Dirty Air is Dangerous Air

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    There's already a thread here in Pollution forum – Airborne particulates in Hong Kong – health risks. But, especially as Hong Kong Government doesn't seem to want to acknowledge that Dirty Air is Dangerous Air, perhaps useful for another thread, inc on health risks from air pollutants in general, and pollutants other than particulates.

    Starting with news report saying that even before they're born, kids may suffer increased risk of asthma because of air pollution. From BBC:

    Traffic pollution causes genetic changes in the womb which increase a child's risk of developing asthma, research suggests.

    A study of umbilical cord blood from 56 children found "reprogramming" of a gene associated with exposure to compounds in traffic fumes.

    The gene was associated with asthma symptoms at age five, the researchers reported in the PLoS ONE journal.

    "Our data support the concept that environmental exposures can interact with genes during key developmental periods to trigger disease onset later in life, and that tissues are being reprogrammed to become abnormal later," said Dr Shuk-mei Ho, study leader and director of the Center for Environmental Genetics at the University of Cincinnati.

    She said detecting early signs of asthma could help prevent the disease than can affect as many as 25% of children in areas with high levels of traffic pollution.

    Dr Elaine Vickers, research relations manager at Asthma UK, said: 'We don't yet know whether air pollution can actually cause asthma and although this study is very interesting, further research is needed before we can say for sure.

    "We do know however that pollution triggers symptoms in two thirds of people with asthma, and many say that a reduction in air pollution would make the single biggest difference to their quality of life."

    Pollution link to asthma in womb


    From AFP report:

    In a study which could impact air quality regulation, researchers said Wednesday that chronic exposure to one of the major components of smog significantly raises the risk of dying from lung disease.

    The study found that the risk of dying from respiratory disease increased as much as 50 percent as a result of long-term exposure to high concentrations of ground-level ozone.

    This is the first study to look at the long-term health impacts of ozone, which is formed through the chemical reaction between sunlight and the nitrogen oxides spewed from vehicle exhaust and industrial emissions.

    "Many studies have shown that a high-ozone day leads to an increase in risk of acute health effects the next day, for example, asthma attacks and heart attacks," said study co-author George Thurston of New York University’s medical school.

    "What this study says is that to protect the public’s health, we can’t just reduce the peaks, we must also reduce long-term, cumulative exposure."

    The researchers estimate that the risk of dying from respiratory causes rises four percent for every 10 parts-per-billion increase in exposure to ozone.

    Smog raises risk of dying from lung disease: study


    Warning: Smog lowers kids' IQs, even before they're born.

    The five-year-old children of city mothers who regularly breathed in car- and truck-polluted air when they were pregnant scored significantly lower on IQ tests than kids with less exposure, a study released Monday found.

    The findings suggest that pre-natal exposure to air pollution could have the same harmful effects on brain development as lead exposure, and helps explain why inner city kids often do worse academically than wealthier youngsters, said Patrick Breysse, an environmental health specialist at Johns Hopkins' school of public health.

    The study appeared in the August edition of Pediatrics.

    Scientists said more study is needed to rule out the possibility that exposure to pollution after they were born contributed to the children's low scores.

    Read more: Smog lowers kids' IQs, even before they're born, shows New York Study


    From WebMD:

    More evidence reveals that short- and long-term exposure to air pollution directly increases the likelihood of heart attack, heart failure, irregular heartbeats, and death, particularly among vulnerable populations, such as those already at high risk for cardiovascular disease, the elderly, and possibly people with diabetes.
  • Long-term exposure to high concentrations of particulate matter further increases cardiovascular disease risk and can shorten life expectancy by several months to a few years.

    Air Pollution Increases Heart Attack, Stroke Risk


more from WebMD:

A new study shows that as little as a week in a place with high levels of air pollution raises the risk of heart attack.

The additional risk is slight compared with classic heart attack risk factors like high blood pressure, smoking, or diabetes. But researchers say it’s significant because many people are exposed to air pollution, and heart disease is the leading cause of death in industrialized countries.

this is the first study to show even short-term exposure to air pollution is enough to increase the near-term risk of heart attack.

The air pollutants included in the review were ozone, carbon monoxide, nitrogen dioxide, sulfur dioxide, and particulate matter.

The results showed all major air pollutants, with the exception of ozone, were associated with a slight increase in heart attack risk.

Researchers say there are several possible explanations for the association between air pollution and heart attack.

For example, previous studies have shown that exposure to air pollution increases inflammation, which is linked to heart attack risk.

In addition, research has shown that exposure to air pollution may increase the heart rate and may make the blood more likely to form potentially dangerous clots.



Further expert views on our air pollution, in a letter to S China Morning Post published today:

Hong Kong government must reduce air pollution levels

May 09, 2012


Air quality is still at dangerous levels most of the time in Hong Kong and may only improve during summer. Most pollution is locally generated.

I am worried about the PM2.5 level (fine particle concentrations) in Hong Kong.

These particles can reach the deepest part of our respiratory system and part of them can enter our circulatory system, disrupting the epithelial cells and increasing inflammation levels and oxidative stress in the body.

At 70 per cent, our PM2.5 to PM10 ratio (particles under 10 microns in diameter) is higher than that in many countries, indicating we are quite close to the emissions, including primary gaseous pollutants, that can form ultrafine particulate which can be subsequently aggregated to fine particulate.

The current average annual PM2.5 levels are about 250 per cent above World Health Organisation guidelines.

I have a number of suggestions for our new government.

It must implement stringent emission controls on vehicles and ships, such as by road-pricing charges (which operate in London and Singapore). An emission control area can reduce marine emissions near the special administrative region.

An annual eco-prize (say HK$10,000) can be awarded to registered households and the commercial sector that meet low levels of electricity consumption per capita.

There should be an award for working-age (18-65) adults who live close to their workplace, thus enabling them to lower their transport fuel consumption.

Automatic waste-collection checkpoint stations should be installed at buildings and estates (monitored by closed-circuit televisions) and the Octopus cards of registered households and organisations should be credited (HK$10-20 a day) if they dump their waste daily into the correct recycling boxes.

Eco-accountants should be employed to handle these prizes and financial awards given to households and organisations that reduce emissions and volumes of waste.

The government should consult environmental and public health experts, and inventors and providers of technology. When it introduces new programmes, it should promote them through extensive public education.

All Hong Kong citizens should write to their district councillors or representatives in the Legislative Council, telling them that improving air quality with the right solutions and tightening environmental standards should be their first priority.

Lai Hak-kan, School of Public Health, University of Hong Kong


Some more research has revealed the dangers of airborne particulates – and (in Beijing) airborne pollutants in general.

In Hong Kong:

Deteriorating air quality in Hong Kong is sending more people to hospital, says a new survey.

According to a pair of researchers at the Chinese University of Hong Kong, who examined day-to-day pollution levels and hospital visits over a six-year period, a rise in airborne pollutants in Hong Kong was associated with a rise in emergency hospital visits.

Published in Environmental Health Perspectives, the study, led by professor Yu Tak Sun Ignatius and Ph.D candidate Hong Qiu, comes as residents report increasing levels of frustration with the city’s pollution.

Mr. Yu and Ms. Qiu found that every 10 micrograms per cubic meter daily increase in coarse airborne pollutant particles resulted in a 1% increase in emergency hospital admissions for respiratory disease, or an additional 830 hospital admissions.

The study controlled for other kinds of pollutants, including PM2.5, superfine air particles dozens of times thinner than a human hair, which Hong Kong and mainland China only began publicly monitoring earlier this year. While such superfine particles are the greatest source of concern for public health experts, because of how they can penetrate the body’s organs, the Hong Kong researchers also found that so-called “coarse” particles—including those between 2.5 and 10 micrometers in size—likewise “have a high impact on public health,” said Ms. Qiu.

“These coarse particles shouldn’t be ignored,” said Ms. Qiu, who says the city’s future air quality objectives should adopt standards that explicitly address such particles. “They can also cause cardiovascular and respiratory disease.”

Air Pollution Fuels Hospital Visits in Hong Kong

– above results also reported in Oriental Daily: 粗懸浮粒子禍害大 致病入院增

More on particulate threats, from Xian:

Researchers from Peking University say minute particle pollution as indicated by high PM2.5 readings will cause a spike in the mortality rate of patients suffering heart and lung diseases.

The researchers from the College of Environmental Sciences and Engineering and Center for Environment and Health at the university published their findings in the American Journal of Epidemiology.

Whenever a reading of PM2.5 rises to 103 microgram per cubic meter, the mortality rate among those with risk factors will increase 2.29 percent, according to the study, which examined data from the city of Xi'an, capital of Shaanxi Province.

High PM2.5 linked to deaths, researchers

And from Beijing:

During the 2008 Beijing Olympics, changes in air pollution were associated with changes in biomarkers of systemic inflammation and thrombosis (formation of blood clot) as well as measures of cardiovascular physiology in healthy young persons, according to a study in the May 16 issue of JAMA, a theme issue on Global Health. …

Air Pollution Level Changes in Beijing Linked With Biomarkers of Cardiovascular Disease





Press release from International Agency for Research on Cancer includes:

After a week-long meeting of international experts, the International

Agency for Research on Cancer (IARC), which is part of the World Health Organization (WHO), today classified diesel engine exhaust as carcinogenic to humans (Group 1), based on sufficient evidence that exposure is associated with an increased risk for lung cancer.


In 1988, IARC classified diesel exhaust as probably carcinogenic to humans (Group 2A). An Advisory Group which reviews and recommends future priorities for the IARC Monographs Program had recommended diesel exhaust as a high priority for re-evaluation since 1998.

There has been mounting concern about the cancer-causing potential of diesel exhaust, particularly based on findings in epidemiological studies of workers exposed in various settings. This was re-emphasized by the publication in March 2012 of the results of a large US National Cancer Institute/National Institute for Occupational Safety and Health study of occupational exposure to such emissions in underground miners, which showed an increased risk of death from lung cancer in exposed workers (1).


The scientific evidence was reviewed thoroughly by the Working Group and overall it was concluded that there was sufficient evidence in humans for the carcinogenicity of diesel exhaust. The Working Group found that diesel exhaust is a cause of lung cancer (sufficient evidence) and also noted a positive association (limited evidence) with an increased risk of bladder cancer (Group 1).

The Working Group concluded that gasoline exhaust was possibly carcinogenic to humans (Group 2B), a finding unchanged from the previous evaluation in 1989.

Public health

Large populations are exposed to diesel exhaust in everyday life, whether through their occupation or through the ambient air. People are exposed not only to motor vehicle exhausts but also to exhausts from other diesel engines, including from other modes of transport (e.g. diesel trains and ships) and from power generators.

Given the Working Group’s rigorous, independent assessment of the science, governments and other decision-makers have a valuable evidence-base on which to consider environmental standards for diesel exhaust emissions and to continue to work with the engine and fuel manufacturers towards those goals.

Increasing environmental concerns over the past two decades have resulted in regulatory action in North America, Europe and elsewhere with successively tighter emission standards for both diesel and gasoline engines. There is a strong interplay between standards and technology – standards drive technology and new technology enables more stringent standards. For diesel engines, this required changes in the fuel such as marked decreases in sulfur content, changes in engine design to burn diesel fuel more efficiently and reductions in emissions through exhaust control technology.

press release and more info at:

IARC Monographs on the Evaluation of Carcinogenic Risks to Humans


Given this, might in future become even more pertinent to ask not only why build Bloody Big Bridge from Hong Kong to Macau and Zhuhai, but also to ask – since building it, why not with a rail link? Why instead only road traffic, which will include many diesel vehicles?


short item in S China Morning Post:

Kids wheezing Down Under – what about those in HK?

LAI SEE; Howard Winn; Jul 25, 2012


There is less than cheery news from Australia on the subject of air pollution and child health.

A national study of 2,860 primary school children found nitrogen dioxide (NO2), found in motor vehicle exhaust, was present in the lungs of two-thirds of the children from the 55 schools tested, according to Melbourne's The Age newspaper. [Dirty air takes breath away.] Researchers found that vehicle pollution is giving otherwise healthy children asthma-like symptoms, potentially affecting their lung growth and function.

In cases where NO2 was found, children experienced ''asthma-like'' symptoms, including wheezing. Their lung volume was reduced and their airways inflamed.

The study found that NO2 exposure was not producing typical asthma but a non-specific lung effect that did not improve with asthma medication.

The National Environment Protection Council commissioned the Australian Child Health and Air Pollution Study and noted that air pollution has a greater impact on children than adults.

Interestingly, that kind of report could not be produced in Hong Kong under the present structure of the Environmental Protection Department. So far as air pollution is concerned it just measures emissions and has no remit to concern itself with public health.

That is the concern of the Department of Health, which likewise does not concern itself with emissions. This is all part of the emasculation of the EPD that has occurred over the past decade. Critics argue that the EPD should have a clear public health remit.

It would be an interesting test of the government's complacency over air pollution to conduct a similar survey on the health of children in Hong Kong.

Just seen this in response, from air pollution and health expert Professor Anthony Hedley:

Things are beginning to move on the NO2 issue in WHO. The medical literature is now replete with studies on health impacts,especially in Maternal and Child Health,with diverse and serious outcomes (leukaemia,congenital heart disease,growth retardation in pregnancy) at levels considerably lower than the

current WHO annual limit. We have also just shown that compliance with the present short term limit (1 hour=200ug/m3) will not achieve the annual limit of 40 in a high pollution environment like HK.So there is a lot to do here.




WHO issues new data and a warning on the health impacts of air pollution

An estimated 2.8 million deaths in the Western Pacific Region in 2012 from heart disease, lung cancer and other illnesses linked to air pollution

News release


The World Health Organization warns that air pollution is taking a mounting toll on health globally with the deaths of an estimated 7 million people in 2012 linked to dangerous air. The figure reflects a strong connection between air pollution—both outdoors and in the home—and a range of illnesses, including heart disease, stroke and lung cancer.

Among the six WHO regions, the Western Pacific bears a disproportionately high burden: an estimated 2.88 million (41%) of deaths globally due to indoor and outdoor air pollution occur here, although the Region accounts for approximately 25% of the world's population.

Further, a serious disparity exists between richer and poorer countries within the Western Pacific Region: the mortality rate attributable to air pollution is estimated to be 5.4 times higher in lower- and middle-income countries than in higher-income countries (172 versus 32 deaths per 100 000 persons).

When considered separately, ambient or outdoor air pollution takes a slightly higher toll than household or indoor air pollution (1.67 million versus 1.62 million deaths, respectively). Ischemic heart disease (or coronary heart disease) is the leading cause of death associated with factors stemming from air pollution, followed by stroke, chronic lung disease, lung cancer and acute lower respiratory disease.

“These new data are an urgent push for all of us, from governments to individuals, to work towards promoting and adopting even stronger measures to control air pollution in order to save lives and safeguard health,” said Dr Shin Young-soo, WHO Regional Director for the Western Pacific. “As we continue to strengthen the data and evidence, it is crucial that the health sector in every country collaborates ever more closely with the environment sector and engages other stakeholders as well. We must translate these data into concrete policies that are effectively implemented, to help decrease the overall health burden from air pollution.”

In 2013, WHO’s International Agency for Research on Cancer (IARC) determined definitively that air pollution is carcinogenic to humans, contributing significantly to the incidence of lung cancer. The latest reports provide more evidence regarding the link between exposure to air pollution, both outdoor and indoor, and non-communicable diseases such as cardiovascular disease (including ischemic heart disease and stroke) and cancer. Addressing air pollution effectively will help in reducing the health burden from non-communicable diseases, which are a particularly significant challenge in the Western Pacific Region.

The primary sources of ambient or outdoor air pollution include industrial and motor vehicle emissions and household heating.

Among the main sources of household or indoor pollution are the burning of fossil fuels, such as solid fuels in open fire cooking stoves, as well as second-hand smoke from tobacco products.

About half of all women and children in the Western Pacific Region are exposed to second-hand smoke, which not only contributes to respiratory diseases but also to a wide range of conditions including cardiovascular diseases and cancer.

The WHO Regional Office for the Western Pacific has been working closely with Member States to help strengthen their capacities to conduct health risk assessments and management to reduce air pollution. Through the Regional Forum on Environment and Health in Southeast and East Asian countries, WHO promotes collaboration between the health and environment sectors within governments and across civil society to address major environmental health challenges.

Existing good practices of air pollution control have been very effective such as: enforcement and compliance with national air and fuel quality standards and fuel emission standards; public health initiatives to improve the home environment (e.g. having adequate windows, using low emission stoves and a separate kitchen or area for cooking); and public health education that encourages adoption of healthy behaviours (e.g. use of pot lids, regular maintenance of stoves and keeping children away from smoke, including second-hand smoke). New guidelines regarding household fuel consumption are set to be released this year along with updates on air quality from more than 1600 cities worldwide.

“Many countries are finally stepping up their actions to combat air pollution,” noted Dr Nasir Hassan, Team Leader, Environmental Health, WHO Regional Office for the Western Pacific. “For example in China, where we have recently seen huge concern over the critical air pollution situation there, Premier Li Keqiang has declared a war on pollution. This signifies a willingness to move towards more intensive and rigorous monitoring of air pollution, and to take stronger measures to tackle the very sources of the pollution in the first place.”

“The air pollution crisis did not occur overnight, and the solutions will not occur overnight,” concluded Dr Shin. “Environmental health in general is a complex issue, as it goes hand in hand with urbanization, economic development and so many other factors. But it’s obvious this crisis—and it is a crisis—can no longer be ignored. The data and evidence are crystal clear, and effective and innovative tools are available for Member States to tackle this issue head on. WHO urges all to work together, quickly and strategically, towards a healthier environment for those of us living on our planet now, as well as those who will follow us in the generations to come.”



Both short- and long-term exposure to some air pollutants commonly associated with coal burning, vehicle exhaust, airborne dust and dirt are associated with the development of high blood pressure, according to new research in the American Heart Association’s journal Hypertension.

High blood pressure linked to short-, long-term exposure to some air pollutants

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