From May 18 until Tuesday, the 68th World Health Assembly (WHA) was held in Geneva, Switzerland, and at the meeting, several WHO member states proposed a draft resolution addressing the health impact of air pollution.
Air pollution is among the leading avoidable causes of disease and death globally, and every year, 3.7 million deaths can be attributed to ambient — outdoor — air pollution. Even low levels of air pollution pose health risks, and because many people are exposed to such conditions, diseases and deaths caused by such pollution are increasing in all nations.
Most air pollutants are byproducts of human activities, such as heating, electricity generation, energy-inefficient transportation systems, inferior urban development, industry, and incineration of waste and forests. Air pollutants that are a source of public health problems include particulate matter smaller than 2.5 micrometers (PM2.5) and gases, mainly carbon monoxide, ozone, nitrogen oxide, sulfur dioxide and volatile organic compounds.
Airborne particulate matter widely distributed in indoor and outdoor environments, which can penetrate the lungs’ finer bronchioles and alveoli before entering the blood stream, are a greater health threat than other air pollutants.
The airborne particulate matter in air pollution are a main risk factor for non-communicable diseases, in particular coronary artery disease, myocardial infarction, strokes, chronic obstructive pulmonary disease and cancer. Eighty percent of deaths attributable to outdoor air pollution are caused by heart disease and strokes, and the remaining 20 percent are caused by respiratory disease and cancer.
The International Agency for Research on Cancer designated airborne particulate matter as a “Group 1” carcinogen for lung cancer, and there is a close relationship between air pollution and the development of children’s lung functions, respiratory inflammation and asthma. Air pollution is also related to low birth weight, premature birth and small body size at birth. Short and long-term exposure to air pollution impacts health, but the negative effects of long-term exposure are much greater than the effects of short-term exposure, which means that air pollution increases the severity of existing diseases.
Perhaps it is because Taiwan is not a member of the WHO that the Cabinet, the Ministry of Health and Welfare, and the Environmental Protection Administration have not paid attention to how this resolution has developed over the past few years, or how it offers many suggestions about how to reduce air pollution that could serve as valuable references for the nation, which often suffers from problems with poor air quality. Examples of these suggestions are the careful selection of power generation technology and fuels; always considering the health impacts of every policy to help discriminate which policies can best address the main sources of pollution; giving county and city governments the administrative power to influence and adopt land use, transportation, building and energy system policies; and investments promoting more effective energy use, as well as the adoption of policies to phase out coal-fired power generation plants, thus reducing air pollution and greenhouse gasses.
The WHO says that its member states’ health authorities should play an important role in the response to air pollution and health issues. This call should correct the oversight of domestic health authorities, who for a long time have paid scant attention to air pollution-related diseases. The WHO makes three suggestions that the Ministry of Health and Welfare as well as county and city government health departments, hospitals and clinics should follow.
First, they should connect health statistics and data to air pollution concentrations and sources. This is particularly important in Yunlin and Changhua counties, which are affected by the Mailiao naphtha cracker; Taichung, Nantou and Changhua counties, which are affected by the Taichung Power Plant; and Tainan, Kaohsiung and Pingtung County, which are affected by state-owned CPC Corp’s petrochemical plant in Kaohsiung.
Second, they should improve the monitoring of air pollution-related health concerns, which is especially important in terms of cancer and, in particular, lung cancer among women.
Third, they should differentiate between the health risks and benefits of pollution improvement policies in the heaviest polluting sectors as well as defining the improvement solution that offers the greatest health benefits. This measure is most urgent in connection with the policies for introducing a ban on the use of bituminous coal and petroleum coke for power generation, and replacing it with natural gas, as well as a ban on diesel use, replacing it with clean fuels.
Taiwan sent a delegation of observers to the WHA meeting in Geneva, but there has been no news about the discussions of air pollution-related disease that were held at the assembly. Hopefully this article will alert Taiwanese to the importance of addressing air pollution issues and the WHO resolution will make the health, environmental, economic and transportation authorities at central and local government level work together to eliminate the PM2.5 problem and fight pollution-related disease.
Chan Chang-chuan is vice dean of National Taiwan University’s College of Public Health and director of the college’s Global Health Center.
Translated by Perry Svensson
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