Kathmandu: Nepal has the highest age-adjusted death rate for chronic lung in the world, a new study shows.
The death rate is at 182.5 per 100,000 people, with more than 3,000 years lost to ill health or disability due to illnesses, according to the study published in The BMJ. The study looked at data related to chronic obstructive pulmonary disease (COPD) from 204 countries, and territories between 1990 and 2019.
From 1990 to 2012, motorized vehicles increased by four-folds in Nepal, resulting in massive carbon emissions. The high death rate in Nepal, according to the study, is because of the failure on the part of the authorities to effectively regulate air pollutants and ineffective implementation of air quality control measures.
According to Dr Baburam Marasini, a former Health Ministry official, this isn’t a new issue in Nepal. “I was involved in a few researches on lung diseases in Nepal when I was at the Health Ministry. The main reason behind Nepal’s poor lung health is the use of traditional cooking stoves,” he said.
People, especially in rural parts, inhale residual smoke left by burning firewood inside their kitchen. They use firewood as fuel to cook.
“As someone who was involved in research regarding lung disease conditions in Nepal, the main reason for bad lung health in Nepal a few decades ago was smoking, using firewood for cooking as well as inhaling the residual smoke left by burning firewood inside the house, which we called indoor air pollution at that time,” Marasini said. He also added, “Asthma has been seen among many Nepali people for a long time.”
In 2019, Nepal had the highest age standardized death rates per 100 000, which was 182.5. Nepal also had the highest age standardized disability-adjusted life year (DALY) rates per 100 000, which was 3318.4.
The study shows that the burden of COPD increases with increasing socioeconomic development up to a sociodemographic index of about 0.42, but then decreases up to a socio-demographic index of about 0.81. Countries with high lung disease rates such as Nepal had much higher than expected burdens.
“Usually when number one causes of deaths are discussed, high blood pressure, cancer and diabetes are at the top of the list,” Dr Marasini mentioned. “COPD isn’t much prioritized even though it is among the top 10 causes of death worldwide,” he added.
Discussing the current state of COPD in Nepal, Dr Marasini said, “Despite efforts made by the government to reduce pollution such as Safa Tempo, the efforts aren’t kept up in a steady manner.”
According to him, Nepal needs to move towards clean energy as soon as possible.
Environmental Engineer Bhushal Tuldhar agrees that COPD is a major cause of death. “COPD is the number one cause of death in Nepal, and a large number of COPD cases can be attributed to air pollution. A lot of the air pollution in urban areas is not only due to excessive use of fossil fuel, but also the pollution from India brought in due to wind,” he stated.
In his view, environmental reasons are equally responsible. “The main two reasons are definitely indoor and outdoor pollution. Two thirds of the population of Nepal suffers from lung issues due to indoor pollution due to burning of firewood,” he said. Outdoor pollution makes the situation worse. “Even though indoor pollution is decreasing due to modernization, outdoor pollution is ever increasing,” he said.
Emphasizing the importance of going green, Tuldhar said “We have a lot of progress to make in terms of making our environment healthy. We need to prioritize the use of public transport instead of private vehicles, and also focus on promoting electric vehicles or bicycles to reduce air pollution.”