\/www.cseindia.org\/national-clean-air-programme-is-a-half-hearted-policy-9234\"><span style=\"font-weight: 400\">criticised for being half hearted<\/span><\/a><span style=\"font-weight: 400\"> because it doesn\u2019t have a legal mandate or a financing plan.<\/span><\/p>\n<p><span style=\"font-weight: 400\">Our reason to visit Delhi was to launch <\/span><a href=\"https:\/\/www.bmj.com\/multisectoral-collaboration\"><span style=\"font-weight: 400\">a new <\/span><i><span style=\"font-weight: 400\">BMJ <\/span><\/i><span style=\"font-weight: 400\">series on multisectoral collaboration<\/span><\/a><span style=\"font-weight: 400\"> at the conference we were attending. The collection is one of the first to systematically study <\/span><a href=\"https:\/\/www.bmj.com\/content\/363\/bmj.k4771\"><span style=\"font-weight: 400\">the enabling factors that lead to better collaboration between different sectors <\/span><\/a><span style=\"font-weight: 400\">to achieve health gains. It\u2019s not a glamorous topic, but Delhi gave us <\/span><a href=\"https:\/\/www.bmj.com\/content\/359\/bmj.j5209\"><span style=\"font-weight: 400\">the perfect example of why it\u2019s important<\/span><\/a><span style=\"font-weight: 400\">. Delhi\u2019s pea soupers are only going to be resolved, and the health of its residents improved, through multiple state governments working together to implement sustained efforts from within the transport, energy, industry, infrastructure and agriculture sectors.<\/span><\/p>\n<p><span style=\"font-weight: 400\">If you\u2019re visiting or living in New Delhi it\u2019s impossible to ignore.<\/span><\/p>\n<p>&nbsp;<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-full wp-image-40450\" src=\"https:\/\/blogs.bmj.com\/bmj\/files\/2017\/10\/DSC07374.jpg\" alt=\"\" width=\"160\" height=\"239\" \/><\/p>\n<p><em><b>Paul J. Simpson <\/b>is the International Audience Editor for <\/em>The BMJ<em>.<\/em><\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-full wp-image-21350\" src=\"https:\/\/blogs.bmj.com\/bmj\/files\/2012\/10\/anita_jain.jpg\" alt=\"\" width=\"106\" height=\"160\" \/><\/p>\n<p><em><strong>Anita Jain<\/strong> is a clinical editor, <\/em>The BMJ<em>.\u00a0<\/em><\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p><strong>Competing interests<\/strong>: None declared.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Delhi\u2019s air pollution problem requires sustained and longer term solutions [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2019\/01\/28\/paul-simpson-and-anita-jain-emergency-measures-alone-wont-stop-new-delhi-from-choking\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":43959,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[5720,116,447],"tags":[],"class_list":["post-43956","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-anita-jain","category-editors-at-large","category-india"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.6 - 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