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.
Children's Environmental Health
Each year millions of children under the age of five die from environmental related exposures. There is concern that high levels of air pollution in rapidly developing countries like India may be associated with both preterm birth and low birth weight. Early exposure to toxic chemicals, nutritional imbalances, and psychosocial stress are also thought to play a substantial role in initiation and progression of Non Communicable Disease (NCDs).
Low-level environmental exposures in utero and neonatal periods of early development are thought to have long lasting effects on health through adult life. India has a large child and adolescent population and the potential for their exposure to environmental pollutants is manifold. Research at the Centre in children’s environmental health will look into early life exposures to better understand the environmental burden of disease of children and youth in India.
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.
Exposure to Toxic Chemicals
Exposure to harmful chemicals takes place through air, water, and food. Many factors such as the type and amount of chemical, the duration and frequency of exposure, and route of exposure all influence how the chemical reacts with the body and the effects it causes.
In India, most of the work on chemical exposures has come from the field of toxicology, in animal or cellular experiments. Work on human populations to understand dose-response associations or the causal links between exposure and disease is in its infancy. The Centre will conduct much needed research in this area to generate evidence on associations between environmental contaminants and health outcomes, for which there is scant high-quality epidemiological evidence with biological validation in India.
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.