Even after two decades of air quality management, air pollution is the fifth largest killer in India. Some of the worst cases of outdoor air pollution in the world are found in Indian cities, even in medium- and small-sized cities.

There are 5,000-odd towns and cities in India. But the air quality monitoring grid tracks just 243; the most recent official data is available for 175 cities only. The most recently published official national database is from 2012. The urban majority do not have access to real time pollution data.

Yet the monitored cities do represent a sizeable urban population. And the available data paints a scary picture. As many as 78 percent of the cities do not meet the clean air standard for tiny particles smaller than 10 micron (one-fifth the width of human hair) in size. Such particles go very deep inside the lung and trigger respiratory and cardiac ailments, cancer and a host of other problems. More than half of the cities have recorded ‘critical’ particulate levels. This also means that close to half the urban population breathes air laced with particulates.

The number and variety of pollutants makes this a daunting problem to understand and remedy. Even before India could reduce the risk from toxic particles, levels of newer pollutants have begun to spiral. Nitrogen oxide, which causes serious respiratory disease, was not considered a problem in India even a decade ago. Now, 13 big cities exceed the standards for this pollutant in their ambient air – it has hit the critical level in several cities.

The magnitude of the multiple-risk burden is known only in a few mega cities, like Delhi, which has an improved air quality monitoring system to track a bigger basket of pollutants. Ozone, hitherto an unknown danger, now exceeds standards frequently in Delhi (ground-level ozone is a pollutant, not to be confused with the ozone layer higher up in the atmosphere). Benzene is carcinogenic, PAHs (polycyclic aromatic hydrocarbons) are mutagenic and can cause congenital anomalies; these can be lethal even in small doses. They are included in the lethal cocktail that hangs in our urban air.

There are also distinct regional trends. Particulate levels remain persistently high in the northern region. Major hotspots are Delhi, Ghaziabad, Raipur and Yamunanagar, where the levels reach four to five times the accepted standards. Lucknow, Kanpur, Amritsar, Faridabad and Ludhiana are among the highly polluted cities. Even in the eastern region 78 percent of the cities monitored in West Bengal and 100 percent in Jharakhand (a coal belt) are critically polluted. Western India has also witnessed rapid growth in pollution in most urban centres.

The particulate levels in southern cities are deceptively lower. However, 46 percent of the cities in the south exceed the standards. Coastal cities like Chennai are buffeted by sea breeze; their pollution peaks are comparatively lower. As the influence of dust is lower in this region, most of the particulates are from combustion sources and are toxic. Even if the levels in this region are lower than the peaks observed in other regions, these are several times higher than the WHO guidelines.

In Chennai, for instance, particulate levels are about three times higher than the WHO’s final guidelines; the annual average levels are rising by 30 percent. The lower pollution peaks in the southern region must not breed complacence as WHO’s estimates show that most health effects occur at lower levels, even before the peak is reached. Early and stringent action can give immense health benefits.

In all cities, however, winter months are the worst. Cool and calm weather conditions trap the pollutants, keeping pollution levels elevated all through, often leading to severe smog. During the 2014 winter in Delhi, the PM2.5 levels have remained two to four times the standards; they rise to 8-10 times the standards. Across the world, when pollution peaks to severe levels for a few consecutive days, city governments clamp down emergency measures. Beijing, for instance, shuts down primary schools, takes off 80 percent government vehicles from roads, personal vehicles are allowed only on alternate days, public transport service is expanded, barbeque and fireworks are banned.

Exposure monitoring has to compliment ambient monitoring in order to refine pollution control measures and to reduce health risk, because pollution levels (especially those linked with traffic) vary widely within the city.

Public health challenge
The grim warning came in 2012 when WHO’s Global Burden of Disease (GBD) report showed that air pollution causes about 6,20,000 premature deaths in India each year. More than 18 million healthy life years are lost due to illnesses related to air pollution. It showed how air pollution is linked with ischemic heart disease, stroke, chronic obstructive pulmonary disease, asthma, lung cancer and acute lower respiratory tract infection. Other studies have shown its links with pre-term birth, low birth weight, diabetes and hypertension, among others. The GBD report said ischemic heart disease causes as much as half of all premature deaths; stroke causes 26 percent of the total premature deaths. The rest is dominated by respiratory conditions and cancer.

Several studies of impressive scale, carried out across the world, provide overwhelming evidence. There cannot be a stronger reason for aggressive action to cut the toxic risks from ambient air pollution. Public policy needs to act on this. It doesn’t make sense to reinvent the wheel, and wait for more conclusive evidence from Indian studies (though Indian cities do provide evidence). This establishes how the elderly, the poor and children are particularly vulnerable.

Some chilling evidence emerged from an epidemiological study on children in Delhi. The central pollution control board (CPCB) and the Chittaranjan national cancer institute of Kolkata covered 11,628 school-going children from 36 schools in different parts of Delhi and in different seasons; the results were published in 2012. Every third child was found to have reduced lung function. Sputum of Delhi’s children contains four times more iron-laden macrophages than those from cleaner environs, indicating pulmonary haemorrhage. The levels of these biomarkers in children have been found to be higher in areas with high PM10 levels.

For more evidence, try the cancer registry of the Indian council of medical research; it shows how lung cancer is increasing in India. Air pollution is one of the key risk factors. Doctors from Delhi hospitals like the AIIMS have observed a sharp increase in lung cancer incidences even among non-smokers. WHO’s International Agency on Research on Cancer classifies outdoor air pollution as class I carcinogen. There is no doubt that air pollution is among the top killers today. This requires proactive policy response and action.

The saga of lost gains
It is not that Indian cities are not doing anything to control air pollution. Air pollution management has taken root; it has even shown results. Delhi is the most notable example. Several forces joined in this effort – judicial interventions, civil society campaigns, media pressure and government action. It catalysed the first generation action in Delhi during 1999 and 2002.

A slew of changes followed: Delhi got rid of its polluting industry, shut down two coal-based power plants, deployed one of the largest public transport systems based on cleaner natural gas, capped the age of commercial vehicles and improved vehicular emissions standards. It resulted in stabilising Delhi’s air pollution trend between 2003 and 2008. Thereafter, pollution levels increased because the first generation of actions were not followed up. The gains in air quality got swamped by the growing pollution from the explosive increase in traffic volume.

Nearly all big cities that have initiated pollution control measures show respite and stabilisation, followed by a rising trend. Kolkata and Bengaluru are two examples. What this proves is: the battle against air pollution cannot be won by playing catch-up. It requires a leap ahead.

Vehicles, a special problem
Emissions from vehicles are a significant contribution to human exposure. Pollution concentration in our breath is three to four times higher than what it is in the ambient air. People residing 500 metres from roads are the most exposed to vehicular fumes, says the Health Effects Institute of the US. About 55 percent of Delhi’s population lives within that zone; so it runs a serious risk of exposure. Studies conducted in Delhi by researchers of University of California in Berkeley show PM2.5 concentration inside vehicles while travelling in Delhi can be 1.5 times the standards. The ultrafine short peaks can be as high as 16 times the daily limits.

Vehicular fume is also extremely toxic. This can be further aggravated by rapid increase in use of diesel in cars and expansion of freight traffic. In June 2012 the WHO has reclassified diesel emissions as class I carcinogen by putting it in the same bracket as tobacco smoking for its strong link with lung cancer. Diesel also has short-term respiratory and cardiac effect. International studies, including one carried out in London, show diesel emissions have worsened the lung function in people with asthma. And the quality of diesel in India is poor.

From the public health perspective, direct exposure to air pollution across the city is critical. The Centre for Science and Environment (CSE) has individually monitored the amount of pollution that citizens are exposed to on a daily basis, and has come up with some startling results. Daily personal exposure to toxic air is significantly higher than the background ambient air pollution that is monitored by the Delhi pollution control committee.
Individuals are exposed to highest pollution levels during night and early morning. Those who go for a morning walk in the ‘fresh air’ for health reasons actually breathe in air thick and heavy with particulate pollution. Asthma patients experience the highest hourly average PM2.5 exposure levels during morning walk – several times higher than the background levels.

Getting the principles right
Even though India has set the national ambient air quality standards for the critical pollutants, these are not enforced. The global best practice – as illustrated by the US Clean Air Act – is that non-compliance with air quality targets can provoke sanctions against state governments, such as a cut in federal grants. Civil society is empowered under the law to sue a non-compliant city government.

In India, however, the Air Act does not lay out a compliance strategy for meeting urban air quality targets, nor does it define punitive action against violators. While non-compliant industrial units are liable for air pollution control action, there is no mechanism to hold the city liable and accountable.Urban air quality management is still very weak in India. The ability to assess urban air pollution and its sources to frame composite plan for mitigation has not matured enough and sparse effort is limited to a few mega cities.

Mobility crisis
New power plants or industrial units are not coming up inside our cities. The tailpipes of vehicles, however, are multiplying. Air pollution is expected to worsen with increased dependence on personal vehicles and erosion of pollution neutral modes. IIT-Kanpur estimates that between 2011 and 2030, daily travel trips will double; the share of public transport trips might fall from 26 percent to 16 percent; the share of personal vehicle trips might increase from 34 percent to 51 percent; and peak traffic might crawl at 8 km per hour, compared to 16 kmph right now. Cities are losing battle of car-bulge.

Studies by the Asian Development Bank show if a city like Bengaluru succeeds in increasing bus ridership share to 80 percent, it can save equal to 21 percent of fuel consumed in a business-as-usual scenario. This can lead to 23 percent reduction in total vehicles; it will free up road space equivalent to taking off nearly 4,18,210 cars. This can bring down particulate matter in the ambient air by 29 percent, and nitrogen oxide by 6 percent.

Unfortunately, most cities are losing their inherited strength in high usage of sustainable modes. The loss is most stark in Delhi, where buses catered to 60 percent of the transport needs in 2000, but have now dropped to 40 percent. If you add the two modes of personal transport – cars and two-wheelers – the rate of personal motorisation in several Indian cities far exceeds that of the cities in the west.

Growing automobile dependence is making enormous demand on road space as well as on public space for parking and causing enormous pollution per person. This is not sustainable. Delhi has not been able to solve its problem of pollution and congestion by building more roads and flyovers for cars. Delhi is most privileged to have more than 21 percent of its geographical area under road space. Delhi has built the maximum roads and 70 flyovers. Yet its roads are gridlocked. Peak hour traffic has even slumped to below 15 kmph. Cars and two-wheelers in Delhi occupy 90 percent of the road space, though they meet less than 20 percent of the travel demand.

More roads are not the answer. The limited urban space used for parking can have other, more important uses. Newly registered cars increase the demand for land for parking each year. This requires land equivalent to 310 football fields.

Cities need to improve the capacity of roads to carry people by influencing travel choices. Even during peak hours, a car carries only 1.5 persons as opposed to a bus carrying at least 40-50 people. Two cars occupy same space as one bus, but carry 20 times less people. If this trend continues, the capacity of roads to carry more people will reduce drastically. The planning challenge is to improve modes of mass transit and the people-carrying capacity of roads, as per the principle of the national urban transport policy that states ‘plan for people, not vehicles’.

Cars are the congestion
The rapid bus corridor (BRT) in Delhi was the first experiment to reallocate road space according to road users. It challenged the conventional wisdom of increasing road space to improve the carrying capacity of ever increasing volume of motorised traffic. On the contrary, it followed the principle of augmenting people-carrying capacity of roads, by segregating spaces to fast-track the sustainable modes including buses, walking and cycling, and to take them out of congestion and make commuting for the majority convenient. Cars cannot be taken out of congestion because cars are the congestion.

Even though some cities have begun to formalise, expand and reform public transport – buses as well as metro – these are still seen as hardware fixes, as gizmos, not as a seamless public transport service with a high level of service quality to make its usage attractive. Bus ridership has begun to pick up again in Delhi. The Delhi transport corporation (DTC) ridership increased by as much as 25 percent between 2010 and 2012. But the majority of the bus users are captive users; they don’t use the bus by choice. It is the quality of public transport service that can attract people with travel choices and consider public transport as an option to running a car.

Air pollution cannot be addressed without restraining the rapid proliferation of vehicles in cities. Rich cities round the world now restrain car usage; they resort to fiscal, regulatory and urban design interventions. Copenhagen and Amsterdam are two shining examples. They provide dedicated infrastructure for walking and cycling; they reduce the width of motorable roads inside the city, slowing down vehicle speed with design and regulations. These rich cities have been able to increase the share of bicycle ridership to 38 percent and 35 percent, respectively. This is several times higher than the share of car ridership in Delhi, which is 14 percent.

Car restraint
London and Stockholm have used fiscal strategies of congestion charges, road pricing and high parking charges to restrain car use. The most dramatic action comes from a city in the grip of massive motorisation: Beijing. After annual car sales hit 8,00,000 per year in 2010, the city government clamped down aggressively to cap the car sale quota to 30 percent of the total cars sold in 2010. The fixed numbers are now offered on lottery. The importance of this move comes from the staggering latent demand for new cars in Beijing – as high as 15,15,449 per year. If this demand is supplied, the pressure will decimate the city.

Indian cities refuse to learn, even though the policy principles have changed. The national urban transport policy emphasises planning for people, and not for vehicles. Yet it has not made any impact on the investment policy of the government. The erstwhile JnNURM programme of the earlier UPA-2 government had spent more than 73 percent of its transport sector investments in building road and flyovers. The same blunders are being repeated.

Evidence? Try the Delhi decongestion plan of the union ministry of urban development. It tables some grand, smart promises: walking and cycling tracks, high parking charges, multi-modal integration and 2,000 new buses. It also cleverly packs in elevated roads and tunnel roads – ostensibly under integrated transportation plan – to decongest Delhi. The plan has not explained even once what decongestion target means and what are they hoping to achieve. It is the budgetary allocation that establishes the policy priority among the menu of action suggested. As much as 73 percent of the allocation of '41,000 crore has been set aside for elevated and tunnel roads.
 
Signpost
The sensible thing is to let the writing on the wall frame the national air quality plan, to push cities to have their own implementation strategy to meet the clean air standards – and in a time-bound manner. The government needs to expand and strengthen an effective air quality monitoring system to inform people about the air quality on a daily basis. This will help them take precaution and enable pollution emergency measures to bring down the deadly pollution peaks during pollution episodes.

Vehicular pollution, one of the primary sources of direct exposure in cities, will require a quick leapfrog to much cleaner Euro VI emissions standards for vehicles and fuels and effective strategies to weed out grossly polluting vehicles from roads. Simultaneously, cities need to adopt design of cities and roads to make them safer, more walkable, and friendlier towards public transport. They will have to ramp up public transport provisions and restrain vehicle usage with fiscal disincentives and parking restraints. This is essential for a big turnaround. This change requires scale, the right principles and public support.

Anumita Roychowdhury is executive director of research and advocacy at the Centre for Science and Environment.