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To Dr Kumar, the dramatic shift in the profiles of lung cancer patients has a clear cause: air fouled by dirty diesel exhaust fumes, construction dust, rising industrial emissions and crop burning, which has created heavy loads of harmful pollutants in the air.
Even in teenage lungs, Dr Kumar sees black deposits that would have been almost unthinkable 30 years ago.
At least 140m people in India are breathing air 10 times or more over the WHO safe limit.
A study published in The Lancet has estimated that in 2017 air pollution killed 1.24m Indians — half of them younger than 70, which lowers the country’s average life expectancy by 1.7 years.
” asks Dr Kumar, who last week launched Doctors for Clean Air to raise awareness about the impact of air pollution. It’s an emergency.” The problem is most acute in India but it is not alone.
Yet India’s 246 coal-fired power plants — most of them inefficient and highly polluting — account for 60 per cent of India’s total electricity production, with a combined capacity of 188GW, and coal is likely to dominate the country’s energy mix for decades to come.
Then every November, this heavy mix is exacerbated by millions of farmers in the states of Punjab and Haryana burning rice stubble after their harvests, a cheap way to dispose of otherwise worthless straw.
Yet Ms Narain says New Delhi has taken “very significant steps to combat pollution”, albeit often under Supreme Court pressure in the past two years.
The 10 most polluted cities in the world are all in northern India.
Top officials in prime minister Narendra Modi’s government have suggested New Delhi’s air is little dirtier than that in other major capitals such as London.