India Accounts for Over 43% of Asia's Chronic Respiratory Disease Disability
A new analysis published in The Lancet Respiratory Medicine has revealed a staggering statistic: India accounts for more than 43% of Asia's chronic respiratory disease-related disability. This represents the highest share in the entire region, highlighting a severe public health challenge.
Air Pollution Identified as a Major Factor
The study, based on estimates from the Global Burden of Disease 2023, identifies air pollution as a primary driver behind India's persistently high lung disease burden. Researchers found that Asia as a whole contributed nearly 67% of global disability-adjusted life years (DALYs) due to chronic respiratory diseases in 2023.
Within Asia, India alone accounted for 43.3% of the region's DALYs, while China contributed 27.8%. Together, these two nations make up over 70% of the regional burden. This disproportionate impact is largely attributed to population size and sustained exposure to environmental risk factors.
High Disability Rates and Vulnerable Populations
In 2023, India's age-standardised DALY rate from chronic respiratory diseases remained alarmingly high at above 2,040 per 100,000 population. This places India among the highest in Asia, reflecting a substantial burden of disability and premature mortality linked to respiratory conditions. Although there has been a gradual decline since 1990, the current rates remain concerning.
Dr. G.C. Khilnani, a pulmonologist and Chairman at the PSRI Institute of Pulmonary, Critical Care and Sleep Medicine, explained the real-world implications. He noted that respiratory illnesses such as pneumonia, asthma, and Chronic Obstructive Pulmonary Disease (COPD) are now among the most common conditions seen in clinical practice. Children and the elderly are particularly vulnerable to these ailments.
Dr. Khilnani emphasized that delayed diagnosis often worsens patient outcomes. He also highlighted that air pollution has emerged as a major driver of respiratory diseases, accounting for nearly half of all COPD cases and a growing share of lung cancers, including among non-smokers.
South Asia's High Prevalence and Poor Outcomes
The study found that South Asia, driven largely by India, recorded the highest age-standardised prevalence of COPD in Asia at 3,044 cases per 100,000 population. While prevalence rates across Asian regions were broadly similar, the analysis revealed that disability and deaths were significantly higher in lower-income regions. This points to poorer healthcare outcomes rather than a higher occurrence of the disease itself.
Dr. Ujjwal Parakh, Senior Consultant in Chest Medicine at Sir Ganga Ram Hospital, commented on the rising trend. He stated that chronic respiratory diseases, particularly COPD, are steadily increasing in India. These conditions are often diagnosed late due to low public awareness and limited access to diagnostic tools like spirometry.
Drawing a stark comparison, Dr. Parakh noted that air pollution damages lungs much like tobacco smoke. He stressed that controlling pollution and improving early detection are critical steps to mitigate the growing burden.
Key Contributors to the Disease Burden
The study pinpointed two major contributors to India's respiratory disease burden: ambient particulate matter pollution and household air pollution from solid fuels. Household air pollution in South Asia was associated with an age-standardised DALY rate of 658 per 100,000 population, ranking among the highest globally.
Warnings and Future Outlook
Researchers issued a cautionary note. Although age-standardised DALY rates for most chronic respiratory diseases have declined across Asia over the past three decades, uneven progress poses a threat. Persistent pollution exposure and gaps in access to quality healthcare could slow or even reverse the gains made so far.
The study warned that without sustained improvements in air quality, a shift to cleaner household energy sources, and more equitable respiratory care, India's lung disease burden is likely to remain high. This underscores the urgent need for comprehensive public health strategies and environmental policies to address this critical issue.
