By Henrylito D. Tacio
A couple of years back, a 50-year-old bus dispatcher in Manila came to the Pasay Filipino-Chinese Charity Health Center. The only breadwinner of his family, the man has two teenage sons and a daughter. For the past two years, he noticed that whenever he sniffed the sooty bus exhausts, he would develop chest pains. At home, he observed that he was tired easily and there were some nights when he would wake up short of breath.
Dr. Willie T. Ong, a cardiologist and the man’s attending physician, could not decipher the cause of the patient’s many heart attacks. An echocardiogram bared that his heart has expanded like a rubber and is only pumping at 20 percent capacity. Medical studies showed that people with such a lame heart may live for three more years.
The man could not believe when told the situation. After all, he didn’t smoke or drink and never taken prohibited drugs. History records showed that both his parents never suffered from any heart diseases. Taking a closer look at his case, Dr. Ong traced the culprit of the patient’s heart problem: air pollution.
In 2000, the World Bank’s annual review reported that in Manila alone more than 4,000 Filipinos die each year because of air pollution. The mortality figure is the third highest for a city in the East Asian region after Beijing and Jakarta. Bangkok and Seoul were ranked 4th and 5th.
Five years later, the problem got worse. Manila’s skies are among the most polluted in the world, surpassed only by Mexico City, Shanghai and New Delhi, said the regional office of the World Health Organization (WHO). In a press conference, Ramon Paje, then undersecretary of the Department of Environment and Natural Resources (DENR), admitted, “The air in Metro Manila is still dirty but significantly improving.”
Today, with more people flocking to the metropolis and more vehicles plying the highways, significant improvement of air quality is no where in sight. “Growing human and vehicle populations and increasing industrial activities are the main causes of worsening air quality in the urban centers of the Philippines,” said the World Bank report in 2002.
A perception survey done in 2001 showed that more than 72 percent of Manila’s residents were alarmed by air pollution and 73 percent said they were not aware that the government was doing something to control it. Two years earlier, the government actually signed the Clean Air Act, which aimed to provide a comprehensive air pollution control policy for the country.
Sources of air pollution in the Philippines include emissions from three sources: mobile like vehicles, stationary such as power plants and factories, and area which comes from garbage burning, road dust and open cooking. Burning of agricultural waste in rural areas also causes air pollution.
In Metro Manila, the air quality crisis is due to growing vehicle population. Statistics showed that vehicle densities have increased from 675,310 in 1990, to 1.2 million in 1998, to over 2 million in 2001. Vehicle density in Metro Manila has gone from 1,600 per square kilometer in 1995 to 3,144 per square kilometer in 2000, and at an accelerating rate of growth. “There is a direct correlation between the number of cars on the road and the amount of pollution in the air,” said Dr. Rafael R. Castillo, a medical doctor and a newspaper columnist. According to Paje, 70 to 80 percent of air pollution in the country is caused by vehicle emissions.
“Increased levels of air pollution are threatening the well being of city dwellers, and imposing not just a direct economic cost by impacting human health but also threatening long-term productivity (material and vegetation damage, quality of life, reduced tourism to the country, discourage foreign investment, etc.),” the 2002 World Bank report pointed out.
“Nowadays, breathing can be a dangerous business,” commented Framelia V. Anonas, a media service staffer of the Department of Science and Technology. “The air that breathes you life is the same one that can snuff life out of you.”
Air pollution affects health in both short and long term. Short-term effects include irritation to the eyes, nose, and throat, and infection on the upper respiratory tract such as pneumonia and bronchitis. Other effects are headache, nausea, and allergic reaction. Air pollution can also worsen asthma and emphysema conditions.
An epidemiological study conducted by the University of the Philippines College of Public Health, showed that the prevalence of chronic obstructive pulmonary disease (COPD) is 32.5 percent among jeepney drivers, 16.4 percent among air-conditioned bus drivers, and 13.8 percent among commuters.
In March 1999, the British Medical Journal quoted Dr. Miguel Celdran, a pediatrician at the Makati Medical Center, saying: “About 90 percent of my patients have respiratory illness, and we’re seeing babies as young as two months suffering from asthma. Twenty years ago, this was unheard of.”
The Philippine Pediatric Society surveyed doctors and asked them to describe the most common illnesses that they treat. The doctor’s response was unanimous: diseases of the upper respiratory tract. One study found out the urine samples from children living and begging on the polluted streets showed that at least 7 percent had high lead concentrations.
Many air pollutants – a mix of gases, droplets, and particles – are able to pass through the lungs into the bloodstream and are eventually transported to the heart and the entire body through blood vessels.
“Because the cardiovascular system is dependent on the functioning of the respiratory system, it is also indirectly affected by the deleterious effects of the pollution on the lungs,” the UN health agency explained. “These impacts combined, damage and inflame blood vessels and affect heart function.”
This has been supported by a study published in Lancet. Dr. Gerard Hoek from the Netherlands, found that those living near a major road have a higher risk of dying than the rest of the population. He concludes that long-term exposure to traffic-released air pollution may shorten life expectancy.
Other studies also revealed that heart attacks, life-threatening heart rhythms, and thickening of the blood can also be traced to exposure to air pollution. “To make it clear: all these bodily changes spell doom for the Filipinos living in Metro Manila (and other highly-urbanized centers),” warns Dr. Ong, who said they treat about 400 indigent patients annually in the health center where he sometimes work.
According to a World Bank study, poor air quality does not only threaten the people’s well-being but also their productivity. The study revealed that filthy air costs the country 2,000 lives lost prematurely plus US$1.5 billion in lost wages and medical treatment. At the then exchange rate of P53 to US$1 when the study was made, a whopping P79.5 billion was lost due to air pollution.
World Bank valued the 2,000 lives lost due to particulate matter at $140 million (or P7.42 billion); 9,000 people suffering from chronic bronchitis at $120 million (or P6.36 billion); and 51 million cases of respiratory diseases at $170 million (or P9.01 billion). “About 65 percent of drugs purchased by the health department every year were for treatment for respiratory diseases,” Paje reported.
Filipinos spend about P2,000 per year on air pollution-related health expenses. — ###
Air Pollution: Death by Lethal Inhalation
By Henrylito D. Tacio