Dr Radhika Banka is Consultant Pulmonology at the Hinduja Hospital, Mumbai. After her MBBS and DNB in Respiratory Medicine, she did an MRCP in the UK and a Fellow (Pleural Medicine, Oxford Pleural Unit, Oxford, UK). After completing her postgraduate residency training at PD Hinduja National Hospital, Mumbai, Dr Banka moved to the UK where she worked at the Norfolk & Norwich University Hospitals followed by at the Oxford Pleural Unit, Oxford University Hospitals, UK and relocated back to India. During her stint in the UK, she gained immense experience in multidisciplinary management of common respiratory illnesses including asthma, COPD, Interstitial Lung Diseases, Pneumonia, Lung cancer and tuberculosis. She has sub specialised in the field of respiratory intervention and pleural diseases. She has gained skills in thoracic ultrasound and has been certified with Level 2 Royal College of Radiology Thoracic Ultrasound Competence. She has gained skills in usage of direct ultrasound for pleural procedures and also has achieved competence in Endobronchial Ultrasound and other bronchoscopic interventions. She has gained expertise for ambulatory management of pleural effusions with indwelling pleural catheters, an area which is still in its nascent phase in India. She has been invited as faculty for pleural courses at the British Thoracic Society and European Respiratory Society conferences. She also worked at the frontline during the UK Covid pandemic in Oxford and was involved in recruiting patients to various Covid trials and gained immense experience in Covid management in a high dependency setting.Dr Banka has around 16 international publications and 4 national publications to her credit.
Her Achievements & Awards include:
- Travel Bursary to attend UK Mesothelioma Research Day, London, UK, 2019
- 1st prize at Annual Research Day at P. D. Hinduja National Hospital, 2016
- 2nd prize at NAPCON Conference in National Level Postgraduate Quiz, 2016
- Silver Sponsorship for the ERS Congress, European Respiratory Society, Netherlands, 2015
She is affiliated and associated with prestigious societies such as European Respiratory Society (ERS), Royal College of Physicians (RCP), British Thoracic Society (BTS), UK Pleural Society and the Indian Medical Association (IMA).
There has been a rise in the pollution levels in all the metro cities in India. And this is not just anecdotal, the AQI (Air Quality Index) has been progressively worsening.
For the consecutive 14th year, Delhi and Varanasi have been amongst the top most polluted cities.
Air pollution is a combination of the gases that are released into the atmosphere along with particulate matter.
There are gases that are released into the environment such as carbon monoxide, nitrogen dioxide, sulphur dioxide, ozone- and these are the harmful gases that are released.
These gases are released into the environment by
- Combustion of vehicular and industrial fuels- most common
- Volcanic eruptions
- Forest fires
All of these forms of combustion lead to release of these gases which lead to the harmful effects.
Particulate matter is a complex mixture which contains solid and liquid particles and these particles are suspended in the air and are invisible to the naked eye. These are ultra fine particles which are in the air.
These particles are released into the environment by
- Burning
- Residential wood burning
- Agricultural burning
- Construction
- Motor vehicles
This particulate matter is further divided based on its size. The particulate matter’s size is in micrometers. And depending on the size they are divided into
- Coarse particles- they have a particulate matter of 2.5 to 10 micrometers
- Fine particles- particulate matter size of 0.1 to 2.5 micrometers
- Ultra fine particles- particulate matter size of less that 0.1 micrometers
When these gases and particulate matter are present in the air, it affects the lungs primarily, it also affects the other organs as well.
The lungs are primarily affected because we inhale and exhale for normal living, and when we inhale, we don’t have a filter. So whatever is the air composition in the ambient air, is what you’re going to inhale.
Thus, if the air that you’re breathing has these harmful gases and fine particulate matter, it is going to enter your body. The coarse particles tend to stick to the bigger breathing tubes whereas the fine particles go upto the smaller breathing tubes. The ultra fine particles can even go beyond the lungs and get dispersed into the circulation. When that happens, all the systemic side effects of air pollution set in.
And this is how air pollution leads to detrimental effects on our body.
The Air Quality Index (AQI) helps us to know how polluted/ how good/ bad our air is. the AQI is an idea which measures 5 factors:
- Level of particulate matter
- Level of ozone
- Level of carbon monoxide
- Level of sulphur dioxide
- Level of nitrogen dioxide
Based on this, we have a grading which starts from 0 and goes upto 500.
The lesser the AQI, the cleaner the air is.
WHO recommends that a good, healthy brewing air should have an AQI of less than 50.
AQI 50- 100: ambient
AQI > 150/ 200: not ambient
AQI > 300: hazardous for breathing
There is enough data to show that lower socioeconomic strata countries have worse AQI which is because of more construction, fossil fuel burning, forest fires, etc.
There are 8 million deaths that happen every year due to air pollution, globally. Of these 4.2 million are due to ambient and outdoor air pollution, where the other half is due to indoor air pollution.
Of these 4.2 million outdoor air pollution India contributes to nearly 1.2 million of these deaths.
China is the leading country in case of air pollution related deaths.
When the AQI is more than 200, it is basically equivalent to the smoke generated by smoking 7 cigarettes. So, despite the fact that you are a non-smoker, if you are living in a city with a high AQI, it means that you are smoking upto 7 cigarettes a day, indirectly.
To make matters worse, babies that are in the womb, infants and toddlers are also smoking the same air which is equivalent to smoking 7 cigarettes a day.
Based on this logic, when you are breathing such unhealthy air, you are going to have detrimental effects because of the same on your body.
The detrimental effects are:
- Restriction in growth. Your lungs do not grow/ expand that your western counterparts would have.
- Reduction in lung capacity and function
- COPD (Chronic Obstructive Lung Disease) is a chronic respiratory disease where your air tubes get narrowed and the air sacs get distended. The most common cause for COPD worldwide is smoking. The leading cause for COPD in our country is pollution- either indoor or outdoor air pollution.
- Worsening of symptoms of COPD/ other respiratory symptoms
- Lung cancer: in India it is more common in females than males and in non smokers. This is because particulate matter has been labeled as a carcinogen, which is released in indoor pollution such as chulha burning.
- Cardiovascular effects such as heart attacks
- Recurrent upper and lower respiratory tract infections
- Shorter life spans
- In pregnant women who are heavily exposed to air pollution, the development of low birth weight babies is seen.
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