Exposure to Vehicular Pollution and Respiratory Health Status of the Inhabitants of Kolkata a Cross...

8/9/2019 Exposure to Vehicular Pollution and Respiratory Health Status of the Inhabitants of Kolkata a Cross Sectional

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EXPOSURE TO VEHICULAR

POLLUTION AND RESPIRATORY

HEALTH STATUS OF

THE URBAN INHABITANTS OF

KOLKATA: A CROSS SECTIONAL

DISTRIBUTION

A THESIS SUBMITTED AS A PARTIAL FULFILLMENT OF

THE REQUIREMENTS FOR THE DEGREE OF

MASTER OF SCIENCE

IN

ENVIRONMENTAL SYSTEM MANAGEMENT

OF PRESIDENCY COLLEGE, KOLKATA

(AUTONOMOUS)

UNDER THE UNIVERSITY OF CALCUTTA

2009

Submitted By

MURARI MOHAN MANNA

Registration No. 063730 of 2004-05

DEPARTMENT OF APPLIED GEOLOGY &

ENVIRONMENTAL SYSTEM MANAGEMENT

PRESIDENCY COLLEGE, KOLKATA


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ACKNOWLEDGEMENT

I feel immense pleasure in expressing my sense of gratitude and gratefulness to

Dr.H.N.Bhattacharya, Professor and Departmental Head, Department of Applied

Geology and Environmental System Management, Presidency College, Kolkata, for kind

permission to allow me to perform this project work in the department and giving

valuable suggestions to complete the entire study.

I convey my regards, sincere gratitude and gratefulness to Dr. Saradindra

Chakraborty, Departmental coordinator and Reader, Department of Environmental

System Management, Presidency College, Kolkata for his overall guidance and

constructive criticism to perform this project work and giving the valuable suggestions inentire study.

I am thankful to the Director, National Institute of occupational health, (NIOH),

Ahmedabad and officer in charge, Regional Occupational Health Centre (Eastern),

Kolkata for providing infrastructural facility and according permission for carrying out

the study in the esteemed institute.

I convey my great regards, sincere gratitude and gratefulness to Dr. B.P.

Chattopadhyay, Scientist Emeritus of Respiratory Physiology Division Regional

Occupational Health Centre (E), Indian Council of Medical Research (ICMR), Block-DP

Sec-V, Salt Lake, and Kolkata-700091 for his guidance, supervision, realistic criticism

and valuable suggestion of this project. I am really indebted to you Sir.

I also convey my regards, sincere gratitude and gratefulness to Dr. Subrata Ghosh,

Reader, Department of physiology & Environmental System Management, Presidency

College, Kolkata for his guidance to perform this project work and giving the valuable

suggestion in the entire study.


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I express my deepest gratitude to Mubaraq Hossain (Research Scholar), Sk. Jane

Alam (Technician) and Tilak Kanti Dasgupta (Lab Assisstant) Respiratory physiology

division of R.O.H.C (E) for their co-operation and encouragement throughout the entire

project work.

I am truly grateful to the inhabitants of Kolkata whom I have studied for their

voluntary cordial cooperation and successful completion of the work. Their kind

cooperation is thankfully acknowledged.

Lastly I convey my thanks to all of my friends and batch mates for their heartily co-

operation and continuous encouragement through out the study.

Date: 01.06.2009 MURARI MOHAN MANNA

Department of Applied Geology

and Environmental System

Management

Presidency College


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Introduction:-

Since the onset of the industrial revolution, there has been a steady change in the

composition of the atmosphere mainly due to the combustion of fossil fuels used for the

generation of energy and transportation. Air pollution is a major environmental health

problem affecting the developing and the developed countries alike. The effects of air

pollution on health are very complex as there are many different sources and their

individual effects vary from one to the other.

Air pollution has been aggravated by developments that typically occur as

countries become industrialized: growing cities, increasing traffic, rapid economic

development and industrialization, and higher levels of energy consumption. The high

influx of population to urban areas, increase in consumption patterns and unplannedurban and industrial development has led to the problem of air pollution. Currently, in

India, air pollution is widespread in urban areas where vehicles are the major contributors

and in a few other areas with a high concentration of industries and thermal power plants.

Vehicular emissions are of particular concern since these are ground level sources and

thus have the maximum impact on the general population. Also, vehicles contribute

significantly to the total air pollution load in many urban areas.

The behaviour of the particles and gases in the respiratory system is greatly

influenced by the region of the lung in which they are located. After the air is channelized

through the trachea to the first bronchi the air is divided at each subsequent bronchial

bifurcation until very little apparent flow is occurring within the alveolar sacs. Because of

the very different flows in the various sections of the respiratory region, particles

suspended in air and gaseous air pollutants are treated differently in the lungs. For

gaseous pollutants released from automobiles, solubility controls removal from the air

stream. Highly soluble gases like SO2 are absorbed in the upper airways , whereas less

soluble gases like NO2, O3 may penetrate to the pulmonary region .Irritant gases are

thought to stimulate neuroreceptors in the respiratory walls and cause a variety of

responses including sneezing, coughing, broncho-constriction and rapid shallow

breathing.(1)

Many studies have shown links between pollution and health effects. Increases in

air pollution have been linked to decreases in lung function, neurological impairments


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and increases in heart attacks. High levels of air pollution directly affect people with

asthma and other types of lung or heart disease (according to the EPA Air Quality Index).

The elderly and children are especially vulnerable to the effects of air pollution in

large metropolitan cities like Kolkata.

The level of risk depends on several factors:

The amount of pollution in the air,

The amount of air we breathe in a given time

Our overall health.

Other, less direct ways people are exposed to air pollutants are:

eating food products contaminated by air toxins that have been deposited where

they grow,

drinking water contaminated by air pollutants,

Ingesting contaminated soil, and touching contaminated soil, dust or water.

The pollution in Kolkata is further aggravated by usage of adultered fuel by the

two-stroke auto-rickshaws. Thousands of these auto-rickshaws fleet plies crisscrossing

the city caring a fig to the Pollution guidelines and health safety of the inhabitants of the

city. Considering the environmental pollution of the city the respiratory health status of

the population is very much essential to be evaluated. Considering the above facts the

present study was undertaken to evaluate the respiratory function status of the inhabitants

of Kolkata. The respiratory function status of the inhabitants is also to be assessed among

according to their age, duration of stay on that area and smoking habit.


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Review of Literature:-

The combustion in the diesel engine produces soot along with smoke. Soot

consists of aggregates of spherical primary particles that form in the combustion

chamber, grow by agglomeration and are emitted as clusters having average particle

diameter ranging from 0.1-0.5 micrometer (2).As released to the environment, the

portions of the mass of the diesel soot consisting of adsorbed organic matter can range

from 5-90 percent (3). Values of 10-15% are representative of modern engines under

most operating conditions. The size of the diesel soot particles makes it easily respirable

.Approximately 20-30 % of the inhaled particles in diluted exhaust can be expected to

deposit in the lungs and airways of humans (4).Regarding the carcinogenicity of diesel

exhaust, however results from animals have not proved to be very helpful becauseessentially the same lung tumor response is obtained with pure carbon soot and other

inert particles as with diesel exhaust at comparable mass concentration (5).When bound

to soot or to haematite, pure chemical carcinogens such as benzo-alpha-pyrene known to

be present in polluted air have been shown to be carcinogenic for lungs of rodents by

intertracheal instillations.(6).In US , the EPA has concluded that diesel particulate is a

probable human carcinogen. The International Agency for Research on Cancer (IARC)

concluded that diesel exhaust is a probable human carcinogen (7). California in 1998

listed diesel exhaust as a toxic air contaminant (California, EPA, 1998)

The important contaminants of the automobile exhausts are oxides of nitrogen

(NOx), CO, hydrocarbons, respirable particles, sulphur dioxide and volatile organic

compounds. Increased Volatile Organic Compounds (VOCs) in ambient air of urban

areas observed because of vehicular exhausts, petrol bunk emissions and industrial

activities prevailing within the areas (8). Ulvarson et al (9) established the reduction of

FVC, FEV1 in vehicular exhaust exposed persons and causing obstructive type of PFT

changes. Nakai et al (10) stated the personal exposure of NO2 concentrations decreased as

distance from the roadside is increased. Laxen and Noordally (11) assessed the major

pollutant NO2 arising from automobile exhausts at a street in London and the

concentration declined as the distance from the road increased. Chattopadhyay et al. (12)

stated the decrement of PFT values with the synergistic effect of age and automobile

exposures. The gaseous pollutants and VOCs are mainly formed due to fuel adulteration,

keeping the vehicles in running condition and traffic density (8). Rao et al (13) revealed


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that exposure to auto exhaust pollutants caused both restrictive and obstructive type of

respiratory impairments. Some studies have already reported the health risks like

increased mortality, morbidity rates and hospital admission due to cardio respiratory

disease, oxidative stress and increase the incidence of cancer among urban population

(14, 15, 16, 9).

Rao et.al (17) reported various volatile hydrocarbons including benzene in ambient air of

industrial areas in New Mumbai. Srivastava et.al (18) identified more than sixty VOC

species in Delhi air at residential, commercial and industrial areas. Pandit et.al (19)

showed that about 10 % of the C2-C5 hydrocarbons are emitted from auto-exhaust in

Mumbai. Ingle et.al (20) reported ambient air levels of pollutants like SO2, NOx and

PM10 in traffic areas of Jalgaon and significant reduction in pulmonary function test

values, particularly the FEV1 and PEFR among traffic police.

One study demonstrated that children inhaling grossly polluted air of Calcutta

suffer from adverse lung reactions and genetic abnormality in the exposed tissues. The

potential health hazards associated with inhalation of airborne pollutants are now well

recognized. In this context, children are reported to be more susceptible to environmental

exposures than adults An estimated 4 million children in developing countries die each

year from respiratory diseases which are potentially preventable and/or treatable. In

addition, some of the adverse effects of air pollution may be obvious in the adult owing

to the prolonged latent period (21). Some 70% of people in the city of Calcutta suffer

from respiratory disorders caused by air pollution, a recent study by a prominent cancer

institute in India has concluded. The city of Kolkata ranks highest in the country in terms

of pollution. Ailments include lung cancer, breathing difficulties and asthma, the

Chittaranjan National Cancer Institute (CNCI) study says. (22) .Diesel soot emitted from

automobiles is carbon compound coated with organic matter are generally less than 1

micron in diameter and can penetrate in the lower portions of the lungs. (23).Suspended

particulate matter is one of the most critical air pollutants in most of the urban areas of

India and permissible standards are grossly violated frequently (24)


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Aims and objectives:

The Study was conducted 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 totheir duration of stay in their area.

Comparative analyses of the lung function of North, Central and South Kolkatainhabitants.

Pic: 5- Two-stroke auto rickshaws are a Pic: 6-City pedestrian, porters, hawkers,major source to the city air pollution. rickshaw pullers are vulnerable groups to

citys environmental pollution.

Pic: 7- People working in the open air like food sellersand traffic policemen are at risk of Citys environmental pollution.


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Materials & Methods:

Selection of subjects:

The present study was carried out North, Central and Southern pockets of

Kolkata. The pulmonary function study was carried out on total 113 inhabitants from the

three areas. The subjects were classified into broadly three groups North (37), Central

(35) and South (41).The subjects were selected from 21-50age range from varied

economic class people.

Questionnaire method :

Detailed present and past personal and occupational history was taken.

Due stress was given to note the smoking history and the frequency of smoking per day.

Among the inhabitants who smoked at least 5-6 beedi and/or cigarette per day are

included in the smoking category and those who have not smoked through out their life

time was considered as non-smoker and those who left smoking are considered as ex-

smokers. The time of taking personal history of the individuals special attention was

given to make the respiratory impairments if any.

Pulmonary Function Test:

Vital capacity (VC) and Forced Vital Capacity (FVC) was recorded by

Spirovit SP-10(Pic-15) (Schiller Health Care Pvt Ltd., Switzerland) and Peak Expiratory

Flow Rate by Wrights Peak Flow meter (Clement and Clarke, UK). Forced expiratory

volume in one second (FEV1) Forced expiratory volume in 1st

sec. as the percentage of

FVC (FEV1%), forced expiratory flow at 200 ml 1200 ml, 25 75% and 75 85% was

calculated from the tracings. Before the recordings were taken all subjects were made

well motivated thus ensuring recording at optimum levels. The PFT measurements were

made in a comfortable standing position. The body height and body weight were

measured with a standard scale without footwear. All measured lung volumes obtained

was expressed in body temperature pressure saturated with water vapour (BTPS). Body


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surface area (BSA) was calculated from the Du-Bois and Du-Bois formula. Pulmonary

function test values were predicted from the standard prediction equation of the Kolkata

normal subjects. The criteria followed for categorization of the severity of restrictive

impairment are based upon the ratios between predicted and observed values of VC and

obstructive impairment based of FEV1%.

Statistical Analysis:

Student two tailt tests are being performed by the inhabitants to find

whether there are any significant changes due to duration of staying at 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 Normal

20.01-30 Mild Restrictive Type

30.01-40 Moderate Restrictive Type


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40.01 Severe Restrictive Type

Terminology and Definitions of Static and Dynamic PFT

parameters:-

Static PFT parameters:-

TV Tidal Volume The respiratory excursion for each breadth.

SVC - Slow vital capacity - This test is performed by having the patient slowly and

completely blows out all the air from the lungs.

IC Inspiratory Capacity - The volume of gas that can be taken into the lungs in a full

inhalation, starting from the resting inspiratory position; equal to the tidal volume plus

the inspiratory reserve volume.

IRV - Inspiratory Reserve Volume Maximum Volume that can be inspired is beginning

from the position of resting inspiration.

ERV - Expiratory Reserve volume Volume which can be expired by a maximum effort

beginning at the position of resting expiration.

Dynamic PFT parameters:-

FVC - Forced Vital Capacity - after the subject has taken in the deepest possible

inspiration, this is the volume of air which can be forcibly and maximally exhaled out of

the lungs until no more can be expired. FVC is usually expressed in units called liters.

This PFT value is critically important in the diagnosis of obstructive and restrictive

diseases.

FEV1 - Forced Expiratory Volume in One Second - this is the volume of air which can be

forcibly exhaled from the lungs in the first second of a forced expiratory maneuver. It is

expressed as liters. This PFT value is critically important in the diagnosis of obstructive

and restrictive diseases.


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FEV1/FVC - (FEV1%) - This number is the ratio of FEV1 to FVC - it indicates what

percentage of the total FVC was expelled from the lungs during the first second of forced

exhalation - this number is called FEV1%, %FEV1 or FEV1/FVC ratio. This PFT value is

critically important in the diagnosis of obstructive and restrictive diseases.

FEV3- Forced Expiratory Volume in Three Seconds - this is the volume of air which can

be forcibly exhaled in three seconds - measured in Liters - this volume usually is fairly

close to the FVC since, in the normal individual, most of the air in the lungs can be

forcibly exhaled in three seconds.

FEV3/FVC FEV3%- This number is the ratio of FEV3 to the FVC - it indicates what

percentage of the total FVC was expelled during the first three seconds of forced

exhalation. This is called %FEV3 or FEV3%.

PEFR - Peak Expiratory Flow Rate - this is maximum flow rate achieved by the patient

during the forced vital capacity maneuver beginning after full inspiration and starting and

ending with maximal expiration - it can either be measured in L/sec or L/min - this is a

useful measure to see if the treatment is improving obstructive diseases like broncho

constriction. This parameter can be studied by Wrights Peak Flow Meter and expressed

in l/min.

FEF - Forced Expiratory Flow - Forced expiratory Flow is a measure of how much air

can be expired from the lungs. It is a flow rate measurement. It is measured as

liters/second or liters/minute. The FVC expiratory curve is divided into quartiles and

therefore there is a FEF that exists for each quartile. The quartiles are expressed as

FEF25%, FEF50%, and FEF75% of FVC.

FEF 25% - This measurement describes the amount of air that was forcibly expelled in the

first 25% of the total forced vital capacity test.


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FEF 50% - This measurement describes the amount of air expelled from the lungs during

the first half (50%) of the forced vital capacity test. This test is useful when looking for

obstructive disease. The amount of air that will have been expired in an obstructed patient

is smaller than that measured in a normal patient.

FEF.2-1.21- Forcefully expiratory flow rate during expired air 200ml to 1200ml of the

forced vital capacity test.

FEF25%-75% - This measurement describes the amount of air expelled from the lungs

during the middle half of the forced vital capacity test. Many physicians like to look at

this value because it is an indicator of obstructive disease.

FEF75-85% - Lung flow rate during expiration of 75% to 85% of the forced vital capacity

test.

MVV - Maximal Voluntary Ventilation - this value is determined by having the patient

breathe in and out as rapidly and fully as possible for 12 -15 seconds - the total volume of

air moved during the test can be expressed as L/sec or L/min - this test parameter reflects

the status of the respiratory muscles, compliance of the thorax-lung complex, and airway

resistance


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Pic: 11- Taking personal history of the subjects using Pic: 12 Stadiometer (height

standard proforma by questionnaire method. and weight measurement).

Pic: 13- Measurement of weight and height of subjects using Stadiometer.


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values in height (male-159.72cm, female-149.94cm), weight(male-54.94Kg, female-

46.59 Kg), body surface area(male-1.56 m2 , female-1.39 m2 ), body mass index (male

21.42, female 20.59)

In South Kolkata, the mean age of male and female individuals are 34.52(8.53)

and 34.95(7.34) respectively. Because of the sex difference males have higher mean

values in height (male-166.33cm, female-148.45cm), weight(male-62.76Kg, female -

53.50 Kg),body surface area(male-1.69 m2

, female-1.46 m2

).The body mass index

showed higher values in females (male 22.74, female 24.3)

Significant changes have been observed in the height and body surface area

between the inhabitants of Central Kolkata male and South Kolkata male and in body

mass index when compared Central Kolkata female with South Kolkata females. The

statistical analyses were carried out separately in the two sexes.

Pulmonary function Tests (PFT) of the study population are presented in Table-3

and Fig:2, 3 and 4. The male subjects are having higher mean values in lung volumes and

flow rates compared to the female inhabitants.

Table:-3: Lung volume and flow rates of male and female inhabitants of north,

central and south Kolkata (Mean SD)

[* p


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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 statistically found to be 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.

.


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The PFT values of male inhabitants according to their duration of stay in theregion have been given in Table-4 and fig 5-11.All the subjects were classifiedaccording to their duration of stay in the area into four groups as: up to 20, 21-30, 31-40,41-50.

Table:-4: Lung volumes and flow rates of male individual according to duration of

stay in north, central and south Kolkata (Mean SD)

Category Duration

of stay

(Yrs)

SVC

(l)

FVC

(l)

FEV1(l)

FEV1% FEF.2-

1.21ml

(l/s)

FEF25-

75%

(l/s)

FEF75-

85% (l/s)

PEFR

(l/min)

Up to 20(n=0)

- - - - - - - -

21-30(n=8)

3.920.35

4.170.56

3.650.43

87.672.97

6.601.73

4.581.06

1.970.79

462.50117.81

31-40

(n=8)

3.51

0.56

3.72

0.79

3.04

0.81

81.26

8.24

6.20

1.95

3.22

1.49

1.06

0.64

453.75

130.81

North

Kolkata

Male

(n=21)

41-50(n=5)

2.55**0.89

2.64*1.19

2.02**0.98

74.95*12.33

3.782.56

1.97***0.61

0.59***0.26

344.00154.37

Up to 20(n=5)

3.620.52

3.740.49

3.180.69

84.409.96

6.562.36

3.601.42

1.320.49

472.0081.98

21-30(n=5)

3.200.09

3.240.12

2.740.26

84.405.18

5.390.76

3.011.01

1.100.38

406.0053.20

31-40(n=6)

3.290.50

3.240.46

2.850.33

88.172.64

5.921.69

3.390.61

1.230.17

430.0064.50

Central

Kolkata

Male

(n=18)

41-50(n=2)

3.320.92

3.261.00

2.780.74

86.004.24

6.720.59

3.390.23

0.900.08

480.000

Up to 20(n=1)

4.53 4.60 3.75 82.00 6.25 3.47 1.68 400.00

21-30(n=7)

4.280.96

4.230.99

3.820.86

90.626.91

7.811.37

4.911.35

2.010.86

532.8670.17

31-40(n=6)

3.741.04

3.581.48

3.241.41

86.8711.18

6.623.23

4.582.11

1.860.95

478.33187.87

SouthKolkata

Male

(n=21)

41-50(n=7)

3.390.66

3.610.54

3.000.54

82.886.40

6.692.22

3.110.87

1.160.54

437.14126.06

[* p


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Fig-8: Different flow rates of north Kolkata male

inhabitants according to duration of stay

0

1

2

3

4

56

7

up to 20 21-30 31-40 41-50

Stay range distribution

Flow

rates(l/sec

)

FEF.2-1.21ml (l/s)

FEF25-75%(l/s)

FEF75-85% (l/s)

Fig-9: Different flow rates of central Kolkata maleinhabitants according to duration of stay

0

2

4

6

8

up to 20 21-30 31-40 41-50


Flow

rates(l/sec)

FEF.2-1.21ml (l/s)

FEF25-75%(l/s)

FEF75-85% (l/s)

Fig-10: Different flow rates of south Kolkata male


0

2

4

6

8

10

Up to 20 21-30 31-40 41-50


Flow

rates

(l/sec)

FEF.2-1.21ml (l/s)

FEF25-75%(l/s)

FEF75-85% (l/s)


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Fig-11: PEFR of Kolkata male inhabitants

according to duration of stay

0

100

200

300

400500

600

up to 20 21-30 31-40 41-50


PEFR(l/min)

North Kolkata male

Central Kolkata male

South Kolkata male

It has been observed that there is a gradual trend of decrement of lung volume and

flow rates with the increase of duration of stay in the respective areas.

Among the North Kolkata males there is a significant decrement of the SVC,

FVC, FEV1, FEV1%, FEF25-75%, FEF 75-85% values of the individuals residing in the area

residing for 41-50 years as compared to residents residing in the area for 21-30 years.

There is also a significant decrement of the FEF75-85 % value of the subjects residing for

41-50 years as compared to subjects residing for 31-40 years. Among the Central Kolkata

males there is a significant decrement of the FEF75-85% value of the subjects residing for

41-50 years as compared to subjects residing for 31-40 years. Among the South Kolkata

males there is a significant decrement of the FEF 25-75% value of the subjects residing for

41-50 years as compared to subjects residing for 31-40 years.

The SVC, FVC and FEV1 values of Central Kolkata in the age group of 21-30 has

been found to be significantly lower than their North Kolkata and South Kolkata

counterparts. In the 31-40 age group the FEV1% mean value of North Kolkata inhabitants

has been found to be significantly lower than the Central Kolkata inhabitants of the same

age group. In the age group of 41-50 the FEF25-75% and FEF75-85% of North Kolkata maleinhabitants have been found to be significantly lower than the South Kolkata inhabitants.

The FEF25-75% value of North Kolkata inhabitants of the same age group has also been

found to be significantly lower than the Central Kolkata male population of the same age

group.

The PFT values offemale inhabitants according to their duration of stay in the

area have been given in Table-5 and fig: 12-18. All the subjects were classified


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Fig-12: Lung volume of north Kolkata female


0

0.5

1

1.5

2

2.53

3.5

Up to 20 21-30 31-40 41-50


litres

SVC (l)

FVC (l)

FEV1 (l)

Fig-13: Lung volume of central Kolkata femaleinhabitants according to duration of stay

0

0.5

1

1.5

2

2.5

3

Up to 20 21-30 31-40 41-50


litres

SVC (l)

FVC (l)

FEV1 (l)

Fig-14: Lung volume of south Kolkata female


0

0.5

1

1.52

2.5

3

3.5

Up to 20 21-30 31-40 41-50


litres

SVC (l)

FVC (l)

FEV1 (l)


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Fig-15: Different flow rates of north kolakta female


0

1

2

3

45

6

up to 20 21-30 31-40 41-50


Flow

rates(l/sec

)

FEF.2-1.21ml (l/s)

FEF25-75% (l/s)

FEF75-85% (l/s)

Fig-16: Different flow rates of central Kolkata

female inhabitants according to duration of stay

0

1

2

3

4

5

up to 20 21-30 31-40 41-50


Flow

rates(l/sec)

FEF.2-1.21ml (l/s)

FEF25-75% (l/s)

FEF75-85% (l/s)

Fig-17: Different flow rates of south Kolkata

female inhabitants according to duration of stay

0

1

2

3

4

5

up to 20 21-30 31-40 41-50


Flow

rates(l/sec)

FEF.2-1.21ml (l/s)FEF25-75% (l/s)

FEF75-85% (l/s)


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Fig-18: PEFR of Kolkata female inhabitants

according to duration of stay

0

100

200

300

400

up to 20 21-30 31-40 41-50


PEFR(l/min)

North Kolkata female

Central Kolkata female

South Kolkata female

It has been observed that there is a gradual trend of decrement of lung volume and

flow rates with the increase of duration of stay in the respective areas.

Among the Central Kolkata females there is a significant decrement in the SVC,

FVC and PEFR values of the resident duration range of 21-30 years as compared to the

group staying up to 20 years. Among the South Kolkata females there is a significant

decrement in the SVC value of the resident duration range of 41-50 years as compared to

the group staying up to 21-30 years.

In the age group of 21-30 the SVC, FVC, FEV1, FEF.2-1.21ml and PEFR of North

Kolkata and SVC, FVC, FEV1 of South Kolkata have been found to be significantly

higher than the population of Central Kolkata .


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The PFT values of male inhabitants according to their age distribution in the

region have been given in Table-6 and fig: 19-25.All the subjects were classified

according to their age into three groups: 21-30, 31-40, 41-50.It has been observed that

there is a gradual trend in the decrement of the lung volume and flow rates of the subjects

with age.

Table:-6: Lung volumes and flow rates of male individual according to age range

(Mean SD)

[* p


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Fig-27: Lung volume of north Kolkata female

inhabitants according to age distribution

0

0.5

1

1.5

2

2.5

3

3.5

21-30 31-40 41-50

Age range distribution

litres

SVC

FVC

FEV1

Fig-28: Lung volume of central Kolkata femaleinhabitants according to age distribution

0

0.5

1

1.5

2

2.5

3

21-30 31-40 41-50


litres

SVC

FVC

FEV1

Fig-29: Lung volume of south Kolkata female


0

0.5

1

1.52

2.5

3

3.5

21-30 31-40 41-50


litres

SVC

FVC

FEV1


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Fig-30: Different flow rates of north Kolkata female


0

1

2

3

4

5

21-30 31-40 41-50


Flowr

ate(l/sec)

FEF.2-1.21ml (l/s)

FEF25-75% (l/s)

FEF75-85% (l/s)

Fig-31: Different flow rates of central Kolkata femaleinhabitants according to age distribution

0

1

2

3

4

5

21-30 31-40 41-50


Flowr

ate(l/sec)

FEF.2-1.21ml (l/s)

FEF25-75% (l/s)

FEF75-85% (l/s)

Fig-32: Different flow rates of south Kolkata female


0

1

23

4

5

21-30 31-40 41-50


Flow

rate(l/sec)

FEF.2-1.21ml (l/s)

FEF25-75% (l/s)

FEF75-85% (l/s)


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The PFT values according smoking habit are represented in Table-8 and Fig-33-

36. The PFT values of the smokers are slightly higher compared to the non-smoker in

several parameters.

Table: - 8:-Lung volume and flow rates of male subjects according to their smokinghabits (Mean SD)

[No statistically significant difference in the values has been observed]

No statistical significant variation has been observed in the

pulmonary function tests of various parameters between the smokers and the non-

smokers of the different areas but variations in the mean values have been observed.

Among the North Kolkata males the mean values of SVC, FVC,

FEF.2-1.21 and PEFR have been found to be higher in the smokers in comparison to that of

the non-smokers. Similarly among the Central Kolkata subjects the mean values of SVC

and FVC have been found to be higher in the smokers than in the non-smokers. Likewise

in South Kolkata all the PFT parameters have been found to be higher in the smokers as

compared to the non-smokers.

A number of reasons may be cited to explain this anomalous variation by the fact

that only small number of individuals (n) have been studied i.e the numbers of smokers

CategoryDuration

of stay

(Yrs)

BSA BMI SVC

(l)

FVC

(l)

FEV1(l)

FEV1% FEF.2-

1.21ml

(l/s)

FEF25-

75%

(l/s)

FEF75-

85%

(l/s)

PEFR

(l/min)

Non-Smoker(n=13)

1.660.19

24.073.38

3.420.85

3.631.04

3.100.98

83.999.46

5.712.40

3.821.45

1.470.89

430.00143.99

North

Kolkata

(n=21)Smoker(n=8)

1.60.19

20.95.06

3.470.70

3.640.96

2.410.93

79.28.2

5.892.11

2.831.53

1.010.71

432.50127.25

Non-Smoker(n=14)

1.550.16

21.262.63

3.340.48

3.380.51

2.930.47

86.794.04

6.171.24

3.460.89

1.220.35

452.1462.04Central

Kolkata

(n=18) Smoker(n=4)

1.580.20

21.994.37

3.440.47

3.390.45

2.800.52

82.5010.66

5.592.75

3.031.19

1.040.33

400.0071.18

Non-Smoker(n=14)

1.660.17

21.674.41

3.720.98

3.731.09

3.291.07

86.378.94

6.772.37

4.041.69

1.660.91

476.43142.70

South

Kolkata

(n=21) Smoker

(n=7)

1.76

0.15

24.86

5.35

4.07

0.80

4.11

0.89

3.56

0.78

86.86

7.66

7.52

2.01

4.36

1.48

1.69

0.69

484.29

111.93


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are very low in comparison to the non-smokers and they had better lung function values

than the non-smokers. From the given table it is observed that the mean values of BSA

and BMI of the smokers are higher than the non-smokers, as the thoracic cavity and the

body surface area of their body are higher they have a greater possibility to have more

lung volume and hence better flow rates. The smoking factor also depends on the number

of beedi/cigarettes smoked per day, duration of smoking and the number of puffs taken

each time.

Fig-33: Distribution of male Kolkata inhabitants

according to their smoking habit

0

2

4

6

8

10

12

14

16

North Kolkata Central Kolkata South Kolkata

Numbers

NON-SMOKER

SMOKER


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Conclusion:-

The health effect of environmental pollution has been a great concern for mankindsince several decades. In the developing countries industrial emission continues to be the

major source of air pollution but with the increasing number of vehicles, vehicular air

pollution is becoming increasingly important especially in the metropolitan city, Kolkata

is one of the polluted cities in India as per the CPCB. The pollution level showed a rising

trends from day to day. This is confirmed by the Lung function impairment data of the

inhabitants only due to the exponential vehicular pollution rise. This produces rise in

SPM and other pollutant levels in residential, commercial area. Urbanization creates

pollution. The 3 Ps- Population, Poverty and pollution are quite interlinked with one

another. Population explosion at Kolkata because of new births and migration is the most

vital reason for deterioration of the environment.

Vehicles pollution occurs due to:-

Unscrupulous use of Adultered Fuel.

Poor maintenance of the vehicles.

Faulty Driving techniques.

Road borne dust.

Age of the vehicle and its present roadworthiness.

Miscellaneous-

Open burning of garbage, running of generator sets, burning of

tyres etc.

Road side dust.

Construction activities.

Effect of deplantation.

Meteorological conditions.

The people residing in the city are exposed to that environment. The

particular populations residing nearer to the main traffic junction or by the side of the

main roads of the city are very much exposed to the automobile exhausts. Rapid increase

of number of vehicles, vehicular air pollution is becoming increasingly important


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Recommendation:-

In the context to the present study some ideas and suggestions for possible

management of environmental pollution of Kolkata air can be forwarded- .

The burning of fuel is major source of pollution so the possible measure should be

the replacement of burning fossil fuel by electricity or solar energy or by improvement of

the fuel quality and fuel burning process. There are number of mechanical devices that

might be helpful for reduction of pollutant emission level from different industries and

other sources.

Since vehicles contribute significantly to the total air pollution load in most urban

areas, vehicular pollution control deserves top priority. A practical strategy should be

devised that reduces both emissions and congestion. Some of these strategies may be Phase out the 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. Catalytic Converters convert comparatively more toxic CO and Hydrocarbons to

less toxic CO2 and water. In addition to these fuels, use of diesel fuel with lower sulfur

content can help to reduce emissions. A newer vehicle that meets more stringentemission standards is purchased to replace the scrapped vehicles.

Bharat Stage IV norms should be enforced on all vehicles and smooth movement

of vehicles should be facilitated by construction of new flyover, bridges, improvement of

road condition and width of the roads. Mass Rapid Transport System may be considered

for the fast expanding and major urban cities like Kolkata. Greater promotion and use of

alternative fuels such as CNG/LPG/Propane/ battery operated vehicles. Expansion of

CNG dispensing facilities and increased fiscal incentives for CNG kits should be

encouraged. Taxes on fuels, vehiclesthe revenue so generated could be used for

pollution control measures. Strengthening of inspection and maintenance (I&M) system:

The I&M system, comprising inspection, maintenance, and certification of vehicles, is

crucial for regulating pollution for the large fleet of in-use vehicles. It should include

testing of various elements of safety, road worthiness and compliance to pollution norms.

Diversion of heavy goods traffic in peak hours is very much essential to

minimize the automobile pollution and the pollution of the city as a whole. Use of Public

Vehicles should be encouraged as it saves not only fuel but also the load of city ambient

air pollution. Plantation at the city road side is essential to reduce the suspended


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(14) Dockery DW, Pope CA IV, Xu X, Spengler JD, Ware JH, Fay ME, Ferris BG,,

Spiezer FE (1993).An Association between air pollution and mortality in six US

cities. The New England Journal of Medicine 329: pp1753-1759.

(15) Padhy PK, Varshney CK (2000) Total non methane volatile organic compounds

(TNMVOC) in the atmosphere of Delhi. Atmospheric Environment 34: pp577-

584.

(16) Samet J, Domonici F, Curriero C, Coursac I, Zeger SL (2000) Fine particulate Air

Pollution and Mortality in 20 US cities,1987-1994,The New England Journal of

medicine 343:pp1742-1749.

(17) Rao MA, Pandit GG, Sain P, Sharma S, Krishnamoorthy TM, Nambi KSV

(1997). Non methane Hydrocarbon in Industrial location of Bombay atmospheric

environment 31(7) :pp1077-1085.

(18) Srivastava A, Joseph AE, Patil S, More A, Dixit RC, Prakash M (2005) Air toxics

in ambient air of Delhi. Atmospheric Environment 39: pp59-71.

(19) Pandit GG, Mohon Rao AM (1990) Evaluation of auto exhaust contribution to

atmospheric C2-C5 hydrocarbonat Deoner, Bombay. Atmospheric Environment

24A: pp811-813

(20) Ingle ST, Pachpande BG, Wagh ND, Patel VS, Attarde SB (2005) Exposure to

vehicular pollution and Respiratory Impairment of Traffic Policemen in Jalgaon

City, India , Industrial health. 43: pp656-662.

(21) Lahiri Twisha, Roy Senjuti, Basu Chandreyi, Ganguly Sangeeta, Et al (Jul 2000),

Indian Journal of Medical Research

(22) CNCI Report 2007.

(23) Wei E T, Shu Helen P et.al (September 1983), Nitro aromatic Carcinogens in

Diesel Soot, Vol. 73, No. 9.

(24) S. T. Ingle, N. D. Wagh, B. G. Pachpande, V. S. Patel and S. B. Attarde, The

influence of workplace environment on lung function of shopkeepers working

near National Highway in Jalgaon: A note. Transporatation Research: Part D,

2005.


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Proforma of the project:Proforma of the project:Proforma of the project:Proforma of the project:

Assessment of the Effects of High Particulate Pollutants on Pulmonary Health

Status in Selected Mega cities of South Asia

Area information

A. Serial no. B. Interviewer:

C. Air Quality Monitoring Station: D. Distance from the station

E. Date: F. Room Temperature:

Part 1. IDENTIFICATION DATA

01. Identification Number (4 Digits):

02. Name:

03. Name of the father/spouse:

04. Name of the Head of the family

05. Age:

06. Sex: (Male - 1, Female - 2)

07. Address:

Part 2. GENERAL INFORMATION ON HOUSEHOLD AND FAMILY

08. Distance from the main road:09. Any local sources of outdoor pollution: (eg. Factory etc):

10. Floor of residence:

11. Number of rooms:Kitchen is in the separate room or in the same room-----------------------------------

Ventilation of the house or room---------Good----------Satisfactory---------------Poor

Regional Occupational Health Centre

(Eastern)(Indian Council of Medical Research)

Block-DP, Sector-V, Salt Lake, Kolkata-700091


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21. How many bidis/cigarettes etc do you smoke or used to smoke every day?(Maximum no. ever) ------

22. How many years you smoked-----------------Number of smoker in the family---------------------------

23. If ex-smoker, reason for stopping: ____________________

24. PERSONAL HISTORY OF THE SUBJECT.

Are you suffering from any respiratory or other diseases already diagnose-----------------------------

If yes specify the name of the disease------------------------------------------------------------------------

Did you have any periodical illness---------------------------------------------------------------------------?

Did you have any respiratory problem like cough-------------------------------------------------Yes/ No,

Specify-------------------------------------------------------------------------------------------------------------

Did you have any respiratory problem like breathlessness---------------------------------------Yes/ No.

Specify-------------------------------------------------------------------------------------------------------------

Did you have any respiratory problem like morning cough--------------------------------------Yes/ No.

Specify-------------------------------------------------------------------------------------------------------------

Did you have any respiratory problem like chest tightness--------------------------------------Yes/ No.

Specify-----------------------------------------------------------------------------------------

--------------------

Did you have any respiratory problem like cough through out the day-------------------------Yes/No.?

Specify-------------------------------------------------------------------------------------------------------------

Do you have the respiratory problem during seasonal variations?Summer, winter, Rainy etc------------------------------------------------------------------

-------------------


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Do you feel any breathlessness: ----------------------------------------------------------------------Yes/No.

FAMILY HISTORY

Any of the family members suffer from respiratory disease--------------------------------------Yes/No.

Relationship with the subject-----------------------------------------------------------------------------------

If diagnosed name of the disease-------------------------------------------------------------------------------

A. Physical Characteristics

Height :______________( cm); Weight :_______________( Kg)

BSA: _______________ ; BMI: _________________

B. Static Lung Function Test Values

(In each parameter selected the best of three simultaneous records)

a) SVC---------------------- (l) b) ERV------------------------------- (l)

c) IRV----------------------- (l) d) TV--------------------------------- (ml)

C. Dynamic Lung Function Test Values:

(In each parameter selected the best of three simultaneous records)

(a)FVC------------------------------ (l)

(b)FEV1----------------------------- (l)

(c)FEV1/FVC---------------------- (%)

(d)FEF.2-1.21------------------------- (l/s)

(e)FEF25-75%-------------------------(l/s)

(f) FEF75-85%-------------------------(l/s)


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Exposure to Vehicular Pollution and Respiratory Health Status of the Inhabitants of Kolkata a Cross...

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