Worried about dust and smog in Mumbai? Doctors recommend timely precautions to mitigate serious health effects

Have you experienced persistent cough, throat irritation, burning eyes, or constantly found yourself covering your nose while travelling in Mumbai recently? It would be a lie if Mumbaikars said they aren't concerned about the smog developing daily in the city. The severity has also made authorities issue guidelines for dust mitigation. Their non-compliance will make the Brihanmumbai Municipal Corporation (BMC) take quick action against defaulters and even fine them.
With construction sites currently on the radar, the municipal corporation has said it has also put together an enforcement squad to make sure the measures are implemented. While smog guns and sprinklers are a part of the plan, according to a recent mid-day report, the sites have been told to raise their barriers and keep construction material covered.

In the meantime, city doctors say it is important for Mumbaikars to not take it for granted. Smog, which simply means fog intensified by smoke, is usually seen during the winter months. With Mumbai and Delhi's air quality reducing by the day, the most recent ‘very poor' AQI status that has been a regular occurrence, means that the bad air quality is here to stay. Unfortunately, it can have adverse effects on the body. The doctors say it's important to take care because people can be susceptible to not only short-term effects but also long-term respiratory diseases.

With the growing concern about the blurry days in Mumbai, mid-day.com reached out to Dr Sulaiman Ladhani, chest physician and consultant pulmonologist, Wockhardt Hospitals in Mumbai Central and Dr Aditya Agrawal, respiratory medicine, consultant pulmonologist, Bhatia Hospital Mumbai, to understand the severity of the effects of the smog in the city on a Mumbaikar's health. Apart from short-term and long-term effects, they say it can also affect those with Covid and respiratory diseases more than others.

How can Mumbai's current smog and pollution affect a person's health?
Ladhani: Mumbai's current smog and pollution can significantly affect a person's health. Smog, a severe form of air pollution, occurs during the winter months when slow winds allow pollutants to mix with stagnant air. This leads to reduced visibility and increased exposure to harmful particles and pollutants. It can cause a range of health issues, both short-term and long-term.

Agrawal: Smog and environmental pollution severely impact a person's health. Prolonged exposure can lead to exacerbation of chronic respiratory conditions such as asthma, bronchitis, and allergies, while also increasing the risk of heart and lung diseases while affecting overall well-being.
What are the symptoms that one is getting affected by the pollution and smog?
Ladhani: Short-term exposure can lead to symptoms including burning eyes, headache, giddiness, fatigue, persistent cough, hoarseness of voice, throat irritation, and weakness. Long-term exposure can result in more severe conditions.

Agrawal: The symptoms arising out of exposure to smoke and pollution can be distressing. Common symptoms apart from cough are breathlessness, and chest tightness. Breathlessness is associated with wheezing. Nasal obstruction, nasal discharge, and frontal headache are upper respiratory tract symptoms associated with pollution. Non-respiratory symptoms include dry and itchy eyes. These symptoms have a significant bearing on an individual's health, thus impacting their quality of life and limiting productivity.

What are the effects of long-term exposure to such pollution?
Ladhani: Long-term exposure to such pollution can have serious effects on health. Depending on the size of the pollutants, they can localise in the upper airways or penetrate deeper into the lungs and bloodstream. This can lead to conditions like asthma, chronic obstructive pulmonary disease (COPD), cancer, heart issues, and cognitive abnormalities.

Agrawal: Long-term exposure to pollution has been found to have a direct correlation to longevity of life, quality of life, and increased risk for chronic respiratory and cardiovascular diseases.

Do the effects of pollution differ from the effects of smog on the body?
Ladhani: Both pollution and smog have harmful effects on the body. Smog is a more severe form of air pollution due to its lower level and stagnant nature. However, their effects are similar, impacting both short-term and long-term health.

Agrawal: Smog is a form of pollution. Pollution of any kind affects living organisms. Additionally, humans experience increased respiration and cardiovascular harm with pollution.

What are the precautions that people can take to prevent getting affected by pollution and smog?
Ladhani: To prevent the adverse effects of pollution and smog, individuals can take several precautions. These include staying indoors during early mornings, avoiding crowded and polluted areas, refraining from outdoor exercises, wearing masks, and minimising car travel during smoggy periods. Avoiding the burning of firecrackers, reducing the use of mosquito repellents, using indoor air purifiers, and regular lung function checks are also essential.

Agrawal: Humans are partly to be blamed for increased levels of pollution. As conscientious citizens, we should find more sustainable solutions such as using public transport, reducing fossil fuel, burning, reducing the usage of plastics, and reducing levels of noise pollution. Both Indoor and outdoor air pollution should be monitored. The use of air quality monitors in homes often helps in mitigating indoor air pollution.

Local municipal bodies have installed several air quality monitoring stations across the city of Mumbai and the use of data from such sources can help you plan your activities such that you avoid times of high pollution. Use of face masks and in case of very severe pollution, N-95 masks provide the physical barrier against harmful particulate matter. For indoor air pollution, the use of air purifiers helps reduce particulate matter. We are all needed together and only a collective effort will help us combat this problem.

What are the sicknesses and diseases that people can get because of pollution and smog?
Ladhani: Sicknesses and diseases that can result from pollution and smog exposure include asthma, COPD, cancer, heart attacks, irregular heart rate, and cognitive abnormalities.

Agrawal: Environmental exposure causes an increased risk for exacerbation of diseases such as asthma and chronic bronchitis, leading to increased respiratory distress. This eventually leads to a weakened respiratory immune response and hence an increased risk for respiration infections which include both viral and bacterial infections. Increased air pollution is also with cardiovascular diseases.

Which age groups are most vulnerable to getting affected by smog and pollution?
Ladhani: Vulnerability to smog and pollution varies by age group, with children, immunocompromised individuals, the elderly, and those with underlying health conditions being the most vulnerable.

Agrawal: People at extreme age that is children and elderly are more susceptible to the effects of environmental pollution. However, environmental pollution spares none.

Should the people travelling by road be more careful than the people travelling by local train?
Ladhani: People traveling by road should be more careful during smoggy conditions, especially during early mornings when visibility is poor, increasing the risk of accidents.

Agrawal: People travelling by trains and by road transport should both be equally careful about air pollution. In a study from Pune, it was found that persons travelling in buses had lesser exposure to pollution than someone travelling by autorickshaw and they, in turn, had lesser exposure than those travelling on motorcycles. Hence all need to be cautious.

What are some of the major types of areas that people should avoid to stay away from pollution and smog?
Ladhani: To stay away from pollution and smog, avoid crowded and polluted places, especially during early mornings when exposure is high.

Agrawal: In our cities, areas with high vehicle density, industrial zones and areas with increased construction activities are known to have higher levels of air pollution. Areas close to the sea are known to have lesser amounts of air pollution. Gardens and areas with large numbers of trees have traditionally had lower levels of air pollution.

Do patients with asthma and other lung diseases have to be more careful than others?
Ladhani: Patients with asthma and other lung diseases should be more careful than others, as they are at greater risk of worsening symptoms and complications.

Agrawal: Patients with chronic respiratory diseases such as asthma, COPD, lung cancer, bronchitis, and lung fibrosis have an increased risk of pollution-associated respiratory complications hence should be more careful during such periods.

Do people who have suffered from Covid need to be more careful? How is it different for them compared to those with other lung disease?
Ladhani: People who have suffered from Covid need to be particularly careful because their lung function may already be compromised, making them prone to recurrent respiratory infections and potential lung damage.

Agrawal: Patients who have severe Covid and associated lung damage should be more careful. However, there is no clinical data to support that patients with a history of severe Covid have an increased risk for pollution-associated illnesses.

What are the foods that people can eat to strengthen their lungs?
Ladhani: Foods that can help strengthen the lungs include seasonal fruits with high antioxidants, and leafy green vegetables like spinach and broccoli, which have anti-inflammatory properties. Proper hydration is also essential.

Agrawal: People should eat a well-balanced diet, which includes equal portions of essential nutrients such as carbohydrates, fats, minerals, vitamins, and most importantly proteins. Patients should strive to have fresh unprocessed season food while avoiding large amounts of salt and sugar.

Do the effects of smog and pollution on the body differ according to the season? For example, is it more during winter?
Ladhani: The effects of smog and pollution on the body can differ according to the season. The winter months, especially from November to March, have more pronounced side effects due to stagnant air and slow winds. It's essential to take adequate precautions during these critical months.

Agrawal: Smog is a feature often found exclusively in the cold months. This happens due to the trapping of particulate matter in water droplets present in the environment which are closer to the surface of the earth than in warm months when these water droplets tend to rise higher in the atmosphere.