New Delhi: To combat one of the worst global air pollution crises, the Union government has called on states and union territories to work on a strong public health response, including setting up special chest clinics in 131 cities to improve air quality under the National Clean Air Program (NCAP).
These chest clinics are to be set up in government health facilities in NCAP cities and must operate for at least two hours a day during peak pollution periods, focusing on screening, risk communication and providing standard care for cardio-pulmonary diseases related to air pollution.
With air quality in the severe category, the Department of Health and Family Welfare has directed states to strengthen patient care services. These include the Outpatient Department (OPD); especially in disciplines such as respiratory medicine and cardiology, and increasing capacities in emergency departments (EDs) with rapid access to essential drugs, oxygen supplies and nebulizers to manage acute diseases and chronic conditions affecting the respiratory, cardiovascular and cerebrovascular systems.
“The purpose of the chest clinic is to screen and provide risk communication for cardio-pulmonary disease related to air pollution. Among patients already suffering from cardio-pulmonary disease, establish possible causes (including air pollution) and confirm the diagnosis; provide standard care for patients suffering from cardio-pulmonary disease; promote behavior change and adoption of healthy practices in potential and diagnosed cases of cardio-pulmonary disease related to air pollution,” the advisor said.
The development assumes significance in the backdrop of a recent Lancet report which estimated that air pollution contributes to around 1.7 million deaths annually in India. The directive further mandates the establishment of a surveillance system under the National Program on Climate Change and Human Health (NPCCHH) in which designated hospitals must report air pollution-related illnesses daily for early analysis and action.
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Better response
Through its updated air pollution and health advisory, the Ministry of Health and Family Welfare (MoHFW) has directed state health authorities and ministries to strengthen their response to the health challenge posed by the “poor to severe level” of air quality that is often experienced during the winter months.
A statement from MHFW secretary Punya Salil Srivastava said the advisory material and action points are meant to promote “effective action at various levels” and serve as a guide for “awareness generation and health system response”.
States and Union Territories are to ensure that health authorities regularly review and coordinate with pollution control boards the collection of daily Air Quality Index (AQI) data. This data must be shared with all healthcare facilities for both health-related purposes and public dissemination.
For thorough preparedness of the health system, the recommendation emphasizes the development of action plans for climate change and health at the district and city levels within the NPCCHH, which specifically include air pollution strategies.
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The MoHFW also calls for intensifying public awareness campaigns using all available channels – social media, posters, radio and television – with locally translated messages during high-risk periods such as winter months, before and after Diwali and stubble burning days.
The guideline is timely as health professionals in the National Capital Region (NCR) report a significant increase in patient visits. Professor Dr. Arvind Kumar, chairman of the lung transplant and thoracic surgery department at Medanta, said air pollution levels are as high as any year in the past.
He found that both healthy individuals and patients with pre-existing conditions experienced problems such as a burning sensation in the nose and eyes, sore throat, cough and viral fever.
Dr. Kumar added that his cardiology colleagues are also seeing a spike in patients reporting heart attacks and increased hospitalizations, an effect typically seen about 10 days after a period of intense pollution.
Health hazard
Professor Dr. Raj Kumar, director of Delhi’s Vallabhbhai Patel Chest Institute, said medical complications and emergency room visits for respiratory patients increase during this rush hour.
The crisis is acutely visible in the Delhi-NCR region, where air pollution is strongly exacerbated by regional and local factors. Air quality in the capital has consistently oscillated between “very poor” and “severe” over the past week.
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On Wednesday, Delhi’s average AQI is firmly in the ‘severe’ category, prompting the implementation of Phase III of the Graded Response Action Plan (GRAP).
A major contributor to hazardous air is stubble burning in neighboring states such as Punjab, Haryana and Uttar Pradesh. While the daily contribution of farm fires varies depending on wind direction, it can increase suddenly, with forecasts suggesting that its contribution to Delhi’s PM2.5 levels may spike when the wind is adverse. Festival season also brings localized dangers; the burning of firecrackers during Diwali releases concentrated pollutants that seriously impair health.
In response to this public health emergency, sales of air purifiers in Delhi-NCR have increased dramatically, with some e-commerce platforms reporting a five-fold increase compared to typical days. This purchasing trend reflects growing consumer awareness of indoor air quality as an essential defense against toxic outdoor environments.
Dr. Anju Goel, deputy director, air quality division, The Energy and Resources Institute (Teri), said there was no action at the site. “There have been many policies and regulations by various agencies of the state and central governments, but the implementation is not so strong, and that is why air pollution has become a big problem every year in winter. We need to upgrade our PUC system with the latest technology and artificial intelligence. We need to strengthen the monitoring and evaluation system, bring more transparency and accountability,” she said.
