A city of cardiac patients if air pollution untamed

ANJALI SUBEDI

KATHMANDU, Jan 17: An international study has put Nepal among the three worst performing countries in the world in terms of air quality as it relates to human health.

But let alone making due efforts for systematic air pollution control, it has taken the Ministry of Environment nearly half a decade just to repair the few air pollution monitoring stations set up in 2002 although the repair costs are minimal.

“We have already repaired the stations at Thamel, Putalisadak, Bhaktapur and Machhegaun and the station at Bhaktapur is already up and running. It cost around Rs 300,000 to bring them back to life,” said Joint Secretary at the Ministry Shankar Adhikari.

“The stations can measure the tiniest dust particles that our eyes cannot see. They basically identify the level of particulate matter and indoor air pollution, which are taken as indicators for air pollution” added the senior engineer.

Air pollution monitoring station at Putalisadak. (File Photo: Bhaswor Ojha)

Though the monitoring machines at home were not working, the pollution level was still measured in 2011 by international bodies and the results they came out with were shocking.

In 2012 the environment performance index ranking prepared by the Yale Centre for Environmental Law and Policy at Yale University in the USA, the Centre for International Earth Science Information Network and Columbia University, also in the US, listed Nepal in the third last position among 132 countries, scoring just 18 out of 100 points for progress against air pollution.

According to the study, the bottom five countries in the rankings from Asia were China, Pakistan, Nepal, India and Bangladesh.

The stations in the aforementioned places, including Kirtipur and Patan, were established by the Ministry of Environment in 2002 with a Rs 60 million grant support from the government of Denmark.

Initially, these were operated as part of the environment sector support program launched by the Danish International Development Agency, DANIDA.

After the project term ended in 2005, the ministry issued a tender to the NGO, Environment and Public Health, giving it responsibility for operating the stations.

However, the stations stopped working one after another by 2008 for lack of proper and timely servicing.

A thick blanket of fog can be seen in Kathmandu in this recent photo.

Once the stations went dysfunctional, the government never again bothered to study air pollution levels in the Valley, though the measurements taken earlier were already alarming.

When it was last measured in 2008, Patan, Thamel and Putalisadak had the highest air pollution level of 122 microgram per cubic meter.

At Bhatkapur, Kirtipur and Machhegaun, the measurement was 120 microgram per cubic meter, according to Environment and Public Health.

According to Joint Secretary Adhikari, the results recorded then were highly alarming when taken against the standards of the World Health Organization, and the air quality has deteriorated even further by now.

He added that the sole reason for taking so long to bring the stations back into operation was lack of due attention.

It would not cost much to repair the stations though the operating cost is a bit high at Rs 100,000 for six months for the four stations.

But the monitoring technology has already become obsolete and the country needs more modern air pollution monitoring equipment by the next three to four years at most, he stressed.

“The stations, except for two, have now begun to work. But they will work for no more than three years. After that we will need better equipment as the current technology has already become obsolete,” Adhikari said.

He added that that the stations need to collect 24-hour air samples automatically and these are analyzed for PM10.

However, due to power cuts, the stations might work for fewer hours.

“This makes a difference in the validity of the results. But it can still be taken as an important indicator of the pollution level,” he said.

According to doctors, the public might panic if they are made aware of the health aspects of air pollution in the city.

They worry that it may already be too late and any further delay in taking necessary measures to control air pollution means Kathmandu could become a city of cardiac patients by 2020.

Talking to Republica, former president of Nepal Medical Association Dr Kedar Narsing KC said the short term effects of air pollution include asthma and bronchitis while the long term effects can be much more severe.

“In the long term a person might suffer lung, heart or liver failure. There is a chain effect when one´s health worsens and respiratory problems due to air pollution leads to this,” he said.

He further added that poor air quality is more harmful for elderly people as they are already feeble due to age.

“When we grow old, exhaling and inhaling is not as easy as when we are young. And in a polluted area, the lungs have to work even harder,” he said.

According to noted physician Dr Dirga Singh Bam, the Valley is going to turn into a major concentration of cardiac patients by 2020 if serious measures are not taken to improve the air quality.

“The air pollution is becoming so severe day by day that this place will become known as cardiac patients country by 2020,” he said.
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INTERVIEW

Air pollution in Kathmandu very poor
Keshab Bhattarai, Secretary, Ministry of Environment

Is the Ministry of Environment concerned at all about checking air pollution? Why has it taken nearly five years to repair the air pollution monitoring stations?

The ministry has been doing many things to counter all kinds of environmental pollution across the country. But everything takes time. As for the stations, we have repaired four out of six stations and the air quality level will be reported soon. Indeed it took much time to repair the stations and this was due to technical reasons. The company which was given the contract for the job had said that they did not get genuine spare parts.

Air quality in the capital is deteriorating day by day. Is there any specific plan to check that?

Yes, the air pollution in Kathmandu is very poor. More than anything else, it is due to the ever growing number of vehicles or the low quality those vehicles. Both the transport ministry and we are equally responsible for ensuring the quality of the vehicles, but making plans and policies but not implementing them has become a sort of culture here. The same thing has happened regarding the inflow of poor quality vehicles. At the same time, the number of vehicles in excess of what our roads can accomodate is also such a huge problem.

What about the environmental policy you have been talking about since some time?

Yes, we are now focusing on an overall comprehensive environmental policy. This has become a must to address various types of pollution separately and for overall environmental reform. As soon as this policy comes into existence, environmental issues will get due priority.

But is it not true that even now we already have good policies and powerful bodies under the Ministry of Environment?

We do have a separate ministry and separate bodies under it. However, there is no comprehensive environmental policy to enable us to function broadly. In lack of this, the ministry has not been able to perform to the fullest.

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Sick city

Air pollution is making Nepalis sick and undermining the national economy

Anna-Karin Ernstson Lampou

Forty-year-old Ali Akhtar never leaves home without what has become an essential accessory for most Nepalis: his brown cloth mask.

As the streets around his fabric shop in Jawalakhel are demolished for road widening and the neighbourood becomes shrouded in a cloud of yellow dust, Akhtar is trying his best to protect himself from the pollution and keep his business running.

While Beijing made headlines this week for the worst air quality on record (see box), Kathmandu Valley is not far behind. The average PM 10 count concentration in Kathmandu, a measure of particulate matter content in the air, was 183 ug/m3 in 2003 and 173 ug/m3 in 2007, both far above the WHO standard of 50 ug/m3 and the US National Ambient Air Quality Standard of 100 ug/m3.

PICS: BIKRAM RAI

There is no data beyond 2007 because the seven  monitoring devices   installed by DANIDA across the Valley in 2002 to measure PM levels have been out of order for the past four years. Without the units, there is no mechanism to monitor and warn citizens to take extra precautions during bad days. The Department of Transportation, however, has said it is going to repair four of the stations by next month.

While mismanaged waste and unplanned urbanisation contribute to the city’s air pollution, vehicle exhaust and brick factories are the biggest polluters. Fumes from the 60,000 plus vehicles plying on the choked roads of the Valley add the most toxins. The road expansion drive has only made things worse.

Anjila Manandhar from Clean Air Network  Nepal says that instead of improving air quality, the government has aggravated the problem: “They just tore down houses and roads, nobody thought about how to get the job done with the least amount of pollution and there were no cleanup efforts either.”

In winter, the Valley’s topography creates a cold inversion layer that traps warm and polluted surface air, trapping dust and smog. “Air pollution has become a huge problem and it gets worse during the winter,” says Buddha Basnyat, a doctor at Patan Hospital, “we have long queues and ward full of patients with respiratory problems at this time of the year and children suffering from asthma are also on the rise.”

Every year the government spends more than $ 21 million in medical bills for pollution related illnesses. Street vendors, construction workers, road workers, and traffic police who are exposed the longest to the smoke and dust face the greatest risk along with those who attend schools, colleges, and offices located along major roads.

According to a recent study conducted by the Nepal Health Research Council   the average PM 2.5 (the smallest pollution particles) around a school in Jawalakhel located next to the road was 200 ug/m3, significantly higher than the WHO threshold, and the national standard of 40 ug/m3.

Arjun Karki, a pulmonologist at Patan Hospital, says pollution is not only harmful in terms of health, but stunts the country’s economic growth. “When an adult falls sick, the family risks losing its source of income, productivity goes down, expenses go up and sometimes the family is pushed into poverty,” explains Karki. Streetfront shops like Akhtar’s lose business when pollution is higher.

While the road widening campaign is partly to blame for the thick clouds of brown dust in Kathmandu, lack of government control and monitoring is also responsible. The state introduced a Vehicle Emission Standards (VES) test in 1995, and those four wheelers which passed were given green stickers. Similarly the ban on vehicles older than 20 years was announced in 2000.

However, many government vehicles don’t have stickers and not all those that do have actually passed the test. Corruption is rife and the traffic police hardly checks the validity period. And despite repeated attempts to stop the worst offenders, the state hasn’t been able to enforce the ban on old vehicles plying on the roads of Kathmandu.

In the absence of clear environmental guidelines, industries are free to let off massive amounts of smoke into the atmosphere without any repercussions. Brick Clean Network   is an exception. It has introduced a new certification system  for brick factories to encourage them to remove exploitation and pollution.

“The pollution is making us sick, affecting our incomes, and turning Kathmandu into a very unpleasant city. But our leaders are so busy with power politics, they don’t care,” says Akthar as he puts on his mask and gets ready to go home.

See also:

Lost in the smog,  DEWAN RAI and SUVAYU DEV PANT

The government doesn’t seem to care about Kathmandu’s worsening air pollution

To see the video What’s in air pollution   click here

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Between Beijing and Delhi

Beijing cleaned up its air for the 2008 Olympics after facing international criticism. Power plants installed scrubbers, emission controls were introduced so athletes and spectators could inhale fresh air. However, once the games were over, things got back to ‘normal’. And this week on 12 January Beijing residents  suffered a day of shockingly bad air with the capital shrouded in thick haze. Beijing witnessed off-the-chart reading of 755 on the Air Quality Index, which maxes out at 500. Any reading above 100 is deemed ‘unhealthy for sensitive groups’ while anything above 400 is rated ‘hazardous’ for all.

Meanwhile, in the Indian capital winter air quality is also steadily worsening after almost a decade of improved policies that raised emission standards, closed polluting industries, and expanded green spaces. The visibly improved air quality has taken a downturn with fine-particle pollution rising by 47 per cent in the last decade and nitrogen dioxide levels up by 57 per cent. It made a costly investment to convert the city’s buses and auto rickshaws to compressed natural gas, but environmentalists say New Delhi now needs aggressive second generation reforms to improve air quality.
How effective is your mask?

Most Kathmandu commuters don masks or hold a handkerchief to their mouths when out on the streets, but these barely provide any protection in this dust bowl. Larger particulate matters above 10 microns (PM 10) are trapped in the nose and mouth, but the finest and most deadly particles, PM 2.5, lodge themselves deep in the lungs.

About 30 times thinner than human hair, PM 2.5 easily penetrates generic masks found in the market. Masks designed for industrial use or professional cyclists and bikers provide better protection and are available in Kathmandu or online, but at Rs 1,500 a piece, they are beyond the reach of most Nepalis. However, considering the health costs, investing in a mask could be worthwhile in the long-term.

WHICH MASK?
Type of mask	Price	Effectiveness
Cotton handkerchief	Rs 20	28%
Cyclist mask 1	Rs 1,500	55%
Surgical mask	Rs 15	80%
Cyclist mask 2	Rs 4,000	83%
3M Dust Respirator	Rs 1,400	96.6%
Teflon filter	Rs 2,500	99.34%
Source: Beneficial cardiovascular effects of reducing exposure to particulate air pollution with a simple facemask

Environmental Kuznets Curve

The Environmental Kuznets Curve draws an inverse relation between a country’s income and pollution. Growing industrialisation leads to increased levels of pollution, but once the country’s GNP crosses a certain threshold, its capacity and willingness to adopt greener alternatives rises and it becomes more eco-friendly.

One dusty morning in Kathmandu, a photo gallery by Bikram Rai 

Pollution in Kathmandu has become a major problem for its residents who try their best to protect themselves from the dusty streets of the Valley.

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Vehicular exhaust hazardous to human health

PARSHURAM S NIRAULA

 

KATHMANDU: Thousands of big and small vehicles move on the streets of Kathmandu Valley every day. Kathmandu with a bowl-shaped geography suffers in this regard, with all the exhaust and particulate matter suspended in the atmosphere for a longer period of time. Exposure to this condition of air poses a serious threat to human health. 

We spend a lot of time travelling in various means of transport that use petroleum fuels to operate but do not realise how much we are exposed to harmful exhausts. Traffic congestions, rising number of vehicles and narrow roads have made the situation even worse. We are constantly exposed to the exhausts, when we wait for someone on the roadside, or have a cup of coffee/tea at a roadside restaurant. Hence, we are likely to suffer from different diseases. 

The time spent on buses by individual students varies between 20 minutes and several hours per day. For one child, a half-hour ride to school, and a half-hour ride home each day amounts to about 180-200 hours per school year. Children’s exposure to diesel exhaust from school buses constitutes an additional exposure. 

Ozone is known to exacerbate asthma, and is normally highest in the afternoon, when children’s exposure to diesel particulates from school bus rides is also likely to be high. 

Diesel exhaust is classified as a probable human carcinogen by many governmental authorities, including International Agency for Research on Cancer (WHO). Diesel exhaust includes benzene, 1,3-butadiene, and soot, all classified as known human carcinogens. Nearly 33 studies have explored the association between diesel exhaust exposure and bladder cancer. Diesel exhaust contains both carbon particulates and 40 chemicals that are classified as “hazardous air pollutants”. Exposure to particulates is associated with increased mortality among those with cardiopulmonary diseases, exacerbation of symptoms for asthma, bronchitis, and pneumonia, decreased lung function and retarded lung development. 

Children may be especially susceptible to adverse respiratory effects following exposure to fine-diameter particulate matter (PM2.5) emitted from diesel engines. Nearly 94 per cent of diesel particulates have diameters less than 2.5 micrometers (um). The average diameter of diesel particulates is 0.2 micrometers. Smaller particles are able to penetrate children’s narrower airways reaching deeply within the lung, where they are more likely to be retained. Higher rates of respiration among children may lead to their higher exposure. There is no known safe exposure to diesel exhaust for children and old people, especially those with asthma or other chronic respiratory disease. 

Engine model, age of engine, number of miles since last overhaul, maintenance cycles, location of bus engine, elevation change, passenger load, and climate may influence levels of interior pollutants and passengers’ exposure. Practicing slow drive, stopping engine in traffic jams, pooling vehicles, use of public transport, walking short distances, and regular pollution checks can help in reducing vehicular exhaust, saving finite resource and helping in combating climate change!

— (Niraula is Chairperson at Centre for Environment Education Nepal (CEEN). 
The article is based based on a research by John Wargo, PhD, Yale University)

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