Presentation 1 Final M M Manna

EXPOSURE TO VEHICULAR POLLUTION AND RESPIRATORY HEALTH STATUS OF THE URBAN INHABITANTS OF KOLKATA : A CROSS SECTIONAL DISTRIBUTION

BY MURARI MOHAN MANNA Reg.No – 063730 of 2004-05 ROLL No. PC/ESM-0819 2009

DEPARTMENT OF APPLIED GEOLOGY & ENVIRONMENTAL SYSTEM MANAGEMENT PRESIDENCY COLLEGE, KOLKATA

Dissertation performed under the joint supervision of Dr. B.P.Chattopadhyay Scientist-E Regional Occupational Health Centre (Eastern) (ICMR), Block-DP, Sec-V, Salt Lake City Kolkata-700091 & Dr.Subrata Ghosh Reader of Physiology & Environmental System Management Presidency College Kolkata-700073

Reasons for High Air Pollution in Kolkata Predominance of 2-stroke vehicles in use. Use of adulterated fuel. Uncontrolled growth of vehicle population and poor inspection and maintenance system for in use vehicle. Poor compliance of standard. Faulty Driving techniques. Road borne dust. Age of the vehicle and it’s present roadworthiness. Open burning of garbage, running of generator sets, burning of tyres etc. Road side dust. Construction activities. Effect of deplantation. Meteorological conditions.

Major pollutants present in auto exhaust gas are • Sulphur dioxide, SO2 (primary pollutant) • Nitrogen oxides NOx (primary or secondary pollutants) • Particulate matter PM (primary and secondary pollutants) • Carbon monoxide (primary pollutant) • (volatile) organic compounds, HC (or VOCs) (primary and secondary pollutants), and photochemical oxidants, • PAN -peroxyacetyl nitrate (secondary pollutant). • Benzo-@-pyrene – a potent carcinogen

WHERE THE WORK WAS DONE & WHY?

The present work “Vehicular Pollution and Respiratory Health Status of the inhabitants of Kolkata” was done in a phased manner in the months of Feb-March 2009 in North, Central and South Kolkata with the following Aims and Objectives• To evaluate pulmonary function status of the inhabitants of Kolkata. • To assess the PFT according to their age, duration of stay and smoking habit. • To evaluate the respiratory function impairments amongst the inhabitants as a whole. • To evaluate the respiratory function impairment amongst the inhabitants according to their duration of stay in their area.

• Comparative analyses of the lung function of North, Central and South Kolkata inhabitants.

Materials and Methods

• Pulmonary function tests were carried on 113 individuals within the age range of 21-50 among both males and females. • Histories taken by questionnaire asking. • Height & Weight was measured by using Stadiometer. • Pulmonary function measured by Spirovit-SP-10 and Wrights peak flow meter. • SVC, FVC, & PEFR were recorded in standing posture with a nose clip. • FEV1, FEV1% , FEF25-75% , FEF.2-1.2l , FEF25-75% , were calculated from the same FVC tracings.

Student two tail ‘t’ tests were being performed on the inhabitants to find whether there were any significant changes due to duration of staying in that area.

Formulae Used:

BMI = Weight in Kg / (Height in Metre)2 BSA = (Height in cm)0.725 * (Weight in Kg)0.425 * 71.84 / 10000

Criteria for Determination of Obstructive Type Impairment:

Obstructive Type Impairment is determined with respect to the FEV1% value. Normal ≥ 70% Mild Obstructive 65-69.99% Moderate Obstructive 50-64.99% Severe Obstructive ≤ 49.99%

Criteria for Determination of Restrictive Type Impairment: Restrictive Type Impairment is determined with respect to the SVC For male (Predicted SVC value)

-0.024 * age + 0.044 * height in cm -

2.704 For female (Predicted SVC Value) -0.025 * age + 0.021 * height in cm – 0.003 (Predicted SVC Value – Observed SVC Value)*100/Predicted SVC Value up to 20 20.01-30

normal mild restrictive Type

Taking personal history of the subjects using standard proforma by questionnaire method &

Measurement of pulmonary function using Spirovit SP-10 Spirometer

Measurement of Height & Weight using Stadiometer for subjects. & Measurement of Peak Expiratory Flow Rates by Wright’s Peak Flow Meter

Ag e a n d a r e a w is e d is tr ib u tio n o f m a le a n d fe m a le in h a b ita n ts o f K o lk a ta

S o u th F e m a le , 20, 18% S o u t h M a le , 2 1 , 19% C e n tra l F e m a le , 17, 15%

N o rt h M a le , 2 1 , 18% N o rt h F e m a le , 16, 14% C e n t ra l M a le , 18, 16%

N o rth M a le N o rth F e m a le C e n t ra l M a le C e n t ra l F e m a le S o u t h M a le S o u t h F e m a le

Observations• The SVC, FEF25-75% and FEF75-85% values of Central Kolkata male population has been found to be statistically lower than South Kolkata males. • The SVC, FVC and FEV1 values of Central Kolkata female inhabitants have been found to be statistically lower as compared to North Kolkata females. • The PEFR value of North Kolkata female population has also been found to be significantly higher than South Kolkata females. • In general the lung volume and flow rates of South Kolkata population have been observed to be better than North Kolkata and the values of Central Kolkata population have been found to be the least.

4.5 4 3.5 3 2.5 2 1.5 1 0.5 0

F lo w r a t e s o f K o lk a ta in h a b it a n t s a r e a w is e

N o rt h K o lk a t a M a le C e n t ra l K o lk a t a M a le C e n t ra l K o lk a t a F e m a le S o u t h K o lk a t a M a le S o u t h K o lk a t a F e m a le

l/sec

N o rt h K o lk a t a F e m a le

8 7 6 5 4 3 2 1 0

N o rt h K o lk a t a M a le N o rt h K o lk a t a F e m a le C e n t ra l K o lk a t a M a le C e n t ra l K o lk a t a F e m a le S o u t h K o lk a t a M a le S o u t h K o lk a t a F e m a le F E F . 2 -1 . 2 1FmEl F 2 5 -7 5 %F E F 7 5 -8 5 %

SVC

FVC

FEV1

PEFR v alues of Kolkata inhabitants are awise 500 North Kolkata M ale

450 PEFR(l/min)

litres

L u n g v o lu m e o f K o lk a ta in h a b ita n ts a r e a w is e

North Kolkata Fem ale 400

Central Kolkata M ale

350

Central Kolkata Fem ale South K olkata Male

300

South K olkata Fem ale

250 PEFR (l/min)

L u n g v o lu m e o f K o lk a ta m a le in h a b ita n ts a c c o r d in g to d u r a tio n o f s ta y N o rth M a le 2 1 -3 0

F lo w r a te s o f K o lk a ta m a le in h a b ita n ts a c c o r d in g to d u ra tio n o f s ta y N o rth M a le 2 1 -3 0

N o rth M a le 3 1 -4 0 N o rth M a le 4 1 -5 0

5

10

C e n tra l M a le U p t o 2 0

4

C e n tra l M a le 3 1 -4 0 C e n tra l M a le 4 1 -5 0 S o u th M a le U p t o 2 0

1

S o u th M a le 2 1 -3 0 FVC

S o u th M a le 3 1 -4 0

FEV1

S o u th M a le 4 1 -5 0

N o rth M a le 4 1 -5 0

8

C e n tra l M a le U p to 2 0

6

C e n tra l M a le 2 1 -3 0 C e n tra l M a le 3 1 -4 0

4

C e n tra l M a le 4 1 -5 0

2 0

S o u th M a le U p to 2 0 S o u th M a le 2 1 -3 0 F E F .2 -1 .2 1 m l F E F 2 5 -7 5 %F E F 7 5 -8 5 % (l/s ) S o u th M a le 3 1 -4 0 (l/s ) S o u th M a le 4 1 -5 0

PEFR values of Kolkata male inhabitants according to North Male 21-30 duration of stay North Male 31-40

PEFR (l/min)

SVC

l/sec

C e n tra l M a le 2 1 -3 0

3 li tr e s 2

0

N o rth M a le 3 1 -4 0

600

North Male 41-50

500

Central Male Up to 20

400

Central Male 21-30

300

Central Male 31-40 Central Male 41-50

200

South Male Up to 20

100

South Male 21-30

0 PEFR (l/min)

South Male 31-40 South Male 41-50

D if fe r e n t flo w r a te s o f K o lk a t a m a le in h a b it a n ts a c c o r d in g to a g e d is tr ib u tio n

5 4 .5 4 3 .5 3 2 .5 2 1 .5 1 0 .5 0 F V C (l)

l/sec

N o rt h m a le 4 1 -5 0

6

C e n t ra l m a le 2 1 -3 0

4

C e n t ra l m a le 3 1 -4 0

C e ntra l m a le 4 1 -5 0 S o uth m a le 2 1 -3 0

2

C e n t ra l m a le 4 1 -5 0

S o uth m a le 3 1 -4 0

0

S o u t h m a le 2 1 -3 0

S o uth m a le 4 1 -5 0 S V C (l)

N o rt h m a le 3 1 -4 0

8

N o rth m a le 4 1 -5 0 C e ntra l m a le 2 1 -3 0 C e ntra l m a le 3 1 -4 0

N o rt h m a le 2 1 -3 0

10

N o rth m a le 2 1 -3 0 N o rth m a le 3 1 -4 0

F E V 1 (l)

F E F . 2 -1 . 2 1 mF lE F 2 5 -7 5 %F E F 7 5 -8 5 % S o u t h m a le 3 1 -4 0 (l/ s ) (l/ s ) (l/ s ) S o u t h m a le 4 1 -5 0

PEFR values of Kolkata male inhabitants according to age distribution 600 North male 21-30 North male 31-40 North male 41-50 Central male 21-30

500 PEFR (l/min)

litres

L u n g v o lu m e o f K o lk a ta m a le in h a b ita n ts a c c o rd in g to a g e d is trib u tio n

400 300

Central male 31-40 Central male 41-50 South male 21-30 South male 31-40

200 100 0

South male 41-50 PEFR (l/min)

litres

L u n g v o lu m e o f K o lk a ta fe m a le in h a b ita n ts a c c o r d in g to a g e d is tr ib u tio n 3.5 3

N o rt h fe m a le 2 1 -3 0

2.5 2

N o rt h fe m a le 4 1 -5 0

1.5 1

C e n t ra l fe m a le 3 1 -4 0

0.5 0

S o u t h fe m a le 2 1 -3 0

N o rt h fe m a le 3 1 -4 0 C e n t ra l fe m a le 2 1 -3 0 C e n t ra l fe m a le 4 1 -5 0

S V C (l)

F V C (l)

F E V 1 (l)

S o u t h fe m a le 3 1 -4 0 S o u t h fe m a le 4 1 -5 0

Percentage (%)

FEV 1% of smokers compared to non-smokers 88

North Kolkata NonSmoker

86

North Kolkata Smoker

84

Central Kolkata NonSmoker

82 80

Central Kolkata Smoker

78 76

South Kolkata NonSmoker

74 FEV1%

South Kolkata Smoker

PEFR values of the smokers compared to that of the non-smokers North Kolkata NonSmoker

PEFR (l/min)

500

North Kolkata Smoker

450

Central Kolkata NonSmoker

400

Central Kolkata Smoker

350 300

South Kolkata NonSmoker

250 PEFR (l/min)

South Kolkata Smoker

Respiratory Impairments •

Obstructive disease characterized by an increase in resistance to airflow owing to partial or completes obstruction at any level, from the trachea and larger bronchi to the terminal and respiratory bronchioles also may be due to mucous occurrence in the trachea.

•

Restrictive disease characterized by reduced expansion of lung parenchyma, with decreased total lung capacity.

•

Each type of impairments was found less among female subjects.

•

Among the total 113 subjects analysed 8.85% of the subjects were detected to be with pulmonary impairments.

•

The highest impairment have been noticed among the Central Kolkata inhabitants with 11.43% followed by North Kolkata (10.81%) and South Kolkata (8.85%)

•

Obstructive Impairments were detected more than the restrictive or combined type.

Mean R P M in am b ien t K o lkata air in the m o n th s of F eb M arch

400 S hyam baz ar

300

Moulali Gariahat

200 100

S tandard 2003-042004-052005-062006-07

250

micrograms/cu.metre

micrograms/cu.metre

M ean S P M in am b ien t K o lkata a ir in th e m o n th s o f F eb M arch

Shyam baz ar

150

Moulali

100

Gariahat

50

Standard

0

2003-04 2004-05 2005-06 2006-07

S hyam baz ar 332

347

281

254

Shyam baz ar 175

Moulali

354

352

291

254

Moulali

Gariahat

324

325

255

169

S tandard

200

200

200

200

M e a n N2Oin a m b ie n t K o lk a ta a ir in th e m o n th s o f F e b -M a r c h

196

163

121

151.5

198.14 166.28

129

Gariahat

169

183.37 144.25

72

Standard

100

100

100

100

Ambie nt air quality of kolkata during the Study work (20th Fe b-20th M arch'09) 300

100 S hya m b a za r M o ula li G a ria ha t S ta nd a rd

50 0 2 0 0 3 -0 42 0 0 4 -0 52 0 0 5 -0 62 0 0 6 -0 7 S hya m b a za r 6 7 76 M o ula li

7 8 .8 4 7 0 .3 3 5 6 .5 5 9 4 .1

micrograms / cu.metre

micrograms/cu.metre

200

250 200

Observed

150

S tandard

100 50 0 SPM

RPM

NOX

7 7 .3 4 9 3 .2 5

G a ria ha t

6 9 .5

8 6 .9

73

5 6 .3

S ta nd a rd

80

80

80

80

Data collected from WBPCB

Summary ►

The ambient air quality of Central Kolkata has been found to be most polluting followed by north and South Kolkata.

►

This relates well with the Lung Function data of lower PFT values in Central Kolkata than North and South.

►

The gradual decrement of the lung volumes and flow rates were found as age increases.

►

The Lung volume and the flow rates of the individuals shows gradient decrement in values with the increase of duration of stay in the region.

►

Among the inhabitants obstructive type of impairments are more compared to restrictive and combined type.

How to Protect the people from the agony?

The elasticity of the pulmonary tissue must be increased, so that the ballooning activity of the lung improves – ►

Clear the airways to remove the mucus settled in the air passage.

►

Lung compliance and lung surfactant must be improved and this may be done partially by regular breathing habits.

►

Exercise regularly as regular exercise can improve the overall strength and endurance and strengthen the respiratory muscles.

►

Eat healthy foods with excess of Vit-C as this can help to maintain the body strength due to anti-oxidative property.

►

Drink plenty of water as water flushes out the toxins from the body.

►

Avoid smoking, in addition to quitting smoking, it's important to avoid places where others smoke. Passive smoke may contribute to further lung damage.

Recommendation

►

Phase out all vehicles older than ten to fifteen years.

►

Two and three wheelers should have four stroke engines with catalytic converter and fuelled by Biodiesel, LPG or CNG.

►

Use of adulterated fuel to be stopped completely.

►

Diesel fuel with lower sulfur content can help to reduce emissions.

►

Bharat Stage IV norms should be enforced on all vehicles.

►

Smooth movement of vehicles to be facilitated by construction of new flyover, bridges, improvement of road condition and width of the roads.

►

Diversion of heavy goods traffic in peak hours.

►

Use of Public Vehicles over private cars.

►

Plantation at the city road side to be encouraged more.