Maharashtra's Chronic Respiratory Disease Burden: 67 Lakh Affected in 2023
A comprehensive new analysis has revealed that approximately 67 lakh people in Maharashtra were living with chronic respiratory diseases (CRDs) in 2023. This staggering figure represents a significant 10% of India's total CRD burden, highlighting a major public health challenge in the state. The study, conducted by the Pune-based Pulmocare Research and Education (PURE) Foundation, underscores the severe impact of these conditions on population health.
National and Global Context of Respiratory Diseases
Globally, chronic respiratory diseases affected about 569 million people in 2023, according to data from the Global Burden of Disease (GBD) 2023 study. India accounted for a disproportionate share of this burden, with 6.89 crore people living with CRDs—approximately 12% of the global total. Dr. Deesha Ghorpade, academic head of PURE Foundation, emphasized that this analysis provides crucial insights into the scale of the problem.
The national picture is dominated by two primary conditions: asthma and chronic obstructive pulmonary disease (COPD). In 2023, India had 3.23 crore people living with asthma and 3.77 crore with COPD. The disability-adjusted life years (DALYs) lost due to these diseases are alarming: COPD alone accounted for nearly 2.39 crore DALYs, while asthma contributed 53.7 lakh DALYs. Overall, chronic respiratory diseases led to an estimated 3.12 crore DALYs lost in India.
Maharashtra's Specific Burden and Disability Impact
In Maharashtra, the burden mirrors the national trends but with distinct local implications. COPD accounted for the majority of cases, affecting about 40.1 lakh people and contributing 11% of India's COPD burden. Asthma affected nearly 27 lakh people in the state, accounting for 8.3% of the national asthma burden. Dr. Sundeep Salvi, director of PURE, noted that these figures reflect a sharp concentration of the national crisis within Maharashtra.
The disability burden in Maharashtra is substantial, with an estimated 34 lakh DALYs lost due to CRDs—about 11% of the national total. Specifically, COPD accounted for 26.5 lakh DALYs and asthma for 5.1 lakh DALYs. These metrics combine years lost due to premature death and years lived with illness or disability, providing a holistic view of health loss.
Major Risk Factors: Air Pollution and Tobacco Exposure
Risk-factor analysis identified air pollution and tobacco exposure as major contributors to COPD in both India and Maharashtra. Nationally, smoking, household air pollution, and ambient particulate matter together accounted for a large share of the COPD burden. Notably, 65 lakh DALYs were linked to ambient air pollution alone. In Maharashtra, these exposures resulted in:
- 4 lakh DALYs from smoking
- 8.2 lakh DALYs from ambient air pollution
- 4.5 lakh DALYs from household air pollution
Dr. Ghorpade explained that the burden across states largely reflects population size. "If you look at absolute numbers, Uttar Pradesh has the highest respiratory disease burden, followed by Madhya Pradesh and Maharashtra. When adjusted per 100,000 population, areas like Delhi rank among the highest," she said.
Global Burden of Disease Data and Regional Insights
The analysis is based on data from the Institute for Health Metrics and Evaluation (IHME), which runs the Global Burden of Disease programme. This platform is widely considered the world's most comprehensive health data resource, used by researchers globally. Dr. Ghorpade highlighted its reliability, stating that "GBD is the most reliable platform for disease burden data across countries, and researchers increasingly rely on it instead of isolated studies."
PURE researchers also published a commentary in The Lancet Respiratory Medicine, highlighting the wider Asian context. The paper noted that Asia accounts for 66.6% of global respiratory DALYs, with South Asia being the epicentre of the COPD burden. Importantly, the commentary emphasized that COPD in the region is not primarily a smoker's disease; household air pollution, outdoor air pollution, and occupational exposures play major roles.
Long-Term Trends and Public Health Implications
Despite advances in diagnostics and treatment, the burden of chronic respiratory diseases in India has steadily increased from 1990 to 2023. Dr. Salvi pointed out that "Our highest-population states continue to report the greatest prevalence, deaths, and DALYs, reflecting long-standing gaps in early diagnosis, air quality control, and access to respiratory care." This trend underscores the urgent need for targeted interventions and policy measures to address these gaps.
The findings from this analysis serve as a critical reminder of the ongoing challenges in managing chronic respiratory diseases. With Maharashtra bearing a significant portion of India's burden, focused efforts on reducing air pollution, controlling tobacco use, and improving healthcare access are essential to mitigate future impacts.
