Air pollution levels have reportedly got worse in several districts across the island in the past few days. This has been borne out by recent data monitoring unhealthy air levels. In view of this rising pollution and the added fears of the Delhi smog affecting Lanka’s air quality, the Health Ministry has cautioned high risk groups to take proper precautions to avert any complications that could arise from breathing polluted air in the environment.
Air pollution is a significant public health problem. The Director, Environment Unit, Dr Thilak Siriwardana was reported to have said at a recent media discussion that one fourth of deaths were due to stroke and heart disease directly linked to air pollution, both indoor and outdoors, caused in Sri Lanka mostly by: poor ventilation inside houses, absence of chimneys or vents in households mainly using firewood, use of unclean fuel such as firewood, burning of polythene and plastics (yoghurt cups, lunch sheets, shopping bags, etc) inside houses to initiate fire when using firewood for cooking, lighting mosquito coils and incense sticks inside households, and cigarette smoking onside houses.
Consultant Community Physician, Environmental and Occupational Health Unit, Health Ministry, Dr Inoka Suraweera discusses with the Sunday Observer the reasons causing this surge in low air quality in Sri Lanka, how people themselves can lower these levels by reducing vehicular emissions etc, and the health impacts of toxic air on the public as a whole.
Excerpts….
Q. Air pollution levels in several districts is said to have worsened significantly in the past few days. Despite clear skies and a temporary pause in thundershowers the US Embassy’s Air Quality Monitor in Colombo reportedly indicated unhealthy levels of air quality last Tuesday (with a value of 167) continuing to rise to 173 by 8 a.m before declining to 165 by `10 a.m. The Coordinator, National Building Research Organisation ( NBRO) was also quoted as agreeing with the air quality records of the US Embassy Air Quality Monitor. Your comments?
A. According to NBRO air quality monitoring data, the Central Environmental Authority monitoring data and several other sources, air quality levels in certain districts had reached unhealthy levels as reported by them.
Q. The current levels of air pollution in Colombo is said to be particularly unhealthy due to the presence of tiny particulate matter referred to as PM 2.5. What is PM 2.5? What is it made up of?
A. PM is fine inhalable particles, with diameters that are generally 2.5 micrometres and smaller. Particulate air pollution is a mixture of solid, liquid or solid and liquid particles suspended in the air. The smaller (PM 2.5 and lower) particles contain the secondarily formed aerosols (gas-to-particle conversion), combustion particles and recondensed organic and metal vapours.
Q. How small is 2.5 micrometres?
A. Think about a single hair on your head. The average human hair is about 70 micrometres in diameter – making it 30 times larger than the largest fine particle.
Q. An NBRO official was also reported to have said that the high air pollution levels in Delhi may have contributed to the spike n air pollution in Sri Lanka in recent days. Any likelihood for this to happen due to our close proximity to New Delhi?
A. The atmosphere does not have boundaries. Transboundary air pollution is a possibility. However, to identify the exact source would need further investigations
Q. Is air pollution closely linked to the weather?
A. Air pollution has linkages to weather patterns.
Q. Can they enter the body and penetrate the lungs and enter the blood systems?
A. Yes, especially the PM 2.5 and less ultrafine particulates can enter the blood stream through the alveoli.
Q. Will chronic exposure to these tiny particles over a period of time lead to developing non communicable diseases ( NCD) which are now at an unacceptable level in the country? Give us some examples of the most common and most serious of these NCDs directly linked to air pollution exposure.
A. Cardiovascular diseases, stroke, lung cancer, chronic respiratory diseases.
It is associated with the development of diabetes too, according to recent research conducted worldwide.
Q. How does poor air quality impact on the human body? What happens when you are constantly exposed to breathing polluted air?
A. In children and adults, both short- and long-term exposure to ambient air pollution can lead to reduced lung function, respiratory infections and aggravated asthma. Maternal exposure to ambient air pollution is associated with adverse birth outcomes, such as low birth weight, pre-term birth and small gestational age births. Emerging evidence also suggests ambient air pollution may cause diabetes and neurological development in children, especially autism. Additionally, when children are exposed to air pollution they are at a higher risk of developing stroke, heart attacks and Ischeamic heart disease, lung cancer and chronic lung diseases early in adulthood.
Q. Who are those most at risk due to air pollution?
A. Those most vulnerable are unborn foetuses, children, pregnant mothers, those with lung and heart diseases, elderly, and outdoor workers like traffic Police, agriculture workers, three wheeler drivers, construction workers and street vendors.
Q. Age wise who are most at risk ? Elders? Very young children? Pregnant women?
A. Unborn and young children are very vulnerable to the adverse health outcomes of air pollution. When pregnant mothers are exposed again it is the foetus that is affected. Studies by the WHO show that an estimated 4.2 million premature deaths globally are linked to ambient air pollution, mainly from heart disease, stroke, chronic obstructive pulmonary disease, lung cancer, and acute respiratory infections in children, as indicated below:
* 29% of all deaths and disease from lung cancer
17% of all deaths and disease from acute lower respiratory infection;
24% of all deaths from stroke
25% of all deaths and disease from Ischaemic heart disease
43% of all deaths and disease from chronic obstructive pulmonary disease.
Q. Considering that Sri Lanka has a fast aging population on the one hand, and a large youth dominated population on the other what steps has the Ministry of Health taken to face the challenges of increasing air pollution resulting from an anticipated surge in vehicular traffic?
A. Mitigating adverse health, social and economic consequences of air pollution needs a concerted effort from multi stakeholders. Different stakeholders need to identify their roles and act accordingly to find a solution to this important problem. The Environmental and Occupational Health Directorate of the Ministry of Health, Nutrition and Indigenous Medicine has taken several steps in this regard.
The main role of the Ministry is advocacy. Consultants of the Ministry provide expert opinion with regard to policy, strategic plan development on the mitigation of air pollution to relevant authorities such as, the Ministry of Environment, Central Environmental Authority, Transport Ministry, Industry Ministry, through the introduction of:
Euro 4 standards
Clean air action plan by the Ministry of Environment
Polythene plastic burning regulations
Indoor air quality guideline development
Vehicular emission testing program,
Additionally, the Health Ministry conducts awareness raising among stakeholders and the public in general in relation to adverse health outcomes. Capacity development to Public Health staff is also being carried out and they in turn raise awareness among communities, and advocate decision making at regional level.
Q. Any other interventions?
A. Development of IEC material for public health staff and the public on air pollution. Research and surveys are also being conducted to take better informed policy decisions.
Q. Your message to the public on precautions to reduce risks of adverse air pollution.
A. The atmosphere does not have boundaries. Air pollution affects everyone and nobody is spared. We need to have laws, rules and regulations to control air pollution. The government, all other stakeholders, especially, civil society need to join hands in this effort.
Each individual has a responsibility not to pollute the air. If we all change our attitudes we can really better manage this situation.
When the air quality is poor, those vulnerable (sensitive) should avoid unnecessary exposure to bad air. Children should not do vigorous physical activity and patients already with heart and lung ailments should refrain from outdoor physical activity.
As adults we have a huge responsibility towards our children. Please join hands not to pollute the air and influence the authorities to show the need for sustainable and effective solutions.