Air Pollution and Pregnancy Losses: Lancet Report

• 07 Jan 2021

Why in News

According to recent study poor air quality is associated with a considerable proportion of pregnancy loss in India, Pakistan, and Bangladesh.

• It is the first study to estimate the effect of air pollution on pregnancy loss across the region.

Key Points

• The Study:
  
  • They created a model to examine how exposure to PM 2.5 increased women’s risk of pregnancy loss, calculating risk for each 10 µg/m³ increased in PM 2.5 after adjusting for maternal age, temperature and humidity, seasonal variation, and long-term trends in pregnancy loss.
  • Each increase in 10 µg/m³ was estimated to increase a mother’s risk of pregnancy loss by 3%.
    
    • The increase in risk was greater for mothers from rural areas or those who became pregnant at an older age, compared to younger mothers from urban areas.
• Area Specific Report:
  
  • Of the pregnancy loss cases, 77% were from India, 12% from Pakistan, and 11% from Bangladesh.
• Limitations:
  
  • The study was unable to distinguish between natural pregnancy loss and abortions, which may have led to an underestimation of the effect of air pollution on natural pregnancy loss.
  • There was under-reporting of pregnancy losses because of stigma or ignoring very early pregnancy losses.

Air Pollution

• Air pollution refers to any physical, chemical, or biological change in the air. It is the contamination of air by harmful gases, dust, and smoke which affects plants, animals, and humans drastically.
• Air Pollutants: Pollutants are the substances which cause pollution. Types:
  
  • Primary: The pollutants that directly cause air pollution or the pollutants that are formed and emitted directly from particular sources. Examples are particulate matter, carbon monoxide, nitrogen oxide, and sulfur oxide.
  • Secondary: The pollutants formed by the intermingling and reaction of primary pollutants are known as secondary pollutants. Examples are ozone and secondary organic aerosol (haze).
• Causes of Air Pollution: Major sources of air pollution are:
  
  • Indoor burning of fossil fuels, woods and other biomass to cook, heat and light homes.
  • Industry, including power generation such as coal-fired plants and diesel generators.
  • Transport, especially vehicles with diesel engines.
  • Agriculture, including livestock, which produces methane and ammonia, rice paddies, which produce methane, and the burning of agricultural waste.
  • Open waste burning and organic waste in landfills.
• Impact of Air Pollution on Human Health:
  
  • As per the State of Global Air 2020 (SoGA 2020) released by the Health Effects Institute (HEI):
    
    • High PM contributed to the deaths of more than 1,16,000 Indian infants who did not survive their first month.
    • More than half of these deaths were associated with outdoor PM2.5 and others were linked to the use of solid fuels such as charcoal, wood, and animal dung for cooking.
  • According to the 2017 Global Burden of Disease report published by the Lancet Planetary Health journal:
    
    • India, which accounts for 18% of the global population, recorded 26% of the global premature deaths and disease burden due to air pollution.
    • One in every eight deaths in India (2017) could be attributed to air pollution, which now contributes to more disease burden than smoking.
  • Household air pollution causes about 3.8 million premature deaths each year.
  • Air quality has become a serious health issue because the pollutants enter deep inside the lungs and the lungs capacity to purify blood gets reduced which affects the person’s growth, mental ability and the working capacity especially for children, pregnant women and elderly people.
    
    • In children, it is associated with low birth weight, asthma, childhood cancers, obesity, poor lung development and autism, among others.
• Indian Initiatives to Control Air Pollution:
  
  • The Commission for Air Quality Management in National Capital Region (NCR) and Adjoining Areas: It coordinates efforts of state governments to curb air pollution, and will lay down the parameters of air quality for the region.
  • Bharat Stage (BS) VI norms: These are emission control standards put in place by the government to keep a check on air pollution.
  • Dashboard for Monitoring Air Quality: It is a National Air Quality Monitoring Programme (NAMP) based dashboard, built on data from the Central Pollution Control Board’s National Ambient Air Quality Monitoring (NAAQM) Network which was started in 1984-85 and covers 344 cities/towns in 29 states and 6 UTs.
  • National Clean Air Programme: Launched in 2019, it is a comprehensive pan-India air pollution abatement scheme for 102 cities.
  • National Air Quality Index (AQI): It focuses on health effects one might experience within a few hours or days after breathing polluted air.
  • National Ambient Air Quality Standards: They are the standards for ambient air quality with reference to various identified pollutants notified by the Central Pollution Control Board under the Air (Prevention and Control of Pollution) Act, 1981.
  • Breathe: It is a 15 point action plan to fight air pollution by NITI Aayog.
  • Pradhan Mantri Ujjwala Yojana (PMUY): It aims at providing clean-cooking fuel to the poor households and bringing in qualitative charges in the living standards.
• International Initiatives:
  
  • Climate and Clean Air Coalition:
    
    • Launched in 2019
    • It is a voluntary partnership of governments, intergovernmental organizations, businesses, scientific institutions and civil society organizations committed to protecting the climate and improving air quality through actions to reduce short-lived climate pollutants.
    • India is a member of the coalition.
  • United Nations Clean Air Initiative: It calls on national and subnational governments to commit to achieving air quality that is safe for citizens, and to align climate change and air pollution policies by 2030.
  • World Health Organization (WHO)’s 4 Pillar Strategy: WHO adopted a resolution (2015) to address the adverse health effects of air pollution.

PM (Particulate Matter) 2.5

• PM 2.5 is an atmospheric particulate matter of diameter of fewer than 2.5 micrometres, which is around 3% the diameter of a human hair.
• It causes respiratory problems and also reduces visibility. It is an endocrine disruptor that can affect insulin secretion and insulin sensitivity, thus contributing to diabetes.
• It can only be detected with the help of an electron microscope because of them being very small.
• Sources of fine particles include all types of combustion activities (motor vehicles, power plants, wood burning, etc.) and certain industrial processes.

Way Forward

• There is a need to urgently confront air pollution and strengthen health systems. The short-term respite from air pollution that most big cities in the world experienced was because of lockdown measures and not a permanent fix.
• Also there is a need to increase public awareness on air pollution. Educate and inform people about what they can do to reduce air pollution. Put out public health messages on the metro, buses, billboards, and radio to help change public behaviour.

Source:IE