CLIMATE CHANGE AND PUBLIC HEALTH ADAPTATION IN INDONESIA Budi Haryanto

Department of Environmental Health Faculty of Public Health

INTRODUCTION
Climatic changes have already affected numerous damaging impacts on human health. Spreading infectious disease, longer and hotter heat waves, and extreme weather claim thousands of additional lives nationwide each year. Warming climate is creating the ideal conditions for spread of infectious disease, putting millions of people at risk. Climate change has lead to increase the outbreaks and spread of Dengue Hemorrhagic Fever (DHF), malaria, cholera, encephalitis, hantavirus, and other diseases all over the world. Ironically, the countries which have less contributed to the global warming are highly susceptible and more outbreaks of diseases and deaths due to global warming impact

The Nautilus Institute Workshop on Mapping Causal Complexity in Climate Change Impacts and Adaptation, Melbourne, 21-22 November 2008

OUTLINE PRESENTATION
1. Introduction 2. Climate change and health impacts 3. Research in Indonesia 4. Public health adaptation 5. Strategic idea for public health adaptation in Indonesia

Moderating influences

Health Health effects Effects

Temperature-related Temperature-related illness and death Extreme weatherExtreme weather related (floods, storms) related health effects health effects

Environment Impacts:
Regional weather changes Heat waves Extreme weather Temperature Precipitation Sea-level rise Microbial changes: Contamination pathways Contamination paths Transmission Transmission dynamics dynamics

Air pollution-related pollution-related health effects Water Water and and food-borne food-borne diseases diseases Vector Vector -borne borne and and rodent- borne rodent borne diseases diseases Effects of food and water shortages Mental, nutritional, infectious-disease and other effects

Climate Change

Changes in agroecosystems, hydrology Socioeconomic and demographic disruption

EXTREME EVENTS HEALTH IMPACTS (DoH, WA)

Potential health impacts of gradual climatic changes

Potential health impacts of gradual climatic changes

Potential health impacts of gradual climatic changes

Potential health impacts of gradual climatic changes

Trend of Temperature and DHF Cases in Indonesia 1968-Sept 2007

26,6 26,4 26,2 26 150000 25,8 25,6 100000 25,4 25,2 25 24,8
19 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 2099 2000 2001 2002 2003 2004 2005 2006 07

Incident and CFR Dengue Indonesia, 1968-2007

250000
60

TEMP DHF
200000
40

IR dan CFR
20 0
1968 1970 1972 1974 1976 1978 1980 1982 1984 1986 1988 1990 1992 1994 1996 1998 2000 2002 2004 2006 2008 2010

50000

Tahun

IR/100.000 CFR(%)

Dengues principal vector: Aedes aegypti

Malaria Cases
Trend of Confirmed Cases of Malaria 2000-2006
3.50 3.00 2.50 2.00 1.47 1.50 0.98 1.00 1.42 1.31 3.14 2.67 2.85

Principal vector is female Aedes aegypti mosquito. Infected mosquito remains infective for life. Indonesia: reported dengue cases doubled in 2007 vs. 2005.

0.50 0.00 2000 2001 2002 2003 2004 2005 2006

Malaria Endemic Areas

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Effects of Temperature Rise on Dengue Transmission

Shorten viral incubation period in mosquito

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Shorten breeding cycle of mosquito Increase frequency of mosquito feeding More efficient transmission of dengue virus from mosquito to human

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# #

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>75 o/oo

25-75 o/oo

0-25 o/oo

Non Endemis 1 dot = 100 kasus 1 dot = 500 kasus

IMPACTS CLIMATE CHANGE ON HUMAN HEALTH IN INDONESIA

Direct effects:
Increasing of injuries associated with extreme weather events

Indirect effects
Increasing of malnutrition cases is related to food production and land use shifts Increasing of cardio cerebral vascular diseases, hypertension, and mental disorders are associated with urban stress, life style, displacements and conflicts. Increasing of influenza (ARI) and respiratory diseases (asthma, pneumonia) are associated with increasing of air pollution outdoor as well as indoor Increasing of food borne diseases is associated with contamination, food handling, and poverty.

Indirect effects:
Increasing of vector borne diseases (malaria, dengue, filariasis) associated with increasing of temperature, rainfall, humidity, and vector density. Increasing of water borne diseases (diarrhea, cholera, typhoid, leptospirosis) associated with decreasing of water quality and water supply as well as floods and droughts.

MAIN CONCERN: SPREADING OF DISEASES

Unique transmission pathways Specific for every single disease outcome Once the impact occurred, the disease will spread from infected person to others and from the new infected people to broader population as snow ball phenomenon The spread of disease may not be controlled directly even by manipulating or modifying the environment Analysis of each of these steps allows a logical determination of vulnerability and subsequent development of adaptive measures that aim to decrease vulnerability It will need specific discipline of technology, method, and expert such as public health/environmental health, medical, and pharmacy to deal with the impacts.

CURRENT RESEARCH & REVIEWS

Rainfall and rain date in Jakarta associated with Incidence Rate and Case Fatality Rate of Dengue Infection in 2002-2006 by Nainggolan L et al., UI 07. Aedes aegypti density in Jakarta associated with climate change by Sungkar S et al., UI 07. The influence of climate change to the spreading of dengue virus serotypes and the increasing of cases in Jakarta by Adriansjah et al., UI 07. Pulmonary tuberculosis and climate change in Indonesia by Burhan E et al., UI 07. The incidence of leptospirosis and its risk factors in Jakarta by Nainggolan L et al., UI 07. Mental health of adolescents associated with climate change by Ismail RI et al., UI 07. Increasing morbidity and mortality caused by air pollution associated with climate change in City of Bandung 2002-2006 by Soemirat J & Dirgawati M, ITB 07. Occupational dermatosis incident associated with climate change in Surabaya by Martiana T et al., Unair 07. Lung disorders associated with climate change in Jakarta by Andarini S et al., UI 07.

Research
Lung cancer associated with climate change in Jakarta by Syahruddin E et al., UI 07. Predicting the increasing of malaria cases in endemic area caused by climate change 2002-2003 by Yudhastuti R et al., Unair 07. Approach and method of studies on health and infectious diseases-related to climate change by Haryanto B, UI 07. Early warning system for malaria outbreak by Subirosa BS et al., UI 07. The pattern of malaria distribution as impact of climate change in Pacitan regency 1998-2002 by Chatarina UW et al., Unair 07. Global warming ad public health impact in Indonesia by Sutomo S, UI 07. Climate change and DHF in Tanah Laut District of South Kalimantan Province 2001-2006 by Basuki H et al, Unair 07. Climate change and voice of public health association in Indonesia by Indonesian Public Health Association 2007.

Health impact assessment

to evaluate the impact of climate variability and change in a range of areas and populations; to evaluate possible threshold effects; to evaluate the effects of multiple stresses, including changes in socioeconomic systems; to evaluate uncertainty and its implications for risk management; to evaluate the effects of reducing emissions, such as by comparing impact under scenarios with business-as-usual and stabilization of emissions; and to measure coping capacity, especially under different socioeconomic futures and in the context of sustainable development.

PUBLIC HEALTH RESPONSE AND ADAPTATION IN INDONESIA

Infectious disease surveillance Health action in emergencies Safe drinking water Integrated vector management Environmental health capacity building Healthy public policy (healthy housing, school, forest, industry, city)

WHO Adaptation Focus

Health security Strengthening health systems Health development Evidence and information Delivery Partnership

 Empowering ecological-diseases surveillance system and developing public health early warning system Development response to disaster effects of climate change Enhancing capacity building for government, private sector, and civil society on managing prevention and control climate change on human health Increasing political awareness on climate change human health Empowering public health services system for disease prevention and control Generating research and method on epidemiology and medicine to find out the approach in breaking the disease transmission chains Preventing and eradicating climate change vector-related diseases

PUBLIC HEALTH ADAPTATION IDEAS IN INDONESIA

Impacts, Vulnerability, Adaptations

Characteristics of exposed group
(location, wealth, resources, health status, culture, etc.)

Adaptations Vulnerability of group Exposure

Mitigation : Reduced exposure

Learning

Health Impact
BREAKING TRANSMISSION CHAINS

Actions in response to impact

Health Effects of Outdoor Air Pollution in Developing Countries of Asia: A Literature Review

MetaMeta -Analysis of Asian Studies of Daily Mortality/Hospital Admissions

Num ber of Studies

Systematic identification of 140 peer-reviewed Asian studies 1980-2003 Special focus on studies of daily changes in air pollution and health Conduct first ever Asian meta analysis quantifying risks, finding initial similarities with West Identify knowledge gaps to guide future research Active communication to policy makers

28 recent daily time series studies examined in depth Studies find effects of air pollution on rate of death, illness ~0.5% increase per 10 g/m3 of PM10 High levels of air pollution in Asian cities (>100 g/m3), imply a substantial public health impact Limitations Small number of cities Not geographically representative (poorest, most polluted countries under-represented)

12 10 TSP 8 6 4 2 0
All-Caus e Mortality Respiratory Mortality Cardiovasc ular Mortality Res piratory Hospital Adm iss ions Cardiovas c ular Hos pital Admis sions

PM10 PM2.5 SO2 NO2 CO O3

Outcome Diagnosis

Percent Increase in Mortality per 10 micrograms PM10

0,8 0,6 Percent 0,4 Increase 0,2 0 US(90 Cities)* Eur(21 Cities)* Asia (4 Cities)

0,62 0,46

0,49

New Research in Asian Cities

Eight new studies of air pollution and health now underway in Asian Cities Acute Effects (initial cities):
Bangkok, Hong Kong, Shanghai, Wuhan Strong teams, quality data

New PAPA (Public Health and Air Pollution in Asia ) Studies in India
Goal: Understand air pollution health effects in less-studied areas Representative time series studies of pollution and daily death
Diverse, highly populated regions Public health impact could be significant Significant data challenges (air quality, morbidity, mortality - frequency, access, quality)

Long Term (chronic) Effects

Guangzhou, China pilot study in elderly cohort

New! Study teams now identified and Approved in India following extensive investigator competition

City Chennai
(formerly Madras)

Region South North North

Population 7,400,000 18,550,000 1,625,000

Delhi Ludhina

PAPA: Looking Ahead

A Special Challenge: Understanding the interaction among air pollution, poverty, and health
In Asia high levels of air pollution, dense population, extensive poverty are prevalent Some initial evidence (mostly from West) that the poor face worse effects from air pollution

Potential Public health implications could be significant

Higher Risks Among the Less Educated

Evidence from HEI Reanalysis Attained education inversely associated with PM relative risk in ACS and Six-Cities studies An indicator of social class Due to differences in true exposure? Sensitivity to air pollution?

Why the Poor May Suffer More Health Effects From Air Pollution
Likely higher exposures to air pollution
Living close to traffic Roadside occupational exposures Small and medium scale enterprises / Cottage industries Use of solid fuels for cooking (indoor air)

The poor may be more susceptible to air pollution

Poor nutrition / immunosuppression Higher incidence of diseases of poverty (TB, ALRI) Lack of timely access to health care

Limited evidence from the West, but with

- high pollution, high urban population density; significant poverty -Clear need to explore this issue in the Asian context

CAI-Asia Goals

Air Pollution, Poverty and Health: Key elements of initiative

I Assessment of respiratory health of children (ALRI others) of different SES
Designing targeted case-control and panel studies to provide quality local data of poverty effects

The Clean Air Initiative promotes and demonstrates innovative ways to improve the air quality of Asian Cities through sharing experiences and building partnerships

II Household survey to assess

exposure to multiple sources of air pollution health prevalence (status) Perceptions, coping mechanism and economic burden

III Policy impact study (integrating above for policy making) Strong commitment to capacity building throughout

Sharing knowledge and experiences on air quality management Capacity building Improving policy and regulatory frameworks at the regional level Assisting cities in formulating and implementing integrated air quality management systems Piloting projects to encourage innovation Creating an Air Quality Management Community in Asia

36

CAI-Asia Membership
GAs
CITIES
Bangkok,Thailand Chiang Mai,Thailand Chengdu,PRC Chittagong,Bangladesh Chongqing,PRC Colombo,Sri Lanka Dhaka, Bangladesh Guangzhou,PRC Haiphong, Viet Nam Hangzhou,PRC Hanoi,Viet Nam Harbin,PRC Ho Chi Minh City,Viet Nam Hyderabad, India Islamabad,Pakistan Kathmandu,Nepal Lahore , Pakistan Makati,Philippines Metro Manila, Philippines Mumbai, India Naga,Philippines Phnom Penh,Cambodia Pune , India Singapore , (NEA) Surabaya,Indonesia Tianjin,PRC Ulaanbaatar, Mongolia Yogyakarta,Indonesia
Andhra Pradesh Pollution Control Board, India Australia Department of Environment and Heritage Balochistan EPA , Pakistan Central Pollution Control Board, India Department of Environment , Bangladesh Department of Forests, Ecology and Envt, Karnataka State, India Department of Environment and Natural Resources, Philippines Department of Energy, Philippines Department of Transportation and Communications, Philippines Dhaka Transport Coordination Board, Bangladesh Environmental Management Bureau, Ministry of Environment , Japan Environment Protection Department, Hong Kong, SAR Environmental Protection Agency Karachi, Pakistan Ministry of Environment , Cambodia Ministry of Environment , Indonesia Ministry of Public Works and Transport , Cambodia Ministry of Road Transport and Highways, India Pollution Control Department , Thailand State Environmental Protection Administration (PRC focal point) Viet Nam Register, Viet Nam

Part 2
54 NGOs and Academic Institutions in the Region

Review of Status of AQM in Asia

DEVELOPMENT AGENCIES
Asian Development Bank Australian Department for Environment and Heritage German Agency for Technical Cooperation The William and Flora Hewlett Foundation United States-Asia Environmental Partnership Sida World Bank

FULL PRIVATE SECTOR Member

Ford Motor Co. Shell Clean Diesel Tech. Inc.

ASSOCIATE PRIVATE SECTOR Member

AVL DEKRA Cerulean MAHA Corning ESP IPIECA SGS ACFA Johnson Matthey 37

38

Drivers: Urbanization

Drivers: Population growth

1600.0 1400.0 1200.0

Population millions

East Asia
1000.0 800.0 600.0 400.0 200.0 0.0 1980 1990 2000 2002

Southeast Asia South Asia

Source: United Nations, World Urbanization Prospects, The 1999 Revision

39

More than one billion extra from 1980 2002 South Asia growing most rapidly

40

Drivers: Motorization

Drivers: Increase in 2 & 3 wheelers in Asia

10,000,000 Bangladesh2&3 w heelers
35,000,000 40,000,000 Indonesia Thailand 2&3 wheelers India PRC

C am bodia H ongkong, China 8,000,000 Japan Korea, R epublic of

600
30,000,000 25,000,000 20,000,000 15,000,000 10,000,000 5,000,000 -

M alaysia Pakistan2& 3 wheelers 6,000,000

Vehicle Population (millions)

500

Sri Lanka2&3 w heelers V iet N am

400

300

4,000,000

1994

1995

1996

1997

1998

1999

2000

2001

2002

2003

2004

200

U.S. Current Level

2,000,000

100

0 1995 2000 20052010 2015 2020 2025 2030

The Global Market for New Motorcycles and Mopeds

Total: 29792139
North Am erica Middle East
0.4% 3.1%

Oceania
0.3%

Latin Am erica
3.5%

Africa
0.4%

Europe
7.9%

Vehicle growth scenario China

Source: Dongquan He, Energy Foundation 2004

0 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004
Asia

Source: ADB 2002. Policy Guidelines to Reduce Vehicle Emissions

41

84.4%

Source: CAI-Asia, 2004

42

Source: Honda Facts & Figures

Drivers: Energy consumption

3500
Milli on Tons Oil Equivalent

Drivers: Energy consumption

Energy Intensity, (BTU per 1995 USD Market Exchange Rates)

2003 World Energy Consumption Share (10.5 billion toe)

120,000 China India 100,000 80,000 60,000 40,000 20,000 0 1980 1982 1984 1986 1988 1990 1992 1994 1996 1998 2000 2002

3000 2500 2000 1500 1000 500 0

Total Asia Pacific China India Japan

Source: Enerdata, 2005

1980

1985

1990

1995

2000

2003

Source: BP Statistical Review of World Energy 2004

Source: International Energy Annual 2002 by EIA-DOE

2003 World Energy Consumption by Source

Source: Enerdata, 2005

1/3 of world energy consumption is attributed to Asia Since 2000, coal share in energy mix is increasing by 1 percent in lieu of oil 57% of the increase from 2002 to 2003 energy use is attributed to China 2/3 of the the world coal consumption increase is located in China, but the demand for coal grows almost everywhere 43

China has seen great improvements in energy intensity (energy/GDP output) in the past two decades in the more recent years however, energy consumption is growing faster than GDP again in China

Primary energy consumption growth 1990-2001 = 3.0%/a 2001-2002 = 9.9% 2002-2003 = 13.2% GDP Growth 1990-2001 = 9.9%/a 2001-2002 = 8.9% 2002-2003 = 9.1% Energy elasticity 1990-2001 = 0.30 2001-2002 = 1.11 2002-2003 = 1.47
Source: Wu Zongxin, 2005 Paper Presented 25 February at the CTI Industry Joint Seminar on technology Diffusion of Energy Efficiency in Asian Countries Note: Wu is from the 3E Research Institute, Tsinghua University.

44

State: Average Annual Air Pollution Concentration in selected Asian Cities (2000-2003)
400

State: 20002003 compared with 1990 1999 Air Quality Data

SO2 NO2 > ? > < < > ? < < > < < SPM < ? ? ? < < < < < < < ? ? PM10 < < < < ? < < < ? > < Bangkok Beijing Busan Colombo Hong Kong Kolkata Manila Mumbai New Delhi Seoul Shanghai
Sh an gh ai Sin ga po re Su ra ba ya Ta ip ei, Ch in a

350

< < > > < ? < < < < < <

300

concentration in g/m3

250

Most of the cities have been able to reduce levels of SO2 to safe levels with the exception of Beijing and Hanoi NO2 levels gradually increasing levels and just above the WHO guidelines Almost all cities have been able to reduce levels of SPM and PM10 compared to the 90s level, however levels continue to remain above the guidelines except those of the more developed cities
46

200

150

100

50

0
Ko ng Ja ka rta Ka th m an du Ko lk at a M um ba i Bu sa n C olo m bo hi M in h Be ijin g To ky o ok Se ou l Ha no i D elh i ha ka an ila Ba ng k

Ho ng

H o

Ne w

Taipei,China Tokyo
Notes:

SPM Guidelines = 60-90 g/m3 (WHO, 1979) PM10 Limit = 50 g/m3 (USEPA, 1997)

SPM PM10

SO2 Guideline = 50 g/m3 (WHO, 1999) NO2 Guideline = 40 g/m3 (WHO, 1999)

SO2 NO2

45

- about 5% increase - about 5%decrease ? data not available

Source: CAI-Asia Research, 2004

Source: CAI-Asia, 2004

State: Trend of Aggregated Annual Averages of SO 2 for selected Asian Cities (1993 2003) Trends of Aggregated Annual Averages of SO for selected Asian Cities (1993 - 2003)
2

State: Trend of Aggregated Annual Averages of SPM for selected Asian 2003) Trends of Cities Aggregated (1993 Annual Averages of SPM for selected Asian Cities (1993 - 2003)
600
Bangkok Beijing Colombo Dhaka Ho Chi Minh Hong Kong Kolkata Seoul Shanghai Singapore Surabaya Taipei,China Tokyo
Bangkok Busan Hong Kong Kolkata Manila Mumbai 500 New Delhi Seoul Shanghai Bangkok Busan Hong Kong Kolkata Manila Mumbai New Delhi Seoul Shanghai Bangkok Busan Hong Kong Kolkata Manila Mumbai New Delhi Seoul Shanghai Bangkok Busan Hong Kong Kolkata Manila Mumbai New Delhi Seoul Shanghai Bangkok Busan Hong Kong Kolkata Manila Mumbai New Delhi Seoul Shanghai Bangkok Busan Hong Kong Kolkata Manila Mumbai New Delhi Seoul Shanghai Bangkok Busan Hong Kong Kolkata Manila Mumbai New Delhi Seoul Shanghai Bangkok Busan Hanoi Hong Kong Jakarta Kolkata Manila Mumbai New Delhi Seoul Shanghai Bangkok Hanoi Hong Kong Jakarta Kolkata Manila Mumbai New Delhi Seoul Shanghai Bangkok Hanoi Hong Kong Kolkata Manila Mumbai New Delhi Shanghai Bangkok Hong Kong Kolkata Manila Mumbai New Delhi Shanghai

140
Busan Hong Kong Kolkata Mumbai New Delhi Seoul Shanghai Singapore Taipei,China Tokyo Busan Hong Kong Kolkata Mumbai New Delhi Seoul Shanghai Singapore Taipei,China Tokyo Busan Hong Kong Kolkata Mumbai New Delhi Seoul Shanghai Singapore Taipei,China Tokyo Bangkok Beijing Busan Hong Kong Kolkata Mumbai New Delhi Seoul Shanghai Singapore Taipei,China Tokyo Bangkok Beijing Busan Colombo Hong Kong Kolkata Mumbai New Delhi Seoul Shanghai Singapore Taipei,China Tokyo Bangkok Beijing Busan Colombo Hong Kong Kolkata Mumbai New Delhi Seoul Shanghai Singapore Taipei,China Tokyo Bangkok Beijing Busan Colombo Hong Kong Kolkata Mumbai New Delhi Seoul Shanghai Singapore Taipei,China Tokyo Bangkok Beijing Busan Colombo Ho Chi Minh Hong Kong Kolkata Mumbai New Delhi Seoul Shanghai Singapore Taipei,China Tokyo Bangkok Beijing Busan Colombo Hanoi Ho Chi Minh Hong Kong Kolkata Mumbai New Delhi Seoul Shanghai Singapore Surabaya Taipei,China Tokyo Bangkok Beijing Busan Colombo Dhaka Hanoi Ho Chi Minh Hong Kong Kolkata Mumbai New Delhi Seoul Shanghai Singapore Surabaya Taipei,China Tokyo

550

120

450 400 350 300 250 200

100
3

concentrations in g/m

80

60

40

concentrations in g/m

150 100

20

50 0
0 1993 1994 1995
3

1993
1996 1997 1998 1999 2000 2001 2002 2003 SO2 Guideline = 50 g/m (WHO, 1999)

1994

1995
3

1996

1997

1998

1999

2000

2001

2002

2003

SPM Guidelines = 60-90 g/m (WHO, 1979)

Notes: The graph show s the aggregated average of the annual averages of major criteria pollutants; The range of data is show n by the vertical lines for each year, the maximum and minimum values are marked by horizontal lines on the top and bottom most part of the line. The quality for each data point varies corresponding to the number of cities w here data is present

Source: CAI-Asia, 2004

Notes: The graph show s the aggregated average of the annual averages of major criteria pollutants; The range of data is show n by the vertical lines for each year, the maximum and minimum values are marked by horizontal lines on the top and bottom most part of the line. The quality for each data point varies corresponding to the number of cities w here data is present

Source: CAI-Asia, 2004

47

48

State: Trend of Aggregated Annual Averages of PM10 for selected Asian Cities (1993 2003)
Trend of Aggregated Annual Averages of PM10 for selected Asian Cities (1993 - 2003)

State: Trend of Aggregated Annual Averages of NO 2 Trends ofCities Aggregated(1993 Annual Averages of NO for selected Asian Cities (1993 - 2003) for selected Asian 2003)
2

80
300
Hong Kong Mumbai New Delhi Singapore Taipei,China Tokyo Busan Hong Kong Mumbai New Delhi Seoul Singapore Taipei,China Tokyo Busan Hong Kong Mumbai New Delhi Seoul Singapore Taipei,China Tokyo Bangkok Busan Hong Kong Kolkata Mumbai New Delhi Seoul Singapore Taipei,China Tokyo Bangkok Busan Colombo Hong Kong Kolkata Mumbai New Delhi Seoul Singapore Taipei,China Tokyo Bangkok Beijing Busan Colombo Hong Kong Kolkata Mumbai New Delhi Seoul Singapore Taipei,China Tokyo Bangkok Beijing Busan Colombo Hanoi Ho Chi Minh Hong Kong Jakarta Kolkata Mumbai New Delhi Seoul Shanghai Singapore Taipei,China Tokyo Bangkok Beijing Busan Colombo Hanoi Ho Chi Minh Hong Kong Jakarta Kolkata Mumbai New Delhi Seoul Shanghai Singapore Surabaya Taipei,China Tokyo Bangkok Beijing Busan Colombo Hanoi Ho Chi Minh Hong Kong Jakarta Kolkata Manila Mumbai New Delhi Seoul Shanghai Singapore Surabaya Taipei,China Tokyo Bangkok Beijing Colombo Hanoi Ho Chi Minh Hong Kong Jakarta Kolkata Manila Mumbai New Delhi Shanghai Singapore Surabaya Taipei,China Tokyo Busan Hong Kong Seoul Singapore 70 Taipei,China Tokyo Busan Hong Kong Seoul Singapore Taipei,China Tokyo Busan Hong Kong Seoul Singapore Taipei,China Tokyo Bangkok Busan Hong Kong Seoul Singapore Taipei,China Tokyo Bangkok Busan Hong Kong Seoul Shanghai Singapore Taipei,China Tokyo Bangkok Busan Colombo Hong Kong Seoul Shanghai Singapore Taipei,China Tokyo Bangkok Busan Colombo Hong Kong Seoul Shanghai Singapore Taipei,China Tokyo Bangkok Busan Colombo Hanoi Hong Kong Jakarta Seoul Shanghai Singapore Taipei,China Tokyo Bangkok Busan Colombo Hanoi Hong Kong Jakarta Seoul Shanghai Singapore Surabaya Taipei,China Tokyo Bangkok Busan Colombo Dhaka Hanoi Hong Kong Jakarta Seoul Shanghai Singapore Surabaya Taipei,China Tokyo Bangkok Colombo Dhaka Hong Kong Jakarta Shanghai Singapore Surabaya Taipei,China Tokyo

250

Hong Kong Mumbai New Delhi Singapore Taipei,China Tokyo

60

concentrations in g/m3

200

concentration in g/m

50

40

150

30

100

20

50

10

0
0 1993
Notes: The graph show s the aggregated average of the annual averages of major criteria pollutants; The range of data is show n by the vertical lines for each year, the maximum and minimum values are marked by horizontal lines on the top and bottom most part of the line. The quality for each data point varies corresponding to the number of cities w here data is present

1993

1994

1995
3

1996

1997

1998

1999

2000

2001

2002

2003

1994

1995
3

1996

1997

1998

1999

2000

2001

2002

2003

NO2 Guideline = 40 g/m (WHO, 1999)

PM10 Limit = 50 g/m (USEPA, 1997)

Source: CAI-Asia, 2004

Notes: The graph show s the aggregated average of the annual averages of major criteria pollutants; The range of data is show n by the vertical lines for each year, the maximum and minimum values are marked by horizontal lines on the top and bottom most part of the line. The quality for each data point varies corresponding to the number of cities w here data is present

49

The high variability and wide range of values requires additional analysis

50

State: Ambient versus Roadside

Bangkok Air Quality Trends (1993 2003)
600
Roadside SPM Ambient SPM Ambient PM10

State: Ambient versus Roadside

Hong Kong Air Quality (PM10) Trends (1993 2003)
100 90 80 70
concentrations in g/m3

500
3 concentrations in g/m

Roadside PM10

400 300 200 100

60 50 40 30 20 10 Ambient PM10 Roadside PM10

0 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003
Note: SPM ambient annual standards = 100 g/m3 PM10 ambient annual standards = 50 g/m3

0 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002
51
Note: PM10 ambient annual standards = 55 g/m3

52

State: Ambient versus Roadside

Ho Chi Minh City Air Quality (PM10) Trends (2000 2003)
140 120
concentrations in g/m3

Ambient Air Quality in Major Asian Cities

350 300
concentrati ons in g/m

Bangkok (1992 2003)

350 300 250 200 150 100 50 0

Hong Kong (1992 2003)

250 200 150 100 50 0

100 80 60 40
Roadside PM10
concentrations in g/m
3

1990

1992

1994

1996

1998

2000

2002

2004

1990

1992 SPM

1994 PM10

1996 SO2

SPM
Source: PCD, 2004
3 50

PM10

NO2

CO

O3

1998 CO

2000 NO2

2002 O3

2004

Source: Hong Kong EPB, 2004

350 300 250 200 150 100 50 0
1993 1994 1995 1996 SPM 1997 RSPM 1998 SO2 1999 2000 NOx 2001 2002

Shanghai (1992 2003)

3 00 2 50

New Delhi (1992 2003)

2 00

20 0

Ambient PM10

1 50

1 00

50

2000
Note: No standards for PM10

2001

2002

2003
0 1 990 19 92 1 994 19 96 199 8 200 0 200 2 2 004

S PM

P M10

S O2

NO 2

53

Source: Shanghai EMC, 2004

Source: ESMAP, 2004 Note: Levels of SPM are all above 350 g/m3

54

Impacts: Health Effects

Impacts: Epidemiological studies and Health Costs

Health Costs per year

Health Effects
Number of Premature Deaths
Risks
Unsafe Water Urban Outdoor Air Indoor Air
Source: WHO, 2002

Exposure Risks
0.7 0.6 0.5 0.4 0.3 0.2 0.1 0
Percent Increase

Global Estimate
1,730,000

Asian Estimate
730,000

0.46 0.62 0.5

US (90 Cities)* Eur (21 Studies)* Asia (6 Studies)

799,000

487,000

1,619,000

1,025,000

Source: Greenbaum and OKeefe, BAQ 2003

Manila (2001)1 : Chronic bronchitis (8,439) and excess deaths associated with PM10 (1,915) costs US$392M Shanghai (2000)2: Chronic bronchitis (15,188) and premature deaths (7,261) associated with PM10 costs US$880M Bangkok (2000)3: Chronic bronchitis (1,092) and excess deaths (4,550) associated with PM10 costs US$424M India (2002)4: estimated annual health damage of pre-Euro emissions for the 25 Indian cities were from a low of US $14 million (Rs.679 crore) to a high of US $ 191.6 million Jakarta (1998)5: estimated health effects from PM10 only is US$ 100 million

Exposed to diesel exhaust

Exposed to clean air

Source: NIES, www.nies.go.jp

55

Percent Change in Mean Number of Daily Deaths from all causes per 10 g/m3 increase in 24-hr mean level of PM10 Source: HEI, 2004

Source: 1 Worldbank (2002) Philippines Environment Monitor 2002 2 Chen et.al. (2002) Integrated Risk Assessment on Human Health & Ambient Air Pollution Shanghai 3 Worldbank (2002) Thailand Environment Monitor 2002 4 Mashelkar Committee (2002) India Auto Fuel Policy Report 5 Worldbank (2003) Indonesia Environment Monitor

56

Response: Benchmarking AQM Capacity

1. Air quality measurement capacity 2. Data assessment and availability 4. Management enabling capabilities

Response: Benchmarking AQM Capacity

AQM Profile 15-20 page document:

General information Description of pollution sources Air Quality Data Impacts of air pollution Policies, Programs and Projects Conclusions

AQM Indicator Ratings

Air quality measuremen t capacity Assesses the ambient air monitoring taking place in a city and the accuracy and precision and representativeness of the data collected Data assessment and availability Assesses how air data is processed to value and provide information in a decision-relevant format. It also assesses the extent to which there is access to air quality information and data through different media Emissions estimates Managemen t enabling capabilities Asseses the administrative and legislative framework through which emission control strategies are introduced to manage air quality

3. Emissions estimates

25 scores each
1992 MARC/UNEP/WHO AQM Indices applied to 84 cities

Cities covered in Benchmarking Bangkok Jakarta Shanghai Study

Beijing Busan Colombo Dhaka Hanoi Hong Kong Ho Chi Minh Kathmandu Manila Mumbai New Delhi Kolkata Seoul Shanghai Surabaya Singapore Taipei Tokyo

Review
Both city profile and questionnaire have been reviewed by air quality experts in the city
57

Assesses emission inventories undertaken to determine the extent to which decisionrelevant information is available about source pollution in the city

58

Response: Overall AQM Capability

100 90 80 70
Overall index

Response: AQ Monitoring Capacity in Asia

City Bangkok Beijing Busan Colombo Delhi Dhaka Hanoi Ho Chi Minh Hong Kong Jakarta Kathmandu 1 6 1 11 Status of AQ monitoring 7in Asia 9 14 5 1 Manual Continuous 21 24 14 City Kolkata Manila Mumbai Osaka Seoul Shanghai Singapore Surabaya Taipei Tokyo Yogyakarta 6 23 Manual 12 12 22 14 27 21 16 5 19 82 Continuous 5 5

60 50 40 30 20 10 0
ng ko Be k i jin Bu g Co san lo Ne mb w o De l Dh hi ak a Ho Ha C no h i Ho i M ng inh Ko n g J Ka aka th rta m an d M Ko u et lka ro t M a an M ila um ba S i S eou ha l n Si g h ng ai a Su p o r ra e Ta ba ip y a ei Ci t To y ky o

Ba

Source: Benchmarking Study Urban Air Quality Management and Practice in Major and

Mega Cities of Asia Stage 2 (draft)

Measurement

Data assessment & availability

Emission estimates

Management tools
59 60

10

Response: Online Ambient Air Quality Data of Selected Asian Cities

City Beijing Shanghai Chengdu Chongqing Guangzhou Jilin/Harbin Hangzhou Tianjin Kolkata Mumbai New Delhi Tokyo Busan Kathmandu Metro Manila Singapore Thailand Ho Chi Minh Website URL http://www.bjepb.gov.cn/ http://www.sepb.gov.cn/user/outweb/index-en/index-en.jsp http://www.hbj.chengdu.gov.cn/ http://www.cqemc.cn/ http://www.gzepb.gov.cn/ http://hbj.jl.gov.cn/ http://ems.hzepb.gov.cn/20031224/index.htm http://www.zjepb.gov.cn/ http://www.wbpcb.gov.in/html/airquality.php http://mpcb.mah.nic.in/envtdata/envtair.php http://www.cpcb.delhi.nic.in/ http://www2.kankyo.metro.tokyo.jp/kansi/portal.htm http://www.bihe.re.kr/ http://mope.gov.np/mopepollution/ http://www.emb.gov.ph/ http://www.nea.gov.sg/psi/ http://pcd.go.th/AirQuality/bangkok/ http://www.hepa.gov.vn/

Response: AQ data analysis in Asia

City Bangkok Beijing Busan Colombo Delhi Dhaka Hanoi Ho Chi Minh Hong Kong Jakarta Kathmandu Kolkata Manila Mumbai Osaka Seoul Shanghai Singapore Surabaya Taipei Tokyo Yogyakarta Emissions Inventory domestic comm'l power indust'l mobile Summary yes yes yes no limited 1998 only limited limited yes yes yes limited yes yes yes yes yes limited, NDA yes yes yes yes, NDA

Many cities have initiated development of Emission Inventories

BUT
Level of detail/ disaggregation varies greatly Reliability of activity data on which inventories are based and Emission factors used is questionable for many of the cities Inventories in many of the cases were conducted by outside groups: academe or consulting firms

CAUTION
in formulating AQM policies based on current Emission Inventories

61

62

Response: Ambient Air Quality Standards

Country Bangladesh China Hong Kong India Indonesia Japan Nepal Pollutants
TSP, CO, NOx, and SO2 TSP, PM10, CO, SO2, NO2, Pb TSP, PM10, CO, SO2, NO2, Pb, O3 TSP, PM10, CO, SO2, NO2, Pb TSP, PM10, CO, SO2, NO2, O3, Pb CO, NO2, O3, SO2, TSP TSP, PM10, CO, SO2, NO2, Pb, C6H6

Response: Institutionalizing Vehicle Emissions Standards ( new light duty vehicles)

Most countries have more lenient standards than those prescribed by WHO and USEPA Standards for PM10 have been largely based on USEPA limits There is a need to review current PM standards, considering Europes move to 50g/m3 limit for 24-hour averages of PM10 Standards for other air toxics e.g benzene should be legislated
63
Country European Union Bangladesh Hong Kong, China Indiaa Indiab Indonesia Malaysia Nepal Philippines PRCa PRCc e Singapore Singaporeg Sri Lanka Taipei,China Thailand e Viet Nam Viet Namf
a b

Remarks 1997 standards established for a few pollutants depending on land use category; new standards are pending approval Standards require cities to comply with Class I, II, or III standards. Class I standards more stringent than the WHO and USEPA limits Standards less stringent than WHO and USEPA limits Established based on different land-use categories i.e. industrial, residential and sensitive areas. National and local (Jakarta) standards less stringent that WHO; PM limits less stringent than USEPA Comparable and to some extent more stringent than WHO guidelines with the exception of CO limits for an 8-hour exposure. Established only in 2003; standards less stringent than WHO; PM limits less stringent than USEPA No legislated ambient air quality standards

95
Euro 1

96

97

98

99

2000

01

02

03

04

05

06

07

08

09

10

Euro 2

Euro 3

Euro 4 Euro 2 (under discussion)

Euro 5

Euro 1

Euro 2

Euro 3 Euro 1 E1 Euro 2 Euro 2 Euro 1 Euro Euro Euro Euro US Tier 1 1 1 2 2

Euro 4 Euro 2 Euro 3 Euro 2 E4 Euro 1 Euro 2 Euro 2 Euro 3 Euro 4 Euro 1 US Tier 2 for dieseld Euro4 Euro 2 E3 Euro 2 E3 E3

Euro 1

Euro 3

Pakistan Philippines Singapore Sri-Lanka

TSP, PM10, CO, SO2, NO2, O3, Pb PM10, CO, SO2, NO2, O3 TSP, CO, SO2, NO2, O3, Pb TSP, PM10, CO, SO2, NO2, O3, Pb TSP, CO, SO2, NO2, O3, Pb

Euro 1 Euro 1

based and comparable to WHO and USEPA (for PM10). Standards more lenient, selecting the higher/max allowable limits Despite adopting only both WHO guidelines and USEPA limits, Singapore PSI reporting is very efficient TSP standards twice more lenient than USEPA, No annual standard for SO2, 24-hour limit for SO2, a slightly lenient O3 and NO2 compared with USEPA and WHO, respectively TSP twice more lenient than USEPA; SO2 and CO almost same as USEPA limit, stringent NO2 compared to WHO Hourly limits for NO2 and CO are more lenient than WHO, no PM10 standards, the rest of the standards are almost same as WHO

Euro 1 Euro 1

Euro 2

Euro 3 Euro 1

Thailand Vietnam

Entire country Delhi and other cities; Euro 2 introduced in Mumbai, Kolkata and Chennai in 2001; Euro 2 in Bangalore, Hyderabad, Khampur, Pune and Ahmedabad in 2003, Euro 3 to be introduced in Delhi, Mumbai, Kolkata, Chennai, Bangalore, Hyderabad and Ahmedabad in 2005 c Beijing and Shanghai d Gasoline vehicles under consideration e for gasoline vehicles f for diesel vehicles g for all types of diesel vehicles Source: CAI-Asia, 2005 * italicized to be confirmed

64

Response: Institutionalizing Fuel Quality Standards

Country Bangladesh Cambodia China Hong Kong SAR India Indonesia Japan Korea Malaysia Nepal Philippines Singapore Sri-Lanka Thailand Vietnam Euro 2 by 2005 Euro 1; still partly leaded Euro 1; 500 ppm sulfur diesel Euro 2 in place Euro 1 in place Euro 3 gasoline and Euro 2 for Diesel Euro 3 in 2009 announced and under discussion Current Status Euro 1 under discussion No formal standards, still leaded Euro 3 - Beijing and Shanghai Euro 2 - Rest of the country Euro 4 in place Euro 3 for Metros and Euro 2 for the rest of the country Euro 2 (?) Euro 4 Equivalent (S 50ppm) Future Directions No dialogue or plans to move beyond Euro 1 No roadmap in place 11th Five Year Plan laying out road map for Euro 3 and Euro 4 for entire country ULSD and Euro 5 (diesel) under consideration for 2007 Euro 4 for Metros and Euro 3 for the rest of country under discussion Euro 3 gasoline by 2006 & Euro 3 diesel after 2010 Ultra-low sulfur gasoline and diesel 2007 Ultra-low sulfur gasoline and diesel by 2007? Euro 4 by 2009-2010 No structured discussion on how to move ahead Euro 2 mid 2005. Initial discussions on Euro 4 by 2010. Euro 4 diesel in 2006, no plans for gasoline No roadmap in place Euro 4 for 2009 with discussion ongoing on ULSD in some locations Euro 2 in 2007 and Euro 4 in 2010 under discussion and 65 tentatively scheduled for July 2005

Part 4

CAI-Asia Programs

66

11

Phase 2 CAI-Asia: 2005 - 2007

Summary of Results Phase 1

Goals Regional Coordination and Cooperation on Air Quality Management firmly established in Asia Asian countries ability manage air quality is improved Air quality is improved Results Improved scientific understanding of air pollution in Asia Better policies for air quality management in Asia Strengthened air quality governance in Asia Improved implementation of air quality management policies and programs
67

Knowledge Management Website:

http://cleanairnet.org/caiasia

Largest on-line information source on AQM in Asia Over 1100 daily visitors High client satisfaction according to CAI-Asia evaluation Listserv: CAI-Asia has provided a platform and bulletin board where air quality management issues can be actively discussed CAI-Asia Evaluation Report 2004
To join, send a blank email to: join-cai-asia@lists.worldbank.org
68

Summary of Results Phase 1

Summary of Results Phase 1

Capacity Building
CATNet-Asia: Partnership of World Bank, USEPA and Pollution Control Department Thailand to strengthen capacity to deliver air quality management training
http://www.cleanairnet.org/caiasia/1412/propertyvalue-19618.html

Regional Cooperation
Strategic Framework for Air Quality Management in Asia: Joint activity with APMA Project to develop a high level conceptual approach to air quality management by Asian Cities. http://www.cleanairnet.org/caiasia/1412/article-58180.html Dialogue among other Regional Initiatives/ Institutions with AQM Component: Annual dialogue to promote the development and adoption common agendas on air quality management in Asia.
http://www.cleanairnet.org/caiasia/1412/article-58414.html

Distance Learning Course: World Bank Institute Program to deliver Air Quality Management training
http://www.cleanairnet.org/caiasia/1412/propertyvalue-19618.html

Fuel Quality Strategies Training Workshop: ADB IFQC program to strengthen capacity of Asian countries to develop fuel quality improvement strategies
http://www.cleanairnet.org/caiasia/1412/article-58140.html

South-South Exchange Program: Exchange of experiences among CAI-Asia member cities and organizations

Benchmarking Study on UAQM Capability of selected Asian cities - 2nd Stage: Assessment of air quality management capabilities among 20 Asian cities Initial Results - http://www.cleanairnet.org/caiasia/1412/article-59072.html CAI-Asia Oil Industry Dialogue for Cleaner Fuels in Asia: Dialogue aimed to result in a joint roadmap for cleaner transportation fuels in Asia
http://www.cleanairnet.org/caiasia/1412/article-58858.html 70

69

Summary of Results Phase 1

Summary of Results Phase 1

Pilot Projects
Public Health and Air Pollution in Asia (PAPA): $2 million research and capacity building program to investigate impact of air pollution on public health in Asian cities
http://www.cleanairnet.org/caiasia/1412/article-48844.html

Workshops The annual BAQ workshop has developed into an institution and is now the largest urban air quality event in Asia.
Better Air Quality 2002: 16-19 December 2002. Hong Kong,
SAR Hosted by the Hong Kong Polytechnic University and Environmental Protection Department and supported by the Air Pollution in the Mega-cities of Asia Project, CAI-Asia, and the California Air Resources Board
http://www.cleanairnet.org/caiasia/1412/article-35730.html

Poverty and Air Pollution: Ho Chi Minh based case study to develop methodology to assess linkage of air pollution and poverty in Asia. Developing Integrated Emissions Strategies for Existing Land Transport (DIESEL): Bangkok based regional program to develop solutions to reduce emissions from in-use diesel vehicles
http://www.cleanairnet.org/caiasia/1412/article-48845.html

Better Air Quality 2003: 17-19 December 2003. Manila,

Philippines Hosted by the Air Pollution in the Mega-cities of Asia Project, the Partnership for Clean Air (Manila), and CAI-Asia
http://www.cleanairnet.org/baq2003/1496/channel.html

Partnership for Sustainable Urban Transportation in Asia: Regional Partnership of ADB and EMBARQ to promote sustainable urban transport in Asia through policy dialogue and indicator development. http://www.cleanairnet.org/caiasia/1412/article-58616.html Emission Reduction Potential of Low Sulfur Diesel Fuels in Asia: Studies in support of CAI-Asias activities on fuel quality improvement. http://www.cleanairnet.org/caiasia/1412/article-58109.html
71

Better Air Quality 2004: 6-8 December 2003. Agra, India.

Hosted by Indias Ministry of Environment and Forests and CAIAsia, and jointly organized by the Society of Indian Automobile Manufacturers, Central Pollution Control Board, and CAI-Asia
http://www.cleanairnet.org/baq2004/1527/channel.html 72

12

BAQ 2006

BAQ 2006
Yogyakarta, Indonesia September 2006
73

13