The deteriorating air quality in the national capital region (NCR) has caused concern, leading people to adopt various strategies to combat the adverse effects of air pollution. Prof. GC Khilnani, India’s leading pulmonologist joins Health On Air for a discussion on its impact on our well-being and offers advice on mitigating the problem. Additionally, he clarifies the effectiveness of masks and air purifiers in dealing with air pollution.
HoA: There’s no way of escaping the air we breathe. What are some health problems that may arise due to air pollution?
Dr. Khilnani: We breathe an average of 10,000 litres of air every day. With each breath, we inhale 500 ml of air. Unfortunately, these toxins don’t remain confined to the lungs. Ultrafine particulate matter, measuring less than 0.1 micron in size, as well as noxious gases like carbon monoxide, nitrous oxide, and sulphur dioxide, enter the lungs and penetrate the entire body system. They affect every part of our body, including the heart, blood vessels, kidneys, the gastrointestinal system, and even the urinary system. Air pollution can cause breathlessness, dryness of mouth, cough, and wheezing, even in healthy people.
HoA: What types of concerns do patients bring up showcasing adverse effects of air pollution?
Dr. Khilnani: In the past few weeks, as air pollution levels have increased, patients with previously stable respiratory conditions are now reporting severe symptoms, with some cases requiring intensive care. In some instances, a minor viral infection becomes severe over time. On occasion, viral pneumonia can take a very serious and life-threatening turn. Due to air pollution, the duration of viral illnesses tends to be prolonged. As a result, the fever may subside, but coughing and breathlessness can persist for weeks or even months in certain cases.
N99 masks outperform N95 for filtering, says Prof. Khilnani
HoA: How does air pollution impact our health?
Dr. Khilnani: Our research conducted at AIIMS many years back indicates an increase in the number of heart attacks, COPD and almost 22% increase in chances of asthma attacks due to increased air pollution. This shows that we’re at serious risk from air pollution. Recently concluded study in Chicago said that the average life expectancy of an Indian is reduced by 5.3 years. And for the people of Delhi, life expectancy is reduced by 11.9 years. Not only the quality, but the longevity of life is severely impacted.
HoA: What can people do to prevent the adverse impact of air pollution?
Dr. Khilnani: People who have lung diseases like asthma and COPD, heart ailments, or are elderly should avoid going for a walk early in the morning when there is smog. During these hours, pollutants are present in the air at our breathing level. As the Sun comes up, ‘inversion’ of the particulate matter happens and the gases rise up in the atmosphere making it safer for joggers. The pollutants present in the air become less of a concern at our breathing level.
HoA: Is it possible that exercising in the morning could have a negative impact rather than being beneficial?
Dr. Khilnani: When we exercise, we breathe five times more the quantity of air than we do normally, and we tend to open our mouths obviating the nasal filter. So you’re breathing air five times more, which is directly going into the lungs.
So firstly, don’t exercise during early morning hours. Secondly, susceptible people must not go to crowded places like traffic intersections. The concentration of air pollution is maximum in such areas.
HoA: Masks proved to be effective in preventing the transmission of infections during the COVID-19 pandemic. But can masks prove effective against air pollution?
Prof. Khilnani examining an elderly patient
Dr. Khilnani: When it comes to pollution, simple cloth masks or surgical masks are ineffective. Scientific evidence shows that a handkerchief offers little protection from air pollution. The WHO Expert committee strongly emphasises that masks do not provide reliable protection against air pollution. For individuals susceptible to airborne ailments, an N95 mask can offer some degree of usefulness, but there are more effective options such as ‘KN95’ or ‘N99’ masks. However, when engaged in physical exercise, individuals may experience breathlessness and claustrophobia while wearing these masks. Furthermore, while they can filter particulate matter, they are unable to prevent exposure to noxious gases.
HoA: Can air purifiers guarantee safety from air pollution? What are some health benefits of air purifiers?
Prof. Khilnani: People often believe that purchasing an expensive air purifier will solve their air pollution problems, but this is a myth. An air purifier typically consists of two main components: a filter, which removes particulate matter, and an adsorber, which traps noxious gases. For an air purifier to be effective, it should include both of these components.
An important factor to consider is the capacity of the air purifier, which should be proportionate to the volume of the room. A small purifier is ineffective in a large space. It should run continuously, and windows should be kept closed. Additionally, the airflow direction of the purifier should be directed towards the person present in the room.
It’s essential to note that there is limited scientific evidence supporting the health benefits of air purifiers. While they are not entirely useless, they are of less benefit to healthy individuals and may be more useful for chronic patients. This perspective is largely anecdotal, and the World Health Organization (WHO) rejects claims of significant health benefits associated with air purifiers.
Prof. G.C. Khilnani serves as the Chairman of the PSRI Institute of Pulmonary, Critical Care, and Sleep Medicine, bringing over 41 years of experience in the field. Prior to this role, he held the position of Head and Professor in the Department of Pulmonary Medicine and Sleep Disorders at AIIMS New Delhi. His expertise lies in the fields of Pulmonary and Critical Care Medicine, as well as Sleep Medicine.
