Statistically, in India, more than 200,000 children are born with Congenital Heart Disease in a year, which means approximately every 3 minutes, a child is born with congenital heart disease. The corresponding global aggregate is between 0.8% and 1.2% of births (National Library of Medicine). Besides biological predispositions and the contributing social factors, environmental pollution, too, cause these numbers to grow.
What is Congenital Heart Disease?
Congenital Heart Disease is marked by abnormalities in the heart before birth, that often occurs due to maternal exposure to environmental pollutants. While the cause for such defects is multifactorial, such exposure to pollutants or solid fuels may predispose the child to congenital heart defects (National Library of Medicine). With advanced medical technology, in most children, if they receive timely treatment for Congenital Heart Defects, they survive into adulthood.
Effect of Pollution
Concerning the etiology of the defects, the American Heart Association study found that infants born in socially and economically deprived and polluted neighborhoods were 48% more likely to have a CHD requiring Congenital Heart Disease treatment at a later stage.
In the Indian context, according to the Indian Academy of Pediatrics, states including Uttar Pradesh, Jammu and Kashmir, Rajasthan, Punjab, and Haryana, Uttarakhand, Bihar, and Himachal Pradesh, fared worse in their probability of births with CHDs, due to higher birth rates. Statistically, children born with CHDs in the Southern states are 70% more likely to receive medical intervention.
Conversely, Bihar and Jharkhand fare worse despite a heavier caseload. According to a report by the Lancet Planetary Health, the worst-hit states in pollution are also in the North and the East, including Uttar Pradesh, West Bengal, Bihar and Rajasthan, with UP reporting a death toll of approximately 349,926 due to pollution in 2019 alone. Drawing from these statistics, there is a mild positive correlation between the two.
Globally, the discussion of the cause and effect association between pollution and congenital heart defects lacks consensus among researchers. For example, as per environmental research conducted in Israel, there is little to no association between gaseous air pollutants and congenital heart defects. Conversely, the British National Library of Medicine struggles for consensus about the effects of specific fuels on this predisposition. In India, while the network of cardiovascular functions is expansive, little attention is paid to the correlation between congenital heart defects and pollution.
Challenges to Treatment
However, the system and research for treatment for Congenital Heart Defects are elaborate and expanding rapidly. While looking into treatment patterns, pollution factors are a precursor and could be subdued through preventive measures. According to Dr Anita Saxena from the All India Institute of Medical Sciences, improving treatment in India requires awareness about CHDs in the print media, better preventive measures and screening, and enhanced geographic distribution of cardiac facilities. Additionally, improved treatment would also require focusing on in-country training and prioritizing care.
Conversely, systems for children’s heart treatment still suffer a delayed diagnosis, maldistribution of resources, financial constraints and the general health-seeking behaviour of the community, and other less defined factors, including inefficient infrastructure and growing population.
All in all, the association between pollution and congenital heart defects is far from definitive. Environmental pollutants increase the vulnerability to heart disorders and the need for children’s heart treatment, but there is little evidence of their contribution beyond that. However, while the correlation study may be mild in India, the network for Congenital Heart Disease treatment is fast expanding.
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