Burden Apportionment of India: Prioritizing the Regional and Sectoral Emissions to Maximize the Health Benefit at Near Future

Fine particulate matter (PM_2.5) pollution and its long-term exposure is one of the most critical environmental and public health risks in India, and has caused an enormous disease burden. However, the particle load is being shared from various sectoral contributions and a significant proportion found at any specific state would have originated from distant sources that are often outside the immediate jurisdiction and control of local authorities. This poses an injustice to some of the states which are emitting less emission but suffering from excess health burden. This study quantifies the burden apportionment under three model scenarios (baseline, advanced technology, and sustainable development) for the years 2015 and 2030, which forecast the future PM_2.5 exposure based on current emission, and partial or full implementations of cost-effective interventions, as part of the Global Burden of Diseases, injuries, and Risk factor study. In 2030, the total excess mortality burden is projected to be 0.79-0.8 million (0.57-1.1) and DALYs burden of 24.1-24.3 million (16.6-30.4) from regional and sectoral emissions, respectively. Low SDI states would have a higher share in India. The state itself, outside, and neighbouring state emissions would be the leading contributors under the regional emission scenario; however, emissions from the secondary, power plant, high stack, transport and waste sectors would lead to higher burden apportionments in 2030. IHD, COPD, and type-2 diabetes would be the leading causes of health burden, especially in adults. The results add evidence for prioritizing sectors and efficacy for revising relevant environment standards and health policies. Immediate adaptation to the best available cost-effective modern technologies (SDS scenario) in households and commercial emission sectors is extremely necessary to reduce the substantial avoidable deaths and disease burden from this major environmental risk factor, improving the medical infrastructure and awareness in low and middle SDI states that are commensurate with the magnitude of air pollution.