The first thing I do every morning is open my balcony door and check the air outside. If I spot the blue sky, I'm overjoyed and draw in a deep breath. But many days, the air has a dusty, burnt taste. I make a mental note not to forget my air filter mask before I leave the house.
This is life in India's capital, New Delhi.
In the nine years that I have been living here, the air quality has rapidly deteriorated. When I first moved to the city, the winter fog that rolls around this time of the year was white. But over the years, it has turned grayish-brown from smoke and dust. On days I don't wear a face mask, I have a constant headache and my nose clogs up. When the pollution level is high, I try to take shallow breaths, absorbing only as much air as absolutely necessary.
I wanted to know how pollution was affecting my health. So last week, I went to visit Dr. Sunil Kohli, the head physician of Hamdard Institute of Medical Sciences and Research, a public hospital in Delhi.
Kohli specializes in internal medicine. That's the whole body. But a whopping 25 percent of his patients, he says, come in for respiratory problems.
My nostrils have a burning sensation almost all the time, I told the doctor. He nodded. The air pollution makes it hard for him to breathe sometimes, too.
Delhi's air is a toxic concoction, according to a 2008 study by the Central Pollution Control Board, an Indian government body. It includes high levels of dangerous gases like carbon monoxide, nitrogen oxides, sulphur oxides, ozone gas, aerosols and particulate matter (PM) of varying sizes. The finer particles of pollutants — of 2.5 micrometers or smaller — are the most dangerous, the study reports, as they reach the deepest corners of our lungs and into our bloodstream, a 2018 WHO report points out.
This month, the concentration of these tiny pollutants was over 20 times the safe limit set by the World Health Organization.
The poor air quality in Delhi is largely due to transportation, industry and construction, according to a 2013 report by the Indian Journal of Community Medicine. In 2017, 10 million cars plied Delhi's roads, estimates the Delhi government. The tailpipe exhaust and fumes from hot tires on asphalt pose a high risk to commuters' health. On top of that, there's dust from giant construction projects, exhaust from factories around the city, and crop fires hundreds of miles to the north.
So how does breathing in pollution affect health?
A 2016 study published in the Journal of Research and Medical Sciences found that long- and short-term exposure to air pollution has a direct association to respiratory and cardiovascular diseases, eye irritation, skin diseases and cancer, among other ailments.
There's also concerns that the body's hormone system can be affected, according to a 2013 U.N. report — although there are no definitive findings on that yet.
People in Delhi are frustrated. There have been awareness campaigns and government committees to improve the air quality. There have even been restrictions on the use of fireworks on Diwali — one of the major Hindu festivals in India — which has been cited as a contributor to air pollution. Schools are closed on especially polluted days.
And after a public health emergency was declared due to high levels of pollution last November, city authorities implemented a scheme to reduce the number of cars on the road. Cars with even license plate numbers were allowed to drive on alternate days from cars with odd-numbered plates. The step was taken to temporarily cut down on vehicle emission and curb the pollution level.
But when I breathe in the air on my balcony, I still can't tell a difference.
To minimize the harmful effects of breathing, Delhi doctors suggest staying indoors whenever pollution levels spike. That means not being able to do some of the things that I enjoy — like dining outside or going on a picnic with friends.
Over the years, products like air purifiers, oxygen cans and filtered air masks have flooded the markets. Different types of masks are now available. Disposable ones cost as low as 15 cents, and reusable ones, which can last about six months, for $28. For the fashion-conscious, there are even "designer masks," featuring colorful prints.
I recently bought my third reusable mask. It's pretty sophisticated, or so I thought. It has head and neck straps, a nose bumper to seal the air and changeable air filters.
But when I showed my mask to Dr. Vineet Jain, a general physician at Jamia Hamdard Hospital, he wasn't completely convinced of its effectiveness. Polluted air can still make its way through the mask, he says.
Jain suggested nasal filters, which you stick over your nostrils, helping you breathe through the tiny filters. He says they are slightly better in ensuring leak-proof filtering of the air. They look like bandages.
I just ordered them on Amazon.
Every day, I wonder how many years of my life I am giving up, breathing in New Delhi.