Author: Dicky Chen, Antonio Da Roza

Originally: Civic Exchange; HKU Medical Centre; Department of Community and Family Medicine, CUHK; Institute for the Environment, HKUST (published by Civic Exchange)

Date: 9/8/10

Originally: June 2008

Hospital bed days, lost productivity and doctor visits associated with the health impact of high air pollution costs HK$1.1 billion annually. The direct health care costs were the cost of illnesses and the indirect costs were the productivity losses due to hospital admissions and short term premature deaths.

The estimated unadjusted annual direct health care cost for all 4 criteria pollutants is HK$839 million. The adjusted direct cost is HK$0.8 billion. (note: adjustment is based on comparing the GDP per capita of the relevant region [Pearl River Delta or Macau], to that of Hong Kong. So, for Hong Kong the “adjusted” cost is also the raw value). The unadjusted 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 the Pearl River Delta, and $38m per million population for Macau.

These results are very likely merely low-end estimates.

The reduction of pollution to the levels in other world cities, such as London, Paris and New York, would avoid over 1,600 deaths annually. Between 1997-2003, total emissions of SO2 in Hong Kong increased by 39%, whereas NOx, PM10 and VOC emissions fell by 10%, 38% and 36% respectively.

With regards to SO2, 12 out of the 16 Pearl River Delta/Hong Kong monitoring stations exceeded the WHO AQG by more than 5% in 2006 and 14 out of 16 exceeded the WHO AQG in 2007. For O3, most of the high annual mean concentration values were measure in rural areas such as Tap Mun in HK. Roadside concentrations of PM10 and NO2 have consistently exceeded WHO guidelines by roughly four times and two and a half times respectively.

The majority of days in Hong Kong fall in the 51 to 100 threshold on the API, which are not presented as “bad” air days but still produce significant long term public health impacts. In the 1980s there were typically no hazy days in summer in Hong Kong and on average only five hazy days per month in winter. The number of hazy days per month went up to about four in summer and 15 in winter during the 1990s, and eight in the summer and 25 in the winter from 2000 onwards. In Hong Kong, “hazy days” are days when visibility drops below 8km.

The power sector accounts for 89% of SO2, 44% of NO2, and 32% of local RSP emissions, whilst transport emissions have been shown to be the most important determinant of daily air quality for approximately 50% of the time in Hong Kong. Satellite images show that conditions from air pollution have worsened since 2003.

However, local research in the Pearl River Delta, Hong Kong, and Macao on air pollution and health is deficient compared to the size of the problem. In the last 25 years, only 37 papers (12 in local journals and 25 in international journals) were published on air pollution and health. There were no local public health studies in and on Shenzhen, Dongguan, and Foshan, and hence there is a lack of understanding of the problem by the public and government policymakers.

Poor air quality is a major threat to the regional economy, but there is little research on it, and what is available is sketchy. The region is uninformed, and as the Government has failed to make the public's health the priority, air quality continues to deteriorate, policies are not effective, and the economic impact and impact on the quality of life is enormous.

Recent Measures

- The Government began a review of the 1987 Air Quality Objectives.

- The Hong Kong Council for Sustainable Development (CSD) launched a public consultation exercise in June 2007 to seek input on 3 proposed measures for improving air quality: alerts on high air pollution days, demand-side management and road pricing to reduce congestion in urban areas. However, the way the consultation was structured does not seem to move the debate forward.

- The governments of Hong Kong and Guangdong initiated a mid-term review of the Pearl River Delta Regional Air Quality Management Plan in 2006. Main tasks include the recalculation the 1997 emission inventory, estimating the 2003 emission inventory, and measuring progress towards the 2010 targets. This was completed in December 2007.

What can be done?

- Tighten air quality standards according to World Health Organisation guidelines; establish standards (Air Quality Objectives) based on protecting health to the highest level established as necessary by current research.

- Take collaborative action before East Asian Games – learn from Beijing in 2008 Olympics.

- Provide real-time data to the public from the regional monitoring network.

- Push for emissions reductions in land and marine transport.

- Determine a timeline and pathway for emissions reduction.

- Adopt a clean fuel initiative so cleaner fuels are available for vehicles and generators used in manufacturing.

- Initiate an emissions trading scheme, whereby plants are allocated emissions allowances and can purchase credits from other plants to cover actual emissions quantities. The Hong Kong and Guangdong governments introduced a pilot scheme in 2007 but no trades have been attempted.

- Conduct a long-term cohort study to measure the total years of life lost, the higher incidence of respiratory and cardiovascular diseases, and decline in lung growth among children due to air pollution. Successful example includes “Harvard Six Cities Study” in the United States.

- Improving energy efficiency in the building sector.

- Buses running on the busiest routes should switch to natural gas, and bus-rail interchanges must be optimised to make it easier for passengers to switch. Rail construction should be subsidised to keep fares down and make rail transport affordable. In addition, stronger road policies can make quick, dramatic improvements in urban air quality.

- Town planning measures can be imposed to reduce the “street canyon effect”, pedestrian schemes can be promoted, and open spaces can be designed into zoning plans for recreation, aesthetic, and air circulation reasons.

- Progressive energy policies should be adopted for consideration.

- Policies and standards should be reviewed periodically. A review of the air quality framework should be conducted every 5 years, consistent with the United States and European Union. It could be argued that the review should be conducted even more frequently because China is developing rapidly.

- Funding should be provided for research that analyzes the outcome of policy measures.

- A new Government-led review of regional emissions data for 2007 should be conducted.


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