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Author: Bryan Chan

Date:8/8/10

Introduction

When air pollution rises, more people spend time in hospital, visit the doctor, or die – based on this correlation, the number of premature deaths, hospital visits, doctor visits and direct and indirect costs can be calculated for pollution. [1]

Direct and Indirect Costs

The direct health care costs are the cost of illnesses and the indirect costs are the productivity losses due to hospital admissions and short term premature deaths. [2]


Hospital bed days, lost productivity and doctor visits associated with the health impact of high air pollution cost HK$1.1 billion annually. The estimated annual direct health care cost for all 4 pollutants is HK$839 million while the annual indirect cost is HK$258 million.


The estimated costs, both indirect and direct, sums up to HK$162m per million population, compared to RMB $210m per million population for PRC, and $38m per million population for Macau. However, these are very likely merely low-end estimates, [2] not to mention the intangible costs of pollution measured in terms of willingness-to-pay, to avoid a day of respiratory symptoms such as cough, a hospital admission for heart or lung problems and a premature death, all caused by breathing pollutants value around $20 billion each year. [3]

Details of Total Health Costs in Hong Kong by Year

2004

In 2004, a total of 1,349 premature deaths, 96,859 hospital bed days, 8.74 million doctor visits, and 405 hospital admissions for asthma for the age group 0 – 14 in Hong Kong were attributed to local air pollution. This amounted to a tangible total health cost of HK$2772 million and an intangible total health cost of HK$19,463 million for Hong Kong in 2004. [4]


2005

In 2005, a total of 1,269 premature deaths, 89,562 hospital bed days, 8.07 million doctor visits, and 372 hospital admissions for asthma for the age group 0 – 14 in Hong Kong were attributed to local air pollution. This amounted to a tangible total health cost of HK$2570 million and an intangible total health cost of HK$18,208 million for Hong Kong in 2005. [4]


2006

In 2006, a total of 1,159 premature deaths, 82,873 hospital bed days, 7.59 million doctor visits, and 347 hospital admissions for asthma for the age group 0 – 14 in Hong Kong were attributed to local air pollution. This amounted to a tangible total health cost of HK$2398 million and an intangible total health cost of HK$16,783 million for Hong Kong in 2006. [4]


2007

In 2007, a total of 1,137 premature deaths, 82,345 hospital bed days, 7.59 million doctor visits, and 346 hospital admissions for asthma for the age group 0 – 14 in Hong Kong were attributed to local air pollution. This amounted to a tangible total health cost of HK$2386 million and an intangible total health cost of HK$16,557 million for Hong Kong in 2007. [4]


2008

In 2008, a total of 1,155 premature deaths, 81,023 hospital bed days, 7.25 million doctor visits, and 335 hospital admissions for asthma for the age group 0 – 14 in Hong Kong were attributed to local air pollution. This amounted to a tangible total health cost of HK$2317 million and an intangible total health cost of HK$16,515 million for Hong Kong in 2008. [4]


2009

In 2009, a total of 830 premature deaths, 63,383 hospital bed days, 6.15 million doctor visits, and 271 hospital admissions for asthma for the age group 0 – 14 in Hong Kong were attributed to local air pollution. This amounted to a tangible total health cost of HK$1884 million and an intangible total health cost of HK$12,506 million for Hong Kong in 2009. [4]

Impact of Air Pollution on Health and Economy

Health

Over the last 10 years, there has been a slow decline in mortality due to respiratory diseases, but the hospitalization rate has remained the same. [5]


Health impacts are a bigger problem for low-income families if affected members must miss days of work. [5] Moreover, PM10 and NO2 are associated with greater risk of mortality on people living in public rental housing than private housing. Effects of all four pollutants were significantly greater in blue-collar workers than the never-employed and white-collar groups. [6]


Business

A recent poll by the American Chamber of Commerce suggests that Hong Kong’s worsening air quality is deterring foreign investment and the inflow of overseas talent. Business will be lost as firms choose to relocate their hubs and headquarters to say Singapore, which is capitalizing on its green image. Moreover, tourism will suffer as people can be put off visiting on public health grounds. [7]


Economic Benefit of Reducing Air Pollution

A reduction of HK’s average annual pollutant levels down to the levels of WHO guidelines would avoid nearly 7 million doctor visits, over 60,000 hospital bed-days and up to 1,600 deaths each year. [3] The benefits of a modest effort to reduce air pollution in Hong Kong were estimated at US$200 million. [8]

Footnote

  1. ‘Air Pollution: costs and paths to a solution’, Department of Community Medicine, HKU, Department of Community and Family Medicine, CUHK, Institute for the Environment, HKUST, Civic Exchange, June 2006 - last accessed 8/8/10
  2. 2.0 2.1 ‘A Price Too High: The Health Impacts of Air Pollution in Southern China’, Civic Exchange, HKU Medical Centre, Department of Community and Family Medicine, CUHK, Institute for the Environment, HKUST, June 2008 - last accessed 8/8/10
  3. 3.0 3.1 ‘The Sustainable Development Council Invitation and Response Document: Clean Air-Clear Choices - Will High Air Pollution Alert Days provide an efficient path to health protection?’, Department of Community Medicine, HKU, The Air Quality Objective Concern Group - last accessed 8/8/10
  4. 4.0 4.1 4.2 4.3 4.4 4.5 Calculation according to Hedley Index - last accessed 8/8/10
  5. 5.0 5.1 ‘Experts Symposium on Air Quality’, Civic Exchange, 9 January 2009 - last accessed 8/8/10
  6. Socieconomic disparities in air pollution-associated mortality, Chun Quan-Ou, AJ Hedley et al, 2008, Environ Res 107:237–244
  7. ‘Boomtown to gloomtown – The implications of inaction’, CLSA – Christine Loh, James Paterson, September 2006 - last accessed 8/8/10
  8. Blowing in the wind: the impact of China’s Pearl River Delta on Hong Kong’s air quality, Xiao F, Brajer V, Mead RW, 2006, Sci Total Environ 367:96–111

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