Develop A Push And Make Pollution An Important Issue: Dr Randeep Guleria

The burden of diseases in India has undergone a huge shift, says Dr Randeep Guleria,  adding that from communicable diseases and diseases of childhood the burden has now transitioned towards non-communicable diseases, and the healthcare system has to evolve accordingly to manage them.

“If one talks about infectious diseases like malaria or dengue, after treatment the problem is solved however if one has a non-communicable disease such as respiratory diseases, diabetes, hypertension, or cancers, one needs treatment on a long-term basis, and sometimes throughout one’s life, and therefore the healthcare system needs to see how we can pick up patients early and monitor them on a regular basis. So, they do not develop complications,” Dr Guleria says. He further believes that preventive health and early screening will prove instrumental and crucial in tackling the NCD stack.

On being asked about the role of rising pollution in lung cancers, he says “There's now data emerging that in many diseases such as the chronic respiratory diseases, and even the heart diseases, pollution is coming out to be one of the major risk factors, both indoor and outdoor.”

He further says that one sees a lot of pollution in the Indo Gangetic belt as it's a landlocked area and sometimes there is very little wind velocity to push the pollutants out, especially during the winter months. “But even if one looks at data throughout the year, let's say if one looks at data from Delhi for the last five years, we find that more than 70 per cent of the days throughout the year were of bad air quality. It's only been good for a few days during the rainy season or the monsoon months. That means that we are all breathing that quality of air, both indoors and outdoors,” Dr Guleria says.

He believes if we are breathing this air for a long time, it causes a higher chance of respiratory problems, but it also leads to a higher chance of developing cancers in later life. And the long-term effect of air pollution, both indoor and outdoor is something that medical experts are realising with various associations including cardiology associations that say that this exposure is as much a risk factor for heart disease as high cholesterol or smoking.

Dr Guleria says that the country needs to develop a push and make pollution an important issue to bring any policy change, as the country is not only looking at the problem it can cause to the present generations, but to the future generations as well.

“I think we should all become part of a movement to influence policymakers to get some changes in the policies so that the Indian cities are environmentally friendly,” he says. Giving an example of the industrial pollution in London in the 1950s which was effectively controlled and is now being efficiently managed by the English government despite large motor traffic is something which needs to be replicated in India, Dr Guleria says. 

Respiratory Diseases 

On the rising respiratory diseases, Dr Guleria informed that India still has some communicable respiratory disease burden that it needs to eradicate and one prime example of that is tuberculosis, he says. 

“Tuberculosis still is a big problem in India and there is a need to focus on good treatment for tuberculosis as it's a long treatment and people have drug-resistant TB as well. The second issue is chronic respiratory diseases which are increasing due to allergies, asthma, rhinitis, and also related to COPD because of use of tobacco and pollution itself. 

Path To Prevention

Dr Guleria believes that society at large needs to work on reducing its carbon footprint, with each individual bearing responsibility and making simple yet impactful changes such as taking a walk instead of driving for short distances and pushing for green paths where it's safe to cycle or walk. On preventing indoor pollution, he says that air purifiers may work to some extent but the data is not very strong in the favour of air purifiers. 

Further, he believes that one should be aware of the air quality in their residential areas and before stepping out they should check the AQI levels and wear a mask when the air quality is bad. “If you're going out and AQI is bad, you should wear a mask and people who have chronic respiratory diseases, chronic heart disease should avoid going out, especially early morning walks in winter, when air quality is usually bad,” he says.

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