There are a few elements on this planet that are vital for the existence of mankind and animals, including some species which are at the brink of extinction. It is unfortunate to be writing this short report on how air quality affects our well-being, health, and the environment.
An extensive amount of evidence has shown that long-term exposure to toxic- or poor quality ambient air leads to poor health and an onset of chronic respiratory diseases. One of the main advantages of population-based studies, and more specifically prospective studies, is to present mortality and disease associations, and to evaluate the effectiveness of health interventions or policies across specific scheduled calendar time.
So, just how many years of our lives are lost from poor air quality? It is quite difficult to justify on the number of life-years lost without the access to nationwide data. However, it is possible to estimate on the number of years lost if the following variables are given:
- Three year average of the annual PM2.5 concentrations recorded in µg/m3
- Age-specific mortality rate by exposure to ambient pollution
- The non-exposed group’s life expectancy at birth or remaining life-expectancy (LE) at age x, e.g. LE50
Table 1 shows the number of years lost in life expectancy for an individual residing in mild-, moderate- and heavy polluted area in the United States; different regions of Italy; and on the north-side of the Huai River in China.
Particulate matter air pollution (PM) with an aerodynamic diameter <2.5µm, PM2.5 is associated to an increase risk for mortality, and hence, all estimates presented in this report are based on PM2.5. To further avoid jargon in this article, cities which suffer from heavy pollution usually experience a long-term exposure of 30 µg/m3 of PM2.5, a phenomenon observed in the city centres of China, India, and other developing countries. The counterfactual level is set at 10 µg/m3, an assumed baseline for PM comparison among countries, Table 2.
Economic costs of death
From the assessment of World Health Organization (WHO) report in 2010, countries were ranked in accordance to percentage of GDP at purchasing power parity. The top 10 highest economic costs of death from indoor and ambient air pollution in Europe are: Georgia, Serbia, Bulgaria, Ukraine, Kyrgyzstan, Bosnia & Herzegovina Republic of Moldova, Tajikistan, Yugoslavia, Armenia, and Hungary. 2
The best performing countries are: Norway, Finland, Iceland, Sweden, Ireland, Luxembourg, France, Switzerland, Denmark, and Spain.
Causes of death
According to year 2012 WHO methodology and worldwide pollution data, indoor air pollution attributed to approximate 4.3 million premature deaths and ambient pollution was estimated at 3.7 million.3
Outdoor air pollution-caused deaths – breakdown by disease:
- 40% – ischaemic heart disease;
- 40% – stroke;
- 11% – chronic obstructive pulmonary disease (COPD);
- 6% - lung cancer; and
- 3% – acute lower respiratory infections in children
Indoor air pollution-caused deaths – breakdown by disease:
Forest Fire: South-East Asia, you are not alone.
- 34% - stroke;
- 26% - ischaemic heart disease;
- 22% - COPD;
- 12% - acute lower respiratory infections in children; and
- 6% - lung cancer
For countries such as Singapore and Malaysia, the haze season is becoming a ritual. According to 3M manufacturing, since September 2015, the demand for N95 respiratory masks has increased by 30%. For residents living in South-east Asia, it may not be a bad news to know that they are not the only people in the world who are trapped under the haze blanket, Figure 1.
Poor-air quality is a global concern. On the 22nd of October 2015, WHO released a report on, ‘Reducing global health risks through mitigation of short-lived climate pollutants’. The report was produced in collaboration with the Climate and Clean Air Coalition to Reduce Short-Lived Climate Pollutants (SLCPs). WHO recognizes that interventions to cut SLCPs can reduce disease and death, contribute to food security, improve diets and increase physical activity.4
For affluent countries such as Singapore, it is possible to avoid the haze. The easiest approach is to buy your next airticket to Bhutan or Switzerland for a breath of fresh air. As for the long-term approach, there are certainly more than ‘stop burning the forest’ situation for the government and policy-makers to tackle.
Writer: Yuhui N Lin