Polluted Air Cuts Years Off Lives of Millions in India, Study Finds

COLOMBO, Sri Lanka — More than half of India’s population lives in places with such polluted air that each person loses an average of 3.2 years in life expectancy, according to a recent study by researchers from the University of Chicago, Yale and Harvard.

Altogether, 660 million Indians could lose 2.1 billion years as a result of air pollution at enormous cost to the country’s economy, the researchers found.

“This study demonstrates that air pollution retards growth by causing people to die prematurely,” said Michael Greenstone, an author of the study and the director of the Energy Policy Institute at the University of Chicago.

A World Health Organization study last year found that 13 of the 20 most polluted cities in the world are in India, with New Delhi’s air the world’s worst. But India’s government has made economic development its priority and has announced its intention to double the country’s use of coal over the next five years, which is likely to worsen the country’s air pollution.

But a growing array of studies has shown that the costs of India’s poor air are substantial. For instance, research has shown that India’s air pollution problems may cut agricultural production by a third. That might explain why wheat and rice yields in India have begun to level off or even drop in some states after decades of growth.

The authors of the recent study say that India should improve its monitoring of air quality, institute a system of civil monetary penalties for excessive polluters and adopt a trading system for pollution rights.

For years, Indians have seemed largely unaware of the country’s pollution woes. But a concerted campaign over the past year by Indian media outlets is beginning to change that.

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Delhi Wakes Up to an Air Pollution Problem It Cannot Ignore

NEW DELHI — For years, this sprawling city on the Yamuna River had the dirtiest air in the world, but few who lived here seemed conscious of the problem or worried about its consequences.

Now, suddenly, that has begun to change. Some among New Delhi’s Indian and foreign elites have started to wear the white surgical masks so common in Beijing. The United States Embassy purchased 1,800 high-end air purifiers in recent months for staff members’ homes, with many other major embassies following suit.

Some embassies, including Norway’s, have begun telling diplomats with children to reconsider moving to the city, and officials have quietly reported a surge in diplomats choosing to curtail their tours. Indian companies have begun ordering filtration systems for their office buildings.

“My business has just taken off,” said Barun Aggarwal, director of BreatheEasy, a Delhi-based air filtration company. “It started in the diplomatic community, but it’s spread to the high-level Indian community, too.”

The increased awareness of the depth of India’s air problems even led Indian diplomats, who had long expressed little interest in climate and pollution discussions with United States officials, to suddenly ask the Americans for help in cleaning India’s air late last year, according to participants in the talks. So when President Obama left Delhi after a visit last month, he could point to a series of pollution agreements, including one to bring the United States system for measuring pollution levels to many Indian cities and another to help study ways to reduce exhaust from trucks, a major source of urban pollution.

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250,000 Could Die Early From Breathing in China’s Cities, Study Finds

Improved data has made it possible to better calculate how many people could die early deaths in China as a result of air pollution, researchers say. The results are grim.

According to a fresh analysis conducted by Peking University and the activist group Greenpeace, more than 250,000 people living in the country’s major cities could die prematurely as the result of the Middle Kingdom’s smog-ridden skies.

In what the researchers describe as a first, the study is based on data reflecting levels of small particulate matter known as PM 2.5 that the government began more widely reporting for certain cities in 2013.

The study looked at China’s major cities, specifically the country’s 31 provincial capitals. It concluded that an average of 90 out of every 100,000 people living in such cities could die prematurely following prolonged exposure to the levels of particulate matter pollution recorded in 2013.

Still, Peking University professor Pan Xiaochuan, who led the study, said that at least by certain indicators, the country’s air doesn’t consist of quite the same sickening morass of pollutants it used to be. For example, he said, levels of sulfur dioxide – which can cause various respiratory problems, particularly for the asthmatic –  have dropped in cities.

“On the whole, air quality has had some improvement,” he said, though he said given limited PM 2.5 data availability for past years, it wasn’t possible to determine whether such pollutants – which experts say are most damaging to human health – had intensified or waned.

China’s government last year declared a “war” on pollution, a year after releasing more ambitious targets for PM2.5 reduction in several regions. For example, in Beijing — whose high levels of air pollution recently prompted the mayor himself to call the city “unlivable” — concentrations are targeted for around 25% reduction by 2017. The city is surrounded by some of the city’s highest levels of haze, thanks in part to its proximity to Hebei province, home to seven cities with the country’s dirtiest skies.

Greenpeace staffer Fang Yuan said he is “cautiously optimistic” that such targets can be reached, adding that Beijing’s PM2.5 levels dropped 4% compared with last year, thanks in part to stricter traffic controls and efforts to reduce coal consumption. However, he said, even if the city reduces PM2.5 levels to meet national targets by 2017, such levels will still be too high for recommended breathing levels.

– Te-Ping Chen

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U.S. hospitals make strides in cutting superbug infections: CDC report

U.S. hospitals have made strides in cutting the rates of hospital-acquired infections caused by the deadly superbugs MRSA and C. difficile, but officials say more work is needed to reduce infections, which affect 1 in 25 patients each day.

In a report released by the U.S. Centers for Disease Control and Prevention on Wednesday, blood infections caused by central line catheters — tubes inserted into a large vein to deliver medicine to critically ill patients — fell 46% between 2008 and 2013.

The report also showed a 19% drop in surgery-related infections associated with 10 procedures between 2008 and 2013. Procedures on that list include heart and colon surgeries and hysterectomies.

“Hospitals have made real progress to reduce some types of healthcare-associated infections — it can be done,” CDC Director Dr. Thomas Frieden said a statement.

U.S. hospitals made strides in controlling infections from some of the most worrisome pathogens. In the report, bloodstream infections caused by Methicillin-resistant Staphylococcus aureus or MRSA, a drug-resistant strain of staph bacteria, fell by 8% between 2011 and 2013.

U.S. hospitals also showed a 10% drop in C. difficile infections, an opportunistic diarrheal infection that preys on sick patients whose protective gut bacteria has been destroyed by antibiotics, allowing invaders such as C. difficile to flourish.

Despite the progress, the report said more work is needed to reduce infection rates.

Between 2008 and 2013, hospitals showed a 6% increase in urinary tract infections associated with the use of urinary catheters, it said.

Such infections can occur when these devices are inserted improperly or left in a patient too long, allowing germs to infect the bladder and kidneys. Preliminary figures for 2014 suggest the rates of these infections are beginning to drop, the CDC said.

Frieden said the findings suggest that every hospital can make improvements in reducing infection rates. The key is having a rigorous infection control plan, he said. Preventing such infections could help reduce demand for antibiotics, helping to slow a rise of antibiotic-resistant pathogens.

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Scientists Trace Infection’s Spread Through a U.S. City

In the latter half of 2014, Americans were transfixed by a handful of Ebola cases in the country. Meanwhile, another disease generates much less hype but, on these shores, does much more damage. Sometimes called a “silent epidemic,” Meticillin-resistantStaphylococcus aureus (MRSA) has been spreading through U.S. cities at a clip the Ebola virus could never hope to match.

MRSA is typically thought of as a scourge of hospitals. In recent years, however, U.S. hospitals have managed to reduce rates of the infection; according to the CDC, serious hospital-acquired infections fell by more than 50 percent between 2005 and 2011. But another type of the disease, known as community-associated MRSA, has been circulating beyond the hospital walls. It’s become a major public health problem.

MRSA often manifests as a mild skin infection, but its more severe forms can lead to pneumonia, comas and death. (For a vivid image of how serious a skin abscess can get, look here. Or, if you’re squeamish, definitely don’t.) According to a USA Today investigation, MRSA sickens hundreds of thousands of otherwise healthy Americans every year — many more than the official government statistics catch.

While hospitals can set policies to fight the disease — from hand hygiene to isolation of patients — what happens when it spreads throughout the unruly environment of an entire city?

To answer this question, scientists at Argonne National Laboratory and the University of Chicago studied data from 2001 to 2010, when Chicago was going through a CA-MRSAepidemic. They examined the day-to-day patterns of about three million (anonymous) people, moving to and from 1.2 million locations, such as households, schools and workplaces. (They used aggregate data from the census and time use surveys, which gave them what’s called a “synthetic population.” That is, they did not have information on real individuals, but rather on “agents,” or avatars of actual Chicago residents.)

“The whole point of our investigation and project was to model the process of how CA-MRSA could possibly have developed and taken over,” says Charles Macal, an Argonne engineer and the paper’s lead author. “What were the sources? What were the dynamics?” He adds, “It’s not necessarily just an urban disease, but it’s affecting most urban areas.”

Similar models have been formulated for diseases such as malaria, HIV/AIDS, tuberculosis and, most frequently, influenza. But, Macal says, “I like to think of it as unique, because it’s so focused on cities and the fine-grained space and time.” What’s more, each disease spreads in a different way. MRSA is transmitted through skin-to-skin contact, as well as shared items such as towels and razors, so the researchers included jails and gyms in the model.

What makes this disease particularly challenging is that many people are “colonized” with the bacteria but not infected. Like Typhoid Mary, a carrier may experience no symptoms but can pass the bacteria on to others, who may be more vulnerable to infection. Carriers are also at greater risk of becoming infected themselves, as when an abrasion allows the bacteria to enter the blood.

Based on national and local data, the researchers estimated the number of colonized people in Chicago. They also made assumptions about the amount of physical contact in various settings, as well as the likelihood of cuts, injuries and abrasions. Sports, for example, are considered high-risk.

In Chicago, the disease originated in inner-city neighborhoods (perhaps because of closer living quarters), and spread in a more diffuse pattern to other areas of the city. Over the course of the decade, each person had an average of 39 estimated “contact events” per day. There were about 116,000 new infections and over two million colonizations. (This does not mean that two million people were colonized; in some cases the same person may have been colonized multiple times.) Of the new colonizations, 98.6 percent resulted from contact with someone who was merely colonized, not infected. And the authors determined that the most common site of transmission was households — responsible for 65 percent of new colonizations.

The authors argue for a major overhaul in urban health policy to address the disease. As of now, efforts focus on treating infections and on screening in healthcare settings. But given the spread of CA-MRSA in our daily habitats, more expansive measures may be needed. Because colonizations are such a risk factor for infection, Macal believes we need to shift our attention to that early phase.

One possibility is to identify colonized people by swabbing inside their noses and try to de-colonize them with a regimen of antibiotic ointment and antibacterial soap. This approach has been implemented successfully in the Netherlands. The question is how to prioritize which people to test outside healthcare facilities (while avoiding the overuse of antibiotics and antibacterials).

“One has to weigh what’s practical,” says Diane Lauderdale, a professor at the University of Chicago who is also involved in the research. “If you screened everyone in the country and treated them, you would have a big impact. But that’s not feasible.” There have also been cases in which infections seem to occur in the absence of nasal colonization, which complicates matters.

The authors are currently working on follow-up research that would plug different interventions into the model, such as testing and de-colonizing all members of an infected patient’s household. The model certainly has limitations — it relies on assumptions (about the amount of physical contact, for instance) that are impossible to verify. But if the assumptions are reasonable, this method can provide an otherwise unavailable glimpse of how hypothetical scenarios might play out.

“You can test at a system level an intervention that you really can’t do practically,” says Lauderdale. “You would need to in effect randomize whole cities … and that would be absolutely impossible.”

The Science of Cities column is made possible with the support of the John D. and Catherine T. MacArthur Foundation.

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Inside Beijing’s airpocalypse – a city made ‘almost uninhabitable’ by pollution

The scene could be straight from a science-fiction film: a vision of everyday life, but with one jarring difference that makes you realise you’re on another planet, or in a distant future era.

A sports class is in full swing on the outskirts of Beijing. Herds of children charge after a football on an artificial pitch, criss-crossed with colourful markings and illuminated in high definition by the glare of bright white floodlights. It all seems normal enough – except for the fact that this familiar playground scene is taking place beneath a gigantic inflatable dome.

“It’s a bit of a change having to go through an airlock on the way to class,” says Travis Washko, director of sports at the British School of Beijing. “But the kids love it, and parents can now rest assured their children are playing in a safe environment.”

The reason for the dome becomes apparent when you step outside. A grey blanket hangs in the sky, swamping the surroundings in a de-saturated haze and almost obscuring the buildings across the street. A red flag hangs above the school’s main entrance to warn it’s a no-go day: stay indoors at all costs. The airpocalypse has arrived.

Beijing’s air quality has long been acause of concern, but the effects of its extreme levels of pollution on daily life can now be seen in physical changes to the architecture of the city. Buildings and spaces are being reconfigured and daily routines modified to allow normal life to go on beneath the toxic shroud.

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