NEW DELHI: Reduce fine-particle pollution through measurable targets, strengthen health surveillance, control construction dust and industrial emissions, and make cleaner alternatives affordable. These are among the recommendations of a new FICCI-EY report as India faces a mounting health burden from air pollution, with exposure to human-caused fine particulate matter (PM2.5) linked to more than 22 lakh deaths in 2023.
The knowledge paper, Clean Air, Healthy India, released on November 5, calls for a health-led approach to pollution control, with explicit targets for reducing PM2.5 under the National Clean Air Programme (NCAP). It argues that progress should be measured by reductions in people’s exposure and improvements in health outcomes rather than simply counting pollution-control interventions.
PM2.5 particles are particularly dangerous because they penetrate deep into the lungs and can enter the bloodstream. Prolonged exposure is associated with respiratory illnesses, cardiovascular disease, stroke and cognitive impairment, adding to healthcare expenditure and affecting productivity.
“Clean air must be central to India’s healthcare agenda, not 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,” said Dr Ashutosh Raghuvanshi, Chair, FICCI Health Services Committee and MD and CEO, Fortis Healthcare.
Dr Arun Agarwal, Chair, FICCI Working Group on Air Pollution (Healthcare Perspective), former Dean of Maulana Azad Medical College and former Additional Director General of Health Services, said pollution control 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. This requires linking air-quality monitoring with health surveillance, strengthening preventive action and tailoring interventions to local pollution sources,” he said.
The report identifies several gaps in India’s clean-air strategy. NCAP performance is measured primarily through PM10, while monitoring remains uneven across smaller cities, peri-urban areas and rural regions. Enforcement capacity also varies across states and local jurisdictions.
It recommends explicit PM2.5 reduction targets, wider monitoring networks, stronger compliance mechanisms and coordinated action among cities and states sharing the same air basin.
Amit Goyal, Partner, Strategy and Transactions, EY India, said NCAP should be supported by reliable monitoring, regional coordination and investments in affordable cleaner alternatives. Progress, he said, should be measured through sustained reductions in people’s exposure to pollution.
The paper outlines 10 practical interventions covering construction, transport, industry, agriculture, waste management and financing.
For urban areas, it recommends making large construction sites closed-loop for dust management to prevent construction and demolition activities from releasing particulate matter. Intra-city monitoring networks should identify pollution hotspots linked to traffic, industries, construction and waste burning and help authorities assess the effectiveness of interventions.
Smart traffic signals could reduce congestion and vehicle emissions caused by prolonged idling and frequent acceleration and braking.
To tackle industrial pollution, the report proposes pollution markets based on real-time stack-emission data, retrofitting traditional brick kilns with zig-zag firing technology and replacing diesel-based backup power systems with battery-hybrid alternatives.
Agricultural residue should be converted into fuel and marketable products instead of being burnt in fields. The report also recommends using recovered plastic, industrial residue and construction and demolition waste in housing and infrastructure projects.
To make these interventions financially viable, it proposes grouping similar clean-air projects so that smaller initiatives can attract funding collectively.
The report also stresses the importance of preparing the health system ahead of the peak pollution season. Hospitals and schools should have preparedness plans, while healthcare institutions should strengthen disease surveillance and issue timely public health advisories.
Delhi’s own emissions account for approximately 36% of its PM2.5 pollution during winter and 26% during summer, according to the report. This highlights why measures confined to municipal boundaries cannot adequately address the problem. Coordination with neighbouring states and cities is necessary to tackle pollution originating outside the national capital.
Dr Agarwal said air-quality monitoring must be linked to health surveillance, with interventions tailored to local pollution sources.
The report also calls for clear government standards and predictable regulations, greater industrial compliance and community participation in local clean-air decisions.
