London: Exposure to high levels of ambient and household air pollution in India is associated with an increased risk of cardiovascular diseases such as heart attack and stroke, according a study.

A team led by the Barcelona Institute for Global Health (ISGlobal) in Spain is the first to explore the association between ambient and household air pollution, and carotid intima-media thickness (CIMT) -- a marker of atherosclerosis or thickening of arteries -- in a population of a low-and-middle income country.

The study, performed in a periurban area in Hyderabad, Telangana, shows that people most exposed to fine particles have a higher CIMT index, which means they are at higher risk of developing cardiovascular diseases such as stroke or heart attack.

The study, published in International Journal of Epidemiology, was performed with 3,372 participants.

The team measured CIMT and estimated exposure to air pollution using an algorithm called land use regression (LUR), which is frequently used to predict the amount of fine particles -- suspended particles with a diameter under 2.5 micrometres -- in high-income countries.

The participants also provided information on the type of cooking fuel they used.

The results show that high annual exposure to ambient fine particles was associated with a higher CIMT, particularly in men, participants above 40 years of age, or those with cardiometabolic risk factors, the researchers said.

Sixty per cent of participants in the study used biomass cooking fuel.

"People using biomass fuel for cooking had a higher CIMT, particularly women who cooked in unventilated spaces," Otavio Ranzani, ISGlobal researcher and first author of the study, explained.

"Women had a higher CIMT than men, which could be due to the fact that they spend more time in the kitchen, breathing air polluted by biomass fuel," he said.

Annual average exposure to PM2.5 was 32.7 microgrammes (mg) per cubic metre (m3), far above the maximum levels of 10 mg/m3 recommended by the Word Health Organzation (WHO).

"This study is relevant for countries which, like India, are experiencing a rapid epidemiological transition and a sharp increase in the prevalence of hypertension, diabetes and obesity," said Cathryn Tonne, ISGlobal researcher and coordinator of the study said in a statement.

"In addition, the country is affected by high levels of air pollution, both ambient and indoors," Tonne said. She said the findings highlight the need to perform more studies on air pollution in low- and middle-income countries.

The conclusions may differ considerably from studies in high income countries due to differences in population characteristics and air pollution levels and sources, Tonne noted.

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Dewas/Indore (PTI): At least three workers were killed and 15 persons injured after a fire broke out following an explosion at a firecracker factory in Madhya Pradesh's Dewas district on Thursday, an official said.

Chief Minister Mohan Yadav expressed grief over the incident and ordered an investigation. The state government will provide an assistance of Rs 4 lakh to the kin of each of the deceased, and the injured will receive free treatment, he said in a post on X.

Three persons were killed in the fire at the firecracker unit located in Tonk Kalan area, and around 15 injured persons were sent to hospitals in Indore and Dewas, Collector Rituraj Singh told reporters after inspecting the site.

Videos of the aftermath surfaced on social media, showing thick white smoke billowing from the factory along the Agra–Mumbai national highway. The clips also showed people rushing the injured for treatment amid cries for help, with body parts seen scattered at the site.

The collector said the fire has been brought under control. The administration has taken possession of explosives stored at another location within the unit, he said.

The work to manufacture small firecrackers at the factory of a person named Anil Malviya had begun only 15 days ago, and a licence has been issued for the unit, the collector said.

A detailed investigation is underway into the incident, he added.

CM Yadav said, "I have directed Deputy Chief Minister and Dewas district guardian minister Jagdish Devda, the home secretary and senior officials to visit the spot. An inquiry has also been ordered into the incident."

Local residents said there was a massive explosion at the factory, and the victims' body parts were found scattered far away from the site.

They said construction work was underway at the site and different sheds were being built there.