New Delhi: Several health experts have opined that chronic smokers and those working in brick kilns are more vulnerable to severe coronavirus infections.
Although there are not too many studies investigating the link, there is enough evidence to establish that smoking suppresses immune function in the lungs and triggers inflammation.
Long-term smokers are at a heightened risk of developing chronic lung conditions, which have been associated with more severe cases of COVID-19.
"Scientifically, any amount of exposure to tobacco smoke is damaging to the lung's mucus membrane. It may not be adequately big to be diagnosed, but the damage is there. If someone is a chronic smoker, then she/he is continuously damaging their lungs.
"A damaged mucus membrane is more susceptible to severe infection arising out of coronavirus than a healthy membrane. Not just smokers, those exposed to large amounts of smoke are at a higher risk of being infected," said Dr Arun Sharma, Director Professor at University College of Medical Sciences.
A study, which has been published online in the Chinese Medical Journal, involved 78 patients with COVID-19 and found that those with a history of smoking had a 14 per cent higher risk of developing pneumonia.
"The immunity of the lungs is damaged due to smoke arising out of tobacco and any bio-mass fuel," added Sharma, suggesting greater risks involved with novel coronavirus.
According to health experts, during a respiratory infection in the lungs, there tends to be an influx of white blood cells called neutrophils — the first responders that start killing the pathogen — followed by an influx of lymphocytes — which are responsible for clearing the infection.
“I think once you start perturbing this sequence of events in any which way or direction, that’s when things can go awry,” said Ray Pickles, an associate professor of microbiology and immunology at the University of North Carolina in a report by Scientific American.
Apart from triggering pneumonia, smoking is also a risk factor for influenza.
"Anything that weakens the lungs is a problem. Smoking is definitely one of the primary reasons," said Sunita Narain, Director General at the Centre for Science and Environment and a prominent environmentalist.
Meanwhile, with most cities under partial lockdown, migrant labourers, most of who work in brick kilns and construction sites, are returning to their villages.
A case in point is Odisha's Balangir where it is estimated that around 50,000 people from the district alone work in metro cities. Besides, around one lakh people work in brick kilns.
A research paper published by the National Center for Biotechnology Information in 2018 states that brick manufacturing workers are continuously exposed occupationally to high levels of dust and toxic fumes at their workplace.
"These workers were found to have both obstructive as well as restrictive patterns of pulmonary dysfunction," said the report.
Balangir Collector Arindam Dakua said the administration is alert and labourers returning to their villages are being advised to stay in isolation in their homes.
In another district, Koraput, the district administration has directed all panchayat-level officials to isolate people, migrant workers, in particular, returning to the district from coronavirus-affected states.
Police and labour department officials have been asked to monitor inflow of labourers at different railway stations and bus stands.
Private bus owners have been directed to inform the administration about labourers being taken outside the district by agents.
India, which is the second-biggest brick producer in the world with output at nearly 250 billion bricks annually, has an estimated 2,00,000 brick kilns.
Though it is not possible to ascertain the exact number of workers because of the unorganised nature of the industry, some estimates say that there are close to 12 million brick kiln workers in the country.
A good part of the brick-making process remains manual as it is a cheaper option to machines.
"Any profession that has exposure to respiratory distress of any kind are definitely at a higher risk. Brick kiln workers are anyway made to operate in really bad working conditions.
“Also, because of the unorganised nature of the industry, if one person in infected, it will very difficult to contain the spread," said health economist Ravi Duggal.
Several experts also attributed air pollution as one of the reasons for the spread of coronavirus. However, it may be too early to come to a conclusion in this regard. Dr Arun Sharma, Director Professor at University College at Medical Sciences explained why.
"Whatever air pollution level we have, it is not affecting our lungs on an urgent basis. People who are exposed to it for close to 15-20 years may develop lung diseases like chronic bronchitis.
Once the person is in that diseased condition, the chances of him or her getting severely infected by novel coronavirus is very high. However, it will be wrong to deduce that fall in air pollution will definitely reduce the chances of being infected by coronavirus," he said.
"For example, if we close down all industries and impose a strict lockdown and pollution levels come down by say more than 50 per cent, will it reduce the chances of coronavirus, we don't know. There is no scientific evidence," he added.
He, however, said pollutants act as a medium for the virus to piggyback on and get deposited in different places. Therefore, with more pollutants, the chances of spreading of the virus go up.
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