Air pollution increases the risk of diabetes

Air pollution increases the risk of diabetes

Dr KK Aggarwal
National President iMA

Air pollution has been dominating headlines in the past few days and has been at an all-time high in Delhi. The air quality in Delhi continues to remain in the severe category, with no respite.

There is increasing evidence for the role of environment in pathogenesis in many diseases with air pollution emerging as the largest environmental health risk globally. Exposure to the toxic air can affect the lungs, blood, vascular system, brain and the heart leading to significant adverse health effects and associated high overall morbidity and mortality.

Environmental pollution, with traffic associated pollutants, gaseous, nitrogen dioxide, especially high particulate matter PM 2.5 exposure, has been linked with risk of incident diabetes. Several studies have shown a positive association between long-term exposure to air pollution and increased risk of type 2 diabetes. Individuals who have prediabetes are especially vulnerable to the effects of air pollution.

According to the WHO, the air content of PM2.5 should be less than 10 μg/m3 but in India the levels are always more than 60 μg/m3 as 60 μg/m3 concentration has been accepted as normal in India. That means that an Indian is already six times more exposed to PM2.5. However, recently, extremely high levels of PM2.5, crossing 400, have been recorded. The risk of future diabetes associated with exposure to 10 μg/cu mm increase of PM2.5 ranges between 10 and 27% (Endocrine. 2016 Jan;51(1):32-7).

Any particulate matter of less than 2.5 µm in size can get absorbed from respiratory system, enter into the blood. The exact mechanisms as to how air pollution causes diabetes Air pollutants are hypothesized to exert their effects via impaired endothelial function, elevated systemic inflammation, mitochondrial dysfunction, and oxidative stress, all of which are hallmarks of type 2 diabetes (Trends Endocrinol Metab. 2015 Jul;26(7):384-94). Increased oxidative stress leads to insulin resistance, β-cell dysfunction, impaired glucose tolerance, and, ultimately, type 2 diabetes.

India has the second highest number of people living with diabetes 69.2 million with a prevalence of 8.7%. China has the highest number of people living with diabetes with 109 million cases of diabetes in the year 2015 and a prevalence of 10.6%.

This scenario calls for high priority action to minimize the air pollution to contain the rising incidence of type 2 diabetes in the country.

The responsibility towards this end lies with each one of us as it does with the government.

Not just the government, citizens too share the responsibility to control pollution

Not just the government, citizens too share the responsibility to control pollution

Dr KK Aggarwal

Air pollution has often been in the news, especially since the last few years. Evidences of the harmful effects of air pollution on public health are accumulating. And, each time the Air Quality Index (AQI) crosses the red zone indicating ‘very poor’ or ‘severe’ air quality, much is written about or talked about to ascribe blame for this rise in pollution to hazardous levels. The pollution levels increased to ‘severe’ levels, this year too, in the National Capital Region (NCR) post-Diwali. This was despite the ban on the sale of firecrackers in NCR by the Supreme Court of India.

Such high levels of pollution are not only harmful to people with existing disease, but also for healthy individuals.

This situation should give us all pause to think. It is easy and very convenient to be on the sidelines and fault-find the government for its apathy or lack of stringent measures to bring down the pollution levels. And, it’s not just air pollution, noise pollution and water pollution are also a serious cause for concern.

“Ask not what your country can do for you, ask what you can do for your country”. These historic words from President John F Kennedy, though addressed to the citizens of the United States, also challenge us to act for the betterment of the society we live in.

Instead of always pointing an accusatory finger at the government, we should introspect and ask ourselves “Am I really a responsible citizen?”

Preventing and controlling pollution is not the sole responsibility of the government. Most of existing pollution levels are man-made, so we also must contribute in the efforts to control pollution. It is the moral duty of each one of us, as active members of the society, to adopt measures to help control pollution. As responsible citizens, we must respect laws of the state in place and abide by them. We must make individual efforts to control pollution.

Here are some simple steps that each one of us can take to help reduce pollution. More can be added to this list.  

•  I will not burn agarbatti, incense sticks and dhoop batti at my home or workplace till pollution levels drop.
• I will not burn flame producing candles.
• I will not use kerosene oil for any purpose.
• I will avoid using polythene bags, or plastic.
• I will use products, which can be recycled, as much as possible.
• I will not use wood and coal for any purpose be it cooking or heating.
• If any unfortunate death occurs in my family, I will bravely opt for electric cremation.
• I will not smoke cigarettes/beedis nor allow anyone else too.
• I will resort to wet mopping the floors in my house and workplace.
• Wherever possible, I will practice carpooling.
• I will opt for public transportation as much as possible.
• I will regularly get my vehicle/s checked for pollution standards and serviced so that it is in good condition.
• I will walk or cycle for short distance commutes.
• I will make sure that the ACs at my home/vehicle/workplace do not have a choked filter. If yes, I will regularly get the AC checked and serviced as scheduled.
• I will check air purifiers at my home and workplace for choked filters and replace them if necessary.
• I will not burn leaves/garbage/ paper waste.
• I will raise my voice against air pollution.
• If at a petrol pump, I see no mechanism for absorbing toxic vapors, I will speak up.
• I will not allow construction material to linger on roads after the work is finished.
• I will insist that the roads in my vicinity are cleaned only mechanically between 12 pm to 5 am.
• I will talk to my RWA to plant more trees.
• I will sell my diesel car and buy a CNG one.
• I will avidly vote for heavy taxes on crackers and tobacco.
• I will educate people every day to avoid contributing to air pollution, and how to avoid pollutant exposure.

Answer yes to most of the above, if not all, to do your bit and make your significant contribution. You will find that 90% of these are a matter of personal choice. Only about 10% factors are beyond one’s control.

Not just the government, each one of us has a civic responsibility and the contribution from each of us, no matter however small, has an impact. Every little step taken at the individual level will only work towards the goodwill of the society as a whole.

Disclaimer: The views expressed in this write up are entirely my own