CPCB AQI definitions India 4 >501 Severe-Plus All are in - PowerPoint PPT Presentation

Indicus Foundation #ResponsibleSport // #MyRightToBreathe icare- 1 I ndian C hildrens’ A ctivity Re commendations – Mark 1 Slide Presentation rev_25 October 2019 BACKGROUND RESEARCH & ANALYSIS BY: RECOMMENDED BY GITA SINHA, MD, MPH #RESPONSIBLESPORT FACILITATED BY: INDICUS FOUNDATION #MYRIGHTTOBREATHE 20 OCTOBER 2019 icare- 1

Indicus Foundation #ResponsibleSport// #MyRightToBreathe The Indian Children’s Activity Recommendations: Summary Points � Children are among the most vulnerable to health harm from air pollution � Air pollution exposure harms both short- and long-term physical and mental health � We need to balance the benefits of physical exercise outdoors with the harms of outdoor air pollution � icare-1 does not substitute for individualized, professional medical advice � icare-1 has been designed as a guidance by a multidisciplinary group including health professionals and air pollution experts � Always refer individuals to professional medical care for any concerns or concerning symptoms, regardless of the air quality icare- 1

Indicus Foundation #ResponsibleSport// #MyRightToBreathe The Indian Children’s Activity Recommendations: Parameters included in the Guidance � What is the risk profile? � Age > 10 y.o., Age <10 y.o., Age < 5y.o., Age >60 y.o. � Underlying Medical Condition (e.g. Asthma, Respiratory Disease, Cardiovascular Disease) � Exertion Level � Breathing Rate � Heart Rate � People can sense changes in their breathing and heart rate. � The higher these rates, the greater the ingestion of air pollution components � Duration of the Exercise � Longer time of exercise means greater ingestion of air pollution components � Air Quality icare- 1

Indicus Foundation #ResponsibleSport// #MyRightToBreathe CPCB AQI definitions India 4 >501 Severe-Plus All are in emergency levels of hazardous effects on health icare- 1

Indicus Foundation #ResponsibleSport// #MyRightToBreathe India CPCB standards for pollutant cutoff levels and associated health impacts icare- 1

Indicus Foundation #ResponsibleSport // #MyRightToBreathe The ICARe – 1 Guidance Healthy children above 10 Children between 5 and 10 Children under 5 years old or any CPCB-Defined AQI years, no underlying medical years old, with no underlying child with medical conditions; and range and category conditions. Also teachers and medical conditions senior citizens( >60 y) and adults healthy adults with medical conditions. Blue: Intense Blue: Intense Blue: Intense 0-50 Good Green: Moderate Green: Moderate Orange: Light 51-100 Satisfactory Orange: Light Orange: Light Red: Mild 101-200 Moderate Orange: Light Red: Mild Maroon: Relax 201-300 Poor Red: Mild Maroon: Relax Maroon: Relax 301-400 Very Poor Maroon: Relax Maroon: Relax Maroon: Relax 401+ Severe icare- 1

Indicus Foundation #ResponsibleSport // #MyRightToBreathe Relax Do not undertake any outdoor physical activity: avoid any increase in breath rate or heart rate No yoga or pranayama Avoid even walking or strolling ✓ Stay indoors. ✓ Monitor the indoor air quality as well. ✓ Consider using an air purifier or an appropriately fitted face mask in indoor environment. Maroon: ✓ Minimal duration of any physical exertion Relax icare- 1

Indicus Foundation #ResponsibleSport // #MyRightToBreathe Mild Activity Do not raise your breathing rate or your heart rate with physical activity No athletics, running games and/or sports No pranayama ✓ For most individuals, only undertake very light physical activity ✓ Slow walking or strolling if necessary ✓ Can undertake light yoga with face mask Red: ✓ Use of N95, properly fitting face mask highly recommended Mild ✓ Suggested duration of outdoor activity no more than 20 minutes (only for healthy children) icare- 1

Indicus Foundation #ResponsibleSport // #MyRightToBreathe Light Exercise Your breathing rate and heart rate can increase, but you should be comfortable talking in a normal conversation during the exercise period. High intensity sports and games not recommended ✓ Can undertake light exercise ✓ Can undertake light yoga, physical training etc. ✓ Use of N95, properly fitting mask recommended while doing any exercise Orange: ✓ Suggested duration of outdoor activity no more than 40 minutes Light icare- 1

Indicus Foundation #ResponsibleSport // #MyRightToBreathe Moderate Exercise Activity should include rest and regular break periods to ensure that the breathing rate and heart rate come to resting levels regularly, throughout the practice period. No intensive exercise, and avoid highly competitive sports with no breaks, including long distance running, cycling or marathons ✓ Can take part in non-intensive and non- competitive games and sports ✓ Can undertake low intensity yoga and pranayam ✓ Use of N95, properly fitting N95 mask will still be advisable for children who exercise Green: regularly Moderate ✓ Suggested duration of activities for up to 1-2 hours. For children under 5 years old and children with chronic medical conditions, suggest a more conservative duration of up to 1 hour icare- 1

Indicus Foundation #ResponsibleSport // #MyRightToBreathe Intense Exercise No specific restrictions on breathing or heart rate : if you experience any concerning symptoms, rest and seek medical attention Must be aware of concerning symptoms and rest and/or seek medical attention for any concerns, especially if there are underlying medical conditions ✓ Can take part in all competitive games and sports, irrespective of intensity or duration, ✓ Any form of athletics or competitive sports can be undertaken as well Blue: ✓ Consider using an N95 face mask if there Intense are concerns for risk factors such as chronic underlying disease conditions ✓ Can exercise for longer periods of time (up to 4 hours) icare- 1

Indicus Foundation #ResponsibleSport // #MyRightToBreathe Important Suggested Steps to Implement This Guidance. � 1) Assemble an institution-based group of � 5) Study this guidance to design Alternative stakeholders (e.g. leadership, teachers, coaches, Activity Plans for days when normal activities parents, older/mature students, etc.) must be limited. Alternative activities will have to be designed around a) level of exertion b) � 2) Assess sources of air pollution exposure in and duration c) location d) restricting some students around the institution grounds (e.g. vehicular due to their age or medical conditions traffic <200m from school entry/exit points; DG � 6) Implement the plan and Test the plan. Daily, sets; construction sites; power plants) - Can any of these be minimized? record a) air quality reading b) change in activities implemented c) whether the activity � 3) Determine the risk factor profile of the change was feasible/acceptable to the students/staff: focus on risk groups of children stakeholders. d) Take feedback and record your <10 years old, children and adults with medical impressions! conditions, and elderly adults >60 years old. � 7) Use the findings from 6) to make adjustments � 4) Create a system for receiving AQI/regular air and improvements to the activity plan. Even small quality monitoring at or closely around the changes can help to make a difference to institution. Receive local AQI readings and children’s air pollution exposures and short- and forecasts online, and/or install sensors/monitors long-term health harm. around the school grounds.

Indicus Foundation #ResponsibleSport // #MyRightToBreathe Healthy children Children between 5 Children under 5 years CPCB-Defined ICARE Mark – 1 above 10 years, no and 10 years old, old or any child with AQI range and underlying medical with no underlying medical conditions; category Revisited conditions. Also medical conditions and senior teachers and healthy citizens( >60 y) and adults adults with medical conditions. ✓ All institutions should have an asthma emergency action plan and kit for Blue: Intense Blue: Intense Blue: Intense 0-50 addressing immediate needs of children or adults suffering an acute Good asthma episode. Green: Moderate Green: Moderate Orange: Light ✓ All institutions should provide for 51-100 immediate attention and referral to a Satisfactory health care provider, for any individual with concerning symptoms, at any Orange: Light Orange: Light Red: Mild 101-200 time. Moderate ✓ All institution staff should refer any health related issue IMMEDIATELY to Orange: Light Red: Mild Maroon: Relax certified medical practitioner, per their 201-300 institution’s health action policies Poor Red: Mild Maroon: Relax Maroon: Relax 301-400 Very Poor Maroon: Relax Maroon: Relax Maroon: Relax 401+ Severe icare- 1

Indicus Foundation #ResponsibleSport // #MyRightToBreathe Thank You icare- 1