Dr Tirathram Kaushik (Sr Consultant GI, HPB, Gynecological & Thoracic Oncosurgery and Robotic Surgery at HCG Cancer Centre, Borivali)
What if the air you breathe every day is silently increasing your risk of a life-threatening disease? In bustling Indian urban areas with heavy traffic and rapid growth, air quality is a growing concern. The 2025 report by the Centre for Research on Energy and Clean Air (CREA) highlights urban persistent struggle with air pollution, with PM2.5 levels far exceeding World Health Organization (WHO) guidelines. For lung cancer specialists, including medical and radiation oncologists, understanding the link between air pollution and lung cancer is critical. This article explores how environmental toxins contribute to lung cancer development, offering insights for specialists to guide patient care and advocate for cleaner air.
Air Pollution: A Hidden Threat
Air pollution, particularly fine particulate matter (PM2.5), is a silent intruder that can penetrate deep into the lungs and bloodstream. These tiny particles, often released from vehicle emissions, industrial activities, and construction dust, are classified by the World Health Organization’s cancer research arm as a Group 1 carcinogen—on par with tobacco smoke and asbestos. While air quality in some cities has improved, with reductions in certain pollutants due to national clean air initiatives, PM2.5 levels in many urban areas still pose a health risk.
The Environmental Toxin–Cancer Connection
Exposure to PM2.5 and other environmental toxins can increase the risk of lung cancer, even in non-smokers. These pollutants trigger inflammation, oxidative stress, and DNA damage, which can lead to cancer over time. Indoor pollutants, like smoke from biomass fuels used for cooking, and occupational exposures, such as asbestos or diesel fumes, further heighten the risk. In urban settings, vehicle emissions and industrial discharges are major contributors, while in households, poor ventilation and reliance on traditional fuels can create hazardous indoor air.
Beyond lung cancer, air pollution is linked to chronic conditions like COPD, asthma, and cardiovascular issues, which can complicate cancer diagnosis and treatment. These overlapping health impacts make it essential for specialists to consider environmental factors when planning patient care.
Pathways of Exposure
- Urban Exposure: Vehicle exhaust, construction dust, and industrial emissions are key sources of PM2.5 in cities, silently accumulating in the lungs of residents.
- Indoor Exposure: Smoke from cooking with biomass or kerosene, particularly in poorly ventilated homes, poses a significant risk, especially for non-smoking women.
- Occupational Exposure: Workers in industries like construction, mining, or transportation face heightened risks from exposure to toxins like silica, asbestos, or diesel fumes without proper protection.
These exposures can spark a cascade of biological effects—chronic inflammation, DNA mutations, and disrupted cell regulation—that may lead to lung cancer over years or decades.
The effects of air pollution extend beyond lung cancer, compounding challenges for specialists. PM2.5 exposure is linked to chronic obstructive pulmonary disease (COPD), asthma, and respiratory infections, which can mimic or exacerbate cancer symptoms. The CREA report highlights that PM2.5 can enter the bloodstream, contributing to cardiovascular issues, which complicates treatment planning for oncologists.
Strategies for Mitigation and Prevention
Reducing exposure to air pollution and environmental toxins is critical for lung health. Here are practical steps individuals and communities can take:
- Breathe Cleaner Indoors– Keep homes well-ventilated while cooking, use chimneys or exhaust fans, and avoid burning wood, coal, or kerosene indoors.
- Limit Outdoor Exposure on High Pollution Days– Track your city’s Air Quality Index (AQI), wear a good-quality mask (N95 or equivalent) when outdoors during poor air days, and avoid heavy outdoor exercise in smoggy conditions.
- Adopt a Smoke-Free Environment– Stay away from active and passive tobacco smoke, incense smoke in poorly ventilated spaces, and occupational dust or fumes without proper protective gear.
- Policy & Regulation: Strengthen enforcement of emission norms, acceleratevehicle transition policies, and enforce pollution control technologies in power plants.
- Targeted Urban Action: Deploy hotspot monitoring and mitigation (e.g., dust reduction, industrial zoning).
Conclusion: Cleaner Air, Healthier Lungs, Happier Lives
In most urban cities, lung cancer is driven not only by personal habits like smoking but also by environmental pollutants embedded in everyday city life. Mainly urban cities air pollution, driven by PM2.5 and other toxins, poses a significant threat to lung health, amplifying the risk of lung cancer and complicating treatment for specialists. Air pollution and environmental toxins are silent yet potent contributors to lung cancer, often going unnoticed until it’s too late. By demanding cleaner air, reducing personal exposure, and supporting preventive health check-ups, we can collectively protect our lungs and safeguard future generations from this preventable tragedy.