Panoramic view of a neighbourhood in southern Mexico City, with buildings semi-hidden by air pollution. Credit: Emilio Godoy/IPS

By Martin Khor
PENANG, Nov 14 2016 (IPS)

As evidence mounts on the threats posed by air pollution to both human health and the environment, action must be urgently taken to address this problem.  

At the global level, the Paris Agreement that came into force on 10 November aims to get countries to significantly reduce Greenhouse Gas emissions and to better cope with climate change.

In May 2016, Health Ministers approved a global “roadmap” to address air pollution at the World Health Assembly.  And the United Nations’ sustainable development goals, adopted in 2015, contain accompanying targets for reducing air pollution.

But much more needs to be done, especially at the national level, to seriously tackle this crisis.

The adverse health effects of air pollution have been growing worse with a 8% increase from 2008 to 2013 in deaths globally caused by urban air pollution, according to World Health Organisation data. Although the situation has improved in developed countries, it has deteriorated in most developing countries.

Countering air pollution should thus be a top priority. What should be done?   First, more details and data should be collected in all countries, through improvements in monitoring air pollution and its adverse health effects.

Second, a public education campaign is needed to make the public more aware of the dangers of air pollution so they can take actions to prevent the pollution and to avoid being exposed.

Third, and most important, the causes of the pollution must be identified and action plans drawn up to eliminate or reduce the factors these sources.

Martin Khor

Outdoor air pollution is caused by transport vehicles that emit pollutants, 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 fuels that are based on wood and coal.

Besides the direct effects on human health, the 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 of coal powered plants, shift to clean modes of power generation, and promote renewable energy
• Impose strict air pollution controls in industry and phase in clean low-emissions technologies.
• Promote energy efficiency in the design of buildings.
• Phase out the use of wood and charcoal as household fuels used in traditional stoves, 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. (The WHO guideline for particulate matter (PM) outdoor pollution is 10 microgram per cubic meter annual mean for particles below the size of 2.5 microns in diameter, and 20 microgram for particles below 10 microns in size).

Drastically reducing air pollution would be tackling the world’s biggest health and environmental problems, as air pollution is the major source of deaths and diseases, as well as the main cause of climate change
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.  In May 2016, the World Health Assembly for the first time adopted a road map to tackle air pollution and its causes. (WHA Document A69/18;  6 May 2016).  The four-point road map calls on the health sector to:

• Expand the knowledge base on air pollution, its health effects and effectiveness of policies;
• Increase monitoring of air pollution locally and assess the health impacts of its sources;
• Take on a leadership role in national policies to respond to air pollution and at the global level;
• Build its own capacity to influence policy and decision making processes to take joint action on air pollution and health.

The UN’s Agenda 2030 and its Sustainable Development Goals, adopted by world leaders in September 2015, also has goals and targets relevant to air pollution.   These include goals and associated targets relevant to health (Goal 3); cities (Goal 11) and household energy (Goal 7).   The three indicators most relevant to air pollution are:

• SDG Indicator 3.9.1 for goal 3 on health (mortality rate attributed to household and ambient air pollution);
• SDG Indicator 11.6.2 for goal 11 on cities (annual mean levels of fine particulate matter (PM) in cities; and
• SDG Indicator 7.1.2 for goal 7 on energy (proportion of population with primary reliance on clean fuels and technologies).

Cutting down on air pollution, which is closely related to emissions of Greenhouse Gases, is one the major actions (if not the very top action) countries are expected to take to fight climate change, and thus most relevant to the implementation of the Paris Agreement of the UN Climate Change Convention adopted in December 2015.

Indeed, drastically reducing air pollution would be tackling the world’s biggest health and environmental problems, as air pollution is the major source of deaths and diseases, as well as the main cause of climate change.

Action plans on air pollution are thus urgently needed at both national and global levels.

“Fast action to tackle air pollution can’t come soon enough,” said Dr Maria Neira, WHO Director, Department of Public Health, Environmental and Social Determinants of Health. “Solutions exist with sustainable transport in cities, solid waste management, access to clean household fuels and cook-stoves, as well as renewable energies and industrial emissions reductions.”

We are only at the starting phase of understanding the huge health problem that air pollution causes.  We have however been made conscious of the grave crisis that it has caused to the environment.

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

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Dark pollution clouds over Cairo. Credit: Khaled Moussa Al-Omrani/IPS.

By Martin Khor
PENANG, Nov 11 2016 (IPS)

New research is showing that air pollution is a powerful if silent killer, causing 6.5 million worldwide deaths as well as being the major cause of climate change.   

Air pollution has emerged as a leading cause of deaths and serious ailments in the world.  Emissions that cause air pollution and are Greenhouse Gases are also the main factor causing climate change.

Therefore, drastically reducing air pollution should now be treated as a top priority.

The seriousness of this problem was highlighted by the heavy smog that enveloped New Delhi for days at the beginning of November, forcing the government to declare an emergency, schools to be closed and a ban on construction work for several days.

The level of the harmful PM2.5 pollutants had almost reached 1,000 at some times in the Indian capital city, far above the safety level of 60.

Recent research shows that air pollution is the number one environmental cause of human deaths and kills more people annually worldwide than road accidents, violence, fires and wars combined.

This “silent killer” is not as dramatic or visible as car crashes, murders, terrorist attacks or natural disasters, but it is nevertheless even more dangerous as it contaminates vital organs, causing serious diseases and deaths to many millions of people.

Altogether 6.5 million people worldwide are estimated by the World Health Organisation (WHO) to have died prematurely in 2012 because of air pollution.

This means that of the 56 million deaths worldwide in 2012, 11.6% or one in nine were attributable to air pollution.

In comparison, there were 5 million deaths from all injuries including from road accidents (1.3 million deaths), falls, fires, and war in 2012, according to WHO data.

Martin Khor

Indeed, air pollution may have become one of the top killers. Tobacco use, usually described as the world’s leading preventable cause of death, is responsible for nearly 6 million deaths annually, or around 10% of total deaths.

Air pollution may have overtaken it as the world’s leading cause of death.

The WHO estimates that there are 4.3 million deaths attributable to indoor pollution and another 3.7 million deaths to outdoor pollution.

Because some deaths may be due to both outdoor and indoor pollution, it is not possible to add up the two figures to obtain the total deaths.

Thus in its latest estimate in September 2016, the WHO has explained that there were 6.5 million deaths from outdoor and indoor air pollution combined in 2012.

Young children are among the most vulnerable to the effects of air pollution.  A new UNICEF study released on 31 October 2016 found  air pollution is a major contributing factor in the deaths of around 600,000 children under five every year, and that around 2 billion children live in areas where outdoor air pollution exceeded the WHO air quality guidelines.
Besides its threat to human lives and health, air pollution is also the major cause of climate change as it is linked to much of the Greenhouse Gas emissions.

The Paris Agreement of the UN Climate Change Conference that came into force on 10 November aims to limit the rise of the average global temperature to 2 or 1.5 degrees Celsius above the pre-industrial era levels.

At the current rate of global emissions, and even at rates reduced by the Paris Agreement commitments, global warming will far exceed this limit, and thus the world faces potentially catastrophic effects to the global environment, food supplies and also human health.

Thus, air pollution ranks as the biggest threat to both human health and the environment.  Reducing this pollution should therefore be at the top of the global agenda as well as national agendas.

Outdoor Air Pollution

At the end of September, the WHO for the first time published country-by-country details about the extent of outdoor air pollution and the deaths associated with it.

The study shows that 3 million premature deaths worldwide were linked to ambient or outdoor air pollution in 2012.   Of this, 88% of the deaths were in developing countries and two out of three occurred in the Southeast Asia and the Western Pacific regions.

Two countries alone accounted for more than half of the total deaths — China with 1.03 million and India with 621,138.

Other high-numbered countries include Russia (140,851), Indonesia (61,792), Ukraine (54,507), Egypt (43,531), Nigeria (46,750), Pakistan (59,241), United States (38,043), Bangladesh (37,449), Turkey (32,668), Japan (30,790) the Philippines (28,696), Vietnam (27,340), Poland  (26,589), Iran (26,267), Brazil (26,241) and Germany (26,160).

Most of the deaths attributable to outdoor air pollution were caused by non-communicable diseases, especially ischaemic heart diseases (36% of the total deaths), strokes (36%), lung cancer (14%), chronic obstructive pulmonary disease (8%), and acute lower respiratory infections (8%).

The situation is truly pervasive: 92% of the world’s population are exposed to the dangers of unsafe air quality as they live in places that do not meet the WHO health standard for outdoor air quality.

The world as a whole has an annual median exposure to outdoor mean annual concentration of PM2.5 of 39  microgram per cubic metre.  This is four times above the WHO’s guideline limit of 10 microgram per cubic metre for PM2.5.

The regions with the highest outdoor air pollution rates are Eastern Mediterranean high-income countries (91 microgram per cubic metre of PM2.5), Eastern Mediterranean low and middle income countries (55), Southeast Asia (55), Western Pacific low and middle income countries (49) and Africa (32).

The situation is truly pervasive: 92% of the world’s population are exposed to the dangers of unsafe air quality as they live in places that do not meet the WHO health standard for outdoor air quality.
Countries with high incidence of outdoor air pollution include Saudi Arabia (108 microgram per cubic metre of PM2.5), Qatar (103), Egypt (93), Kuwait (75), Bangladesh (84), Cameroon (65), Mauritania (65), United Arab Emirates (64), India (62), Libya (61), Pakistan (60), Bahrain (60) and China (54).

The PM2.5 level is the annual median concentration of particulate matter of a diameter less than 2.5 micrometres.  PM2.5 includes very fine (and thus the most damaging) particles of pollutants such as sulphate, nitrates, ammonia, sodium chloride, black carbon and mineral dust, which penetrate and lodge deep inside the lungs and in the cardiovascular system, posing the greatest health risks of developing cardiovascular and respiratory diseases and lung cancer.

Air quality is normally measured in terms of daily or annual mean concentrations of PM10 or PM2.5 particles (with diameter of 10 or 2.5 micrograms) per cubic metre of air volume.

(The WHO guidelines for particulate matter (PM) outdoor pollution is an annual mean of 10 microgram per cubic meter for particles below the size of 2.5 microns in diameter, and 20 microgram per cubic metre for particles below 10 microns in size.)

The world also suffered 84.9 million years of life lost in 2012, attributable to outdoor air pollution, according to the WHO report.   Years of life lost is a measure of the extent of premature death compared to the normal expected life span.

Of the total years of life lost, 26% was due to lung cancer, 17% to stroke, 17% to acute respiratory disease, 16% to ischaemic heart disease and 8% to chronic obstructive pulmonary disease.

The WHO report “Ambient air pollution: a global assessment of exposure and burden of disease” was based on satellite data, air transport models and ground station monitors for more than 3000 rural and urban locations.

The study does not include indoor or household air pollution, which may be even more dangerous than outdoor air pollution.

Indoor Air Pollution

Worldwide, 4.3 million people die annually from indoor air pollution, mainly from stroke (34%), ischaemic heart disease (26%), chronic obstructive pulmonary disease (22%), pneumonia (12%) and lung cancer (6%).

The main form of the deadly household pollution is the use of solid fuels for cooking and heating.  Nearly 3 billion poor people rely on wood, animal dung, charcoal, crop wastes and coal which are burned in highly polluting simple stoves or open fires.

The resulting pollution, which includes small soot particles that penetrate deep into the lungs, especially affects women and children who spend a lot of time near the kitchen or hearth.

In poorly ventilated homes, indoor smoke can be 100 times higher than the acceptable levels for fine particles, according to WHO.   The use of kerosene lamps for lighting also exposes the families to very high levels of fine particles.

The emissions of black carbon and methane from the stoves also contribute to outdoor air pollution and increase climate change as both are powerful Greenhouse Gases.

The WHO has new indoor air quality guidelines for household fuel combustion and recommendations on types of fuels and technologies to protect health, in addition to guidelines on specific indoor pollutants.  It will also do a study of indoor pollution and when the figures are published they will reveal the full problems caused by air pollution.

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