Veteran interventional cardiologist Dr Dev B Pahlajani of Breach Candy Hospital recently shared his concerns in a candid discussion about how Mumbai’s aggressive urban redevelopment is fueling air pollution and posing serious risks to public health, particularly cardiovascular health.

Joined by senior architect Shirish Sukhatme, the conversation highlighted the surge in high-rise construction—towers reaching 18–19 storeys or up to 75–80 meters—driven by liberalized Floor Space Index (FSI) norms under the updated Development Control Regulations (DCR/DCPR 2034). These projects generate substantial dust and particulate matter from materials used in tall structures, compounded by excavation for multiple basements (often 3–4 levels for parking).

Dr Pahlajani, with over six decades in Mumbai (since around 1955), emphasized that this is a relatively recent and worsening phenomenon, especially over the last 2–5 years. He noted a dramatic shift in the city’s Air Quality Index (AQI). Mumbai, historically blessed by its open Arabian Sea frontage and typically moderate pollution (AQI around 100–125), has seen spikes matching Delhi’s levels—reaching 250–300 in foggy mornings or dusty periods, far exceeding WHO guidelines (acceptable annual PM2.5 below 5 μg/m³, with interim targets still much lower than current realities).

Key pollutants like PM2.5, nitrogen dioxide, and elevated CO₂ are particularly toxic to the heart and coronary arteries. Fine particles (PM2.5) are inhaled, enter the bloodstream via the lungs, inflame arteries, accelerate atherosclerosis, and can rupture plaques in vulnerable individuals, triggering myocardial infarction (heart attack). Even in those without prior issues, chronic exposure promotes plaque buildup over time. This is in addition to lung damage, allergies, asthma exacerbations, and potential for increased viral infections as particles can carry pathogens.

Dr Pahlajani pointed to the correlation with relaxed FSI rules, enabling societies to redevelop for extra area, often without adequate planning. This leads to haphazard growth: inadequate road widening (BMC’s responsibility shifted to builders via FSI incentives), overwhelmed drainage, water shortages, and sharply rising vehicle numbers—each 3-BHK flat now allocated multiple parking spaces, potentially adding dozens of cars per building and boosting emissions despite PUC norms.

While no formal patient registry tracks pollution-linked cases at his practice, he observes a clear trend of rising heart attacks in megacities like Mumbai and Delhi (far worse than southern cities like Chennai or Thiruvananthapuram, where AQI remains better). He views the unchecked boom as a public health warning, predicting more lung diseases, cardiac issues, allergies, and related complications without intervention.

His core message: Redevelopment must be planned and regulated, not indiscriminate. Strict enforcement of dust control, adherence to WHO air quality standards, better urban infrastructure, and balanced growth are essential to avert a future burdened by preventable respiratory and cardiovascular epidemics.

Recent events underscore his points—Mumbai’s AQI has fluctuated wildly, hitting unhealthy/severe levels (200+) in hotspots due to construction dust, but improving markedly (to moderate/satisfactory, e.g., 60–90) when authorities cracked down, issuing stop-work notices to hundreds of violating sites and intensifying road washing/misting. This demonstrates construction’s dominant role and the potential for quick gains through enforcement.

Mumbai’s redevelopment push offers housing and growth, but as Dr Pahlajani warns, without thoughtful planning, the hidden cost to public health—especially hearts and lungs—could be immense.