New Delhi, November 12, 2025: The Union Health Ministry has issued a comprehensive advisory to all states and Union territories, urging them to enhance healthcare preparedness and response for diseases associated with air pollution. The advisory comes at a time when several regions across the country experience a marked rise in particulate matter during the winter months, posing significant health challenges to vulnerable populations, particularly children, the elderly, pregnant women, and individuals with pre-existing respiratory or cardiovascular conditions.

Under the National Programme on Climate Change and Human Health (NPCCHH), the Ministry has instructed government health facilities and medical colleges to establish and operate chest clinics dedicated to diagnosing, managing, and treating patients affected by air pollution-related health conditions. These clinics, the advisory emphasizes, should function for a minimum fixed duration of two hours daily during peak pollution months, typically spanning from September to March. The guidance reflects a proactive effort to mitigate the health impact of deteriorating air quality, particularly in urban centers covered under the National Clean Air Programme (NCAP).

Role of Chest Clinics in Managing Air Pollution-Related Diseases

The advisory outlines a detailed framework for the operationalization of chest clinics in community health centers, district hospitals, and medical colleges in urban areas. These clinics are expected to perform multiple critical functions: screening patients for risk factors, confirming diagnoses, providing treatment, and offering long-term care for respiratory and cardiovascular diseases aggravated by air pollution. Additionally, they are tasked with maintaining comprehensive patient records using state or national-level digital platforms such as the Integrated Health Information Platform (IHIP).

A key element of the guidelines is the identification of high-risk individuals, whose details are to be recorded in registers and shared with local health authorities, such as ASHA workers, Auxiliary Nurse Midwives (ANMs), and Community Health Officers (CHOs), for community-based follow-up. This approach seeks to ensure that preventive measures, early interventions, and continuous monitoring are systematically implemented at the grassroots level.

Training and Capacity Building for Healthcare Staff

Recognizing that effective management of air pollution-related health issues requires specialized skills, the advisory stresses the importance of training healthcare professionals, including doctors, nurses, and ancillary staff. Training programs are to focus on diagnosis, treatment, and management of respiratory and cardiovascular cases, alongside guidance on counseling patients regarding behavioral changes and adoption of healthier practices to minimize exposure to pollutants. These clinics are envisioned as centers not only for treatment but also for promoting awareness among both potential and diagnosed patients, thereby enhancing community-level resilience against air pollution hazards.

Union Health Secretary Punya Salila Srivastava, in her communication to chief secretaries of states and UTs, highlighted that during winter, air quality frequently deteriorates to poor or severe levels across many regions, making preparedness crucial. She emphasized that coordinated efforts across government departments, healthcare facilities, and local authorities are vital to achieving a cleaner, healthier, and more resilient environment.

Identifying Vulnerable Groups

The advisory underscores that certain groups are particularly susceptible to adverse health outcomes due to air pollution. These include children under the age of five, elderly individuals, pregnant women, patients with asthma or cardiovascular conditions, people from lower socio-economic backgrounds with poor nutritional status, and workers exposed to outdoor environments for prolonged periods. Healthcare facilities are expected to prioritize these groups for screening, preventive care, and ongoing monitoring.

The advisory also directs hospitals to ensure the availability of essential medical resources, including medicines, oxygen cylinders, nebulizers, ventilators, wheelchairs, stretchers, and ambulances. Proper referral mechanisms must be in place to facilitate timely access to specialized care in case of emergencies.

Monitoring Air Quality and Implementing Preventive Measures

States and UTs are required to closely monitor daily Air Quality Index (AQI) levels reported by pollution control boards and take proactive measures when pollution reaches high-risk thresholds. Mitigation strategies suggested in the advisory include controlling dust and emissions from construction sites, prohibiting open burning of waste, crop residues, plastics, and other materials, and providing personal protective equipment such as masks to workers in high-exposure environments.

Construction sites, in particular, are advised to employ measures such as water sprinkling, use of fine sprays to suppress dust, and rotating worker duties to minimize prolonged exposure. Regular health check-ups and training for workers are recommended to ensure awareness of air pollution-related risks and preventive practices.

Guidelines for Schools and Educational Institutions

The Ministry also emphasized precautions for schools to protect children from harmful exposure. Schools are advised to limit or suspend outdoor activities during days with poor AQI, stay indoors during break sessions, and avoid physical activities such as running, jogging, or outdoor games. Even extracurricular activities, functions, and celebrations should be adjusted according to pollution levels.

School staff, including teachers and health coordinators, are to be sensitized on air pollution-related health risks and trained in emergency response procedures in coordination with nearby health facilities. Awareness programs and activities promoting understanding of air pollution among students are encouraged. Reward-based educational events may be organized to reinforce the adoption of healthier behaviors and mitigation practices.

Short-Term and Long-Term Health Impacts of Air Pollution

The advisory provides detailed guidance on recognizing the health effects of air pollution. Short-term exposure, especially to high levels of pollutants, can result in acute symptoms such as irritation of the eyes, nose, throat, and skin, coughing, wheezing, chest discomfort, headaches, giddiness, limb weakness, and facial deviations. Vulnerable populations may experience more severe reactions, including lower respiratory tract infections, exacerbation of asthma or bronchitis, and worsening of chronic illnesses such as chronic obstructive pulmonary disease, ischemic heart disease, and cerebrovascular strokes.

Long-term exposure, even to lower pollutant levels, is associated with chronic illnesses affecting the respiratory and cardiovascular systems, lung cancer, and premature mortality. The advisory calls for systematic interventions and monitoring to reduce both immediate and cumulative health impacts on the population.

Coordination and Implementation

The advisory stresses the need for interdepartmental coordination to address air pollution and its health consequences effectively. State and UT authorities are tasked with integrating health preparedness measures with broader pollution mitigation efforts under the NCAP. Regular monitoring, data collection, and reporting are to be carried out to track health outcomes and effectiveness of interventions.

By establishing dedicated chest clinics, training healthcare personnel, implementing preventive measures in workplaces and schools, and closely monitoring vulnerable populations, the Ministry aims to create a comprehensive, multi-layered strategy for reducing morbidity and mortality associated with air pollution.

Conclusion

Air pollution remains one of India’s most pressing environmental health challenges. The updated advisory issued by the Union Health Ministry underscores the need for proactive planning, strengthened healthcare capacity, and community engagement to mitigate the adverse impacts of pollution, particularly during peak winter months. By emphasizing preparedness in government hospitals, medical colleges, schools, and workplaces, the Ministry aims to protect vulnerable populations and ensure timely treatment for those affected.

The document serves as a critical guide for states and UTs to operationalize effective strategies under the NPCCHH, safeguard public health, and create a healthier and more resilient environment for all citizens. The holistic approach outlined in the advisory—from early screening and treatment to preventive measures and behavioral interventions—reflects the government’s commitment to addressing the complex interplay between air quality and public health.