Act on Air Pollution, the Silent Killer

Yves here. The focus of this site is often, and too often, on first world issues because that is where the bulk of our readers live. The severity of pollution in China has gotten some attention in the US, in that advanced economy lifestyles have come to depend on shifting the cost of pollution onto emerging economies. But even though we read the occasional horror story about, say, what it means to have cadmium in the soil, most readers lack a visceral sense of what it means to live in an environment that is seriously contaminated.

This post about air pollution in Malaysia provides some perspective. The severity of air pollution in Beijing is well publicized, but it isn’t as well recognized how bad the air is in many other Asian cities. Although I gather the situation has improved since then, I was shocked to see how the air was so dirty in Bangkok in 1997 that you never saw a blue sky. I visited Hong Kong in 2001, and even though I don’t have any respiratory problems, I found the air uncomfortable to breathe. So even though the Economist and other internationally-oriented media outlets occasionally weigh in on this problem, it seems to be accepted in too many places as a fact of life when it shouldn’t be.

By Martin Khor, Executive Director of the South Centre, Geneva. Originally published at The Star

What causes as many or more deaths in Malaysia as road accidents but has not been known to be such a dangerous killer?

Air pollution.

This “killer” is not as dramatic or visible as car crashes, but is even more dangerous as it penetrates and contaminates our vital organs, leading to serious diseases and thousands of death.

Outdoor air pollution caused 6,251 deaths in Malaysia in 2012, according to a recent report by the World Health Organisation.

The deaths were due to heart disease (3,630), stroke (1773), lung cancer (670), pulmonary disease (148) and lower respiratory disease (29).

In 2013, road accidents killed 7,129 people in Malaysia, slightly more than the outdoor air pollution figure for 2012.

But the WHO study does not include indoor or household air pollution, which may have harmed many more people. If the deaths from this were known and added, the total deaths caused by air pollution overall would almost certainly be higher than those caused by road accidents.

It is timely to get these new details on the serious health effects of air pollution.

Malaysians have been enduring the effects of the annual “haze” caused by burning in forest and agriculture areas in Indonesia. Memories of the misery this caused in 2015 are still fresh. Fortunately, the haze has been largely absent so far this year.

WHO estimates that 4.3 million die prematurely each year from indoor pollution, and 3.7 million from outdoor pollution.

And 92% of people in the world live in places that do not meet the WHO health standard for outdoor air quality.

The WHO report, Ambient air pollution: A global assessment for exposure and burden of disease, is based on satellite data and ground station monitors for more than 3,000 rural and urban locations.

The figures for Malaysia show that the country has a PM2.5 annual median concentration of 15 (ranging from 9 to 24) micrograms per cubic metre. This is 50% above the WHO’s guideline limit of 10.

By comparison, other Asian countries had the following air pollution levels: China (54), India (62), Thailand (25), Singapore (17) and Indonesia (14).

The PM2.5 level is the annual median concentration of particulate matter of a diameter less than 2.5 micrometres. PM2.5 includes pollutants such as sulphate, nitrates and black carbon, which penetrate deep into the lungs and in the cardiovascular system, posing the greatest health risks.

Due to the premature deaths, Malaysia also suffered 160,693 years of life lost in 2012, attributable to outdoor air pollution, according to the WHO report.

The adverse effects of this hidden killer have been growing fast (8% increase in deaths from 2008 to 2013). It was responsible for one out of every nine deaths (11.6% of the total) in the world in 2012, according to WHO. That makes it one of the top causes of deaths globally.

The air-pollution related deaths worldwide were due to ischaemic heart diseases and strokes (72%), chronic obstructive pulmonary disease or acute lower respiratory infections (14%) and lung cancer (14%) in 2012.

Ninety percent of the deaths are in developing countries and two out of three occur in our neighbourhood – the Southeast Asia and the Western Pacific regions.

Countering air pollution should thus be a top priority. What should be done? First, collect more details through improvements in monitoring air pollution and its effects.

Second, make the public more aware so they can take action to avoid being exposed.

Third, and most important, identify the causes of the pollution and take action to eliminate or reduce them.

Among the causes of outdoor air pollution are emissions from transport vehicles, coal-fired power plants, industrial factories, burning of wastes, and fires in forest and agricultural areas. Indoor pollution is mainly caused by the use of cooking fuels based on wood and coal.

Besides the direct effects on human health, air pollution is also a major cause of global warming, which in turn also affects health.

It is thus doubly important to tackle these causes. Actions should include the following:

Reduce vehicle emissions through better energy-efficiency and air-pollution standards for vehicles and control of private transport.

Give priority to public transport and promote clean transport such as railways, bicycles and walkways.

Phase out coal-powered plants, shift to clean modes of power, and promote renewable energy.

Impose strict air pollution controls in industry and phase in clean low-emissions technologies.

Phase out the use of wood and charcoal as household fuels, and replace them with safe and efficient stoves.

Reduce waste through recycling and reuse, introduce alternatives to open incineration of solid waste and stop the open burning of household wastes.

Stop the burning of forests, mangroves and in agriculture; this is the most important to prevent the South-east Asian “haze.”

Take measures so as to adhere to the WHO guidelines for outdoor and indoor air pollution.

Air pollution reduction measures should become part of wider health and environmental strategies and be given priority and resources in the country’s development plans.

The problem must also be given the global attention it deserves. Reducing air pollution is one of the targets of the United Nations Sustainable Development Goals. And in May 2016, the World Health Assembly for the first time adopted a four-point road map to tackle air pollution.

Air pollution reduction is crucial to tackling the world’s biggest health and environmental problems.

Though the serious environmental effects of air pollution are well known, we are only at the starting phase of understanding the huge health problem it causes.

While the actions needed are quite clear, getting them implemented will be an immense challenge, as the causes of air pollution are presently so much embedded in modern lifestyles and economic structures.

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  1. PlutoniumKun

    As I have quite a few Chinese friends my social media feeds are stuffed always with constant complaints about air quality (and food contamination). Several of my Chinese friends here in Ireland will state up front that their number 1 reason for liking it here is that its ‘clean’, by which they mean the air is clear and they feel they can trust the food. Anyone who says that pollution is a concern for the well off only has never travelled or talked to people in Asia, rich or poor. It is a constant source of dismay. It is also, I think, why you don’t get many climate change deniers in Asia – when the effects of pollution are so up front and personal, you don’t question scientists who confirm this. In fact, climate change denial (and the sort of other denials of the impact of pollution you find Hayakians and others discuss) is a luxury for those who live in prosperous countries which have spent billions on either eliminating most source of pollution, or exporting them elsewhere.

    China’s air quality is notorious of course, but ironically its probably the healthiest form of air pollution – mostly large, dirty soot particles. The pollution in poorer parts of Asia such as in India or Pakistan or Indonesia is not quite as overt, but is likely to be much deadlier – finer particles, mixed in with lots of nasty photochemicals which are the result of low quality fuels in cheap engines mixed with high temperatures. These are killing and disabling people at a terrifying rate.

    Bangkok is an interesting and somewhat depressing example of how to do things wrong (even though it has improved a little, mostly because of a transfer of industry elsewhere and better than average vehicle emissions). Go walk in some of the older parts of Bangkok and you can see the city that might have been. Narrow little lanes lined with dense, but relatively low rise homes and small businesses, with tropical trees providing shade and wonderful scents, everyone getting around on foot and scooter. But most of the city is terrible (like, to be honest, most Asian cities). Huge highways, massive highrises, sprawling suburbs on a cheap and tacky imitation of not particularly good American and European models. A reliance on air con instead of sensible design, cars instead of public transport, and big malls rather than local networks of shops and markets. In other words, entirely capitalist driven. Even the public transport was designed primarily for the benefit of the better off classes and tourists – its too expensive for many locals and it connects prosperous areas to the airport and malls, it ignores the areas most poorer Bangkokites live in.

    The worst thing is that in many cities, the solutions are neither particularly complicated nor expensive. Curitaba in Columbia is classic example of how to do it right. Take away road space from cars and provide fast, cheap bus services on the existing roads (vastly cheaper than metro systems). Put in segregated bike lanes on existing roads to shove away cars and give people a cheap alternative to moving around. Incentivise the replacement of scooters (terrible polluters) with battery powered alternatives. Encourage denser, low rise neighbourhoods with shops at ground floor and provide cheap market places. Plant trees… lots and lots of trees. They are the cheapest way of cleaning and cooling a city. When you do those things, then you can start grappling with the big expensive pollution problems.

    The reason these things don’t happen is all too obvious. In countries with real bottom up democracies, they are driven by local governments. Where you have autocratic top down governments (whether capitalist or not), then you don’t.

    1. Raj

      Can vouch for 2 wheeler pollution here in Delhi. The state/local government identified them as one of the primary polluters which was no surprise considering how many of them there are. Unfortunately because of shitty politics, the central government, which is a different, right wing party, is not cooperating with the state government to help them build the capacity for public transport required to replace the two wheelers. Wish NC could expose some of the nonsense going on like they did with CalPERS

      1. RabidGandhi

        Here in my part of South America, a call to eliminate 2-wheelers would be decisively classist. At least outside of the major cities, public transport is scarce, and since most people cannot afford cars, it is not uncommon to see a family of 5 stacked on a moto. This is not outlandish when one considers that a scooter can be had for the same amount it takes to fill up two tanks of gas in a car. It thus surprises me that Modi would not be on the bandwagon of eliminating (or making life more difficult for) two-wheelers, since here the four-wheeler crowd would be his constituency.

        Also, there are major macro policies that can go even further toward mitigating pollution, beyond emissions controls. These include making jobs more available to lessen commutes, favouring local production over internal/external imports to reduce shipping, and of course green public transport. I don’t expect Modi or our the LatAm nouvelle vague neoliberals to support any of these policies.

        1. Bjornasson

          The scooter/two-wheeler has a symbolic meaning in India – the classic image of the whole four-person family on one scooter captures the typical urban middle class lifestyle that has existed for decades. It was to transition families away from this arrangement that Ratan Tata devised the $1600 or so Tata Nano car – an ill-fated market-based solution.

          The biggest problem with Indian cities in general is their lack of walkability and poor public transportation system. Couple that with a bourgeois dream of owning a car for every household (traditional Hindu households perform a religious ceremony every time a new car enters the house) means that traffic and pollution is a much more complex problem than simply reducing two-wheelers. Furthermore, Uber-imitators have capitalized on the lack of public transport to vastly increase the number of taxis on the streets. A lot of the air pollution in Indian cities also comes from the burning of trash, pointing to another public intervention issue.

          1. Raj

            Yes true. Regarding pollution due to garbage burning and construction the environmental pollution control agency has releases an app called ‘ hawa badlo’ ( ‘change the air’) where one can quickly lodge a complaint with them. Apparently they are required by law to act by a month on the complaint. As for four wheelers I suppose it’s a complex mixture of the car lobby, finance that help evade taxes and politicians who have been historically involved in corrupt practices. That’s why a well investigated expose is needed to make sense of why something so obvious is mot being tackled head on.

  2. Cry Shop

    One of those air pollution stats that gets downplayed is indoor air quality, which is pretty shockingly bad in large parts of the USA. Houses are built with petrochemical materials to lower costs, and houses and people clean up with even more, to either save labour or feel cleaner/safer.

    Housing that was shipped to Haiti by Clinton’s for profit associates were units condemned by the rather lax US standards. Then there are the industrial indoor small plants that compose most of the industry that stayed in the USA, horribly, but as to those scooters in South East Asia , they may be small but they emit 25 times the particulate pollution of Euro 5 standard cars.

    ed: Meant to link this to the first comment. Oh well.

    1. Katharine

      Unfortunately, too, efforts to make houses more energy efficient sometimes make houses so well sealed as to be poorly ventilated. Unless occupants open windows fairly regularly, bad air can build up. With good design, that may be less of a problem, and fortunately the efforts to improve older houses seldom produce a good enough seal to create problems. I would guess the biggest hazard is in low- to mid-range new construction. Anybody have any good information?

  3. Walt

    Malaysians have been enduring the effects of the annual “haze” caused by burning in forest and agriculture areas in Indonesia.

    Twice Mr. Khor puts “haze” in quotes, suggesting that he thinks the term inappropriate or euphemistic. He’s not alone. In the 1960’s, airline pilots asked the U.S. Weather Bureau to report widespread industrial pollution as “smoke,” rather than as “haze” (then defined as “salt particles or dust”). In response, the Bureau redefined “haze” in 1967 to include smoke that had traveled “25 to 100 miles or more.” Increased reporting of “haze” helped hide the continental scale of pollution, supporting industry’s preference of tall stacks over emission controls.

    Air pollution is not only a problem of cities. For example, more than three quarters of New York City’s fine particle pollution is generated hundreds of miles up wind. Accurate identification of this obscuration as “smoke” or “smog” in weather reports would help us recognize the origins and scale of pollution. And If we understood that the ubiquitous “summer haze” is pollution we might more readily accept the science on climate change.

    1. Vatch

      I agree that the interpretation of the quote marks around “haze” is that the smog is so thick, we really need to use a different word from “haze”. In my mind, haze is something that enhances sunsets, not something that chokes people.

  4. Raj

    We here in Delhi(India) are well familiar with the topic being labelled the most air polluted city in the world in 2010 and still amongst the top 20 most polluted cities in the world

    Hopefully NC will cover in more detail why such is the state in India.

  5. Katharine

    Fifty to sixty years ago, before catalytic converters on chimneys, when some chimneys didn’t even have good gratings to contain large ash, Illinois compounded urban problems by mandating that all public schools burn Illinois coal, which was mostly bituminous, high-sulfur, and certainly contributed to ailments like chronic bronchitis, asthma, and the like. Yet even in that unhealthy environment, there were days of clear deep blue sky, a thing I haven’t seen in years even in the rural midwest. The pictures of polluted sky in China and some other Asian countries are appalling, and the reports of deaths from the Indonesian forest fires earlier this year were very troubling. It’s one of those situations where you don’t want to be the American buttinsky telling other people what to do, but yet my gut reaction is “Dear people, care for your people!”

  6. David

    I have suspected that it was the pollution that caused the Chinese government to put the breaks on economic growth more than their debt bubble. It also fits with their plan to cut meat consumption. The morbidity and mortality could easily have made it the Chinese decade not century

  7. Bjornasson

    I remember one winter I visited my friend in Paris and I could see the Eiffel tower from four miles away through his kitchen window.

    Then he came and visited me in India and I took him to the Taj Mahal. During the day we could see a hazy outline of the Taj Mahal’s roof from our hotel’s roof, which was only about a kilometer away. At night, all we could see was a smoggy cloud.

  8. David

    You can usually see the former sears tower and the trump building and most Chicago skyscrapers from 20 miles

  9. cnchal

    Larry Summers should be proud. Breath the pretty air here, choke on the air over there. Thanks.

    It is thus doubly important to tackle these causes. Actions should include the following:

    Reduce vehicle emissions through better energy-efficiency and air-pollution standards for vehicles and control of private transport.

    What are you gonna do? Pry my dead cold hands off the handlebars of my scooter?

  10. chuck roast

    Ever wonder what happened to the rubber on your bald tires…or the asbestos from your squeaky brakes?
    You probably have occasionaly thought about some vicious material that disappears into the air unseen, unmentioned and unthought about. There must be plenty of them.
    I was concerned about these air pollutants in my days working locally with the Clean Air Act. We were required to test ambient air for CO, NOX, Ozone and the rest of the “criteria” pollutants. But we never “speciated”, that is tested all of the particulate matter in our filters to determine what exactly the stuff was. Some of it surely had high toxicity and morbidity levels. But, hey, whose to know?
    I’m sure that EPA never wanted to know. Otherwise they would certainly have funded research efforts.

  11. Anon

    Well, air pollution is air pollution no matter if it’s “toxic” or not. That’s what the EPA PM-10 regulations are for. ANY particulate matter 10 micrometers or less are considered harmful because they find their way into our respiratory systems (and not readily discharged).

  12. Larry Y

    One of the things that I think Internet of Things will deliver on – lots of remote networked air sensors. Just one node (US Embassy in Beijing) has had an a significant impact.

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