Women cover their faces with brightly coloured saris when they cross roads crowded with cars, lorries, mopeds and motorcycle taxis. Everywhere people struggle to breathe. Welcome to New Delhi, the most polluted city on Earth.

A report by Greenpeace and Swiss environment group IQ AirVisual has named two districts of the capital – Gurugram and Ghaziabad – as the world’s most polluted spots.

Fifteen of the worst 20 cities were in India with Delhi overall ranked 11th.

But air pollution is a catastrophe of global proportions. Around the world it will kill seven million in the next year, says Greenpeace.

Last year Gurugram and Ghaziabad, suburbs both ranked as cities in their own right, averaged 135.8 and 135.2 microgrammes per cubic metre of the most dangerous pollutant of all – tiny particles known as PM2.5s. 

The World Health Organization (WHO) has set a safe target of 10 microgrammes per cubic metre.The UK, which has its own pollution problems, averages 10.8 microgrammes.

Leading Delhi chest surgeon Professor Arvind Kumar said that on some days Delhi can exceed 1,000 microgrammes – 100 times the safe target.

Much smaller than the width of a human hair, PM2.5s build up in the lungs over time, causing potentially fatal health problems from asthma and pneumonia to lung cancer.

The particles are particularly dangerous for the young.

Professor Kumar said: “This is a public health emergency. It needs to be tackled as a priority. It cannot wait for years and years or there will be irreversible damage.

“I have seen a threefold increase in lung cancer. I am seeing lung cancer in non-smoking patients in their 30s.”

He cited the case of a young married man, a non-smoker, who had terminal lung cancer at the age of 28.

He added: “Nowadays there are no non-smokers in India. Breathing in 22.5 microgrammes per cubic metre is like smoking one cigarette. In Delhi the average is about 200 microgrammes – or about 10 cigarettes a day.  In the coming decades I reckon we will have an explosion of ailments in India because we are all smokers now.”

As an example of concern over pollution levels, Professor Kumar recalled the lengths the US Government pursued to protect President Obama on a visit to Delhi in 2015.

“The US imported 1,800 air purifiers,” he said. “The only place he sat out in the open was for a cup of tea for a couple of hours with Prime Minister Modi. Someone calculated that by doing that Mr Obama shortened his life by three minutes.”

This week the US-based Health Effects Institute calculated that air pollution is shortening lives by an average of 20 months worldwide and up to 30 months in the most polluted areas such as India. The WHO said that air pollution killed 543,000 children worldwide in 2016 and condemns many more to “a life sentence of illness”.

The air in India is being poisoned by traffic fumes, dust from construction and demolition, burning of domestic rubbish and industrial waste, crop burning and even fireworks at festivals. In addition, about 60 per cent of India’s electricity comes from 246 coal-fired power plants.

Diesel buses were banned in Delhi 20 years ago – but now there are large numbers of modern diesel cars on the road because the fuel is cheaper than petrol.

Diesels remain on the road all over the world.

Yeb Sano, executive director of Greenpeace South East Asia, said: “Air pollution steals our livelihoods and our futures In addition to human lives lost, there’s an estimated global cost of $225billion (£171billion) in lost labour and trillions in medical costs.

“We can change that. When we understand the impacts of air quality on our lives we will act to protect what’s most important.” But that will take time and money. And out on the streets the smog is still there.

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