Reducing the burden of anaemia in Indian women of reproductive age with clean-air targets

Anaemia (having insufficient red blood cells to carry enough oxygen) is a global health burden associated with exposure to air pollution. This study finds large potential in reducing anaemia prevalence in women of reproductive age if India meets its recent clean-air targets. India has one of the highest (53%) global prevalences of anaemia among women of reproductive age (WRA, 15-49 years). Long-term exposure to ambient fine particulate matter (PM2.5), a type of air pollution, may increase the prevalence of anaemia through systemic inflammation. Using a linear mixed model adjusted for potential confounding factors, we show that for every 10 mu g m(-3) increase in ambient PM2.5 exposure, the average anaemia prevalence among Indian WRA increases by 7.23% (95% uncertainty interval, 6.82-7.63). Among PM2.5 species, sulfate and black carbon are more associated with anaemia than organics and dust. Among sectoral contributors, industry was the greatest, followed by the unorganized, domestic, power, road dust, agricultural waste burning and transport sectors. If India meets its recent clean-air targets, such anaemia prevalence among WRA will fall from 53% to 39.5%, taking 186 districts below the national target of 35%. Our results suggest that the transition to clean energy would accelerate India's progress towards the 'anaemia-free' mission target.