India is in the midst of a serious air pollution crisis with the country’s capital Delhi claiming most of the bad press at an index value of 375. Truth is that many Indian cities are in the red as far as their air quality is concerned. According to the latest data from the Central Pollution Control Board, 25 cities in India has “Very Poor” air quality, which can result in respiratory illnesses on prolonged exposure.
“It is that time of the year when Delhi NCR and its surrounding areas grapple with bad air and pollution which makes life difficult for most of us. The problem of air pollution has increased dramatically since the last decade which may have increased the prevalence even further,” says Dr Sharad Joshi, Associate Director, Pulmonology, Max Hospital, Vaishali.

Since air pollution is the ninth leading risk factor for deaths due to heart and lung diseases, health experts across the country are understandably concerned about the air quality. It also bears bad news for people with COPD or Chronic Obstructive Pulmonary Disease.
What is COPD?
COPD is a disease where the airflow to the lungs gets limited usually due to exposure to harmful substances. A common cause of death, COPD causes chronic inflammation that leads to structural changes in the lung that obstructs airflow.
The narrowing of the airway and decreased lung recoil results in symptoms like cough, dyspnea and sputum production. Symptoms of COPD can range from being asymptomatic to respiratory failure.
Cases of COPD in India have been on a staggering rise of almost 100%, says Dr Joshi quoting The Lancet. “The study also witnessed a gigantic 13% loss of life, killing around 10 lakh patients with COPD every year,” he adds.
Notably, COPD remains a leading cause of death even in the era of the COVID-19 pandemic.
Dr Joshi adds that while COPD is the second most common cause of “Non-Communicable Disease-related mortality in the country, it is preventable and treatable.
The Symptoms of COPD
The most common symptoms of COPD are cough, breathlessness and phlegm production. Lesser but more worrisome symptoms include wheezing, tightness in the chest and chest congestion.
“The onset of problems associated with COPD usually is symptomized from mid-life onwards where the sufferer feels shortness of breath, difficulty in breathing, or breathlessness that may cause long stabbing cough with phlegm and episodes of frequent tiredness,” notes Dr Joshi.
While the symptoms develop gradually, they are usually a result of multiple risk factors, from smoking (active and passive) to exposure to environmental pollutants, dust, fumes and chemicals.
How pollution affects COPD
While COPD is most commonly seen in smokers, a 2015 study saw a 1.1% to 40% prevalence of COPD in non-smokers. This points to the role played by either second-hand smoke or air pollution.
A 2014 meta-analysis study reported that outdoor air pollution was linked to increase of COPD incidence and prevalence. So more the exposure to pollution, more the incidences of various respiratory infections and COPD attacks.
” Various studies also claim and prove that those living nearby excess road traffic are at a higher prevalence and risk for developing COPD.”
“Since the pollutants suspended in the air become deeply lodged inside the lungs and cause irritation thereby damaging the respiratory tract, extensive exposure to bad air has a significant connection to trigger a COPD attack,” mentions Dr Joshi.
The doctor also informs us that every person — irrespective of age or gender barrier — reacts differently to the damage caused by air pollution. “Some may be more affected than the others.”
How to protect your lungs from pollution
How does one avoid pollution? Escaping to the verdant countryside may seem tempting, but it’s not really practical. In such cases, lifestyle modifications are the best bet, say Dr Joshi.
“Despite being an irreversible condition, the treatment regime looks to relieve the symptoms, improve the quality of life by further reducing the risk of further damage.”
The first step is kicking the cigarette butt. Smoking cessation, in other words.
Avoiding areas with poor or severe air quality is the most intuitive thing to do.
“Eliminate exposure to toxic fumes and chemicals as much as possible to manage the symptoms and exacerbations,” says Dr Joshi.
Keeping your lungs in ship shape is important to thwart the effects of pollution. “Regular exercising and physical activities help in strengthening the lungs and generally improves the cardiovascular function in those with COPD.”
While there is a dire need to raise awareness regarding this disease and act accordingly, people should not ignore the lung problems or delay treatment, but try to improve the quality of life by staying fit and healthy, signs off the doctor.