The Air Quality Index (AQI) of Chandigarh and Panchkula has slipped into the very poor category, as analysed by the Continuous Ambient Air Quality Monitoring Stations (CAAQMS) set up in Sector 22, Sector 25 and Sector 53 and Sector 6 (for Panchkula).
The deterioration of AQI, health experts stated, ought to be taken seriously by the public, especially those with chronic respiratory disorders.
Professor Ashutosh N Aggarwal, head of the Department of Pulmonary Medicine, PGI, said that in view of the poor air quality nowadays, people with chronic respiratory disorders are at a greater risk of their symptoms — like cough and breathlessness — worsening if they stay outdoors for long periods.
“It is advisable that people with compromised lung function stay indoors as much as feasible, and wear masks to minimise exposure to airborne pollutants if they venture outside. Those on long-term treatment should continue to take their drugs regularly as prescribed. In case patients experience any deterioration in their lung condition, or if they develop new respiratory symptoms, they should immediately consult their doctor to assess if their medications need to be temporarily increased or changed,” explained Aggarwal.
As for the rising use of inhalers, Aggarwal stated that like any other drug, inhaled medications should be used judiciously, and only for the purpose they are intended for. People with respiratory diseases, such as asthma, use inhalers for long periods of time and regular usage helps to keep their disease under control.
“Doctors generally prescribe drugs and dosages that maximize medical benefit, while keeping side effects to a minimum. But several people use inhalers on their own for any respiratory symptom, and often also as a preventive measure, without any medical prescription and without knowing the constituent drugs in these devices. Naturally, such usage is unlikely to provide the intended health benefits but may potentially cause harm. Depending on the inhaled drugs, some people may experience throat discomfort, higher risk of throat and lung infections, palpitations, visual complaints, or urine retention” said Aggarwal.
Dr Ravindra Khaiwal, additional professor of the Department of Community Medicine and School of Public Health, PGI, stated that cities with weak winds are more prone to pollution.
“We examined the data on air quality in Chandigarh and found that greater PM10 or PM2.5 values appear at low wind speeds. Polluted air is being carried farther and subjected to higher ‘ventilation’ across a wider area. Increased emissions over the past few days are linked to higher vehicular emissions, waste burning, crop residue burning in rural regions, and the recent firecrackers,” he said.
The winter temperature inversion, lower atmospheric boundary layer, and increased moisture with a high level of air pollutants are responsible for a thin layer of smog in the region, Khaiwal added.
“Long-term exposure to high air pollution is a major risk factor for various lung and cardiovascular diseases. People with pre-existing health conditions, such as respiratory or heart illness, may be affected more severely, including pregnant women and children,” he added.
“Post-Diwali, the air worsened, and we started seeing more cases of exacerbations (worsening of pre-existing symptoms) of asthma, COPD, and new patients with no history or family history of asthma. Stay indoors as much as possible and avoid outside travel early morning or evening hours. Maintain good hydration with good fluid intake. Wear a triple layer or simple cloth mask to decrease the particulate matter being inhaled when outside,” said Dr Amit Kumar Mandal, director of Pulmonology, Sleep and Critical Care, Fortis Hospital. Inhalers, he added, are excellent for patients with obstructive airway diseases – like asthma and COPD.
These patients should continue with the use of inhalers on a regular basis as per medical advice.
“They are more harmful if not taken appropriately and patients should stay in touch with their physicians for management and preservation of their lung functions,” stated Mandal.
‘Do not use air purifiers’
Health experts also did not recommend routine use of indoor air purifiers. The rising pollution levels have also increased the queries for indoor air purifiers.
Talking about the use of air purifier systems for homes, Professor Ashutosh N Aggarwal said these purifiers can theoretically capture particulate matter from the air entering its inlet, releasing air with lesser pollutants at its outlet.
However, the efficiency of various such filters in cleaning the air in the entire room over a given time is highly variable, and not known in a real-world setting.
“Since indoor air pollutants are substantially derived from outdoor air entering the rooms, any potential benefit is also not sustained unless the room stays permanently closed. It is also not clear if these filters can reduce indoor polluting particles to a level that is sufficient to achieve measurable health benefits. Currently, therefore, we do not recommend indoor air purifiers for routine use at homes,” he said.
Air purifiers, added Mandal, may be effective in the NCR region (where levels are far worse) for patients with chronic lung problems and on respiratory support – home oxygen or non-invasive ventilator support.
Khaiwal agreed that these could be effective for people with underlying diseases and children. However, air purifier cleaning efficiency depends on indoor and outdoor air pollution and exchange ratio.
“This is an expensive solution to minimise air pollution and restrict physical activity, as the person will be confined to limited space. Further, the benefits of improving indoor air quality is diminished as outdoor air quality deteriorates. Air purifiers only effectively reduce exposure to mainly fine particles in enclosed environments — such as homes and offices. However, many individuals spend a lot of time in cars and other public locations where it may be difficult or impossible to install an air purifier,” he stated.