Pune: About 67 lakh people in Maharashtra were living with chronic respiratory diseases in 2023, contributing 10% of India’s total CRD burden, according to a new analysis by a city-based respiratory research organisation. Air pollution and smoking were among the major contributors, the analysis showed.Pulmocare Research and Education (PURE) Foundation, formerly known as Chest Research Foundation, compiled Global Burden of Disease (GBD) 2023 data to estimate the scale of chronic respiratory diseases in India and Maharashtra, highlighting the state’s significant contribution to the national burden.As per data culled from GBD, globally, chronic respiratory diseases (CRDs) affected about 569 million people in 2023. India accounted for a disproportionate share, with 6.89 crore people living with CRDs, about 12% of the global burden, said Dr Deesha Ghorpade, academic head of PURE Foundation.The analysis showed that asthma and chronic obstructive pulmonary disease (COPD) dominated the national picture. India had 3.23 crore people living with asthma and 3.77 crore with COPD in 2023. COPD alone accounted for nearly 2.39 crore disability-adjusted life years (DALYs), while asthma contributed 53.7 lakh DALYs. Overall, chronic respiratory diseases led to an estimated 3.12 crore DALYs lost in India.DALYs measure the total health loss from a disease. They combine years lost due to early death and years lived with illness or disability into one number.“The national burden is reflected sharply in Maharashtra. COPD accounted for the majority of cases in Maharashtra, affecting about 40.1 lakh people, and contributing 11% of India’s COPD burden. Asthma affected nearly 27 lakh people in the state, accounting for 8.3% of the national asthma burden,” Dr Sundeep Salvi, director of PURE, said.The disability burden was also substantial. Maharashtra lost an estimated 34 lakh DALYs due to CRDs, about 11% of the national total. COPD accounted for 26.5 lakh DALYs and asthma 5.1 lakh DALYs.Dr Ghorpade said, “Risk-factor analysis showed air pollution and tobacco exposure remain major contributors to COPD in both India and Maharashtra. Nationally, smoking, household air pollution and ambient particulate matter together accounted for a large share of COPD burden, including 65 lakh DALYs linked to ambient air pollution alone. In Maharashtra, these exposures accounted for about 4 lakh DALYs from smoking, 8.2 lakh DALYs from ambient air pollution and 4.5 lakh DALYs from household air pollution.“Dr Ghorpade added that the burden across states largely reflected population size. “If you look at absolute numbers, Uttar Pradesh has the highest respiratory disease burden, followed by Madhya Pradesh and Maharashtra. When adjusted per 100,000 population, areas like Delhi rank among the highest,” she said.Explaining why 2023 data remains relevant, she said disease-burden estimates are updated periodically as new studies emerge. The GBD platform brings together data from countries and uses statistical modelling to produce comparable national estimates. “GBD is the most reliable platform for disease burden data across countries, and researchers increasingly rely on it instead of isolated studies,” she said.PURE researchers also recently published a commentary in The Lancet Respiratory Medicine, highlighting the wider Asian context. The paper noted that Asia accounts for 66.6% of global respiratory DALYs and South Asia is the epicentre of the COPD burden. The commentary emphasised that COPD in the region is not primarily a smoker’s disease, with household air pollution, outdoor air pollution and occupational exposures playing a major role.“Despite advances in diagnostics and treatment, the burden of chronic respiratory diseases in India steadily increased from 1990 to 2023. Our highest-population states continue to report the greatest prevalence, deaths, and DALYs, reflecting long-standing gaps in early diagnosis, air quality control, and access to respiratory care,” Dr Salvi said.The estimates are based on data from the Institute for Health Metrics and Evaluation (IHME), which runs the Global Burden of Disease programme, widely considered the world’s most comprehensive health data platform and used by researchers across the globe.
