The Center has issued an updated advisory for all states and Union Territories with guidelines to combat air pollution-related diseases.
In the directive, the union government has asked states and UTs to ensure availability of chest clinics in state health facilities and medical colleges under its National Program on Climate Change and Human Health (NPCCHH).
During the months with the highest air pollution, which usually start in September and last until March, the clinics are expected to operate for a fixed period of at least two hours each day.
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In its 33-page directive, the Union health ministry has told states and union territories that cases of respiratory and heart diseases tend to rise due to pollution and hence hospitals must maintain special preparedness.
The directive recommended the establishment of chest clinics in community health centres, district hospitals and medical colleges in urban areas, initially covering all such facilities in cities under the National Clean Air Program (NCAP).
At these centers, patients are to be screened for risk factors, diagnosis confirmed, treatment provided and long-term care provided to those suffering from respiratory and heart diseases aggravated by pollution, the adviser said.
The ministry has also directed these facilities to maintain records of these patients using digital tools such as the Integrated Health Information Platform (IHIP). A register of individuals who have been identified as high risk should also be maintained and details of these individuals may also be shared with the respective blocks for community surveillance through ASHAs, ANMs and CHOs.
The advisory also called for training of doctors and staff to treat respiratory and cardiovascular cases, strengthening support for managing cases attributed to air pollution.
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These clinics should also promote behavior change and the adoption of healthy practices in potential and diagnosed cases of air pollution-related cardiopulmonary disease.
In a letter to the chief secretaries, Union Health Minister Punya Salila Srivastava said that during the winter months, air quality often reaches poor to severe levels in several regions across the country, posing a significant health concern.
“Together we can work towards a healthier, cleaner and more resilient ecosystem,” she said, according to PTI.
According to the recommendations, children, especially under 5 years of age, seniors, pregnant women, patients with asthma or heart disease, people from low socio-economic conditions, with poor nutritional status and belonging to outdoor work groups are most at risk.
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Health facilities should have adequate medicines, oxygen cylinders, nebulizers, ventilators and hospital beds, sketchbooks, wheelchairs and ambulances and should have proper referral mechanisms in place, the advisory said.
Health departments, including medical facilities, were asked to strictly monitor daily AQI levels during days or months of high air pollution as reported by pollution control authorities.
States have also been asked to minimize pollution by mitigating or reducing from sources such as construction sites and burning of waste, crop residues, plastics, bottles and food packaging, etc.
Construction workers should have masks or personal protection against inhaling fine particles (PM2.5), dust and odors. There should also be regular health checks for them as well as training and their duties should be rotated to minimize long-term exposure to high dust environments.
Regular use of water sprinkling or fine sprays from nozzles should be adopted to suppress the dust on site and prevent it from being resuspended into the air.
The recommendation also lists precautionary measures and avoiding outdoor activities in schools if the AQI level is low and above. Check out:
- It suggested schools limit outdoor activities during days with higher pollution levels, stay indoors during breaks, minimize outdoor exposure and avoid physical activities such as running, jogging, playing, school activities, events, parties and even birthday parties.
2. Doctors and staff in the school should be sensitized to health problems related to air pollution and ways to manage such cases so that the nearest health facilities can also provide assistance if necessary.
3. School health authorities, principal, teachers and parents were asked to create mechanisms to create awareness and motivation in adopting better practices among students to mitigate and adapt to air pollution.
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3. The guidance stated that children should be rewarded by organizing activities and events on air pollution at school level.
The health effects of air pollution depend on the level of pollution and the duration of exposure. Individuals’ vulnerability to the health effects of pollution may also vary based on demographic factors and predisposing health conditions, the paper said.
Short-term high exposures can lead to acute health reactions involving various human organs and patients may have some suggestive symptoms such as eye, nose, throat and skin irritation. cough, difficulty breathing, wheezing, chest discomfort, chest pain, headache, dizziness, limb weakness, facial distortion, etc.
Vulnerable groups may experience more severe effects such as lower respiratory tract inflammations and infections, asthma exacerbations, bronchitis or exacerbations of chronic diseases such as chronic obstructive pulmonary disease (respiratory system), ischemic heart disease (CVS) and cerebrovascular events (CNS), etc.
Long-term exposure to even lower levels of air pollution can result in chronic respiratory and cardiovascular diseases, lung cancer and premature death.
