According to WHO (World Health Organization), the air we breathe is growing dangerously polluted and 9 out of 10 people now breathe polluted air killing about 7 million people every year.

The simplest one-line advice when air quality deteriorates is to stay indoors and close the doors and windows.

Outdoor air quality in developing countries, including India has always been a matter of concern.

Air pollution poses a significant risk to public health by worsening asthma, increasing hospitalizations, and even leading to premature death due to heart and lung disease. Air pollutants emitted from cars, trucks and industry contain toxins that can also cause cancer.

1 out of 3 deaths due to air pollution are from stroke, lung cancer and heart disease. Air pollution affects all – the rich and the poor. One might have some relief if living in a posh locality, but one has to realize that air pollution is all around us.

The microscopic pollutants in the air can slip past our body’s defenses and enter the lungs and blood vessels eventually damaging our lungs, heart and brain.

Based on the Supreme Court of India directions, the Delhi government on 25th November 2021 reimposed the ban on construction and demolition activities in the city. Earlier, the Delhi government had banned construction activities on 13th November.

Subsequent to the Supreme Court of India directions, the chief minister of Delhi, an Indian state, announced that schools in the national capital will be closed for a week. The decision was taken to ensure that children do not breathe polluted air, the chief minister said.

The chief minister also said that government officials will be working from home for a week, adding that private offices are also advised to follow the same protocol.

What should be the advice by an OH physician to workers in an organization when air quality worsens? The first step should be to send an advisory to all employees warning about deterioration of air quality and steps to be taken to minimize its impact.

Subsequently trigger points on air quality should be set about the content of the advisory to be sent. It is important to align this with the management of the company. This is an ongoing activity.

AQI (air quality index) above 101 appears to be a good trigger when the first advisory should go advising employees about steps to be taken. As the AQI goes up, the employees must be advised accordingly. And at AQI 201, which is considered ‘very unhealthy’, the employees should ideally be advised to work from home.

Issuance of a timely health advisory to the workers in a company by the Occupational Health physician about worsening outdoor air quality will help mitigate the harm it can cause. 

A sample of advisory chart for reference – OutdoorAQI.Advisory

AQI charts are indicative. The discretion is on the user after a medical advice and government declarations.

The AQI of USA accounts for 5 major pollutants that are regulated by the Clean Air Act – ozone, particle pollution (particulate matter), carbon monoxide, nitrogen dioxide and sulfur dioxide. The AQI for each pollutant is generally based on the health-based national ambient air quality standard for that pollutant and the scientific information that supports that standard.

Restriction of outdoor activity is affected by ground-level ozone pollution, and it should be used to modify plans for outdoor activities. In USA, it is advised to call the local air quality agency for up-to-date information for the specific location before cancelling an outdoor athletic event.

The health effects of Ground-level Ozone are:

  • Constriction of windpipe making it difficult to breathe
  • Coughing, pain when taking a deep breath, wheezing etc.
  • Increased fatigue
  • Decrease in athletic performance
  • Long-term exposure to polluted air can have permanent decrease in lung function, possible development of diseases such as asthma and bronchitis, or a shortened life span.

Ground-level ozone reaches its highest level during the afternoon and early evening.

When the air quality outdoors is poor, improve indoor air quality by:

  • Keeping the house clean by vacuum cleaning, preferably using HEPA filters
  • Changing/cleaning filters regularly
  • While cooking, use vents or keep a window partially open
  • Having indoor plants (snake plant, spider plant, bamboo palm, aloe vera etc.) to keep indoor air fresh
  • If the house has air ducts, make sure they are circulating fresh, clean air
  • Avoiding kerosene heaters
  • Avoiding smoking, burning candles or fireplaces
  • Consider purchasing an air cleaner but avoid the one that works by generating ozone as it will increase the pollution indoors.

Precautions taken when outdoor air quality is bad helps to mitigate the harm it can cause. 

To know more, contact

___________________________________________________________________________________________________

Dr Ajay Sati is an Occupational Health physician who prefers to describe himself as an Occupationist, to denote, ‘an expert in diseases and other concerns of occupations’. Dr Sati has managed health and wellness programs in industries he worked, like the atomic energy, and energy (oil & gas) in India and overseas. He was involved in many greenfield and brownfield projects providing inputs from health point of view. Known for SOPs and protocols, he is currently involved with an energy MNC in designing protocols to support employees during the covid pandemic, and protocols to safely reopen offices and plants.