8:15 AM — I hope I get a rickshaw immediately today. I don’t want to miss my train like yesterday. I walk-run to the crossroad where it’s easier to get a rick. Ten minutes later, after being turned down by four rickshaws, I’m on my way. By 8:35 am, I’ve reached the station but I know I’m late for my 8:41 to Churchgate. After a jog through the subway, then a jog through the platform, I make the next train with two minutes to spare. Forty-five minutes later, I’m waiting in the scorching heat to get a shared cab to my office. By 10:00 AM, I’ve arrived — pushed, shoved, and elbowed, and having been pushed, shoved and elbowed. I feel mentally exhausted, physically drained and sweaty, and the day has not even started yet.

I should say I’m lucky I get in at the first stop, which gives me the privilege of finding a good spot to stand. At least, on the way to work. On the way back, it’s a whole different story.

But not an unusual story. Mumbai is a city of commuters, whether by rick, train and taxi, like me, or by other methods of transport. Losing two to four hours each day to getting somewhere is just part of a hectic city lifestyle. Presently, there are no reliable numbers for travel time. But a survey conducted by Ford Motor Company in 2016 suggests 49% of Indian drivers spend 12 hours per week (approximately 100 minutes a day) in cars. Numbeo, a statistical database, puts Mumbai, Pune and Kolkata among the top 10 cities with the worst traffic conditions in the world. The rankings take into account numerous factors, including average time spent by a commuter one-way.

You might think, given the amount of time I jog from one mode of transportation to the next, that commuting is good for my health. It’s not. Commuting, no matter how you do it, comes with some seriously negative effects on health.

Assuming the numbers above are correct, that’s a lot of time spent exposed to outdoor air pollution; 14 Indian cities feature on the list of top 20 polluted cities in the world, per the World Health Organization, including Kanpur, Delhi, Varanasi, Patna, Lucknow and Jaipur. Big city air is rich in fine particulate matter or PM2.5 which research has linked to strokes, heart disease, lung cancer, and both chronic and acute respiratory diseases, including asthma. (India has roughly 15 to 20 million asthmatics, and the number is growing.) Worldwide, this kind of air pollution is estimated to cause about 25% of lung cancer deaths, 8% of COPD deaths, and about 15% of ischaemic heart disease and stroke.

The physical positions of commuting also takes a toll. According to the Mayo Clinic, “An analysis of 13 studies of sitting time and activity levels found that those who sat for more than eight hours a day with no physical activity had a risk of dying similar to the risks of dying posed by obesity and smoking.” The article goes on to point out that 60 to 75 minutes of moderate exercise a day can offset the health risks of sitting, but urban living has pushed us into a consistently more sedentary lifestyle, in offices and at home. And while standing for long times may not come with such dire potential effects on health, I can say personally it causes back pain, leg muscle fatigue and perpetually swollen ankles.

But perhaps the biggest health risk of commuting comes from stress. Since commuting is a repeated activity, the stress from it could be classified as chronic for some. Chronic stress is known to progressively reduce healthy functioning of the body’s systems, which can contribute to high cholesterol, diabetes, cardiovascular disease, obesity, depression, inflammation and immune suppression. In fact, driving more than 10 miles (or, presumably, the equivalent length of time) has been associated with higher levels of blood sugar, a risk factor for diabetes. It has also been associated with higher levels of cholesterol, higher blood pressure, poorer cardiovascular fitness and less sound sleep.

Long distance commuters also experience higher risks of depression as well as anxiety as compared to those who have shorter commute times. This is true even for people who aren’t directly behind the wheel. In a study conducted by University of Montreal’s School of Industrial Relations, nearly 2000 people were surveyed with regards to their commuting patterns. “Carpooling reduces the passenger commuters’ sense of control, which causes them more stress before they’ve even arrived at work,” says the lead researcher Annie Barreck. While Barreck found the mental health effects of commuting vary with the duration as well as the mode of transport and area in which a person works, she concluded on average, a person is at a risk of burnout if their commute lasts longer than 20 minutes.

For many, including for myself, it’s not possible to eliminate commuting from our lives. And we can’t control certain aspects of it, like sitting or air pollution. But we can take measures to protect our stress level. I’ve started chatting up the people in the train with me, since friendship is known to help relieve stress. When I’m not in a social mood, I make my commute into me-time; I’ve begun to watch my favourite TV show during my train ride to work. Some experts suggest audio books or music can have the same relaxing effect. I plan to try that out, too – at least, until driverless cars cut my commute time in half.