Condemned to Inhale Poison
Severe air pollution, with its associated health risks, has now become a grim and recurring feature of life in Delhi-NCR. What was once an occasional smog episode has evolved into a chronic crisis — one that now defines the rhythm of the region’s seasons as predictably as the monsoon or the winter chill.
By Dr Amitav Banerjee
Due to consistently poor air quality, people tend to stay indoors more often and lead increasingly sedentary lives. Those who dare to venture out risk respiratory distress and irritation, while those who remain indoors face a slower assault from physical inactivity, obesity, and metabolic disorders. In short, citizens find themselves trapped between the devil and the deep blue sea — whether they choose to step outside, or stay within, the outcome is harmful either way.
A rapidly expanding economy and rising individual affluence are fuelling unrestrained urban growth. Skyscrapers, expressways, and sprawling suburbs symbolise progress, yet this very progress has come at the expense of foresight and environmental prudence. The city’s unplanned expansion, poor zoning practices, and haphazard land use reflect an economic model that values speed over sustainability. The environmental chaos emerging from unregulated construction, poor public transport planning, and unchecked vehicle ownership has created a vicious cycle where the quest for mobility and comfort undermines public health.
The result is an imminent trade-off between air quality and economic expansion. If public health is to be protected, hard policy choices must be made — choices that may slow growth in the short term but promise healthier, more liveable cities in the long run. The recurring poor Air Quality Index (AQI) readings across NCR and other parts of the country stem from a combination of causes. Some are natural, dictated by meteorology, but an increasing number arise from human negligence, weak regulation, and misplaced priorities. The tragedy is that while we cannot control the weather, we have consistently failed to control ourselves.
Meteorological Factors
Each year, Delhi breathes easy for a brief window — during the monsoon months of July to September. During this time, the sky clears, the wind picks up, and the rain sweeps away pollutants, restoring a fleeting illusion of normalcy. But this reprieve is deceptive and short-lived. As soon as the monsoon withdraws, a toxic haze begins to return, thickening over the region by late October and persisting until February.
The meteorological reasons are well understood but relentless. During winter, the phenomenon of temperature inversion traps cold, dense air near the ground beneath a layer of warmer air above. This inversion acts like a lid, preventing pollutants from dispersing vertically. Compounded by weak wind speeds, the trapped pollutants stagnate near the surface, forming a grey-brown shroud that refuses to lift.
To this natural trap, human activity adds further fuel. Each October and November, farmers in Punjab and Haryana burn leftover paddy stubble to prepare fields for the next sowing season. The resulting smoke, borne by north-westerly winds, travels hundreds of kilometres into the NCR, mingling with urban emissions and choking the city. Satellite images at this time of year show vast stretches of northern India glowing with fire — a grim testament to a practice that continues despite bans and alternatives.
As if this were not enough, the festival of Diwali, meant to celebrate light and life, has increasingly become an annual assault on the atmosphere. The rampant and often illegal bursting of firecrackers, despite Supreme Court restrictions, pushes particulate levels into the “severe” range within hours. The ensuing days bring a deadly calm: biomass and waste burning intensify as the temperature drops, vehicles crawl through traffic jams, and the smoke finds nowhere to go. What follows is a predictable descent into hazardous air quality that lingers well into the new year.
Constant Contributors Throughout the Year
Even outside the infamous “pollution season”, Delhi’s air remains among the dirtiest in the world. This is because of constant, year-round sources of emissions that rarely pause or slow down.
Vehicular emissions remain the single largest and most persistent source. As affluence grows, car ownership has become synonymous with status, convenience, and modernity. Yet, this car-centric culture has filled the roads beyond capacity, slowing traffic to a crawl and setting off a vicious cycle where idling engines emit even more pollutants.
Industrial pollution adds another relentless layer to the problem. The NCR region is surrounded by industrial clusters, many operating with outdated technology and weak oversight. These emit enormous quantities of suspended particulate matter and gaseous pollutants. In the unorganised sector, compliance is nearly non-existent, and enforcement remains patchy at best.
Then comes the dust — from construction sites, unpaved roads, and constant infrastructure expansion. Every new flyover, metro corridor, and apartment complex adds clouds of dust to an already overloaded atmosphere. Despite regulations mandating dust barriers and sprinkling, implementation remains half-hearted, turning every construction project into a slow-motion contributor to public ill-health.
Open waste burning, though illegal, continues unabated. In the absence of efficient municipal waste management systems, garbage piles are routinely set ablaze in empty plots or by roadside sweepers. The resulting toxic smoke adds not only particulate matter but also dioxins and heavy metals into the air — a silent, invisible poison.
Together, these sources ensure that Delhi’s lungs never get a break. Even when the weather is kind, the emissions are unrelenting.
Delhi’s Post-Diwali Report Card
The weeks following Diwali offer an unflinching snapshot of this environmental catastrophe. AQI levels routinely breach 400 and even touch 500 in certain hotspots, placing them in the “hazardous” category. At these levels, even healthy individuals experience coughing, eye irritation, and breathlessness, while the elderly and those with chronic diseases suffer exacerbated symptoms.
This year, the capital experienced consecutive days of “severe” air, with the index peaking at 428 soon after the festival. The major pollutants — PM2.5 and PM10 — were several times higher than the permissible limits. Calm wind conditions prevented dispersion, trapping the haze over the city like a dome. The authorities invoked Stage III of the Graded Response Action Plan (GRAP), ordering stricter restrictions on construction, waste burning, and vehicular movement. Schools up to Class V were closed or shifted to online mode to protect children from the worst exposure.
Despite these measures, the relief was marginal. Air quality varied sharply between neighbourhoods — some recording readings around 257 (Severe), while others crossed 500 (Hazardous). The pattern underscores how deeply entrenched the crisis has become, and how Delhi’s geography and population density amplify its effects. Each winter, the city becomes an urban gas chamber, its residents struggling to breathe and its skyline disappearing behind a toxic veil.
Impact on Public Health
The health implications of air pollution are staggering and extend far beyond respiratory illness. Airborne toxins do not merely affect the lungs — they infiltrate every organ system, accelerating ageing, disease, and death. Fine particulate matter (PM2.5) is especially lethal; its microscopic size allows it to bypass the body’s natural defences, reaching the bloodstream and vital organs.
In the short term, exposure leads to eye and throat irritation, coughing, wheezing, headaches, nausea, and fatigue. For people with asthma or bronchitis, these symptoms can turn into full-blown medical emergencies. Hospitals across Delhi report surges in outpatient visits and admissions every winter, as pollution levels rise.
Over the long term, the damage compounds silently. Air pollution is now recognised as one of the leading risk factors for heart attacks, strokes, hypertension, and heart failure. It contributes to the development of chronic obstructive pulmonary disease (COPD), emphysema, and lung cancer. Emerging research shows that tiny particulate pollutants can cross the blood-brain barrier, increasing the risk of dementia, Alzheimer’s, and Parkinson’s disease.
Among pregnant women, exposure has been linked to low birth weight, preterm delivery, and impaired neurological development in children. Other studies suggest that air pollution can lead to toxicity in the liver and kidneys as the body struggles to filter out inhaled contaminants. In essence, no organ system is spared.
Vulnerable Populations
While pollution affects all, certain groups suffer disproportionately. Children breathe faster and take in more air relative to their body weight, making them more vulnerable. The elderly and those with pre-existing heart or lung diseases face exacerbated risks, while pregnant women experience added complications due to the susceptibility of the foetus. Outdoor workers — traffic police, construction labourers, delivery personnel — face near-constant exposure with little protection.
Those from lower socioeconomic backgrounds suffer the double disadvantage of high exposure and limited access to healthcare. Without air purifiers or climate-controlled homes, they bear the harshest brunt of the crisis. Air pollution thus becomes not only a health issue but also a question of environmental justice and social equity.
What Is the Way Out?
Years of policy inertia and market complacency have brought India to this crossroads. Successive governments, wary of slowing economic growth, have hesitated to impose tough environmental regulations. But the time for half-measures has passed — public health can no longer be the price of prosperity.
The automobile sector remains one of the biggest contributors to the problem. Valued at $240 billion and expected to exceed $300 billion by 2026, it accounts for 6% of India’s GDP and employs nearly 30 million people. Slowing this industry might seem economically costly, but without reducing vehicular emissions, no meaningful progress can be achieved. The gradual scaling up of electric vehicles (EVs) offers a path forward. Investment in EV infrastructure — charging points, battery recycling, and domestic manufacturing — can cushion the transition while protecting jobs.
Equally crucial is rethinking urban mobility. Cities must become walkable, with pedestrian-friendly pavements and dedicated cycling tracks. This will not only reduce congestion and emissions but also promote physical fitness. Public transport systems must be reliable, affordable, and aspirational enough for all classes to use. As Gustavo Petro, the former Mayor of Bogotá, wisely remarked, “A developed country is not a place where the poor have cars. It’s where the rich use public transport.” India’s fast-growing cities would do well to reflect on that wisdom.
Finally, addressing stubble burning is vital. Farmers must be empowered with sustainable alternatives such as in-situ residue management through the Happy Seeder, which allows sowing without burning the previous crop. Ex-situ options like composting, converting straw into biofuel or biogas, mushroom cultivation, and using residue in paper or animal feed industries can turn waste into wealth. Government support, farmer incentives, and awareness campaigns are essential to make this shift viable and enduring.
Clean air must be treated as a fundamental right — as vital as food, water, or shelter. The health of our citizens, our children, and our future depends on how seriously we act now.
(The author, a renowned epidemiologist, is currently Professor Emeritus at Dr D Y Patil Medical College, Pune, India. He is included in Stanford University’s list of the world’s top 2% scientists for three consecutive years. He is the Founder-Chairperson of the Universal Health Organization, a registered watchdog on public health issues — https://uho.org.in. He is also the author of the book “COVID-19 Pandemic: A Third Eye.”)