The Union health ministry has asked people to desist from burning firecrackers, as it said that the pollution caused by them has serious impact on the health of people, especially those suffering from respiratory and cardiovascular diseases.

People shop for jewellery on the occasion of Dhanteras in Noida on Friday -- two days ahead of Diwali on Sunday. (Sunil Ghosh/HT Photo)
People shop for jewellery on the occasion of Dhanteras in Noida on Friday -- two days ahead of Diwali on Sunday. (Sunil Ghosh/HT Photo)

“Avoid fire-crackers burning especially by people suffering from asthma or another lung disease. Stay indoor during nights of Diwali to reduce exposure to air pollution. Wear a mask (N95 or N99) to reduce exposure to air pollution by fire-crackers… Pollution due to fire-cracker burning can seriously impact health of persons suffering from cardiovascular, respiratory diseases… who have recovered from COVID-19…,” read the advisory released on Friday.

It further said that a person should consult a doctor immediately if they develop breathing difficulties.

“When complete escape from air pollution is difficult, taking some measures can provide you a certain level of protection from its harmful effects on your health…,” the advisory added even as it listed refuge burning, use of solid fuels, vehicular exhaust, and industrial emissions as other sources of air pollution.

The ministry also advised that schools limit outdoor activities and during days recording higher pollution levels, and entirely avoid or postpone physical activities such as running.

In its advisory to states, especially Delhi and its neighbouring regions, the health ministry asked the respective governments to adequately prepare their health infrastructure to manage the probable rush of patients affected by poor air quality that is likely to get worse during and after Diwali.

In a letter to the health departments of Delhi, Haryana, Punjab, Uttar Pradesh and Rajasthan this week, director general of health services, health ministry, Atul Goel said that air pollution not only accounts for acute illnesses but also precipitates exacerbation of chronic illnesses of respiratory, cardiovascular and cerebrovascular systems.

Goel wrote, “As you may be aware that air pollution has become a serious health challenge in recent times, it is further concerning to note that the Air Quality Index (AQI) from Delhi NCR is being reported to have reached from poor to severe levels in last few days. This may even worsen considering the upcoming festive season and onset of winter.”

“The consequences are graver for vulnerable population such as children, pregnant women, older people, those with pre-existing illnesses, and those exposed due to their occupations such as those involved in traffic policing and municipality work, etc.,” said Goel, urging states to have necessary healthcare preparedness.

This would require an increased allocation of beds, stock updates on medicines and equipment related to case management, capacity building of health workforce, and enhanced public awareness.

In a separate advisory to all states and Union territories last month, the ministry asked them to establish and expand sentinel surveillance on air pollution-related illnesses, analyse statistics of such illnesses and share them at the state and central levels for timely actions. The states have also been advised to draft Health Sector Response Action Plans for when air pollution level increases.

“The state health department(s) are also requested to issue advisories to hospitals in regard to making necessary patient care preparations anticipating an increased attendance in emergencies, outdoor and indoor patient departments of medicine and paediatric specialties,” Goel said in last week’s letter.

Goel also stressed on increasing awareness among the general public about desisting from activities that could further deteriorate air quality such as stubble and waste burning, and instead take to activities that prevent pollution such as using mass public transport systems, avoiding use of personal diesel-based generators and avoiding smoking.

The ministry also asked to strictly monitor daily air quality index levels to inform people.

“Particulate matter (PM) may potentially serve as a vehicle for airborne transmission of SARS COV-2 virus. Short-term and long-term exposures to PM2.5, and long-term exposures of NO2, appear to be correlated with increased susceptibility to COVID-19 infection, and higher mortality among those infected,” read the latest advisory.

According to an ICMR study, 1.7 million deaths, or 18% of the total deaths in India, in 2019 were attributable to air pollution, stated the health ministry.

The advisory stated that short-term high-level exposures can result in acute health reactions with involvement of various human organs and patients may present with certain suggestive symptoms like irritation of eyes, nose, throat and skin, cough, breathing difficulty, wheezing, chest discomfort, chest pain, headache, giddiness, limb weakness, facial deviation, etc. Vulnerable groups can experience more severe effects such as lower respiratory tract inflammation and infection, exacerbation of asthma, bronchitis or exacerbation of chronic illnesses such as chronic obstructive pulmonary disease (respiratory system), ischaemic heart diseases, and cerebrovascular strokes.

Long-term exposures to even lower level of air pollution can result in chronic illnesses of respiratory and cardiovascular systems, lung cancer and premature deaths.

Currently, emergency wards in various hospitals in the Capital are packed with patients with respiratory issued.

“There has been an exponential rise in patients with acute attacks of asthma and chronic obstructive pulmonary disease. People are having prolonged severe symptoms and all this is directly related to increased pollution levels,” said Dr GC Khilnani, former head of pulmonary medicine department, AIIMS, Delhi.

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