Seventy-five-year-old Vijay Chawla never ever missed his 6.30 am walk. But after four seasons of wading through the smoky haze of Delhi winter mornings, he collapsed and was diagnosed with Chronic Obstructive Pulmonary Disease (COPD), a chronic inflammatory lung disease that obstructs airflow in the lungs. What he didn’t realise is that for four years, he had been breathing a deadly cocktail of polluted air, one that was layered with diesel from overnight trucks, the smoke from small fires lit by people for warmth, the chokehold of burnt stubble and the heavy particles that clogged his airways. Low temperatures and little or no wind in the bowl-shaped city means that the pollutants settle down deep and thick. This is one of the reasons that Chawla’s grandchildren routinely sneeze through the season and wheeze with asthma-like symptoms.
With the rising pollution in the Delhi NCR region, the vulnerability of children, senior citizens and those spending more time outdoors for work has doubled. Doctors say that the children and senior citizens should be prevented from stepping outdoors and should not play or go for a walk in the morning and evening hours when pollution levels are extreme.
WHY CHILDREN ARE THE MOST VULNERABLE?
According to Dr Manish Mannan, Head of the Paediatrics and Neonatology department at Paras Hospital in Gurugram, children under the age of five breathe air faster than adults and as a result take in more contaminants. “Children are more susceptible than adults to the impacts of pollution as they breathe air that is 93 per cent polluted on a daily basis. This can seriously endanger their health and development. Asthma and childhood cancer can be brought on by air pollution, which also has an effect on neurodevelopment and cognitive function. High levels of air pollution may put children at a higher risk of developing chronic conditions like cardiovascular disease later in life,” he says.
He is seeing a large number of children this year complaining of migraine and headaches. “Lead, carbon monoxide, nitrogen dioxide, sulphur dioxide and particulate matter (PM10 and PM2.5) are among the air pollutants that have been linked positively to migraine intensity, frequency and duration as well as the frequency of medical visits as a result of migraine attacks,” says Dr Mannan.
Dr Krishan Chugh, Director and Head of the Paediatric Department, Fortis Memorial Research Institute, says that asthma in children had increased significantly over the last week. “Until last month, asthmatic children formed only 10-20 per cent of my patients. This number has increased to almost 80 per cent of my patients. A few have had serious symptoms and required hospitalisation,” he adds.
Dr GC Khilnani, Chairman, PSRI Institute of Pulmonary, Critical Care and Sleep Medicine, says that those involved in outdoor activities are prone to developing serious cough, headache and burning sensation in the eyes apart from chronic respiratory and heart issues which they will eventually develop.
WHEN SHOULD THE ELDERLY TAKE THEIR MORNING WALK? INDOOR AND OUTDOOR RISKS
Pollution is the worst trigger for senior citizens as it ends up aggravating their pre-existing conditions. So no way should they be walking at 7 am. In fact, they should postpone it to later in the day when the pollutants are suitably dispersed or devise some indoor routines.
Dr Khilnani says senior citizens, for whom walking is compulsory, should walk only when sunshine arrives.“When there is sunshine, the pollutant load lessens at the surface level. There is a phenomenon called inversion when pollutants disappear in the air as the sunshine arrives. Those who want to walk can venture out then but going for a walk before that can be fatal and create severe health issues,” says he
Says Prashun Chatterjee, Associate Professor, Department of Geriatric Medicine at the All India Institute of Medical Sciences (AIIMS), “As we age, our body reserves decrease. The lung function of a 70-year-old person will always be weaker than that of a 40-year-old person. The elderly have weak lungs, heart and develop COPD easily. Most of them complain of spasm-related symptoms.” Pollution also raises the risk of heart failure and dementia, he adds. An adult breathes approximately six litres air per minute while resting and 20 litres while exercising or engaging in some physical activity. So imagine the volume of toxins that an adult will inhale during any kind of physical activity outdoors.
“Winter is a double-edged sword. Because of pollution, the senior citizens are asked not to step out. Restricted mobility means they can develop sarcopenia and complain of lower muscle mass,” he adds. In such a situation, an indoor exercise routine has to be worked out for them. Dr Khilnani suggests a steady regime of pranayama.
ARE PARKS SAFE?
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Green spaces tend to have a higher saturation of moisture in the form of early morning dew and humidity. This forms a smoky veil that traps pollutants close to the ground and contributes to higher PM 2.5 concentrations. Open areas, by contrast, see the dispersal of pollutants due to some movement of air and the passage of vehicles and human activity.
TIME TO WEAR THE N 95 MASK AGAIN
All doctors were unanimous about the mandatory usage of N95 masks by the elderly and young while stepping outdoors. Surgical or cloth masks do not work in high levels of PM 2.5 and PM 10 which need to be filtered out. In fact, they should be worn with the same rigour as we did during the pandemic. If you have vulnerable family members, then experts recommend using air purifiers to counter indoor air pollution which gets aggravated by poor ventilation.
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According to Dr Khilnani, children should be advised to wear N-95 masks before heading to school and physical activities like sports and dancing in open areas should be avoided. “We advise them to use masks, take anti-allergic tablets at night and vitamin C pills with plenty of water and, of course, foods containing Omega 3 fatty acids,” says he.