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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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 Environment (Regulation in India: Design, Capacity, Performance, Hart Publishing)

Summary

Environmental health across indicators in India is rapidly declining, and the state’s failure to regulate sources of, and causes for, environmental degradation has never been more apparent. The reasons for this failure are numerous and complex: conflicting interests in limited resources; inadequate regulatory capacity to design and enforce the law effectively; lack of interagency coordination; and environmental issues not being politically salient enough to trump competing policy interests and priorities. As the country grapples with an increasing array of environmental problems, it is an important moment in time to reflect on the nature and quality of the environmental regulation that is in place.

 

This chapter analyses the design, implementation, and enforcement of two environmental laws passed by the Parliament – the Water (Prevention and Control of Pollution) Act 1974 and the Air (Prevention and Control of Pollution) Act 1981 – with a view to understanding the factors that contribute to the failure of pollution regulation in India. Section I analyses the regulatory landscape of pollution control in India, and examines the role of the main statutory environmental regulators, the Pollution Control Boards, in implementing and enforcing the Water Act and the Air Act. Section II explores the administrative and judicial tools available for the enforcement of pollution regulation. Section III outlines critical issues affecting the efficacy of pollution regulation in India. Finally the chapter proposes the way forward through incremental changes in the regulatory landscape which could lead to significant gains.

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The Ecological Costs of Doing Business: Environment, Energy and Climate Change

Summary

What perspective did the BJP government bring to the link between environment, energy and climate change on the one hand and development on the other, and what consequent actions has it taken? In this essay published in ‘Re-forming India: The Nation Today’, Penguin India, the authors assess the government’s actions in areas of environment, energy and climate change with a view to interpreting its track record.

Focusing less on environmental outcomes and more on the changes in direction introduced by the government, Dubash and Ghosh explore four themes. First, they examine the government’s focus on the ‘cost of doing business’ and ask whether reducing this cost has come at an environmental price. Second, they analyse cases in which an environment and energy agenda was driven by political imperatives, such as around energy access or Ganga rejuvenation. Third, they explore whether and how the government has addressed the emergent big picture environment and energy questions that will shape India’s future, beyond immediate regulatory changes. Finally, they examine its diplomacy in the areas of climate change and energy, and reflect on what the accumulated record implies in terms of India’s environmental governance.

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Indian Environmental Law: Key Concepts and Principles

Summary

For more than three decades now, the Indian courts have delivered far-reaching judgments on a range of significant environmental matters. In their effort to adjudicate complex disputes with serious environmental repercussions, involving the interplay of multiple social, economic and political factors, the courts have developed a framework of environmental rights and legal principles, which now forms an integral part of Indian environmental jurisprudence. The judiciary invokes this framework creatively to identify constitutional, statutory and common law obligations of public and private actors to protect the environment, and to enforce the performance of related duties. There is, however, limited in-depth study of these crucial rights and principles in existing legal literature.

Indian Environmental Law: Key Concepts and Principles fills this gap through its critical analysis of the evolution of this environmental legal framework in India. It studies the origins of environmental rights, substantive and procedural, and the four most significant legal principles— principle of sustainable development, polluter pays principle, precautionary principle and the public trust doctrine—and elaborates how Indian courts have defined, interpreted and applied them across a range of contexts.

As environmental litigation and legal adjudication struggle to respond to worsening environmental quality in the country, conceptual clarity about the content, application and limitations of environmental rights and legal principles is crucial for the improvement of environmental governance. With chapters written by Saptarishi Bandopadhyay, Lovleen Bhullar, Shibani Ghosh, Dhvani Mehta and Lavanya Rajamani, this book explores the judicial reasoning and underlying assumptions in landmark judgments of the Supreme Court, the High Courts and the National Green Tribunal, and aims to provide the reader with a comprehensive understanding of the framework of rights and principles.

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Indian Environmental Law: Key Concepts and Principles has been reviewed by The Hindu and Down to Earth. To learn more about this book, read the chapter descriptions below.

Chapter 1: The Judiciary and the Right to Environment in India: Past, Present and Future
By Lovleen Bhullar
Bhullar discusses the evolution of the right to environment as a substantive right in Indian environmental law. Drawing from judgments of different fora, she identifies the linkages made by the Indian judiciary between environmental protection and the Constitution, specifically Articles 21, 47, 48A and 51A(g). She finds the courts to have adopted a predominantly anthropocentric approach to environmental protection, with occasional recognition of the right of the environment. While the path of evolution of the right to environment, and its realization, has been problematic, Bhullar argues that the inherent imprecision of the right, while unfortunate in some cases, allows courts the flexibility to adapt their directions to a given fact situation, often in the interest of the environment.

Chapter 2: Procedural Environmental Rights in Indian Law
By Shibani Ghosh
Ghosh examines three procedural environmental rights – the right to information, the right to public participation, and the right to access to justice – in detail, and identifies loopholes and limitations in the adjudication of each right. In particular, the chapter refers to relevant provisions of the Environment (Protection) Act 1986, the EIA Notification 2006, the Right to Information Act 2005, the Forest Rights Act 2006, and the National Green Tribunal Act 2010. Ghosh concludes that despite statutory expression of procedural environmental rights, there is no room for complacency as these three rights are routinely curtailed and denied.

Chapter 3: Sustainable Development and Indian Environmental Jurisprudence
By Saptarishi Bandhopadhyay
Bandhopadhyay critically analyses the principle of sustainable development, as interpreted and applied by the Indian judiciary. The chapter provides a succinct description of the historical evolution of the principle internationally. It analyses the Vellore judgement to distill the Indian Supreme Court’s definition of the principle, and examines the Narmada judgement to reveal how the Supreme Court has ‘instrumentally harnessed the vagueness inherent in sustainable development’. Bandopadhyay concludes that while the interpretive flexibility of the principle diminishes the extent to which litigants and lawyers can expect the Court to justify its determinations, this flexibility is not necessarily undesirable, as it leaves the field of legal argumentation and political struggle relatively open.

Chapter 4: The Polluter Pays Principle: Scope and Limits of Judicial Decisions
By Lovleen Bhullar
Bhullar discusses the origin of the polluter pays principle in Indian judicial decisions, and poses five questions to understand how the Indian courts have operationalised it – who is the polluter; how and when is the application of the principle triggered; how is the loss assessed and compensation determined; what does the polluter pay; and finally, what are the limits of the principle. She concludes that while the flexible way in which the Indian judiciary has operationalised the principle has allowed different aspects of the principle to be fleshed out in each case, it has also led to courts speaking in contradictory voices.

Chapter 5: The Precautionary Principle
By Lavanya Rajamani
Rajamani explores the conceptual underpinnings of the precautionary principle, tracing its definition, interpretation and legal status in international law, before turning to Indian law. She argues that the application of the principle in the Vellore judgement is at odds with the Supreme Court’s own definition of the principle. The chapter discusses this lack of clarity in the Court’s engagement with the principle, and the blurring of lines between two distinct legal principles – precaution and prevention. Rajamani concludes that the invocation of the indigenous version of the precautionary principle may be instrumentally useful in arriving at environmentally favourable judicial outcomes, but it does not bode well for the development of a clear line of jurisprudence.

Chapter 6: Public Trust Doctrine in Indian Environmental Law
By Shibani Ghosh
Ghosh traces the growth and application of the public trust doctrine, and explains why it is difficult to identify how the doctrine could lend predictability to decision-making regarding public trust properties. She explains the contours of the doctrine as inferred from Indian judicial pronouncements – the source of the doctrine, properties that are held in public trust, and principles that are applied by courts while implementing the doctrine. Rather than insisting on its redundancy, she argues that it is desirable to make the doctrine more relevant, and proposes ways in which it may afford greater protection to natural resources held in trust.

Chapter 7: The Judicial Implementation of Environmental Law in India
By Dhvani Mehta
Mehta provides an overview of the compliance and enforcement mechanisms available to environmental regulatory authorities in India, and then, with references to case law (many of which rely on the four legal principles in this book), illustrates the implementation mechanisms developed by the Indian courts. She concludes that judicial implementation mechanisms have had mixed success. Apart from external factors, there are certain internal weaknesses that impact the implementation process: courts have been inconsistent while deploying implementation mechanisms, their orders require more robust legal reasoning and they need to integrate better with the existing regulatory framework.

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Public Trust Doctrine in Indian Environmental Law

Summary

In this chapter published in Indian Environmental Law: Key Concepts and Principles, Ghosh traces the growth and application of the public trust doctrine, and explains why it is difficult to identify how the doctrine could lend predictability to decision-making regarding public trust properties. She explains the contours of the doctrine as inferred from Indian judicial pronouncements – the source of the doctrine, properties that are held in public trust, and principles that are applied by courts while implementing the doctrine. Rather than insisting on its redundancy, she argues that it is desirable to make the doctrine more relevant, and proposes ways in which it may afford greater protection to natural resources held in trust.

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Procedural Environmental Rights in Indian Law

Summary

In this chapter published in Indian Environmental Law: Key Concepts and Principles, Ghosh examines three procedural environmental rights – the right to information, the right to public participation, and the right to access to justice – in detail, and identifies loopholes and limitations in the adjudication of each right. In particular, the chapter refers to relevant provisions of the Environment (Protection) Act 1986, the EIA Notification 2006, the Right to Information Act 2005, the Forest Rights Act 2006, and the National Green Tribunal Act 2010. Ghosh concludes that despite statutory expression of procedural environmental rights, there is no room for complacency as these three rights are routinely curtailed and denied.

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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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