The sale of anti-asthma medicines in India has grown by 43% in the past four years, Hindustan Times reported on Tuesday, which is also World Asthma Day. In 2016 alone, prescriptions for drugs to treat the lung disease among both adults and children showed a 16% rise, the newspaper added, quoting a World Health Organisation report and a market study. The analysis attributed the increase in asthma cases to the worsening air quality in the country.

Asthma is a chronic disease characterised by recurrent attacks of breathlessness and wheezing, which vary in severity and frequency from person to person. The causes of the disease are not completely understood, but risk factors for developing asthma include inhaling “triggers” such as allergens, tobacco smoke and chemical irritants. Asthma cannot be cured, but appropriate management can control the disorder.

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According to a 2014 WHO report, New Delhi has six times the level of airborne particulate matter than is considered safe. Other cities in the country are only slightly better off. The same WHO report reveals that 13 of the 20 most polluted cities in the world are in India. The report ranked cities after studying their air for the presence of harmful gases such as nitrogen dioxide, carbon monoxide and sulphur dioxide, besides particulate matter 10 and 2.5.

Particulate matter, or small airborne particles, is among the most detrimental of these pollutants. Studies link it with increased rates of chronic bronchitis, lung cancer and heart disease.

The WHO advises that fine particles of less than 2.5 micrometres in diameter (PM2.5) should not exceed 10 micrograms per cubic metre. At the top of the WHO ranking, Delhi had 153 micrograms of PM2.5 per cubic metre. Not far behind were Patna (149 micrograms), Gwalior (144 micrograms) and Raipur (134 micrograms). The other Indian cities in the list included Ahmedabad, Lucknow, Kanpur, Firozabad, Amritsar and Ludhiana.

Of the seven non-Indian cities in the rankings, three were from Pakistan. Karachi had 117 micrograms of PM2.5 per cubic metre, Peshawar had 111 micrograms and Rawalpindi, 107 micrograms.