‘Construction dust can make symptoms worse for those who have chronic lung diseases’

Pulmonologist Dr Lancelot Pinto sheds light on effects of poor air quality and what early warning signs we must pay attention to. Construction dust forms a significant chunk of PM10, particulate matter that is slightly larger in size than dust in general, which is comprised of smaller particles or PM2.5

Dr Lancelot Pinto, consultant pulmonologist and epidemiologist, in a chat with mid-day, spoke about the city’s deteriorating air quality and its possible connection with the increase in lifestyle diseases, the risks linked to exposure to air pollution, and the efficacy of masks and air purifiers, among other things. 

Edited excerpts from the interview

How does air pollution impact not only respiratory health but also foetal development and overall growth in children?
We all are aware that during this time of the year when air pollution is high, people very often have a prolonged cough. Some also have a cold that lasts for a long time and children experience upper respiratory symptoms when playing outdoors. So, it is obvious that air pollution affects the respiratory system. What we are sometimes not aware of is that it can affect unborn children. Studies have shown an association between the weight of newborn babies and air pollution. The more the exposure to air pollution, the likelier a baby’s weight is to be low. It can affect growth and development as well as lung function in the long run. People who grow up in countries with high air pollution are less likely to be taller than people growing up in countries with better air quality.
 
What is the difference between construction dust and other kinds of dust?
Construction dust forms a significant chunk of PM10, particulate matter that is slightly larger in size than dust in general, which is comprised of smaller particles or PM2.5. Construction dust contributes anywhere between 40-60 per cent of the larger particles, which are not good for the upper respiratory airways and cause symptoms like wheezing and coughing. The smaller particles get into the bloodstream.
 
How does exposure to dust from construction sites affect the lungs, especially in people with pre-existing respiratory conditions?
If you look at the breakdown of air pollution based on a 2023 report by the Maharashtra Pollution Control Board (MPCB), PM10, that is the construction and demolition dust, contributes significantly to larger particles. However, when you look at PM2.5, construction dust contributes only 10-15 per cent. Vehicular emissions and other factors contribute more to PM2.5.

A change in air quality can cause symptoms to worsen for patients who have chronic lung diseases like Chronic Obstructive Pulmonary Disease or COPD, asthma or lung fibrosis. Their wheezing increases significantly and they grow breathless. They very often need either short courses of steroids, extra inhalers, antibiotics or nebulisers to settle their symptoms. So these are the people who are more sensitive to change in air quality. Very often we have seen people with chronic respiratory disease getting attacks during such points in time. If you ask pulmonologists from across the city, they will all tell you that anywhere between October to February tends to be the worst time for people with chronic respiratory diseases.

One of the leading causes of death in India is COPD.  The western world has always described this disease as being associated with smoking. But a lot of our Indian data tells us that a significant proportion of people who don’t smoke tend to get this disease as well in India. Biomass fuel used for cooking indoors is strongly associated with this. What has not been studied enough is the association of air pollution leading to the same kind of disease. A lot of people in Mumbai who have never cooked on a chulha (traditional stove) or smoked cigarettes end up developing diseases like COPD. It is not unthinkable that air pollution is causing this. So, yes, I definitely think it can cause chronic lung disease.
 
Given the rising prevalence of lifestyle diseases like cardiovascular issues and diabetes in India, how significant is the role of air pollution in accelerating these conditions and what early warning signs should individuals watch for?
I think as Indians we all know that cardiovascular disease, for example, occurs a decade earlier in India than in the rest of the world. We also know that the rates of diabetes, obesity and other lifestyle diseases are clearly rising and we know that they are associated with pollution. An early warning sign is if you have already developed high blood pressure. If there are signs that everything is not in equilibrium, you should look around and wonder whether it is the air pollution of your city that is contributing to you developing these chronic diseases.
 
Can diabetes be directly linked to air pollution?
There are studies that have shown that diabetes could also be related to air pollution. Again, through the same mechanisms, there is a spillover of fine particulate matter into the lungs and from the lungs to the bloodstream and that environment of inflammation can very often cause one to develop diabetes.
 
Are masks and air purifiers effective in reducing the health impact of construction-related air pollution? What do you recommend?
Masks can be recommended but they have to be high-quality ones. Air purifiers can be an option, but in a city like Mumbai, you need air conditioners because for the air purifier to be effective, you have to keep the doors and windows shut.

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