Association between air pollution, body mass index, respiratory symptoms, and asthma among adolescent school children living in Delhi, India

Air pollution and its effects on lung health in never-smoker youth of Delhi NCR versus Pauri Garhwal: a comparative cross-sectional study

Background

Ambient air pollution is a major factor that can affect lung growth and reduce lung capacity. This study aims at drawing parallel between respiratory discomfort and lung function between youth of Delhi-National Capital Region (NCR) where air pollution level is poor and hazardous as compared to that of Pauri Garhwal (Uttarakhand) where air pollution level is low via a comparative cross-sectional study.

Methods

A community-based cross-sectional study conducted among 354 never-smoker subjects (177 from NCR and 177 from Pauri) between the ages of 15 and 29 years. Pulmonary Function Test coupled with COPD Assessment Test (CAT)-based questionnaire for respiratory problems helped elicit information regarding lung health of subjects.

Results

Mean forced vital capacity (FVC), forced expiratory volume in 1st second (FEV1), forced expiratory flow 25-75%, FEV1/FVC ratio, and peak expiratory flow rate were lower by 12.9%, 17%, 5%, 7.8%, and 7.3%, respectively, in NCR participants as compared to that of Pauri. Upon spirometry, restrictive pattern was present in 40 (22.6%), and obstructive pattern was present in 9 (5.1%) of NCR participants. Out of these, nine (5.1%) having obstructive pattern, five (55.6%) had 50% ≤ FEV1<80%, and four (44.4%) had 30% ≤ FEV1<50% of predicted value. Neither restrictive nor obstructive pattern was found evident in subjects from Pauri. The mean CAT score in subjects from NCR was 5.2 ± 4.9 and .46 ± 1.1 in subjects from Pauri.

Conclusion

Subjects belonging to NCR performed poorly in spirometry and reported higher respiratory complaints in comparison to participants from Pauri Garhwal.

Gaps in asthma diagnosis and treatment in low- and middle-income countries

Low- and middle-income countries (LMICs) contribute to a major proportion of asthma morbidity and mortality globally, even though the prevalence is higher in high income countries. Mortality due to asthma is avoidable and patients should be able to live a near normal life. There are factors that influence overall disease prevalence and poor health outcomes due to asthma in LMICs. This article summarizes the gaps in asthma diagnosis and management in LMICs. The gaps are diverse. Each challenge needs to be addressed through policy decisions, upgrade of infrastructure, knowledge and skills for early diagnosis and correct management among health care providers, both clinicians and paramedics. Healthcare accessibility and affordability are genuine challenges, and the public healthcare system needs to be geared up to address these at primary and tertiary levels. Mass education of the population through national level government initiatives is needed to help bridge the sociocultural gaps.

"In small places, close to home": Urban environmental impacts on child rights across four global cities

Urban environments influence child behaviours, exposures and experiences and may affect health, development, achievement and realization of fundamental human rights. We examined the status of eleven UN Convention on the Rights of the Child articles, in a multi-case study across four global cities. Within all study cities, children experienced unequal exposure to urban environmental risks and amenities. Many violations of child rights are related to car-based transportation systems and further challenged by pressures on urban systems from rapid population increases in the context of climate change. A child rights framework provides principles for a collective, multi-sectoral re-imagination of urban environments that support the human rights of all citizens.

Impact of Air Pollution on Child Health in India and the Way Forward

Recent research in epidemiological modelling reveals that air pollution affects child health in various ways resulting in low birthweight, stillbirth, preterm birth, developmental delay, growth failure, poor respiratory and cardiovascular health, and a higher risk of anemia. India has embarked on the national clean air program, but a much stronger coordinated multi-sectoral approach is required to minimize the child health burden caused by air pollution. Air pollution should be treated as a public health crisis that can only be managed with policy backed by science, gradual transition to clean energy use, emission reduction supported by clean air technologies, long-term commitment from the Government, and cooperation of the citizens.