Publication Type: Journal articles

Leveraging Existing Cohorts to Study Health Effects of Air Pollution on Cardiometabolic Disorders: India Global Environmental and Occupational Health Hub

Abstract

Air pollution is a growing public health concern in developing countries and poses a huge epidemiological burden. Despite the growing awareness of ill effects of air pollution, the evidence linking air pollution and health effects is sparse. This requires environmental exposure scientist and public health researchers to work more cohesively to generate evidence on health impacts of air pollution in developing countries for policy advocacy. In the Global Environmental and Occupational Health (GEOHealth) Program, we aim to build exposure assessment model to estimate ambient air pollution exposure at a very fine resolution which can be linked with health outcomes leveraging well-phenotyped cohorts which have information on geolocation of households of study participants. We aim to address how air pollution interacts with meteorological and weather parameters and other aspects of the urban environment, occupational classification, and socioeconomic status, to affect cardiometabolic risk factors and disease outcomes. This will help us generate evidence for cardiovascular health impacts of ambient air pollution in India needed for necessary policy advocacy. The other exploratory aims are to explore mediatory role of the epigenetic mechanisms (DNA methylation) and vitamin D exposure in determining the association between air pollution exposure and cardiovascular health outcomes. Other components of the GEOHealth program include building capacity and strengthening the skills of public health researchers in India through variety of training programs and international collaborations. This will help generate research capacity to address environmental and occupational health research questions in India. The expertise that we bring together in GEOHealth hub are public health, clinical epidemiology, environmental exposure science, statistical modeling, and policy advocacy.

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Rethinking India’s Energy Policy

Introduction

An energy supply approach is inadequate to India’s energy requirements at a time when multiple objectives need to be addressed. The state of play in energy supply and demand is examined, and the recovery of an older tradition of attention to energy demand patterns in addition to energy supply is argued for. The gains from an explicit attention to the fact that India has to address multiple and simultaneous objectives in shaping energy policymaking are laid out, and emerging methodologies to serve this goal are discussed. Shifts in governance patterns are a necessary part of transitioning to a broader, and more development-focused approach to energy policy.

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Exposure to Particulate Matter Is Associated With Elevated Blood Pressure and Incident Hypertension in Urban India

Abstract

Ambient air pollution, specifically particulate matter of diameter <2.5 μm, is reportedly associated with cardiovascular disease risk. However, evidence linking particulate matter of diameter <2.5 μm and blood pressure (BP) is largely from cross-sectional studies and from settings with lower concentrations of particulate matter of diameter <2.5 μm, with exposures not accounting for myriad time-varying and other factors such as built environment. This study aimed to study the association between long- and short-term ambient particulate matter of diameter <2.5 μm exposure from a hybrid spatiotemporal model at 1-km×1-km spatial resolution with longitudinally measured systolic and diastolic BP and incident hypertension in 5342 participants from urban Delhi, India, within an ongoing representative urban adult cohort study. Median annual and monthly exposure at baseline was 92.1 μg/m3 (interquartile range, 87.6–95.7) and 82.4 μg/m3 (interquartile range, 68.4–107.0), respectively. We observed higher average systolic BP (1.77 mm Hg [95% CI, 0.97–2.56] and 3.33 mm Hg [95% CI, 1.12–5.52]) per interquartile range differences in monthly and annual exposures, respectively, after adjusting for covariates. Additionally, interquartile range differences in long-term exposures of 1, 1.5, and 2 years increased the risk of incident hypertension by 1.53× (95% CI, 1.19–1.96), 1.59× (95% CI, 1.31–1.92), and 1.16× (95% CI, 0.95–1.43), respectively. Observed effects were larger in individuals with higher waist-hip ratios. Our data strongly support a temporal association between high levels of ambient air pollution, higher systolic BP, and incident hypertension. Given that high BP is an important risk factor of cardiovascular disease, reducing ambient air pollution is likely to have meaningful clinical and public health benefits.

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Climate laws help reduce emissions

Introduction

Over the last two decades, many countries have passed laws addressing climate change and related areas. Research now shows that these laws make a difference to emission outcomes, but the pathways of impact require further research.

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China and India in the Himalayan climate crisis

Summary

This article describes an unprecedented threat to large parts of India and China emanating from receding glaciers in the Himalaya. It posits that this threat will require these countries to redefine their security calculus by moving beyond military and economic fixations to incorporate an ecological dimension. It suggests four actions – two regional and two international – that could help them set the tone for cooperation in coming decades.

Some of these actions may seem unlikely against the backdrop of stark geopolitical competition today but this article points out that the building blocks for action have already been put in place: research networks for glacial science; regional electricity grids; international finance institutions jointly led by India and China; and joint negotiating positions that define international climate negotiations. The art of diplomacy will vest in transforming these incipient actions into transformative projects that not only define the bilateral relationship for the rest of the century, but make a dent in staving off the worst of a Himalayan disaster.

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Emissions: World has four times the work or one-third of the time

Summary

A decade of insufficient political action on climate change means that nations must now do four times the work — or do the same in one-third of the time — to comply with the climate pact they made in Paris. The authors’ conclusions are based on a synthesis of all ten editions of the Emissions Gap Report produced by the United Nations Environment Programme (UNEP). Each year for the past ten years, this report has examined the difference (the ‘gap’) between what countries have pledged to do individually to reduce greenhouse-gas emissions, and what they need to do collectively to meet agreed temperature goals. The co-authors find that the required emissions cuts from 2020 to 2030 are now more than 7% per year on average for the 1.5 °C temperature limit set in Paris and 3% for 2°C. Had serious climate action begun in 2010, the cuts required to meet the emissions levels for 2 °C would have been 2% per year, on average. The time window for halving global emissions has also narrowed: today it is 10 years for 1.5 °C and 25 years for 2°C; it would have been 30 years in 2010. Some countries, regions, cities and businesses have promised or implemented urgently needed climate action, however. For example, 76 countries or regions and 14 subnational regions or states have set or even implemented net-zero emissions goals. Closing the gap will require scaling up these few success stories and mirroring them with progress in every sector.

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Litigating Climate Claims in India

Summary

Jacqueline Peel and Jolene Lin’s informative assessment of climate litigation in the Global South is a vital and timely contribution to the growing literature on the issue. It relies on a definition of climate litigation that allows the authors to draw on a much larger set of cases from the Global South by including cases in which climate concerns are “at the periphery.” This essay examines climate litigation in India. Although the term “global warming” started appearing in Indian environmental judgments in the 1990s, climate litigation in India is of relatively recent provenance, and with a few exceptions, climate concerns are peripheral to other, more mainstream environmental issues. Peel and Lin analyze five Indian cases as part of their Global South docket; Ghosh expands this set by including fourteen more cases that she believes fit their article’s chosen definitional ambit. She classifies these cases into four categories based on the use of climate language—reference to climate change, greenhouse gas (GHG) emissions, or the international negotiations—in the courts’ judgment. Drawing from case law analysis and Indian environmental litigation, Ghosh makes observations about what one can interpret from the current set of climate cases, and predicts that while conditions are favorable for climate litigation in India to grow, in the near future climate claims are likely to remain peripheral issues.

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The Disruptive Politics of Renewable Energy

Introduction

The expansion of renewable energy (RE) within India’s electricity system is not a technical question alone. It is also an inherently political struggle between powerful incumbents and disruptive challengers, with destabilising consequences for existing institutional forms and power structures. The existing system is held in place by a supporting configuration of technology, politics and institutions. If RE is to substantially displace fossil fuels, the existing configuration will have to give way to a new such configuration that supports RE. This article explains the existing political and institutional underpinnings of the current electricity system, and discusses the forces that hold them in place and what it will take to shake these loose. In doing so, it seeks to make two points to two discrete audiences. First, to electricity and energy practitioners, it suggests that looking at the spread of RE only through a technical lens is highly incomplete; the likelihood, speed and impact of RE will be determined by political and institutional factors as well. Second, to broader analysts of India’s economy and politics, it suggests that disruptions in Indian energy are highly likely to also imply disruptive politics and economics; any story of Indian political economy in the coming decade is incomplete without an exploration of shifts driven by changes in electricity politics.

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The Price of Power: The political economy of electricity trade and hydropower development in eastern South Asia

Summary

This article frames the political economy of electricity trade and hydropower development in eastern South Asia. It distils and analyzes four crucial variables in this regard: the health of distribution companies in India; the role of hydropower in India’s ambitious turn to renewable energy; Bangladesh’s power crisis and import dependency; and the governance of regional electricity trading arrangements. It argues that progress in both electricity trade and hydropower development in the region will be incremental in the next decade, hindered by mixed demand signals and the turbulence of geopolitics.

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The impact of air pollution on deaths, disease burden, and life expectancy across the states of India: the Global Burden of Disease Study 2017

Summary

Background

 

Air pollution is a major planetary health risk, with India estimated to have some of the worst levels globally. To inform action at subnational levels in India, we estimated the exposure to air pollution and its impact on deaths, disease burden, and life expectancy in every state of India in 2017.
 

Methods

 

We estimated exposure to air pollution, including ambient particulate matter pollution, defined as the annual average gridded concentration of PM2.5, and household air pollution, defined as percentage of households using solid cooking fuels and the corresponding exposure to PM2.5, across the states of India using accessible data from multiple sources as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017. The states were categorised into three Socio-demographic Index (SDI) levels as calculated by GBD 2017 on the basis of lag-distributed per-capita income, mean education in people aged 15 years or older, and total fertility rate in people younger than 25 years. We estimated deaths and disability-adjusted life-years (DALYs) attributable to air pollution exposure, on the basis of exposure–response relationships from the published literature, as assessed in GBD 2017; the proportion of total global air pollution DALYs in India; and what the life expectancy would have been in each state of India if air pollution levels had been less than the minimum level causing health loss.
 

Findings

 

The annual population-weighted mean exposure to ambient particulate matter PM2·5 in India was 89·9 μg/m3 (95% uncertainty interval [UI] 67·0–112·0) in 2017. Most states, and 76·8% of the population of India, were exposed to annual population-weighted mean PM2·5 greater than 40 μg/m3, which is the limit recommended by the National Ambient Air Quality Standards in India. Delhi had the highest annual population-weighted mean PM2·5 in 2017, followed by Uttar Pradesh, Bihar, and Haryana in north India, all with mean values greater than 125 μg/m3. The proportion of population using solid fuels in India was 55·5% (54·8–56·2) in 2017, which exceeded 75% in the low SDI states of Bihar, Jharkhand, and Odisha. 1·24 million (1·09–1·39) deaths in India in 2017, which were 12·5% of the total deaths, were attributable to air pollution, including 0·67 million (0·55–0·79) from ambient particulate matter pollution and 0·48 million (0·39–0·58) from household air pollution. Of these deaths attributable to air pollution, 51·4% were in people younger than 70 years. India contributed 18·1% of the global population but had 26·2% of the global air pollution DALYs in 2017. The ambient particulate matter pollution DALY rate was highest in the north Indian states of Uttar Pradesh, Haryana, Delhi, Punjab, and Rajasthan, spread across the three SDI state groups, and the household air pollution DALY rate was highest in the low SDI states of Chhattisgarh, Rajasthan, Madhya Pradesh, and Assam in north and northeast India. We estimated that if the air pollution level in India were less than the minimum causing health loss, the average life expectancy in 2017 would have been higher by 1·7 years (1·6–1·9), with this increase exceeding 2 years in the north Indian states of Rajasthan, Uttar Pradesh, and Haryana.
 

Interpretation

 

India has disproportionately high mortality and disease burden due to air pollution. This burden is generally highest in the low SDI states of north India. Reducing the substantial avoidable deaths and disease burden from this major environmental risk is dependent on rapid deployment of effective multisectoral policies throughout India that are commensurate with the magnitude of air pollution in each state.
 

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