Respiratory problems among children have risen threefold in the city of Bangalore during the last 20 years. The rise has been directly linked with the increase in the pollution levels in the city. The study is based on correlating the respiratory ailments of 20,000 children below the age of 18 years who were treated at the Lakeside Medical Centre and Hospital. The statistical study was conducted under the supervision of H Paramesh, pediatric pulmonologist at the center and Elizabeth Cherian, coordinator of the Lakeside Education Trust.

The incidence of respiratory ailments such as asthma, back in 1979, was recorded at only nine per cent of the child population of the district. By 1999, it had risen to 29.5 per cent. "This clearly demonstrates that each year, the respiratory problems are increasing by about one per cent,' says Paramesh.

The children chosen for the study had been admitted to the general pediatric out patient ward but cases of asthma referred from outside were not included in the study. In children below the age of five years, occurrence of two episodes of wheezing or persistent cough over two weeks in the patient and those who responded well to medicines that dilate the small compartments in lungs were diagnosed as suffering from asthma. Children above the age of five and adults who had a low lung capacity as demonstrated by the amount of air exhaled and showed a 15 per cent improvement after medication were considered to be asthmatic.

To confirm that the problem was not being aggravated by the change in climate or increase in the number of pollen grains in the environment that might be leading to an allergic reaction, data on these two was collected. It was found that the climate had remained more or less the same in the 20 years under study and could not be correlated to the increase in the respiratory problems. In case of pollen grain counts, it was found that the number had actually fallen down during this period due to largescale construction being carried out in the city. While this study has been discontinued now, increase in asthma cases in rural areas are still being studied.

"Environmental pollution accounts for nearly 25 per cent of childhood deaths in India," says Paramesh. Air pollution has the major effect on the lungs as the large surface area of the lungs allows pollutants to be absorbed. Pollutants such as smoke, suspended particulate matter, sulphur dioxide, nitrogen oxides, carbon monoxides, ozone and lead can cause inflammation, airway obstruction and allergic reactions, all of which can lead to symptoms of asthma.

High levels of pollutants in the area have also been associated with heart problems and strokes. It can also lead to deformities of the chest and the back,' Paramesh adds.
More evidence The coverage of the study was extended further by analysing ailments of 6,560 other children studying in 12 schools of Bangalore. The children were categorised into three groups on the basis of the location of their respective schools in low traffic regions, in high traffic regions and in heavy traffic localities. In the heavy traffic area students belonging to low socioeconomic background were specifically chosen. The children studied ranged between the age of six and 15. Children from the low socioeconomic background and studying in the schools located in the areas having heavy traffic had the maximum number suffering from respiratory diseases and children from schools in low traffic areas had 20 per cent fewer cases of asthma as compared to the ones from heavy traffic zones.

The effect of air pollution on respiratory health was further established when a study was conducted correlating the health of 1,045 traffic police officers, the incidence of respiratory problems they suffered in comparison to 1,160 other police officers. While the percentage of traffic policepersons suffering asthma was 26.12, only 14.9 of the other policepersons suffered the ailment. The traffic policepersons also had a higher percentage of other symptoms of respiratory problems. The figures prove the correlation between exposure to pollution and respiratory ailments.

"It is not only that the number of cases have increased but it was also observed that cases of persistent asthma, severe persistent asthma and allergic rhinitis have also increased during the five years under study," says Paramesh.