Unmasking Air Pollution’s Impact on Pulmonary Health

Over the past few decades, air pollution and climate change have become major global concerns. Air pollution has many detrimental effects that pose a threat to global public health in terms of significant disease burden as well as mortality. It is disturbing that severe air pollution is increasing at an alarming rate, especially in India, where major cities like New Delhi and other urban areas are noted for being extremely polluted. The acceleration of activities linked to increased urbanization, transportation, and industrialization are the main sources of this pollution spike1,2. As per current statistics of the World Health Organization (WHO), the ambient air pollution combined with household air pollution causes approximately 6.7 million premature deaths each year in low- and middle-income nations, and 9 million fatalities worldwide1,3.

Dr. Neeraj Mahajan, Scientist, AIIMS, New Delhi

One important indicator of the level of pollution is the Air Quality Index (AQI). India faces significant challenges related to poor air quality as majority of the metropolitan cities in India have a high AQI score due to continuously increasing air pollution. According to IQAir4, 14 out 20 world’s most polluted cities are located in India. As a quickly developing nation with an expanding population, India suffers from extreme air pollution. This problem is mostly caused by factors such as emissions from vehicles, industrial activities, and biomass burning. Sadly, exposure to pollutants like particulate matter (PM2.5 and PM10) and nitrogen dioxide (NO2) can cause severe respiratory issues, cardiovascular diseases, and even premature deaths. Although strict regulations and initiatives such as the National Clean Air Programme, have been implemented by government to reduce air pollution, more comprehensive strategies are needed. Thus, this issue needs to be addressed to safeguard the public health and the environment.

The broad spectrum of health effects primarily consists of less severe effects like upper respiratory tract distress to a consistent array of pulmonary and cardio-respiratory disorders, such as asthma and acute respiratory tract infection in children under five, and lung cancer and chronic bronchitis in adults.  The most common consequences of brief exposure to air pollution are coughing, eyes and nose irritations, wheezing, and allergies that manifest into serious conditions like asthma, and Chronic Obstructive Pulmonary Disease (COPD). This leads to an increase in morbidity index due to higher rate of hospitalization. While prolonged exposure leads to pulmonary dysfunctionality in addition to other cardiac issues and results in shorter life span of the individual1.2.

Moreover, with adverse effects on immune functionality through development of various health conditions, such as pneumonia, asthma, diabetes, and cardio-respiratory diseases, the affected individuals can become prone to PM2.5 and PM10 as they can penetrate to internal spaces due to their small size causing further respiratory disorders. Meanwhile, significant impact on pulmonary health is also influenced by factors such as season, time, country and region of air pollutants exposure1. Long term occupational interface with various pollutants in industrial settings as well as continuous exposure to indoor air pollution from cooking fuels, such as biomass, animal dung, and coal exacerbate respiratory issues in adults5.

Children in comparison to adults are more susceptible to respiratory ailments due to their higher vulnerability to air pollutants and subsequent lung function development. Impeded lung growth and adverse effect on lung function with development of exacerbated asthma, bronchitis and infections might occur on enhanced exposure to air pollution during childhood. Studies evaluating assessment of pulmonary function in children with its extension into adulthood considering air pollution exposure, and disease impact or both may provide better insights on effects of air pollution on lung functionality. In addition to aforementioned, air pollution has been associated with increased risks of low birth weight, premature birth, and developmental issues in a child’s respiratory system. Air pollution mitigation strategies both at larger strata like structural reforms and regulations at national, regional, and local levels, and local measures such as minimizing exposure to air pollution at home and during school hours are necessary steps for reducing the impact of air pollution on child’s well-being6. Some common ways to reduce air pollution may include- promoting cleaner energy sources, improving air quality monitoring systems, reviewing industry and vehicle emission standards, and raising public awareness about the health risks associated with air pollution and how to prevent them.


  1. Manisalidis I, et al. Environmental and Health Impacts of Air Pollution: A Review. Front Public Health. 2020; 8:14.
  2. Kampa M, and Castanas E. Human health effects of air pollution. Environ Pollut. 2008; 151(2):362-7.
  3. Air Pollution. WHO. Available online (accessed on 25-02-24) https://www.who.int/news-room/fact-sheets/detail/ambient-(outdoor)-air-quality-and-health.
  4. https://www.iqair.com/in-en/world-most-polluted-cities
  5. De Matteis S, et al. Current and new challenges in occupational lung diseases. Eur Respir Rev. 2017; 26(146):170080.
  6. Garcia E, Rice MB, and Gold DR. Air pollution and lung function in children. J Allergy Clin Immunol. 2021; 148(1):1-14.
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