An open letter to Mr Sourav Ganguly

India

healthysoch.com

New Delhi, November 01, 2019 :

Air quality should also be considered when determining suitable playing conditions

To

Mr Sourav Ganguly

President, Board of Cricket Control of India

Mumbai

Dear Sourav Ji

Delhi is hosting the first T20 international cricket match between India and Bangladesh scheduled to be played at Arun Jaitley Stadium on 3rd November, 2019.

However, the air quality in the national capital has deteriorated, especially after Diwali. Delhi has been enveloped in a thick layer of smog leading to a fall in air quality and visibility. Since the last few days, the Air Quality Index (AQI) in most parts of Delhi continues to be in the severe to very poor category with pollution levels being several times higher than the permissible limits. The AQI has crossed the 400 mark in several places in Delhi.

An AQI reading of 50 or less is generally considered as good. AQI level from 51-100 is considered satisfactory, 101-200 is moderate, 201-300 is poor 301-400 is very poor, 401 and above is considered severe.

The World Health Organization (WHO) recommends a upper limit of10 μg/ cu mm (annual mean) and 25 μg/ cu mm (24-hour mean) for fine particulate matter (PM2.5) and 20 μg/cu mm (annual mean) and 50 μg/ cu mm (24-hour mean) for coarse particulate matter (PM10) in the atmosphere.

For India, the permissible levels for PM2.5 are less than 60 and for PM10 less than 100.

The dangerously high air pollution levels are a cause of concern for us as the air pollution is a well-recognized health hazard. There is sufficient evidence in medical literature documenting the adverse effects of air pollution on the human body.

Exposure to high levels of air pollution increases the risk of lung and heart disease and may precipitate an acute potentially life-threatening event. It can exacerbate asthma or other existing lung disease such as chronic obstructive pulmonary disease (COPD). Breathing polluted air can increase blood pressure; it can also precipitate an acute cardiovascular event such as heart attack or stroke in patients with known heart disease or those who are at risk of heart disease. Patients of heart disease are also at a risk of sudden cardiac death.

AQI in the severe category not only affects those with underlying heart or lung disease, but also those who are healthy, who may experience cough or some breathlessness on exertion.

Air pollution also reduces performance of athletes and endangers their health as they are especially at a greater risk of inhaling toxic air pollutants.

Some physiological changes that occur during exercise may aggravate the harmful effects of air pollution on health. Breathing becomes faster and deeper during exercise or running. The increased respiratory minute ventilation means people inhale more of toxic pollutants. Changeover to mouth breathing from nasal breathing means the nasal filtration mechanism is bypassed. Exercise practice in polluted outdoor environment, over a period of 5 days, impairs nasal mucociliary clearance in young healthy amateur runners. (J Breath Res. 2016 Dec 21;10(4):046018). As a result of the reduced nasal mucociliary clearance, more air pollutants are absorbed instead of being cleared by the respiratory system (Br J Sports Med. 2001 Aug;35(4):214-22). Because of the increase in airflow velocity, pollutants travel much deeper into the airways, which further adds to the amount of pollutants inhaled.

Air pollution also has a significant negative effect on performance of the athletes. PM10 has a significant correlation with reduced performance in marathon runners. Under normal breathing conditions, PM10 is filtered through the nose. But, because of mouth breathing during exercise, PM10 is not removed and is instead inhaled in large amounts (Med Sci Sports Exerc. 2010 Mar;42(3):585-91).

• If the air quality index (AQI) is between 151 and 200, it is recommended that outdoor exercises should be reduced.

• If the AQI is between 201 and 300, all outdoor activities and sports should be reduced.

• If the AQI is more than 300, all outdoor exercise and activities should be avoided as much as possible.

• If the AQI crosses 400, indoor activities too should be reduced and no exercise even at home is recommended.

In 2017, I had written to the then President, Board of Cricket Control of India (BCCI) and the then President, International Cricket Council (ICC) expressing concern about the cricket match between India and Sri Lanka played in Delhi under conditions of extremely high levels of air pollution. A copy of the letter is enclosed.

It has been two years since then, yet there is no clear policy directive from the Health Ministry as well as the Sports Ministry to also include air quality as a part of weather forecast, when determining suitable playing conditions – for cricket or any other outdoor sport – just as rain and bad light determine the conditions of play.

Now that another international cricket match will be played on Sunday, 3rd November, under similarly dangerously high levels of air pollution, will the Health Ministry intervene in time?

I appeal to you to give a serious thought to the prevailing hazardous air quality in Delhi, before going ahead with the match, so that no player or volunteer or spectator suffers an ill-effect due to exposure to dangerous levels of air pollution

I also request you to consider including air pollution levels in the weather forecast for cricket matches.

Author : Dr KK Aggarwal , President, Confederation of Medical Associations of Asia and Oceania (CMAAO) and Heart Care Foundation of India (HCFI), Past President, Indian Medical Association (IMA)