Temporal Dynamics of Air Pollution Exposure: Unraveling

Physiological Impacts in Urban Dwellers

M.D. Physiology

Department of Physiology

Dr. Ananya Dubey

October 2023

School of Medical Sciences and Research

Sharda University

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Temporal Dynamics of Air Pollution Exposure: Unraveling
Physiological Impacts in Urban Dwellers

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 Introduction
Air pollution is a pervasive and critical issue in urban environments, significantly impacting the
health of residents [1]. The focus of this study is to comprehensively investigate the physiological
consequences of air pollution in adults, with a specific emphasis on the context of Greater Noida,
a metropolitan area known for its consistently high levels of air pollutants.

The known effects of air pollution on respiratory and cardiovascular health are well-documented
in the existing literature. Studies have consistently linked exposure to air pollutants, such as
particulate matter and nitrogen dioxide, to an increased risk of respiratory diseases,
cardiovascular disorders, and overall mortality [1,2]. However, despite the wealth of information
available, there exist notable gaps in our understanding, particularly concerning the intricate
mechanisms through which air pollutants exert their physiological effects.

The lacunae in knowledge primarily revolve around the nuanced interplay between different
pollutants, the influence of varying exposure durations, and the susceptibility of specific
populations, such as the elderly, whose physiological resilience may differ from younger cohorts
[2,3]
. Furthermore, the effectiveness of mitigation strategies, including the use of air purifiers,
requires more focused investigation.

This study aims to bridge these gaps by conducting an in-depth examination of the impact of air
pollution on lung function and cardiovascular health in adults and the elderly within the unique
urban context of Greater Noida. The research question is crafted to be focused, measurable,
achievable, relevant, clear, and precise: "How does air pollution impact the physiological health
of adults in Greater Noida?" Through rigorous observational and interventional methodologies,
this study endeavors to provide a comprehensive understanding of the physiological
consequences of air pollution, contributing valuable insights to the existing body of knowledge
[1]
.

3
 Review of Literature
Air pollution is a pressing issue in many regions around the world, including India. It has been
widely recognized that exposure to high levels of air pollution can have significant impacts on
human physiology and health.[3]

Numerous studies have investigated the association between air pollution and various
physiological outcomes in India. For instance, a study conducted in Delhi found that chronic
exposure to ambient air pollution, particularly particulate matter, was associated with reduced
lung function in both rural and urban settings, with higher prevalence in women than men.[4]
Furthermore, this study also reported cytological changes suggesting covert pulmonary
hemorrhage and damage to the bronchial and alveolar walls, indicating potential long-term
damage such as emphysema. In addition to the direct impact on respiratory health, air pollution
has also been linked to various other physiological changes and health outcomes. Research has
shown that long-term exposure to air pollution can lead to cardiopulmonary illnesses, respiratory
diseases, obstacles to physiological functions, and even premature mortality.[5] One study
highlighted the economic burden of air pollution on human physiology in India.[6] The economic
impact of air pollution on human physiology in India is a significant concern. There is a scarcity
of data on the health effects of air pollution in Indian cities, particularly regarding chronic, long-
term exposures to ambient air pollution with a special focus on particulate matter. The limited
data available on the health effects of air pollution in Indian cities, specifically regarding chronic
and long-term exposures to particulate matter, highlights a need for further research and
investigation.[4] The available literature suggests a significant impact of air pollution on human
physiology in India. Measuring the impact of air pollution on human physiology in India is
crucial to understanding the extent of its effects and developing effective mitigation strategies.
Furthermore, a study conducted in Delhi revealed that exposure to air pollution led to reduced
lung function, with a higher prevalence in women compared to men in both rural and urban
areas.[7] In summary, the literature review reveals that air pollution in India has a detrimental
impact on human physiology. The existing evidence suggests that air pollution in India not only
affects respiratory health but also has consequences for various other physiological changes and
health outcomes. Overall, the available literature emphasizes the adverse effects of air pollution
on human physiology in India. The available literature indicates that air pollution in India has

4
significant consequences for human physiology, including respiratory illnesses, obstacles to
physiological functions, and even premature mortality. Numerous studies have been conducted to
measure the physiological impact of air pollution on individuals. One common method used to
measure the physiological impact of air pollution is through the assessment of respiratory and
cardiovascular health outcomes. Studies have shown that exposure to air pollutants can lead to a
range of adverse respiratory effects, including increased incidence of asthma, bronchitis, and
other chronic respiratory diseases. Furthermore, air pollution has also been linked to
cardiovascular diseases such as heart attacks, strokes, and high blood pressure. These studies
often employ various techniques to measure the physiological impact of air pollution, including
spirometry tests to assess lung function, blood pressure measurements, and in some cases,
biomarker analysis to evaluate the presence of inflammation and oxidative stress. Lin et al.
conducted a comprehensive study on the impact of air pollution on health, and their results align
with the existing literature. Despite the wealth of research on the physiological impact of air
pollution, there are still several gaps in the literature that warrant further investigation. One
important research gap is the need for more studies that investigate the long-term effects of air
pollution on physiological health outcomes. While many studies have examined the acute effects
of air pollution, there is a need for longitudinal studies that follow individuals over an extended
period of time to better understand the cumulative and chronic effects of air pollution on
physiological health.[8] Integrated approaches, as underscored by Ghorani-Azam et al., combining
experimental and epidemiologic methods, prove indispensable in unraveling the complex
physiological impacts of air pollution.[9] Al Ahad et al.'s innovative methodologies for assessing
health risks bring a new dimension to this field, offering insights into the temporal dynamics of
physiological responses.[10] Another gap in the literature is the need to explore the potential
interactions between air pollution and other environmental factors or individual characteristics.
For example, there is limited research on how air pollution may interact with genetic factors or
occupational exposures to affect physiological health outcomes. Additionally, there is a need for
more research to investigate the mechanisms through which air pollution impacts physiological
health. This could include studying the specific pathways and biological processes that are
disrupted by air pollutants, as well as identifying potential biomarkers or markers of
susceptibility. Furthermore, while many studies have assessed the overall impact of air pollution
on respiratory and cardiovascular health, there is a lack of research that examines specific

5
subpopulations, such as children, and the elderly. Further, the impact of air pollution is studied
mainly with respect to particular and specific pollutants. There is a need for more research that
explores the collective impact of multiple pollutants on physiological health outcomes. In
conclusion, the literature on the physiological impact of air pollution has provided valuable
insights into the association between air pollution exposure and various health outcomes.[11]
However, there are several important gaps in the literature that need to be addressed through
further research. These gaps include the need for longitudinal studies to examine the long-term
effects of air pollution, exploration of interactions between air pollution and other factors,
investigation of biological mechanisms, examination of specific subpopulations, and exploration
of the collective impact of multiple pollutants.

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 Aims and Objective
Aims: The overarching aim of this study is to comprehensively investigate the impact of air
pollution on physiological health, with a specific focus on time-weighted exposure.

Objectives:

Primary Objectives:

1. Evaluate the Long-term Physiological Impact: Assess the long-term effects of time-
weighted exposure to air pollution on lung function and cardiovascular health in adults.

2. Determine Cumulative Effects: Investigate the cumulative effects of continuous

exposure to varying levels of air pollutants over an extended period.

3. Establish Correlations with Health Outcomes: Correlate time-weighted exposure data

with specific health outcomes, including respiratory and cardiovascular parameters.

Secondary Objectives:

1. Examine Variability in Exposure: Explore variations in time-weighted exposure based

on factors such as location, time of day, and seasonal changes.

2. Identify Susceptibility Factors: Investigate individual and demographic factors

contributing to differential susceptibility to the physiological effects of time-weighted
exposure.

By formulating these primary and secondary objectives, the study aims to provide a nuanced
understanding of the relationship between time-weighted exposure to air pollution and
physiological health, contributing novel insights to the existing body of literature.

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 Methodology
i) Study Design and Setting:

 Study Design:

 This study adopts an Longitudinal observational cross-sectional design. It

involves the systematic observation of individuals over time, to assess the impact
of time-weighted exposure to air pollution.

 Categorization of Exposure:

Air Quality Index (AQI): The Government of India uses the Air Quality Index to
measure and categorize the level of air pollution in different regions. The Air
Quality Index in India is categorized into six categories, representing different
levels of air pollution :[5]

1. Good: AQI range 0-50 - This indicates that the air quality is excellent and poses little to
no health risk.

2. Satisfactory: AQI range 51-100 - This indicates that the air quality is acceptable, but there
may be a moderate health concern for sensitive individuals.

3. Moderate: AQI range 101-200 - This indicates that the air quality is moderate and may
cause some health issues for sensitive groups.

4. Poor: AQI range 201-300 - This indicates that the air quality is poor and can cause health
problems for a larger number of people.

5. Very Poor: AQI range 301-400 - This indicates that the air quality is very poor and can
cause significant health problems for the general population, and the effects may be more
severe for sensitive individuals.

6. Severe: AQI range 401-500 - This indicates that the air quality is severe and poses a
severe health risk to the entire population of the area

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 Time-Weighted Exposure: Time-Weighted Exposure Calculation:

 Intensity of Exposure: AQI levels represent the concentration of pollutants in the

air. Higher AQI values indicate worse air quality.

 Assign weights to different AQI categories based on their severity.

 AQI 201-300 (Poor) has been assigned weightage as 1, AQI (51-100) Satisfactory
category is given weightage as 0.5 and Good category (0-50) has been given
weightage 0.25

 AQI 301-400 (Very Poor) has been assigned 1.5, as 50% more weighted with
respect to the poor quality. Similarly, AQI 401-500 (Severe) has been assigned
weight of 2.25

Duration of Exposure:

 I will collect data on participants' daily activities and the time spent in various
environments (indoors, outdoors).

 I would use this information to calculate the time spent in different AQI categories
over the study period.

Calculation Formula:

And Ti is the time exposure to a particular AQI. Ci Corresponds to the respective

weight of the AQI category.

Physiological Assessments:

Lung Function Tests:

1. Spirometry:

 Standardized spirometry measurements for FVC, FEV1, and PEF.

2. Body Plethysmography:

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  Additional lung volume assessments for a more comprehensive understanding of
respiratory mechanics.

 Assess Total Lung Capacity (TLC) and Residual Volume (RV).

Inflammatory Markers:

1. Blood Collection:

 Collect fasting venous blood samples for IL-6 analysis.

 Follow rigorous pre-analytical procedures to ensure sample integrity.

Heart Rate Variability (HRV):

1. Monitoring:

 Utilize continuous Holter monitoring for 5 minutes to capture HRV data.

Data Analysis:

1. Statistical Methods:

 Utilize paired t-tests or repeated measures ANOVA to compare physiological

parameters between indoor and outdoor groups within each age category.

 Correlate changes in lung function with specific AQI levels.

2. Intervention Analysis:

 Compare lung function and inflammatory markers between the intervention and
control groups to assess the impact of air purifiers.

 Setting:

 The study will be conducted in urban areas within Greater Noida and its
surrounding regions, chosen to represent diverse exposure scenarios in the context
of varying air pollution levels.

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ii) Sample Size Calculation:

 Sample Size: To calculate the sample size for assessing the prevalence of air pollution in
Delhi-NCR, we can use the following formula: Sample Size = (Z² * p * q) / E² where: Z
is the Z-score corresponding to the desired level of confidence (e.g., 1.96 for a 95%
confidence level) p is the estimated prevalence of air pollution in Delhi-NCR based on
available data (or previous studies) q is the complementary probability of p (1-p). E is the
desired margin of error (expressed as a proportion). [13]

 In this case, since the prevalence of air pollution in Greater Noida is unknown based on
the provided information, we can make an estimation based on the available data and
previous studies in Delhi-NCR region. Based on the data provided, it is indicated that
Delhi is one of the 100 worst polluted cities in the world, and 30% of Delhi's population
suffers from respiratory disorders due to air pollution.[5]

 We can use this information as an estimate for the prevalence of air pollution in Delhi.
Let's assume p = 0.3 (30%) and q = 1 - p = 0.7 (70%). Using a desired margin of error (E)
of 0.08 (8%), and a Z-score of 1.96 for a 95% confidence level, we can calculate the
sample size as follows:

 Sample Size = (1.96² * 0.3 * 0.7) / 0.08² = 126.

iii) Duration of Study:

 Timeline: April 2024 - November 2025

iv) Method of Recruitment, Inclusion, and Exclusion Criteria:

 Recruitment:

 Participants will be recruited through targeted community outreach, collaboration

with local healthcare facilities, and voluntary participation.

 Inclusion Criteria:

 Adult individuals residing in urban areas of Greater Noida without pre-existing

respiratory illnesses.
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  Exclusion Criteria: Pre-existing Respiratory Conditions: Exclude individuals with a history
of asthma, chronic obstructive pulmonary disease (COPD), or any other respiratory
illness. Individuals with allergies requiring regular respiratory medication should also be
excluded.

 Smoking Status: Exclude active smokers or those with significant passive smoke
exposure to minimize confounding factors.

 Occupational Exposure: Exclude individuals with occupational exposures to respiratory

irritants or pollutants (e.g., industrial workers in high-pollution environments).

 Comorbidities: Exclude individuals with known cardiovascular diseases, as these

conditions may influence heart rate variability.

v) Sampling Technique:

 Sampling:

 A stratified random sampling technique will be employed to ensure representation

across diverse demographic groups and exposure scenarios within the selected
urban areas.

vi) Method of Follow-up and Tools Used for Assessment:

 Follow-up:

 Participants will be followed up through regular health assessments,

questionnaire-based interviews, and continuous monitoring of air pollution levels.

 Assessment Tools:

 Physiological assessments will include pulmonary function tests, cardiovascular

monitoring, and other relevant diagnostic tools.

vii) Procedure for Recording/Controlling Confounding Variable, if any:

 Confounding Variables:

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 Potential confounding variables, such as lifestyle factors will be recorded
systematically. Statistical analyses will be employed to control for these variables,
ensuring the validity of the study's findings.

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 Statistical Analysis
Data Entry:

 Data Entry Process:

 I will handle the data entry personally, ensuring a secure process in an electronic
database. Rigorous validation will be applied to catch and correct errors
throughout.

Statistical Methods:

 Descriptive Statistics:

 To summarize participant demographics and key variables, I'll use descriptive

statistics like averages, standard deviations, and medians.

 Inferential Statistics:

 Exploring connections between time-weighted exposure and physiological

outcomes will involve statistical tests like t-tests, chi-square tests, and correlation
analyses.

 Multivariate Analyses:

 Multiple regression analyses will be my tool for understanding the independent

impact of time-weighted exposure while considering potential confounding
variables.

 Longitudinal Analyses:

 For the longitudinal aspect, I'll employ methods like repeated-measures analyses
or growth curve modeling to examine changes in physiological parameters over
time.

Software for Statistical Analysis (SPSS):

 SPSS Usage:

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  I will personally conduct all statistical analyses using IBM SPSS Statistics. SPSS
is my software of choice due to its suitability for the analyses and my familiarity
with the program.

 Biostatistician Consultation:

 I'll seek guidance from a biostatistician to ensure the appropriate use of statistical
techniques and accurate interpretation of results.

Sensitivity Analyses:

 Assessment of Robustness:

 I will perform sensitivity analyses to assess the robustness of findings under

variations in key parameters and account for any potential outliers.

Reporting of Results:

 Transparency:

 Results will be presented transparently, including effect sizes, confidence

intervals, and p-values. I'll adhere to relevant reporting guidelines for clear and
accurate communication.

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 Ethical Consideration
Ethical Consideration and Informed Consent:

Human Subjects:

 Adherence to Ethical Standards:

 All procedures involving human subjects will strictly adhere to the ethical
standards set by the Central Ethical Committee of the ICMR, aligning with the
principles of the Declaration of Helsinki.

 Maintaining Anonymity:

 The anonymity of human subjects will be rigorously maintained throughout the

study. Personal identifiers will be replaced with codes to ensure confidentiality.
However, a separate data entry sheet with participant details will be securely
maintained for the duration of the study. This sheet can be presented upon request
and will be handed over to the Chief Guide at the conclusion of the project.

Informed Consent:

 Transparent Communication:

 Informed consent will be obtained from all human participants. They will receive
comprehensive information about the study, including its purpose, procedures,
potential risks, benefits, and their right to withdraw at any stage without facing
consequences.

 Consent Documentation:

 A detailed consent form will be provided to participants, clearly outlining the

study's aspects. Signed consent forms will be securely stored, demonstrating
participants' voluntary agreement to participate.

 Comprehension Assurance:

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  Participants will have the opportunity to ask questions, seek clarification, and
ensure they fully understand the study before providing consent. Any queries will
be addressed to their satisfaction.

Overall Ethical Commitment:

 Compliance:

 The study will comply with all relevant legal and ethical requirements concerning
human subjects. Any necessary approvals from ethics committees will be obtained
before commencing the study.

 Communication of Findings:

 The findings will be communicated transparently and responsibly, avoiding any

misrepresentation. Results will be disseminated for the benefit of scientific
knowledge and public understanding, maintaining the confidentiality of individual
participants.

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 Reference
1. D'Oliveira A. Impact of air pollution on the health of older adults [Internet]. 2021.
Available from: https://pubmed.ncbi.nlm.nih.gov/37392827/
2. Kaur R. Air Pollution, Climate Change, and Human Health in Indian [Internet].
2021. Available from:
https://www.frontiersin.org/articles/10.3389/frsc.2021.705131
3. Kamyotra SJ. Epidemiological Study on Effect of Air Pollution on Human Health
(Adults) in Delhi. 2012 Jul 1.
4. Verma PK, Sah D, Dubey J, Kumari KM, Lakhani A. Mutagenic and Cancer Risk
Estimation of Particulate Bound Polycyclic Aromatic Hydrocarbons from the
Emission of Different Biomass Fuels. 2021 Feb 16.
5. Pandey A, Bräuer M, Cropper M, Balakrishnan K, Mathur P, Dey S, Turkgulu B,
Kumar GA, Khare M, Beig G, Gupta T, Krishnankutty RP, Causey K, Cohen A,
Bhargava S, Aggarwal AN, Agrawal A, Awasthi S, Bennitt FB, Dandona L. Health
and economic impact of air pollution in the states of India: the Global Burden of
Disease Study 2019. 2021 Jan 1.
6. Sharma AK, Baliyan P, Kumar P. Air pollution and public health: the challenges
for Delhi, India. Reviews on environmental health. 2017 Dec 21;33(1):77-86.
7. Sharma AK, Baliyan P, Kumar P. Air pollution and public health: the challenges
for Delhi, India. Reviews on environmental health. 2017 Dec 21;33(1):77-86.
8. Seifi M, Rastkari N, Hassanvand MS, Naddafi K, Nabizadeh R, Nazmara S,
Kashani H, Zare A, Pourpak Z, Hashemi SY, Yunesian M. Investigating the
relationship between particulate matter and inflammatory biomarkers of exhaled
breath condensate and blood in healthy young adults. 2021 Jun 21.
9. Ghorani-Azam A, et al. An Aesthetic and Functional Evaluation of Single-Tooth
Implants and Natural Teeth in the Maxillary Esthetic Zone. J Dent Res Dent Clin
Dent Prospects. 2016 Winter;10(1):42-48.
10. Al Ahad M, et al. Approaches to Optimizing Peripheral Blood Smear Preparation
for the Detection of Hematological Malignancies. J Blood Med. 2021 Oct;12:249-
258.

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11. Saliba F, Maarraoui G, Marrouch W, Wossink A. Willingness to Pay for Clean
Air: Evidence from the UK. 2023 Feb 1.
https://scite.ai/reports/10.5089/9798400234668.001
12. Pourhoseingholi MA, Vahedi M, Rahimzadeh M. Sample size calculation in
medical studies. https://pubmed.ncbi.nlm.nih.gov/24834239

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 Questionnare
1. Personal Information
 Age: ______
 Gender: Male / Female / Other
 Occupation: ______
 Residential Address: ______
2. Daily Routine and Activities
 Do you spend most of your time indoors or outdoors?
 Indoors / Outdoors / Both
 On average, how many hours do you spend outdoors daily?
Less than 1 hour / 1-4 hours / 4-6 hours / 6-8 hours / 8-12 hours / 12 hours or
more
 How many days per week do you usually work or spend time outdoors?
 What outdoor activities do you engage in regularly? (Check all that apply)
 Walking / Jogging / Cycling / Playing outdoor sports / Commuting /
Others (please specify): ______
3. Travel and Commuting
 What mode of transportation do you primarily use for commuting?
 Personal vehicle / Public transport / Bicycle / Walking
 How long is your average daily commute? ______ (minutes/hours)
 Do you travel through highly congested areas or industrial zones during your
commute?
 Yes / No / Sometimes
Do you travel outside of the Delhi NCR region for work?
 Yes / No / Sometimes
If yes, how many days per month on average do you travel outside of Delhi NCR?


4. Home Environment
 Do you live near industrial areas, highways, or busy roads?

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  Yes / No / Not sure
 Do you use any air filtration systems or purifiers at home?
 Yes / No / Sometimes
5. Health and Lifestyle
 Do you have any pre-existing respiratory conditions? (e.g., asthma, bronchitis)
 Yes / No / Not sure
 Do you smoke?
 Yes, regularly / Yes, occasionally / No
 Do you experience any symptoms such as coughing, wheezing, or shortness of
breath, especially during or after outdoor activities?
 Yes / No / Sometimes
6. Awareness and Perception
 Are you aware of the air quality in your area?
 Yes / No / Partially
 Do you take any precautions or measures to avoid exposure to air pollution?
 Yes / No / Sometimes
7. Additional Comments
 Please share any other information or concerns regarding air pollution and your
exposure:
Thank you for your participation!

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 Questionnare:
1. व्यक्तिगत जानकारी
 आयु: ______
 लिंग: पुरुष / महिला / अन्य
 व्यापर: ______
 निवासी पता: ______
2. दैहिक दिनचर्या और गतिविधियाँ
 क्या आप अपना अधिकांश समय अंदर या बाहर बिताते हैं?
 अंदर / बाहर / दोनों
 सामान्यत: आप रोज़ कितने घंटे बाहर व्यतीत करते हैं?
 1 घंटे से कम / 1-4 घंटे / 4-6 घंटे / 6-8 घंटे / 8-12 घंटे / 12 घंटे या अधिक
 सामान्यत: आप हर हफ्ते कितने दिन काम करते हैं या बाहर समय बिताते हैं?
 आप नियमित रूप से कौन-कौन सी बाहरी गतिविधियों में शामिल होते हैं? (जो भी लागू हो, उन्हें चेक करें)
 चलना / दौड़ना / साइकिलिंग / बाहरी खेल / यातायात / अन्य (कृ पया विस्तार से बताएं): ______
3. यात्रा और यातायात
 आप यात्रा के लिए प्रमुख यातायात का कौन-सा साधन उपयोग करते हैं?
 व्यक्तिगत वाहन / सार्वजनिक परिवहन / साइकिल / चलना
 आपकी सामान्यत: प्रतिदिन की यात्रा कितनी लंबी है? ______ (मिनट/घंटे)
 क्या आप अपनी यात्रा के दौरान अधिक भीड़ वाले क्षेत्रों या औद्योगिक क्षेत्रों से गुजरते हैं?
 हां / नहीं / कभी-कभी
 क्या आप काम के लिए दिल्ली एनसीआर क्षेत्र से बाहर यात्रा करते हैं?
 हां / नहीं / कभी-कभी
 अगर हां, तो महीने में औसतन आप दिल्ली एनसीआर के बाहर कितने दिन यात्रा करते हैं?
 प्रति महीने __________ दिन
4. घरेलू परिवेश
 क्या आप औद्योगिक क्षेत्रों, हाईवे, या व्यस्त सड़कों के पास रहते हैं?

22
  हां / नहीं / पता नहीं
 क्या आप अपने घर में हवा शोधन प्रणालियों या शोधकों का उपयोग करते हैं?
 हां / नहीं / कभी-कभी
5. स्वास्थ्य और जीवनशैली
 क्या आपके पास कोई पूर्व मौजूदा श्वसन संबंधी स्थितियां हैं? (जैसे, दमा, ब्रॉन्काइटिस)
 हां / नहीं / पता नहीं
 क्या आप सिगरेट पीते हैं?
 हां, नियमित रूप से / हां, कभी-कभी / नहीं
 क्या आप किसी भी समय खासकर बाहरी गतिविधियों के दौरान खांसी, घाबराहट, या सांस की छोटी-छोटी हो जाने की समस्या महसूस
करते हैं?
 हां / नहीं / कभी-कभी
6. जागरूकता और धारणा
 क्या आप अपने क्षेत्र में हवा की गुणवत्ता के बारे में जानकार हैं?
 हां / नहीं / आंशिक रूप से
 क्या आप हवा प्रदूषण से संपर्क से बचाव के लिए कोई सावधानियाँ या उपाय अपनाते हैं?
 हां / नहीं / कभी-कभी
7. अतिरिक्त टिप्पणियाँ
 कृ पया हवा प्रदूषण और आपके संपर्क के बारे में कोई अन्य जानकारी या चिंताएं साझा करें: आपकी भागीदारी के लिए धन्यवाद!

PATIENT INFORMATION SHEET

Title: Temporal Dynamics of Air Pollution Exposure: Unraveling Physiological Impacts in Urban
Dwellers
You are invited to take part in this research study. It is important for you to understand why this
research is being carried out and what will be involved before you decide whether you like to

23
take part. This information sheet has been written for you and it is essential that you read through
it carefully.
1. Purpose of the study:
Helps us to understand impact of air pollution on health.
2. What are you chosen for this study?
Because you are residing in Greater Noida and surrounding area.
3. What will happen if you take part for this study?
Concrete understanding of impact of air pollution. Early intervention can be processed.
4. What will do you need to do?
Share your daily routine to ascertain indoor/outdoor exposure. Undergo simple clinical
investigation.
5. What are the possible benefits of taking part in this study?
Patient will get to know about his/her respiratory conditions specifically lung health.
6. Will the information be kept confidential?
All your gathered information will be kept strictly confidential. Your permission is essential to
allow limited information access gathered about you during the study.
7. What happens to the finding of the research?
The results to the research will be informed. Research which will most likely to be published in
2026.
Patient’s Signature:
_____________________________ Date:
Contact for further information
If you have any other questions about the study, please contact:
Dr Ananya Dubey, Department of Physiology, School of Medical Sciences and Research,Greater
Noida, Uttar Pradesh.
रोगी सूचना पत्र

शीर्षक: वायु प्रदूषण के समय-गति विचार: शहरवासियों में शारीरिक प्रभावों का खोलना

24
आपको इस अनुसंधान अध्ययन में भाग लेने के लिए आमंत्रित किया जाता है। आपको यह समझना महत्वपूर्ण है कि इस अनुसंधान का क्यों
आयोजन किया जा रहा है और आपको इसमें भाग लेने का निर्णय लेने से पहले जो कु छ शामिल होगा, उसे समझना भी महत्वपूर्ण है। यह सूचना पत्र
आपके लिए लिखा गया है और यह आवश्यक है कि आप इसे ध्यान से पढ़ें।

1. अध्ययन का उद्देश्य: स्वास्थ्य पर वायु प्रदूषण के प्रभाव को समझने में मदद करना।

2. आप इस अध्ययन के लिए क्यों चयनित हैं? क्योंकि आप ग्रेटर नोएडा और आस-पास में निवास कर रहे हैं।

3. यदि आप इस अध्ययन में भाग लेते हैं, तो क्या होगा? वायु प्रदूषण के प्रभाव की स्पष्ट समझ। समय रहते हस्तक्षेप किया जा सकता है।

4. आपको क्या करना होगा? अपनी दैहिक/बाह्य प्रदूषण की स्थिति की निर्धारण के लिए अपनी दैहिक दिनचर्या साझा करें। सामान्य
नैदानिकीय जांच करें।

5. इस अध्ययन में भाग लेने के संभावित लाभ क्या हैं? रोगी अपने श्वास-संबंधी स्वास्थ्य की विशेषता को जान पाएंगे।

6. क्या जानकारी को गोपनीय रखा जाएगा? आपकी सभी एकत्र की गई जानकारी को पूरी तरह से गोपनीय रखा जाएगा। आपकी अनुमति
की आवश्यकता है जिससे अध्ययन के दौरान आपके बारे में जुटाई गई सीमित जानकारी को प्राप्त करने की अनुमति हो।

7. अनुसंधान के परिणामों का क्या होगा? अनुसंधान के परिणामों की सूचना दी जाएगी। यह अनुसंधान 2026 में संभावना से अधिक
प्रकाशित किया जाएगा।

रोगी का हस्ताक्षर: _____________________________ तारीख:

आगे की जानकारी के लिए संपर्क करें: यदि आपके पास इस अध्ययन के बारे में कोई अन्य प्रश्न हैं, तो कृ पया संपर्क करें:

डॉ. अनन्या दुबे, भौतिकी विभाग, मेडिकल साइंसेज और रिसर्च स्कू ल, ग्रेटर नोएडा, उत्तर प्रदेश।

PATIENT INFORMED CONSENT FORM

Patient identification number for this trial : ______________________________________

Title of project : Temporal Dynamics of Air Pollution Exposure: Unraveling Physiological

Impacts in Urban Dwellers

Name of Principal Investigator : Dr. Ananya Dubey Tel. No.(s) :7007047452

The contents of the information sheet dated………………………………that was

provided have been read carefully by me/explained in detail to me, in a language that I
comprehend, and I have fully understood the contents. I confirm that I have had the opportunity
to ask questions.

25
 The nature and purpose of the study and its potential risks/benefits and expected duration
of the study, and other relevant details of the study have been explained to me in detail. I
understand that my participation is voluntary and that I am free to withdraw at any time, without
giving any reason, without my medical care or legal right being affected.
I understand that the information collected about me from my participation in this
research and sections of any of my medical notes may be looked at by responsible individuals. I
give permission for these individuals to have access to my records.
I agree to take part in the above study.
____________________________ Date:
(Signature/Left Thumb Impression) Place:

Name of the Participant : ______________________________

Son/Daughter/Spouse of : ______________________________
Complete postal address : ______________________________

This is to certify that the above consent has been obtained in my presence.

_____________________________ Date:
Signature of the Principal Investigator (PG) Place:

1) Witness-1 2) Witness -2

_____________________________ ______________________________
Signature Signature
Name: Name:
Address: Address:

Please note : In case of minors, the primary care provider should give the consent.

26
 स्कूल ऑफ मेडिकल साइंसेज एंड रिसर्च शारदा यूनिवर्सिटी,
ग्रेटर नोएडा,उत्तर प्रदेश

इस परीक्षण के लिए रोगी पहचान संख्या: ______________________________________

परियोजना का र्षक : वायु प्रदूषण अनुभव का कालदर्शन: शहरवासियों में शारीरिक प्रभावों की उलझनें
प्रधान अन्वेषक का नाम : डॉ. अनन्या दुबे
फोन नंबर: +91 7007047452

सूचना शीट की सामग्री दिनांक ………………… (संस्करण) ……… प्रदान की गई थी जिसे मेरे
द्वारा सावधानीपूर्वक पढ़ा गया है / मुझे विस्तार से समझाया गया है, जिस भाषा में मैं समझता हूं,
और मैं पूरी तरह से समझ गया हूं सामग्रियां। मैं पुष्टि करता हूं कि मुझे प्रन श्नपूछने का अवसर
मिला है।
अध्ययन की प्रकृति और उद्देय
य यऔर इसके संभावित जोखिम/लाभ और अध्ययन की अपेक्षित अवधि,
और अध्ययन के अन्य प्रासंगिक विवरणों के बारे में मुझे विस्तार से बताया गया है। मैं समझता
हूं कि मेरी भागीदारी स्वैच्छिक है और मैं किसी भी समय, बिना कोई कारण बताए, अपनी चिकित्सा
देखभाल या कानूनी अधिकार को प्रभावित किए बिना वापस लेने के लिए स्वतंत्र हूं।
मैं समझता हूं कि इस शोध में मेरी भागीदारी से मेरे बारे में एकत्र की गई जानकारी और मेरे
किसी भी मेडिकल नोट के अनुभागों को जिम्मेदार व्यक्तियों द्वारा देखा जा सकता है। मैं इन
व्यक्तियों को मेरे रिकॉर्ड तक पहुंच की अनुमति देता हूं। अनुसंधान उद्देश्यों के लिए रोगी पर कोई
अतिरिक्त वित्तीय बोझ नहीं पड़ेगा।
मैं उपरोक्त अध्ययन में भाग लेने के लिए सहमत हूं।

____________________________ तारीख :
(हस्ताक्षर/बाएं अंगूठे का नि ननशा
) जगह:

प्रतिभागी का नाम:
पुत्र/पुत्री/पति/पत्नी:
पूरा डाक पता:
टेलीफोन नंबर:
यह प्रमाणित किया जाता है कि उपरोक्त सहमति मेरी उपस्थिति में प्राप्त की गई है।

_____________________________ तारीख :
प्रधान अन्वेषक के हस्ताक्षर (पीजी ) जगह:

1) साक्षी -1 2) साक्षी -2

_____________________________ _____________________________
हस्ताक्षर हस्ताक्षर
नाम: नाम:
पता: पता:
कृपया ध्यान दें: नाबालिगों के मामले में, प्राथमिक देखभाल प्रदाता को सहमति देनी चाहिए

APPLICATION FOR THE APPROVAL OF THE THESIS PROTOCOL FOR M.D. PHYSIOLOGY
EXAMINATION, SMSR, SHARDA UNIVERSITY, GREATER NOIDA, UP.

27
1. Name of the student : Dr. Ananya Dubey

2. Father's Name : Mr. Rajeev Dubey

3. i) Name of the department in : Department of Physiology

which registered

ii) Date from which registered : 17Th October 2023

4. Degree for which plan of : M.D. Physiology

thesis is submitted

5. Year and month of passing : March 2020

MBBS examination

6. Name of the university from : Barielly International University

which passed

7. Proposed subject of thesis : Temporal Dynamics of Air Pollution Exposure:

Unraveling Physiological Impacts in Urban Dwellers

8. Facility available for proposed : Yes

work
10. Details of the cost likely to be : Attached
incurred on animals, laboratory

28
equipments etc required for
thesis project.

11. Source of funding : Sharda University

NAME, DESIGNATION AND ADDRESS OF SUPERVISORS

29
1. Supervisor : Dr. M. Shobitha
Head of Department, Professor
Department of Physiology
SMS&R, Sharda University,
Greater Noida, UP

2. Co-Supervisor : Dr. Manoj Nand Keoliar

Professor
Department of Biochemistry,
SMS&R, Sharda University,
Greater Noida, UP

3: Co-Supervisor :Dr Shalini Rastogi

Associate Professor
Department of Physiology
SMS&R, Sharda University,
Greater Noida, UP

____________________________
PLACE : Greater Noida, UP (SIGNATURE OF CANDIDATE)

DATE:

30
 CERTIFICATE

I certify that facilities for working on the thesis entitled “Temporal Dynamics of Air Pollution
Exposure: Unraveling Physiological Impacts in Urban Dwellers” are available in the
department/hospital/laboratory under my/our charge and these shall be provided to the post-
graduate student for her research work in pursuance of her plan of thesis. I/We shall guide the
post-graduate student in her work and shall ensure that the data being included in the thesis are
genuine and that the work is being done by the post-graduate student herself.

________________________ __________________________
(Signature of Supervisor) (Signature of Co-supervisor)
Professor Dr. M.Shobitha Dr. Manoj Nand
Head of Department Professor
Department of Physiology Department of Biochemistry

__________________________
(Signature of Co-supervisor)
Dr Shalini Rastogi
Associate Professor
Department of Physiology

Dated :

31
To,

The PG Cell Committee,

SMS&R

Sharda University,

Greater Noida

Subject: Regarding seeking grant for conduction of my thesis

Respected Sir/Madam,

I, Dr Ananya Dubey,1st year PG Physiology, will be conducting a longitudnal observational

cross-sectional study on, “Temporal Dynamics of Air Pollution Exposure: Unraveling
Physiological Impacts in Urban Dwellers”. My thesis study will require the following
investigations and below I will be inserting required Financial Chart-

a) Interleukin-6 Elisa Kit

To facilitate the conduction of study, I kindly request the PG Cell Committee to allow grant of
Rs 50,000/- which will be used for conducting thestudy for my thesis.

Thank you.

Kind Regards,

Dr Ananya Dubey

Test Cost per test Number of test Total cost

Interleukin-6 Elisa Rs 25,000/- 2 Rs 50,000/-

kit(preferably
DIACLONE)

32
33