Latest news with #Lancetstudy
Forbes
23-07-2025
- Health
- Forbes
In India, Air Pollution Can Increase The Risk Of Preterm Birth: Study
TOPSHOT - A woman walks across a railway track amid smog on a winter morning on the outskirts of ... More Jalandhar on December 21, 2023. (Photo by Shammi MEHRA / AFP) (Photo by SHAMMI MEHRA/AFP via Getty Images) India is the third most polluted country in the world, largely due to its extraordinarily high levels of air pollution. While seven out of 10 Indians are exposed to noxious air, pregnant women and their unborn children are among the most impacted. According to a recent study, prenatal exposure to air pollution could increase the risk of a preterm birth by at least 12% and a 5% higher risk of low birth weight — especially in North India. "Medical studies found that the fetus grows rapidly in the third trimester of pregnancy. That period is more sensitive, and exposure to PM2.5 can hemorrhage fetal growth. Nevertheless, the level of thyroid hormone might be affected by the toxicity of PM2.5, which is a responsible factor for less fetal weight,' the researchers explained in the study. 'Previous studies have found that the concentration of ambient fine particulate matter (also known as PM2.5) is highest in the states of the upper-Gangetic plains such as Delhi, Punjab, Haryana, Uttar Pradesh, and Bihar, as observed in the present study. A recent Lancet study suggests that the average PM2.5 concentrations in Delhi were 13.8 times higher than those in Kerala,' the researchers wrote. The first trimester is the most risky period as PM2.5 exposure during this stage, which is above 21.36 μg m3, is linked to higher odds of adverse birth outcomes. 'A large proportion of households in the Northern parts of India use solid fuels compared to other regions. It is well documented that the residential sector is a significant contributor to the total PM2.5 emissions, along with the industry, energy, and agriculture sectors. Among industrial, residential, and energy sources, the contribution of energy sources to total emissions is the maximum, while residential sources contribute the maximum to PM2.5 emissions during winter and post-monsoon,' they added. 'However, at the urban or city level, where most households are already using cleaner fuel, reducing vehicular emissions (both exhaust and non-exhaust) emerges as a crucial strategy for reducing PM2.5 levels. It was prominently observed during the coronavirus pandemic (Covid-19) lockdown in Indian cities when traffic reduction substantially minimized urban areas' exposure to air pollutants.' To date, several studies have shown the deleterious health impacts of unborn children being exposed to large amounts of PM2.5. In the last seven years, researchers have linked this form of air pollution to fetal malformation, miscarriages, and stillbirths. Air pollution is in the top five risk factors for early deaths, in both men and women, making it one of the most omnipresent "silent killers." Scientists estimate that in 2019 itself, particulate matter pollution was linked to over 4.14 million deaths globally. PM2.5 is the most harmful air pollutant, and its major sources are the burning of fossil fuels, such as coal, oil, and gas. Due to the extremely tiny size of PM2.5, which is less than 2.5 microns, it worsens the risk of getting heart disease, lung cancer, respiratory diseases, and stroke. The study was published in PLoS Global Public Health on July 2, 2025.
The Hindu
06-05-2025
- Health
- The Hindu
India needs patient-centric care and trained counsellors to manage Inflammatory Bowel Diseases burden: experts
The Global Burden of Disease (GBD) 2019 study estimated 2,70,719 cases of Inflammatory Bowel Disease (IBD) in India, with an age-standardised prevalence rate of 20.34 per 100,000. This marks a dramatic rise from 1,30,000 cases in 1990. At the same time, more people are being diagnosed with ulcerative colitis, and Crohn's disease --though often underdiagnosed or underreported -- is becoming a big concern for public health. IBD, which includes ulcerative colitis and Crohn's disease, is chronic inflammatory conditions of the digestive tract. Symptoms such as diarrhoea, abdominal pain, fatigue, and weight loss can severely impact quality of life. According to Nandish H. K., senior consultant gastroenterologist, Narayana Health City, Bengaluru, any symptoms like chronic diarrhoea, blood in stool, or abdominal pain lasting more than four weeks warrant referral to a higher centre for colonoscopy and early diagnosis and proper counselling are key to managing complications and improving outcomes. IBD care challenges in India According to the authors of a recent Lancetstudy titled 'Developing IBD counsellors in low- and middle-income countries: bridging gaps in patient care,' hospital-based studies confirm a surge in ulcerative colitis -- a type of IBD that causes inflammation and ulcers in the large intestine (colon) and rectum, cases in India. Crohn's disease, a type of IBD that can affect any part of the digestive tract, from the mouth to the anus though less-frequently documented, is often misdiagnosed due to lack of awareness and limited infrastructure. By 2025, the country is projected to have only 4,200 gastroenterologists for a population of 1.45 billion -- roughly 0.29 gastroenterologists per 1,00,000 people. In comparison, the United States had 3.9 gastroenterologists per 1,00,000 people as early as 2007 -- over 13 times higher than the current projected ratio. This shortage leads to rushed consultations, delayed diagnoses, and inadequate time for patient education. Many IBD cases are mistaken for irritable bowel syndrome or infections, resulting in inappropriate treatments. Dr. Nandish also explains that misinformation around dietary triggers and treatment options further complicates disease management and causes emotional distress for patients and families. Do Western models fall short and why? India's current clinical protocols often mirror Western models that emphasise individual autonomy in decision-making. However, these approaches don't always resonate in the Indian context, where healthcare decisions are often made collectively within families. Arshia Bhardwaj, senior resident, department of Gastroenterology, Dayanand Medical College, Ludhiana, and co-author of the Lancet study explains, 'In India, IBD care is not just about the individual. Family members -- parents, siblings, even children -- influence medical choices. We've had patients decline biologics (a form of treatment) because a family member objected.' Without acknowledging this cultural dynamic, healthcare delivery remains incomplete. Time constraints, language barriers, and a lack of culturally nuanced communication contribute to a disconnect between doctors and patients. 'Many believe IBD is caused by food or stress. Without time to debunk these myths, we lose patient trust,' says Dr. Bhardwaj. Need for IBD care counsellors in India To bridge these gaps, experts advocate for the introduction of IBD counsellors -- healthcare professionals trained specifically in the medical, psychological, nutritional, and social dimensions of IBD in India. Unlike general counsellors or nurses, IBD counsellors would work closely with doctors and families, providing consistent, culturally appropriate support. 'These counsellors could be game changers,' says Arshdeep Singh , associate professor, Department of Gastroenterology, Dayanand Medical College, Ludhiana and co-author. 'They can explain treatment plans, address fears about medication, offer basic dietary guidance, and provide emotional support in a way busy doctors often can't,' Dr. Singh says. IBD counsellors can also play a vital role in dismantling stigma, correcting misinformation, and ensuring follow-up care -- especially in rural and semi-urban regions where access to specialists is minimal and traditional beliefs often dominate Focus on culturally sensitive solutions Talking about the steps from diagnosis to treatment, Dr. Bhardwaj also emphasises the need for specialised care. She notes that while colonoscopy is a crucial diagnostic tool, it is not the only one -- and without proper interpretation and follow-up by specialists trained in IBD, many patients remain confused or misinformed about their condition. And so, given the strain on India's healthcare system, training IBD counsellors presents a scalable and cost-effective solution. Talking about funding and calling for a stand-alone national IBD programme, the authors also notes that this change can be gradual and patient centric. 'This isn't about building more hospitals overnight,' Dr. Bhardwaj explains. 'It's about redesigning what already exists. If even one person in each clinic can take on this role, outcomes could improve dramatically.' The idea is to create a support system that respects India's unique cultural fabric while addressing the complexities of chronic disease care. With the number of general practitioners declining and tertiary centers overwhelmed, the IBD counsellor could become a critical link in India's healthcare chain -- in most regions across the country.
