Air pollution continued to spike to unhealthy levels in 2021, and New Delhi continues to be the world’s most polluted capital city for the fourth consecutive year, according to the World Air Quality Report, prepared by Swiss organisation IQAir. The index listed 35 Indian cities with the worst air quality tag for 2021 with Rajasthan’s Bhiwadi topping the list followed closely by Uttar Pradesh’s Ghaziabad.

Fourteen other cities in Uttar Pradesh, including the capital Lucknow, Ghaziabad, Kanpur, Meerut, Agra, Amroha, Jaunpur, Varanasi, Noida and Greater Noida, also featured on the list. Notably, these exceeded the WHO PM2.5 limit of 0-5 µg/m³ by over 10-15 times.

The report is based on PM2.5 air quality data from 6,475 cities in 117 countries, regions, and territories around the world. The data used to create this report was generated by tens of thousands of regulatory and low-cost air quality monitoring stations operated by governments, non-profit organizations, research institutions, educational facilities, companies, and citizen scientists around the world, noted the report.

Air pollution affects lungs (Source: Getty Images/Thinkstock)

The report also revealed that not a single country managed to meet the WHO’s air quality standard in 2021, and smog even rebounded in some regions after a Covid-related dip in numbers. WHO’s guidelines of September 2021 warrant good air quality with PM2.5 concentration level between 0-5 g/m3. However, all these cities have ultra-fine particulate matter (PM)2.5 levels at least 10 times more than the approved limits.

Here’s the full list of the top 50 cities

Bhiwadi, India
Ghaziabad, India
Hotan, China
Delhi, India
Jaunpur, India
Faisalbad, Pakistan
Noida, India
Bahawalpur, Pakistan
Peshawar, Pakistan
Bagpat, India
Hisar, India
Faridabad, India
Greater Noida, India
Rohtak, India
Lahore, Pakistan
Lucknow, India
Jind, India
Gurugram, India
Kashgar, China
Kanpur, India
Muzaffarpur, India
Varanasi, India
Sahiwal, Pakistan
Bulandshahr, India
Meerut, India
Kadaura, India
Patna, India
Dhaka, Bangladesh
N’Djamena, Chad
Dharuhera, India
Durgapur, India
Karagandy, Kazakhstan
Amroha, India
Sreepur, Bangladesh
Charkhi Dadri, India
Agra, India
Yamuna Nagar, India
Muzaffarnagar, India
Alampur, India
Shchuchinsk, Kazakhstan
Ludhiana, India
Sonipat, India
Kurukshetra, India
Burabay, Kazakhstan
Jodhpur, India
Kostanay, Kazakhstan
Singrauli, India
Ankleshwar, India
Igdir, Turkey
Ambala, India

Why is air pollution a cause for concern?

According to the report’s executive summary, air pollution is now considered to be the world’s largest environmental health threat, accounting for seven million deaths around the world every year. Air pollution causes and aggravates many diseases, ranging from asthma to cancer, lung illnesses and heart disease. The estimated daily economic cost of air pollution has been figured at $8 billion (USD), or 3 to 4 per cent of the gross world product.

pollution Air pollution affects one and all (Source: Getty Images/Thinkstock)

We are increasingly seeing a number of patients develop an acute allergy reaction to these air pollutants resulting in worsening of the existing respiratory illnesses such as asthma or allergies, said Dr Aditya Agrawal, pulmonologist, Bhatia Hospital Mumbai.  “A large number of patients who have been exposed to such pollutants present with breathlessness and/or cough actually turn out to have hypersensitivity pneumonitis which is potentially reversible if detected & treated early. However if the patient presents late it may even result in lung fibrosis,” he told

In India, major sources of air pollution include vehicular emissions, power generation, industrial waste, biomass combustion for cooking, the construction sector, and episodic events like crop burning, noted the report. The UN Intergovernmental Panel on Climate Change concluded in its 2021 report stated that, in addition to slowing the speed of global warming, curbing the use of fossil fuels would help improve air quality and public health.

According to the report,

What can governments do?

*Decrease air pollution emissions
*Pass legislation to incentivize the use of clean air vehicles for personal and industrial use.
*Invest in renewable energy sources.
*Provide financial incentives, such as trade-in programs, to limit the use of internal combustion engines.
*Provide subsidies to encourage the use of battery and human-powered transportation methods.
*Expand public transportation and power with clean and renewable energy sources.
*Build additional infrastructure to encourage pedestrian and bicycle traffic.
*Strengthen and enforce emission limits for vehicles and industry.
*Adopt new air quality standards based on the 2021 World Health Organization

Air quality guidelines

*Implement forest management strategies to limit wildfires.
*Ban agricultural and biomass burning.
*Develop innovative civic strategies for improving air quality.

Expand the air quality monitoring framework

*Increase the number of public air quality monitoring stations.
*Provide incentives to non-governmental organizations and individuals who set up their own air quality monitoring stations

Limit your exposure to air pollution

*Reduce activities outdoors when air quality is unhealthy.
*Wear a KN95, N95, or FFP2 respirator mask when air quality is unhealthy.
*Prevent polluted outdoor air from entering homes and workspaces by closing doors and windows and setting A/C systems to recirculation mode.

*Use air filters and air purification systems where possible. “The best method to keep your indoor air pollution under control is to minimise clutter, use of carpets, control humidity and avoid aerosols,” said Dr Agrawal.
*Follow real-time and forecasted air quality reports to stay informed and safe.
*When possible, heat homes and cook with gas or electric rather than wood burning stoves.
*When outdoor air quality improves, even briefly, ventilate indoor spaces by opening windows and setting A/C systems back to fresh air intake.

Some recommendations to combat the menace

*You can use either artificial or natural purifiers at home. Plants like aloe vera, bamboo palm, golden pothos, peace lily, English ivy, etc. are natural purifiers which can be used as houseplants.
*Do breathing exercises to strengthen the lungs and help them combat the pollutants.
*It is proved that foods rich in vitamin E and C are great to reduce the effects of air pollution.
*Use air masks during the days of high pollution.
*Fluids help in detoxification of the body, so drink plenty of fluids.

How to lower air pollution footprint

*Choose cleaner, greener modes of transport such as walking, biking, and riding public transportation.
*Lower personal energy consumption.
*Reduce waste by recycling, upcycling, and purchasing less.
*Help to raise air pollution awareness in your community.

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