Household and ambient air pollution (HAP and AAP) rank amongst the top risk factors leading to a range of adverse health outcomes including respiratory and cardiovascular diseases – key reasons for air pollution induced premature deaths – per the Global Burden of Disease 2013 country report for India. Annual premature deaths caused by particulate air pollution have increased by six times since the year 2000. Air pollution caused 1.4 million deaths in India in 2013. The burden is borne disproportionately by the poor (especially women and children) primarily due to the widespread use of biomass cook-stoves in India. Indian women may also be susceptible to environmental impact due to their diet and poor nutritional status, predisposing them to further negative health outcomes.
Center’s efforts will explore epidemiological and qualitative research to understand how ambient and household air pollution impacts the health of urban and rural communities; engage with policy makers to influence health-beneficial policies; and undertake risk communication efforts with at-risk communities and general public.
I. GeoHealth Hub
Research Area: Air Pollution & Cardiometabolic Diseases
Goal: A fully integrated research and training program on air pollution and cardiometabolic diseases with policy relevance to improve health of Indians, and a hub for the region (7 in the world)
1. Developing a model to estimate ambient exposure to air pollution (AP) levels in Chennai and Delhi
2. Estimate association between exposure to AP, temperature, CM risk factors & diseases and built environment
3. Examine DNA methylation patterns associated with AP — > bio-markers
4. Examine the association between AP & vitamin D levels
II. Evaluating personal PM2.5 exposure measurements in the CARRS cohort, Delhi – A sub study of GEOHealth Air Pollution and Health GEO Health Hub Research and Capacity Building Program
III. The Ambient and indoor air Pollution in Pregnancy on the risk of low birth weight and Ensuing effects in Infants (APPLE) study funded by Department of Science and Technology, based in an urban slum in Bengaluru where solid fuel use is high, aims to assess the impact of air pollution exposure on low birth weight in infants
IV. PHILAP – Through mixed-methods research including exposure assessment, we are trying to capture the lived experience of asthmatic adolescents across socio-economic divides in Delhi (with a focus on how they deal with high pollution events)
V. Health impact assessment near thermal power plants (HIA) – In partnership with 4 reputed institutions, we are carrying out a rapid health assessment to understand the health impacts of populations living near thermal power plants
VI. White paper on air pollution and health impacts in India –completed for Environment Development Fund (2017)
VII. Situational analysis of Household Air Pollution and Health in India for the World Health Organization and Bloomberg Philanthropies to understand opportunities for intervention in India-‘Opportunities for Transition to Clean Household Energy: Application of the Household Energy Assessment Rapid Tool (HEART)’ was released on 4th October 2018 at the National Consultation on Burden of Disease from Air Pollution and Development of compendium of Indian studies on Air Pollution and Health Impact organized by WHO, India with MoHFW
VIII. Economic cost of air pollution in India- based on literature review, modelling and data analyses
IX: Air Pollution in India: Impacts on the Environmental Burden of Disease, the Economy and Human Capital
E-Waste and Other Areas
-As a Technical partner for Karo Sambhav,an electronic waste PRO, the Centre introduced the health impacts of informal e-waste recycling generation into the school modules prepared by the organisation.The school module outlines the importance of partnership for the sustainable development goals and disseminating the impact of environmental health risks such as e-waste on the communities, especially young children. The interactive module-based program delivered by school teachers over a period of four months contains a mix of class, home and community-based activities apart from educative videos.
-Plasma Pb levels and hypertension in Delhi-PhD with Deakin University, Australia-Melina Magsumbol
-Rapid health assessment near thermal power plants (4 States; multiple partners)-NIE, PGI,SHRC, Udupi
-Occupational exposure to pesticides and breast cancer in Punjab and Haryana
-Review of Emissions Standards Setting Process
-Roadmap to improved National Ambient Air Quality and health sector engagement
-Doctors’ perspectives on air pollution
-EH interventions in Bihar – under discussion, lead acid battery recycling areas –with SPCB and Pure Earth, MoEFCC
-Efficacy of the cracker ban during Diwali in Delhi -2017&2018
-Collaborations established with National Institute of Advanced Studies, Indian Institute of Science Bangalore, Karnataka and Saastra University for work in Telangana and Thanjavur, TN
Climate & Heat Stress
Increasing frequency and intensity of extreme weather events such as floods, storms, droughts, and heat waves are predicted to cause an increase in morbidity and mortality with vulnerable populations including children, elderly, and the poor being disproportionately affected. A World Bank report finds that India’s food security, water resources and health are at risk from climate change.
Ongoing work is examining the link between extreme heat events and increased mortality in the state of Gujarat. This has led to the development of a state-wide heat action plan aimed at reducing mortalities during extreme heat events, and a heat health communication plan for vulnerable populations. Centre’s activities will expand on this work to cover other cities in India. Additional areas of work will include examining the impacts of climate change on vector-borne diseases, food security, nutrition, and access to water. Vulnerability and adaptability studies will be conducted with city planners to identify communities and populations that will be disproportionately affected.
RESEARCH AND ACTIVITIES
I. HEAT ACTION PLAN
-Based on epidemiological research carried out in 2012 looking at heat wave-related all-cause mortality
-Plan targeted at vulnerable populations and health system preparedness
-Successfully deployed in Ahmedabad (Gujarat) in partnership with the local government and municipal body
-Being scaled up to Maharashtra and Odisha
-Under consideration by the National Disaster Management Authority to deploy nationwide
-Featured in International and Indian media prominently
II. Enteric Fever and Climate in Ahmedabad – The project aims to examine the relationship between Enteric Fever incidence and Climate in the city of Ahmedabad between 1990-2014 through secondary data from public and large private hospitals in Ahmedabad- IIPH-G.
III. Climate Adaptive Action Plans to Manage Heat Stress in Indian Cities – This study aims to support in conducting research, and carrying out vulnerability mapping at a city level. It also involves capacity building of relevant stakeholders in the public sector –IIPH-G
IV. Sustainable Health in Procurement Policy (SHiPP) – Mainstreaming sustainable procurement in the health system. Part of a larger project led by UNDP and Health Care Without Harm in 10 countries towards establishment of Climate-smart health systems.
V. Aiming to bring “health” dialogue into the Sustainable Procurement Task Force, GoI, besides main objectives of delivering health care through sustainable practices from manufacture, procurement, healthcare delivery(includes green buildings, energy efficiency, low carbon supply chains and efficient use and disposal of food, water and biomedical waste).
Water, Sanitation, and Hygiene (WASH)
Improving access to sanitation is therefore a critical step towards reducing the environmental burden of disease. It also helps create environments that enhance dignity, self-esteem, and safety particularly for women and girls across India. Government programs like Nirmal Bharat Abhiyan and the Swachh Bharat Abhiyan were created to address the issue of open defecation by building toilets across India. However, evidence suggests that building toilets alone will not be sufficient to address India’s poor sanitation and hygiene status. Various environmental and socio-cultural factors remain impediments and addressing these factors will be essential to improve sanitation practices across India.
Efforts at the Center will focus on understanding the adverse health outcomes linked to lack of access to toilets, factors that impede the use of toilets and designing community-based interventions to improve toilet use.
RESEARCH AND ACTIVITIES
-Enhancing the evidence base for interventions to end open defecation – pilot study with 3iE and LSHTM
-Aimed to establish what part demand creation can play in increasing latrine use among all family members of a household
-Linked well with the Government of India’s Swachh Bharat Abhiyan, aimed at making India OD free by 2019
-Support to enhance WASH use and facilities in CanKIDs (Center for kids with cancer)
-Ongoing grant applications – for work in different states
-Community engagement for enhancing WASH facilities –ex. Ghazipur Action Plan, Nehru nagar