Health Ministry orders strict surveillance in hospitals as pollution rises in Delhi

As air pollution increases due to toxic smog in North India, the Union Health Ministry has instructed states and Union Territories to intensify the tracking of pollution-related illnesses. According to a report by Mint, the Ministry has directed hospitals to examine patients, use standardized disease codes, and report cases regularly. This move aims to create a clear picture of the impact of pollution on respiratory and cardiovascular health.

Under the new guidelines, hospitals operating Cardio-Respiratory Health Effects Screening and Treatment (CHEST) clinics will have to maintain daily records of patients. These cases are to be classified according to World Health Organization (WHO) codes, and regular reports must be submitted to health authorities. Hospitals will send daily patient numbers to district and state health officers, and this data will be shared monthly with the National Centre for Disease Control (NCDC).

The Ministry has made fortnightly progress reviews with states mandatory. Furthermore, chest clinics have been linked with Ayushman Arogya Mandirs (AAMs) for the follow-up of high-risk patients, with ASHA workers providing assistance. Clinicians will use the WHO's International Classification of Diseases (ICD) codes for registering asymptomatic exposure, symptomatic cases, and pollution-related illnesses.

The Central Government runs the National Programme on Climate Change and Human Health (NPCCHH) through the NCDC. The Ministry stated that this programme provides a structured approach for screening, diagnosis, management, and counselling for patients of all age groups by establishing chest clinics in district hospitals and medical college hospitals from September to February every year. The guidelines emphasize maintaining stocks of necessary equipment, medicines, and consumables, and confirming potential causes including pollution.

A 2024 study by The Lancet Planetary Health estimated that between 2009 and 2019, approximately 16.6 million deaths in India were caused by long-term exposure to fine particulate matter, compared to an annual average of 1.5 million as per WHO safety guidelines. According to experts, these pollutants are linked to risks of stroke, cardiovascular and respiratory diseases, lung cancer, and premature death.

The situation in Delhi-NCR is more critical. According to the Semir app, the Air Quality Index (AQI) reached 332 in the 'Very Poor' category at 9:05 AM on 3 November, while a 'Severe' reading of 452 was recorded in Jahangirpuri. According to a BBC report, Delhi's average AQI was 117 on 31 October, which reached 261 on 1 November and 324 on 2 November. Due to this rapid decline, the Commission for Air Quality Management (CAQM) has implemented Stage-II of the Graded Response Action Plan (GRAP), which includes activities such as mechanical sweeping and water sprinkling.

According to an Amar Ujala report, traffic is a major contributor to pollution sources. On 3 November, traffic's contribution was estimated at 17.8%, 15.5% on 4 November, 16.3% on 5 November, and 16.7% on 6 November. However, the impact of stubble burning in neighbouring states is increasing. On 3 November, the contribution of stubble was 8.2%, which is estimated to rise to 20.2% on 4 November. It is forecast to be 18.3% on 5 November and 20.2% again on 6 November. Other sources include residential activities (3.8% to 4.4%), industries (2.9% to 3.3%), construction (2.2% to 2.5%), waste burning (1.3% to 1.5%), and road dust (1.1% to 1.3%).

Regarding neighbouring districts, Jhajjar's contribution was 9.9% on 3 November, which will decrease to 5.9% on 6 November. Sonipat's contribution may rise from 2.8% on 3 November to 5.6% by 6 November. Gurugram's contribution is estimated to decrease from 4.4% to 1.9%, and Bhiwani's from 2.2% to 0.3%, while Rohtak's share may increase from 2.3% to 3.7%. Delhi Environment Minister Manjinder Singh Sirsa targeted the Punjab government, claiming that 933 incidents of stubble burning were recorded in Punjab between 26 October and 1 November.

On the other hand, according to The Economic Times, under GRAP-II, the Municipal Corporation of Delhi (MCD) may double parking charges in approximately 400 parking lots. Currently, the charge is ₹20 for four-wheelers and ₹10 for two-wheelers per hour; the proposal to increase this has been sent to the Law Department for approval.

A separate study highlighted the relationship between Delhi's greenery and temperature. According to an NDTV India report, a 30-year study found that the spread of greenery and its interconnectedness play a significant role. In areas where greenery was more fragmented, surface temperatures were higher, whereas in larger and interconnected green areas, lower temperatures were observed.