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Air pollution in India is no longer a problem that can be addressed through emergency restrictions when winter smog sets in. Its health effects extend beyond cough, wheezing and breathlessness, contributing to cardiovascular disease, stroke and other long-term health risks. A new knowledge paper by the Federation of Indian Chambers of Commerce and Industry (FICCI) and EY, titled Clean Air, Healthy India, argues that the country's clean-air strategy must be built around public-health outcomes, with year-round action to reduce people's exposure to harmful pollutants.
The report states that more than two million deaths in India were attributable to air pollution in 2023. It also points to gaps in the National Clean Air Programme (NCAP), including its emphasis on PM10 reduction over the more harmful fine particulate matter, PM2.5. The recommendations come as air quality deteriorates across several northern cities. On November 6, Delhi's air quality was in the very poor category in early-morning readings, while several cities across Uttar Pradesh and Haryana also recorded high pollution levels. The report makes the case for treating clean air as a healthcare priority, not simply an environmental target.
Air Pollution Is A Health Crisis, Not Just An Environmental Problem
The FICCI-EY report highlights the ability of PM2.5 particles, which are 2.5 micrometres or smaller, to travel deep into the lungs and enter the bloodstream. Prolonged exposure is associated with respiratory illnesses, heart disease, stroke and cognitive impairment. The health burden also translates into higher healthcare costs and lost productivity.
Dr Ashutosh Raghuvanshi, Chair of the FICCI Health Services Committee and MD and CEO of Fortis Healthcare, said clean air must be central to India's healthcare agenda rather than being treated solely as an environmental objective. "Healthcare institutions have an important role to play in strengthening public awareness, tracking pollution-related illness and improving preparedness," he said, calling for closer collaboration between governments, industry and healthcare providers to turn clean-air commitments into measurable public-health improvements.
The economic consequences are substantial, too. According to the report's estimates for 2022, air pollution-related economic losses could amount to 9%-9.5% of India's GDP. Annual business losses were estimated at around $95 billion, or nearly 3% of GDP, because of reduced worker productivity, absenteeism and operational inefficiencies. The report also cites an estimated 1.3 billion working days lost annually due to pollution-related health problems. These are estimates from the report's economic assessment, not a calculation of the cost of one pollution season.
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Why India Needs Year-Round Action On Air Pollution
Dr Arun Agarwal, Chair of the FICCI Working Group on Air Pollution (Healthcare Perspective), former Dean of Maulana Azad Medical College and Medical Advisor to Apollo Hospitals Group, said India must move beyond seasonal responses. "We need to move beyond seasonal responses to air pollution and make exposure reduction a year-round public health priority," he said. He emphasised the need to link air-quality monitoring with health surveillance, strengthen preventive action and tailor interventions to local pollution sources.
The report identifies several major sources of pollution, including vehicle and industrial emissions, construction and road dust, crop-residue burning, thermal power generation, waste burning and polluting household fuels. Their contribution varies across regions and seasons. This means a single intervention or uniform city-level plan may not be sufficient.
It also points to progress under the NCAP: 103 of 130 cities recorded reductions in PM10 between 2017-18 and FY24-25, with 64 registering reductions of more than 20%. However, the report argues that PM10 monitoring must be complemented by explicit PM2.5 reduction targets, controls on precursor gases and indicators that measure people's exposure and health outcomes.
FICCI-EY Report: 10 Recommendations To Reduce Air Pollution
The report proposes practical interventions across urban, industrial and agricultural settings. These include:
- Construction dust control: Large construction and demolition sites should adopt closed-loop dust management, with measures such as barriers, covered materials and wheel washing.
- Hyperlocal monitoring: Intra-city monitoring networks should identify pollution hotspots around traffic corridors, industries, construction sites and waste-burning locations.
- Cleaner traffic management: Smart traffic signals can reduce congestion, idling and stop-start emissions.
- Industrial emissions: Real-time stack-emission data and stronger compliance monitoring should help control industrial pollution.
- Cleaner backup power: Battery-hybrid systems should replace diesel generator sets where feasible.
- Brick kiln upgrades: Traditional kilns should transition to cleaner zig-zag firing technology.
- Alternatives to stubble burning: Crop residue should be converted into fuel and marketable products, supported by collection systems and assured buyers.
- Waste reuse: Recovered plastic, industrial residue and construction waste can be used in building materials and infrastructure.
- Project financing: Similar smaller clean-air projects can be pooled to attract investment and make implementation viable.
- Health preparedness: Hospitals should strengthen pollution-related illness surveillance and public advisories, while schools and communities need better preparedness and reliable information.
The report also advocates an airshed-based approach, as pollution does not stop at municipal or state borders. It notes that sources within Delhi account for approximately 36% of the city's PM2.5 pollution in winter and 26% in summer in the cited assessment. This underlines why neighbouring cities and states need coordinated action.
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The FICCI-EY report's central message is that India's clean-air efforts must be judged by whether they reduce people's exposure and improve health, not simply by the number of policies or interventions announced. Stronger PM2.5 targets, better monitoring, cleaner infrastructure and year-round coordination between governments, healthcare institutions, industry and communities are essential. As pollution affects both urban and rural populations, protecting public health requires sustained action well beyond the winter smog season.
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