Health experts warn cricketers and fans at risk if they attend World Cup game in Delhi

Air quality index (AQI) levels in Delhi on Friday were above 400, with doctors urging spectators to stay away from Sri Lanka v Bangladesh match on Monday

Traffic moves on a road enveloped by fog and smog in New Delhi, India. AP

Indian health experts cautioned fans against attending sports events in the capital Delhi where toxic levels of air pollution have continued to blanket the city and cause a public health emergency.

The South Asian nation is hosting the Cricket World Cup with Delhi set to host the final group match between Sri Lanka and Bangladesh on Monday, where local authorities on Friday announced the closure of all primary schools.

New Delhi, home to 20 million residents, ranks among the world’s most polluted cities and is enveloped in thick smog every winter. The pollution is made worse by farmers in states around the capital burning the stubble of harvested crops to prepare their fields for the next planting season.

Air quality index (AQI) levels in Delhi on Friday were above 400, with the Ashok Vihar station recording 446 AQI, according to the Central Pollution Control Board, the country’s leading environmental watchdog.

But organisers expect a full house at the 40,000-capacity Arun Jaitley Stadium for the Sri Lanka v Bangladesh match, as has been the case for almost all games at the ongoing World Cup.

Doctors, however, have warned fans from doing so, as it could mean exposure to toxic air that could lead to both short and long-term respiratory problems.

Dr Vilkas Maurya, Head of the Department of Pulmonology at Delhi's Fortis Hospital said that people, with risk factors, the elderly and children should avoid attending the match as it could exacerbate respiratory issues.

“As we are seeing high pollution levels people are being exposed to harmful effects and the World Cup is happening at this time. I don’t think it can be shut down now, but I would say that people who have allergies, asthma or risk factors should avoid going to the stadium and stay indoors,” Dr Maurya told The National.

An AQI between zero and 50 is considered “good”, 51-100 is “satisfactory”, 101-200 “moderate”, 201-300 “poor”, 301-400 “very poor” and 401-500 “severe”, according to India's air quality standards, which are less stringent than those followed by the World Health Organisation.

A man walks through a park as the city of New Delhi is engulfed in heavy smog. EPA

Most of the pollution on Friday was from PM 2.5 – particulate matter 2.5 microns in diameter or less – that penetrates deep into the lungs and into the bloodstream and is a major cause of chronic respiratory and cardiac diseases, according to IQAir, a Swiss company that tracks air quality data worldwide.

Dr Maurya’s concerns were shared by Dr Davinder Kundra, Consultant Pulmonologist with Manipal Hospital.

Dr Kundra said that as matches usually involve high-octane energy with spectators screaming, it would increase the chances of people inhaling toxic air.

“People get physically involved, often shouting, which increases excessive respiratory rate. This means inhaling more air pollutants and leading to exacerbation of the underlying problem. They may develop new symptoms and respiratory allergies,” Dr Kundra said.

“Air pollution levels are increasing, it is going to affect the health of people anyway but mainly when an individual inhales air outside, toxic particulate matters in air reach deeper into the lungs and cause infection and exacerbation of asthma. Even people who don’t have asthma will have symptoms.”

The pulmonologists also have shared concerns for the cricketers.

Some English cricketers have reportedly resorted to using inhalers to cope with high levels of air pollution. Test captain Ben Stokes was seen using an inhaler during a training session for their match against Sri Lanka in Bangalore earlier this week.

"It just felt like you couldn't get your breath. It was unique,” England batsman Joe Root told British news website iNews.

A man wearing a facemask walks past a display with air quality information amid heavy smog conditions in New Delhi. AFP

In 2017, a Test match between India and Sri Lanka in Delhi was repeatedly interrupted after Sri Lankan players vomited due to hazardous air quality.

Nine of 11 cricketers from the island nation had worn masks after they returned from a lunch break after two players, bowlers Lahiru Gamage and Suranga Lakmal, left the field due to breathing difficulties.

The umpire halted the match for 20 minutes to consult with team doctors and match officials.

“While we are saying we should limit outside activities, avoid going outside especially in the morning, the match would mean long-standing exposure, almost 6-8 hours, to air pollution. Not only the spectators but also cricketers, who will be staying on the field, will be affected and might develop symptoms,” Dr Kundra said.

Dr Maurya said that it was not wise to hold outdoor activities such as cricket matches in these conditions.

“Sports activities require lots of running and activities, so these should not possibly be held at this time of the year,” he said.

Given the crisis, the Board of Control for Cricket in India has decided to not hold fireworks displays during the matches in Delhi and Mumbai.