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Mumbai, the financial capital, has reported 269 cases of acute respiratory infections (ARI) since establishing the sole sentinel site last month at the government-run JJ Hospital to monitor health issues related to air pollution. However, concerns arise among doctors about the limitations of screening at a single centre for a densely-populated city like Mumbai, estimated to have a population of 2 crore.
In the first week of November, the hospital recorded 27 ARI cases which gradually rose to 269 by the end of the month. However, doctors stressed that the actual figures may be significantly higher if data from all civic, government, and private-run hospitals are considered.
“For a city like Mumbai, with over 2 crore population, 269 cases of ARIs may seem relatively low. However, it’s crucial to note that this figure represents data from just one hospital. While JJ is the largest government-run hospital, civic hospitals such as KEM and Sion handle significantly larger patient footfalls. Therefore, these hospitals should also be incorporated into the sentinel site, alongside monitoring the Air Quality Index (AQI),” said a senior officer from Maharashtra Health Services.
Recognising the critical role of hospitals, a total of 17 healthcare facilities have been designated as ‘sentinel surveillance’ sites—one in each of the 17 districts—for monitoring ARI in Maharashtra. Sentinel surveillance entails the systematic monitoring of specific disease occurrences through a voluntary network of doctors, laboratories, and public health departments. The primary objective is to evaluate the stability or changes in the health levels of the population.
Dr Lancelot Pinto, a pulmonologist and epidemiologist from Hinduja Hospital, known for his vocal stance on the health impacts of air pollution, emphasised that relying on a single site is inadequate and inconclusive as it may not reflect the entire city. He pointed out, “A considerable number of ARI patients seek treatment in private hospitals, which often goes unnoticed. Hence, there is a pressing need to establish representative sites in the private sector as well.”
Upon enquiry by The Indian Express with several civic hospitals, it was revealed that KEM Hospital, the largest civic-run hospital in Mumbai, records 2-3 cases of ARIs daily. Extrapolating this to a monthly figure, the hospital alone registers an average of 80 cases of ARI. However, this hospital does not correlate the cases with the AQI of the patients’ residential area, as it is not covered under the sentinel site.
“We do gather information about the patient’s history, including smoking and drinking habits, recent exposure to smoke, among other factors. However, we do not track the AQI to correlate the infection with air pollutants,” said a doctor from KEM Hospital.
As temperatures drop, doctors anticipate a further increase in cases of respiratory disorders if air pollution intensifies. Observations by doctors already indicate a rise in such cases coinciding with the decrease in temperature.
Dr Swapnil Mehta, a pulmonologist at LH Hiranandani Hospital, highlighted a noticeable increase in the number of outpatient department (OPD) cases with respiratory infections in the last two weeks especially among individuals with underlying lung conditions such as asthma, COPD and ILD, leading to prolonged cough and shortness of breath.
Dr Mehta said, “Precipitating factors, whether environmental or viral, sometimes contribute to secondary bacterial infections. As warm-blooded human beings, our bodies humidify and bring air to body temperature. However, during low temperatures, air irritates the lungs, resulting in bronchospasm. Pollutants, harmful chemicals, further exacerbate airway irritation, especially in cold air, leading to bronchoconstriction.”
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