Exposure to a high level of air pollution is causing physical and mental health hazards in Bangladesh, said a World Bank report released today.

The report "Breathing Heavy: New Evidence on Air Pollution and Health in Bangladesh" assessed the impacts of outdoor air pollution on physical and mental health in Dhaka and Sylhet.

The report states that exposure to high levels of air pollution significantly raises the risks of breathing difficulties, cough, lower respiratory tract infections, as well as depression and other health conditions. Children under five years, the elderly, and people with comorbidities such as diabetes, and heart or respiratory conditions, are most vulnerable.

"Air pollution causes the climate to change, and climate change worsens the air quality. Over time, climate change and urbanization will further intensity air pollution," World Bank Health Specialist Wameq Azfar Raza, lead of the report, said presenting the findings of research at an event held at Renaissance Dhaka Gulshan Hotel on Sunday (4 December).

"The health sector needs to be well prepared to deal with the imminent health crisis arising from air pollution and climate change," Wameq Azfar Raza added.

The report finds that the sites with major construction and persistent traffic in Dhaka have the highest level of air pollution. At these sites, the fine particulate matter (PM), which is considered most hazardous to health, is on average 150% above the WHO Air Quality (AOG), which is equivalent to smoking about 1.7 cigarettes per day.

The second highest concentration of PM levels is found near brick kilns in Dhaka, which is 138% above the WHO AOG equivalent to smoking 1.5 cigarettes per day.

Incidence of lower respiratory tract infections was significantly higher among children living near major construction and traffic congested area than elsewhere in the country, including near brick kilns, Sylhet Division which has the cleanest air in the country, still experiences average PMs concentration levels 80% above WHO AQG. This is equivalent to smoking 1.2 cigarettes per day.

"Ambient air pollution puts everyone at risk, from a child to the elderly. In 2019, air pollution was the second largest cause of deaths and disability in Bangladesh and costed about 3.9 to 4.4% of the country's GDP," said the acting World Bank Country Director for Bangladesh and Bhutan, Dandan Chen.

Air pollution caused about 78,145-88,229 deaths in Bangladesh in 2019. While air pollution levels within the country vary significantly, the concentration of PMs in all the regions is significantly above the threshold recommended by the WHO Air Quality Guidelines.

 Dhaka is the most polluted division whereas Sylhet is the least polluted From 2018 to 2021, Dhaka was ranked as the second most polluted city in the world.

 The western regions - Khulna and Rajshahi are more polluted than the eastern ones - Sylhet and Chattogram.

In the Dhaka division, in addition to local pollution sources, up to one-fifth of the total PM concentration comes from transboundary sources. A 1% increase in exposure to PMs over WHO's AQG can result in a 12.8% increase in the probability of a person experiencing breathing difficulties, a 12.5% increase in the probability of having wet coughs, and an 8% higher risk of contracting lower respiratory tract infections.

Air pollution also affects mental health. Depression is most reported in locations with major construction and persistent traffic.

The study finds that a 1% increase in exposure to PMs above the WHO AQG is associated with a 20% higher probability of being depressed.

To reduce air pollution impacts on health, the report recommended immediate actions, including improving public health services and response mechanisms, improving air pollution data monitoring systems, investing in early warning systems, and engaging in further research.

Urgent actions will include improving the public health service platform to provide curative care and promoting preventive health care. Community-level screening for persistent coughs and breathing difficulties for people living in air pollution hotspots will help the government address emerging health issues Close monitoring of air quality data and further research will help devise effective measures to deal with the health impacts of air pollution.

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