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The road to better respiratory health in India requires a multi-pronged approach—stricter environmental policies, public awareness, and enhanced healthcare interventions
Beyond respiratory diseases, air pollution is increasingly linked to various cancers, including those affecting organs beyond the lungs.
Air pollution has emerged as one of India’s most critical public health challenges, significantly affecting respiratory health and overall well-being. With fifteen of the world’s twenty most polluted cities located in India, the urgency to address this crisis has never been greater.
Dr. Raja Dhar, Director and Head of Pulmonology at C.K. Birla Hospitals, Kolkata, sheds light on the alarming health consequences of pollution, the long-term impact of COVID-19 on respiratory health, and the policy-driven solutions needed to combat this growing epidemic, at the ERS India Summit 2025, organized in collaboration with the European Respiratory Society (ERS) and the Indian Chest Society (ICS).
The Health Impact of Air Pollution
Dr. Dhar: Air pollution affects nearly every organ system in the body, but its most severe toll is on the lungs, accounting for nearly 80% of the damage. The remaining 20% impacts the brain, kidneys, liver, and even muscles, reducing mobility and significantly shortening life expectancy—by an estimated 7.5 years, depending on the study.
Beyond respiratory diseases, air pollution is increasingly linked to various cancers, including those affecting organs beyond the lungs. India has consistently ranked among the worst-hit nations, with Delhi and other major cities recording dangerously high pollution levels. Despite numerous government interventions, tangible improvements remain elusive. As pulmonologists, we witness a threefold surge in hospitalizations for asthma and COPD exacerbations between November and January, underscoring the severity of this crisis.
Strategies to Combat Air Pollution
Dr. Dhar: Both indoor and outdoor air pollution pose serious health risks. Rural populations remain exposed to biomass fuel combustion, while urban areas contend with industrial emissions, vehicular pollution, and construction dust. Indoor pollutants, such as incense and fumes from religious rituals, are often overlooked but contribute significantly to respiratory issues.
Addressing this crisis demands more than political lip service—it requires urgent and enforceable policy action. Governments must move beyond election promises and implement stringent regulations to curb emissions at the source. While personal protective measures like N95/N99 masks and nasal filters offer some defense, they are not practical for long-term use. Air purifiers, though effective, remain a luxury accessible only to affluent urban populations. Sustainable solutions lie in stringent pollution controls—such as regulating construction sites, reducing vehicular emissions, and improving public transport—rather than short-term measures like school closures.
The Lasting Impact of COVID-19 on Respiratory Health
Dr. Dhar: Initially, we anticipated a 25% increase in chronic lung diseases post-COVID, given the virus’s impact on lung tissue. However, we have observed significant healing in many cases over time. While structural lung recovery has occurred, post-COVID immune dysfunction remains a concern. People recovering from COVID-19 are more susceptible to infections, and this vulnerability extends beyond the lungs to other vital organs.
The road to better respiratory health in India requires a multi-pronged approach—stricter environmental policies, public awareness, and enhanced healthcare interventions. Only through collective action can we mitigate the long-term damage of pollution and safeguard the health of future generations.
