Millions of premature births could be linked to air pollution, study finds

Premature births across 183 countries may be associated with fine particulate matter, a common air pollutant, with Africa and Asia especially affected

Air pollution could be a contributing factor in millions of premature births around the world each year, a new report has found.

Nearly 15 million babies are born annually before reaching 37 weeks gestation. Premature birth is the leading cause of death among children younger than five years old, and can cause lifelong learning disabilities, visual and hearing problems, the World Health Organization (WHO) reports.

Researchers for the Stockholm Environment Institute (SEI) have concluded that as many as 3.4 million premature births across 183 countries could be associated with fine particulate matter, a common air pollutant, with sub-Saharan Africa, north Africa and south-east Asia most impacted by the issue.

“Preterm birth and associated conditions are one of the biggest killers of children in the US and worldwide,” said Dr Paul Jarris, chief medical officer at the March of Dimes, a US-based nonprofit focused on maternal and baby health. “Yet, there’s a lot of things we don’t know about what causes preterm birth, so every bit of information we can get is helpful.”

“We have known for a long time that air pollution contributes to asthma and heart disease in adults,” said Jarris. “What I think people fail to recognise is that so many of these risk factors impact babies before they are even born.”

Previous studies have looked at how in utero air pollution might negatively impact babies’ birth weight, or the likelihood that they will be born early. SEI’s study, which examined data from 2010, attempted to calculate how those factors might influence the global rate of premature births.

“By showing in our study that 18% of preterm births are associated with air pollution, we are quantifying the health impacts of fine particulate matter on babies before they are born,” said Chris Malley, an SEI researcher and lead author on the study.

Each year, around one in every 10 babies worldwide are born prematurely, according to the WHO. Africa and south Asia bear a disproportionate burden of premature births, accounting for 60% of all premature births globally. That region also dominated SEI’s report of premature birth associated with air pollution.

SEI’s new report provides an estimate of potential birth impacts associated with air pollution, but the authors acknowledged that the study had considerable caveats because of a lack of research in some of the most affected areas.

Still, two experts who reviewed the study called estimates “conservative”.

A number of factors have been identified in playing a part on premature birth, including poverty, infection, smoking and substance use, physical activity and maternal education. However, even with the report’s limitations, it is still one of the first to argue that reducing air pollution could also be effective in reducing premature births across the world.

Because of a lack of research in regions such as south-east Asia and Africa, researchers used studies conducted in the US and Europe to estimate global outdoor air pollution exposure.

Indoor cooking fires could play a larger role than the study allows for. “The exposure in Asia, and in part in say, China and India, to outdoor air pollution is significantly higher than outdoor air pollution in the US,” said Malley. “So that’s the other part of the uncertainty, that at these higher levels of exposure we don’t know whether this same relationship holds.”

The report focused on one kind of air pollution considered especially harmful to human health: fine particulate matter. This pollution is made up of tiny particles from a variety of emissions, such as diesel emissions and agricultural fires.

The particles, smaller than 2.5 micrometres in diameter, are considered harmful because they can lodge deep in the lungs, affecting the pulmonary and cardiovascular systems. Past studies have looked at these factors as ways that air pollution may impact preterm birth and low birth weight in babies.

South Asia had the most preterm births associated with particulate matter pollution – as many as 1.6 million associated births. Notably, even though China has a relatively low rate of preterm births, researchers found that as many as 521,000 preterm births could be associated with air pollution because of high concentrations of particulate matter.

A similar study conducted in the US found that air pollution had a costly impact on unborn children, estimating that the economic impacts cost $4.33bn in 2010.

Researchers said the estimates support their conclusion that “reduction of maternal [air pollution] exposure through emission reduction strategies should be considered alongside mitigation of other risk factors associated with preterm births.”

“This is one more reason why we need to be good stewards of the environment,” said Jarris. “The most vulnerable among us – unborn children – are affected, and really in a way that impacts families’ lives for generations.”

Source: Millions of premature births could be linked to air pollution, study finds | Cities | The Guardian

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Air pollution ‘final warning’ from European Commission to UK 

The European Commission has sent a “final warning” to the UK over breaches of air pollution limits.

It said limits had been repeatedly exceeded in 16 areas including London, Birmingham, Leeds, and Glasgow.

Germany, France, Spain and Italy were also served with warnings over nitrogen dioxide levels.

The commission said if countries did not take action within two months it could take the matter to the European Court of Justice.

Nitrogen dioxide comes from sources including factories and vehicles, particularly diesel engines.

The commission said more than 400,000 people died prematurely in the EU every year as a result of poor air quality and that millions more suffered respiratory and cardiovascular diseases.

Under EU law, when air pollution limits are breached member states have to implement air quality plans to bring the levels back down.

Friends of the Earth said it was “shameful” that the UK had breached the limits and called for new domestic legislation to protect people from pollution once it leaves the European Union.

Asked whether the UK would remain bound by any legal proceedings after Brexit, Commission spokesman Alexander Winterstein said: “For as long as the UK is a member of the European Union, rights and obligations apply.

“European law applies fully.”

Source: Air pollution ‘final warning’ from European Commission to UK – BBC News

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Research on short-term effects of air pollution on the health of airways of children with chronic respiratory complaints 

Starting in 2017, researchers will commence their study in Eindhoven on the effects of days with high air pollution on respiratory complaints, medication use and lung function of children suffering from chronic respiratory complaints such as wheezing or asthma.

Vera van Zoest, doctoral candidate at the Faculty of Geo-Information Science and Earth Observation (ITC) at the University of Twente is one of the researchers in the project. “We use the information of a high resolution network of air quality sensors in order to map air quality in space and time. By linking this information to the daily variation of asthma symptoms and lung function of children, we gain insight into the effect of air quality on the health of children suffering from asthma.”

The study employs the Innovative Air Measurement System (Innovatief Lucht Meetsysteem, ILM), a sensor network that has been used to measure the air quality in Eindhoven since 2013 on a much more detailed level than currently possible in other cities. The ILM allows for much more accurate recording of the health impacts of air pollution in Eindhoven specifically. The ILM was created by AiREAS, a unique civil initiative in which the local citizens, the municipality of Eindhoven, the province of Noord-Brabant and scientific institutions, including the University of Twente and Utrecht University, all collaborate. Scientists of these universities will conduct the study under the supervision of Professor Alfred Stein.

Reason for the study

Previous studies have shown us that children with chronic respiratory complaints experience more severe complaints on days with increased air pollution. The extent of this effect, as well as the substances that cause these health effects, are not very well known. Research in various countries has demonstrated that the actual effects are not the same everywhere. This is why it is important for a Dutch city like Eindhoven to establish the nature of the health effects, and which substances are most influential. The ILM provides us with accurate information about air quality, which allows us to estimate the level of air pollution exposure for every child much better than we could previously.

Research method

For this particular study, children between the ages of 7 and 11 suffering from chronic respiratory complaints like asthma, frequent wheezing and/or using respiratory medicines (bronchodilators) are asked to answer questions about their medication use and their respiratory complaints daily for a period of four months. They will keep a digital journal to document this. For two months, their lung function is measured twice a day by breathing onto a device as hard as they can.

The air quality sensor network in Eindhoven consists of 35 sensor boxes which give a good overview of the air quality on a daily basis. By using the information of the sensor box closest to the child’s home or school, we know the quality of the air children are breathing in on any given day. This allows us to study whether children experience more severe respiratory complaints, use more medication, or have reduced lung function on days with increased air pollution.

Source: Research on short-term effects of air pollution on the health of airways of children with chronic respiratory complaints — ScienceDaily

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Time is ‘running out’ to protect London children: major air pollution warning from top doctors 


More than 220 doctors today warned time is “running out” to tackle Britain’s toxic air scandal to protect a generation of young children.

The medics, including more than 100 from London, wrote to Theresa May urging her to start phasing out diesel vehicles as soon as possible to cut harmful fumes on the streets of the capital and other cities and towns.

“A national diesel reduction initiative, led by Government, will represent a major public health advance,” they said.

“However, time is running out, without urgent action emissions from diesel vehicles will cause irreversible lung damage to the current generation of children.”

They highlighted “strong and growing” evidence of a wide range of health impacts over lifetimes from nitrogen dioxide (NO2) and black carbon (soot) emissions.

“For example, in infants and children there is strong evidence, including data from children in London, that exposure to fossil fuel-derived air pollution stunts lung growth,” they explained.

They highlighted that 45 per cent of nitrogen oxide emissions in Greater London come from road transport.

“Modelling has shown that, alongside other measures, the percentage of cars that are diesel will need to be reduced from 57 per cent to five per cent of the total if Greater London is to become compliant with legal limits on NO2 emissions,” they added.

Ministers have so far shied away from a nationwide diesel car scrappage scheme, arguing that air pollution is largely an urban problem, or from changing vehicle excise duty to discourage motorists from buying diesel models.

However, the more than 280 doctors, nurses and other health professionals who signed the letter called for national action to dramatically cut the number of diesel cars, vans, taxis and light trucks.

In the letter drawn up by campaign group Doctors Against Diesel, they emphasised that there are now 585 Air Quality Management Areas across the UK, so most town halls had a statutory duty to take action on illegal levels of air pollution but their hands were tied as they had no powers to ban diesel vehicles.


Professor Jonathan Grigg, Professor of Paediatric Respiratory and Environmental Medicine, Queen Mary University of London, said: “In London, we know that diesel engines are a major and unnecessary cause of air pollution along our roads.

“Cutting diesel emissions would have an immediate impact on children’s personal exposure, and improve their long-term health.”

Professor John Middleton, President of the UK Faculty of Public Health, said: “Diesel…is linked to health effects that begin before birth and extend throughout the life course, from childhood lung development and asthma, to increased risk of heart disease, stroke, lung cancer and dementia.

“It is time for diesel to be recognised as the health emergency that it is.”

Scientists estimate the death toll in London from NO2 and small particulate pollution is up to 9,400-a-year, with many more people suffering health problems when toxic air peaks such as in mid-January.

Dr Isobel Braithwaite, a junior doctor at the children’s unit at the North Middlesex Hospital in Tottenham, north London, said: “I’ve seen a lot of patients, including children, come to A&E with asthma attacks, which are much more likely when pollution levels are higher.”

Dr Rajive Mitra, a cycling GP in North Lambeth, said: “I’d advise people heading out onto London’s busier streets to try to walk on quieter roads and walk away from the side of the road.”

Other signatories of the letter include Professor Inderjeet Dokal, Professor of Paediatrics, Centre for Genomics and Child Health, Queen Mary University London, Professor Adrian Martineau, Clinical Professor of Respiratory Infection & Immunity at Queen Mary University of London, Sir Andrew Haines, Professor of Public Health and Primary Care, London School of Hygiene & Tropical Medicine, David McCoy, Professor of Global Public Health, Queen Mary University London, Professor Chris Griffiths, Joint Centre Lead at the Centre for Primary Care and Public Health, Barts and the London School of Medicine and Dentistry, Professor Martin McKee, Professor of European Public Health, London School of Hygiene and Tropical Medicine, Professor Robert Walton, Clinical Professor of Primary Care, Queen Mary University London, Professor Stephen Holgate, Clinical Professor of Immunopharmacology at the University of Southampton, Professor John Yudkin, Emeritus Professor of Medicine, University College London, Professor Alan Maryon-Davis, Honorary Professor of Public Health, Kings College London, Dr Susan Hill, Consultant Paediatric Gastroenterologist, Great Ormond Street Hospital for Children, London, as well as more than 70 GP doctors, registrars, trainees or retired general practitioners.


Source: Time is ‘running out’ to protect London children: major air pollution warning from top doctors | London Evening Standard

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Nigeria declares pollution in southern city an emergency, closes plant 

Nigeria declared an air pollution emergency in a major southern city on Tuesday and closed an asphalt plant there after residents complained about the fumes from its furnaces, in a country plagued by corruption and poor governance.

Residents staged a protest in Port Harcourt, a harbor city in the oil-producing Niger Delta region, waving their hands in the air to show the soot stains from touching cars.

“The Federal Ministry of Environment has declared the air pollution in Port Harcourt an emergency situation and has subsequently issued a notice to temporarily shut down an asphalt processing plant…belching out thick smoke,” the government said in a statement.

It did not name the firm, but a state government statement said it was from China.

“If I am having my bath, the color of the water, the stains on the sink are always black,” businessman Charles Adolor said. “Before we can use already-washed plates we have to rewash them again.”

Adolor and his wife and son have been wearing face masks inside their apartment to protect themselves from the soot that covers everything from the windows to the bathroom.

In the Niger Delta’s oil-producing swamps, residents complain about crude spills from broken or blown-up pipelines and acid rain from gas flaring, the burning of natural gas at oil wells.

Source: Nigeria declares pollution in southern city an emergency, closes plant | Reuters

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Diesel trains may expose passengers to exhaust: Levels of certain airborne pollutants are up to nine times higher in train cars directly behind diesel locomotives than on a busy city street

A new study from U of T Engineering finds that diesel trains may expose passengers to elevated levels of certain pollutants, especially if they are sitting directly behind the locomotive.

“Imagine yourself driving down a busy highway in a convertible, and spending your entire commute sitting behind a very large diesel truck,” said Greg Evans, a professor of Chemical Engineering and director of the Southern Ontario Centre for Atmospheric Aerosol Research (SOCAAR). “That’s comparable to the levels we see here.”

Evans and Dr. Cheol-Heon Jeong, a senior research associate at SOCAAR, measured the concentration of airborne particles using two types of portable instruments: one that detects black carbon (BC) and one that detects ultrafine particles (UFP).

“Black carbon is essentially soot, and is formed right in the cylinder of the diesel engine,” said Evans. UFP are formed when gases in the exhaust condense into microscopic particles less than 100 nanometres in diameter, or about 1000 times smaller than the width of a human hair.

Studies have linked both BC and UFP to detrimental health effects, although evidence is still emerging and not conclusive. However, both measurements also act as proxies for the complex mixture of gases in diesel exhaust, which is an established carcinogen and associated with respiratory, cardiovascular and reproductive health effects.

In prior research, Evans and his team have found elevated levels of BC and UFP next to busy streets and highways. One day, Jeong left the sensors turned on during his morning commute on the train — it wasn’t until he saw the data that he and Evans realized how high the numbers were inside cars pulled by diesel locomotives.

“We were quite surprised, and after making confirmation measurements we got in touch with Metrolinx to let them know of the potential issue,” said Evans. Metrolinx is the transit authority for the Greater Toronto and Hamilton Area.

Over the course of 43 trips, the team gathered more data from inside commuter train cars. They also took measurements while walking along busy streets in downtown Toronto for comparison. In a paper published in Atmospheric Environment, they report that:

  • Cars being pulled by diesel trains and located directly behind the locomotive had an average of nine times the levels of BC and UFP compared to air next to a busy city street.
  • Cars being pushed by diesel trains during a return trip had air that was generally cleaner than that next to busy city streets.
  • When being pulled, cars in the middle of the trains had levels three times lower than the front-most cars. The average BC and UFP concentrations across all pulled cars was about five times higher than on city streets.

“The health and safety of our customers and staff is our number one priority, which is precisely why we’ve supported the work of Dr. Evans and his research team,” said Greg Percy, Chief Operating Officer for Metrolinx. “We welcome any findings that can help us run a healthier, safer transit service and we’re hopeful this work will result in improvements that will be applied throughout the industry and within other public transit agencies in Canada and abroad.”

Percy said that Metrolinx is taking a number of steps to address the issue, such as installing high-efficiency filters in the ventilation systems of its train cars. The organization is also moving to locomotives with improved emissions standards and to electrified service on key routes, which will eliminate the diesel emissions altogether.

Evans and his team are currently working with Metrolinx and SNC Lavalin to test the new improved filters for the air intake vents. Preliminary results are positive. “Installing the higher grade filters did produce a marked improvement, with an 80 per cent reduction in the levels of black carbon,” said Evans.

“Metrolinx has been very supportive of our research.” said Jeong. “Our collaboration with them is most welcome as it will help translate our research findings into action. Further research is also required to evaluate in-transit exposure for all types of diesel-powered passenger trains.”

In the meantime, there are practical steps that passengers can take. “I would advise pregnant women and passengers with heart or respiratory health problems not to travel in the front car,” said Evans. But he would not necessarily suggest avoiding the train entirely.

“I commute by train on a regular basis myself and have done so for years,” said Evans. “As an air quality researcher, I want to see a reduction in overall emissions, and trains are a more efficient system than people commuting in their cars. I don’t want to discourage people from taking transit, or alarm them unduly, but there is an issue here. It underscores the importance of train electrification, which will address this indoor air issue in addition to helping to combat climate change.”

Source: Diesel trains may expose passengers to exhaust: Levels of certain airborne pollutants are up to nine times higher in train cars directly behind diesel locomotives than on a busy city street — ScienceDaily

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India’s Air Pollution Rivals China as World’s Deadliest 

India’s rapidly worsening air pollution is causing about 1.1 million people to die prematurely each year and is now surpassing China’s as the deadliest in the world, a new study of global air pollution shows.

The number of premature deaths in China caused by dangerous air particles, known as PM2.5, has stabilized globally in recent years but has risen sharply in India, according to the report, issued jointly on Tuesday by the Health Effects Institute, a Boston research institute focused on the health impacts of air pollution, and the Institute of Health Metrics and Evaluation, a population health research center in Seattle.

India has registered an alarming increase of nearly 50 percent in premature deaths from particulate matter between 1990 and 2015, the report says.

“You can almost think of this as the perfect storm for India,” said Michael Brauer, a professor of environment and health relationships at the University of British Columbia and an author of the study, in a telephone interview. He cited the confluence of rapid industrialization, population growth and an aging populace in India that is more susceptible to air pollution.

Pollution levels are worsening in India as it tries to industrialize, but “the idea that policy making should be led by government is lacking,” Bhargav Krishna, manager for environmental health at the Public Health Foundation of India, a health policy research center in New Delhi, said in an interview.

As air pollution worsened in parts of the world, including South Asia, it improved in the United States and Europe, the report said, crediting policies to curb emissions, among other things. The report’s website that provides country-by-country data on pollution levels and the health and mortality effects.

Environmental regulations in the United States and actions by the European Commission have led to substantial progress in reducing fine particulate pollution since 1990, the report said. The United States has experienced a reduction of about 27 percent in the average annual exposure to fine particulate matter, with smaller declines in Europe. Yet, some 88,000 Americans and 258,000 Europeans still face increased risks of premature death because of particulate levels today, the report said.

A fraction of the width of a human hair, these particles can be released from vehicles, particularly those with diesel engines, and by industry, as well as from natural sources like dust. They enter the bloodstream through the lungs, worsening cardiac disease and increasing the risk of stroke and heart failure, in addition to causing severe respiratory problems, like asthma and pneumonia.

The report offers good news globally, in some ways.

Although deaths caused by air pollution grew to 4.2 million in 2015 from 3.5 million in 1990, the rate of increase of about 20 percent was slower than the rate of the population rise during that time. That’s because of improved health care in many parts of the world, as well as public policy initiatives undertaken in the United States, Europe and other regions that reduced emissions from industrialization, the authors of the study said in telephone interviews.

China also offers an encouraging sign. Premature deaths from particulate matter each year have stabilized at around 1.1 million since 2005, the report said. Still, that is an increase of 17 percent since 1990, when it was a little more than 945,000.

The health effects of the ultrafine particles are still being studied and the full effects are only beginning to be understood, said Majid Ezzati, a global environmental health professor at the Imperial College, London.

“These studies are hard to do, and isolating the effects of air pollution is hard,” Dr. Ezzati said. “The numbers are still dynamic and nobody should claim an exact number of deaths is known.”

But if he were an Indian citizen, he said, “I’d say, ‘Let’s not sit there and do nothing about it. Let’s not be exposed to it today as more research is being done.’”

Although few studies of the health problems brought by air pollution are based in India, Dr. Ezzati said, “it’s hard to imagine air pollution that is bad for people in London is not bad for people in India.”

Neither India’s environment minister nor its environment secretary could be reached for comment Monday evening.

Robert O’Keefe, vice president at the Health Effects Institute, said China’s trajectory on deaths from air pollution had stabilized as a result of the country’s efforts to reduce air pollution.

India, on the other hand, had yet to undertake sustained public policy initiatives to reduce pollution, said Gopal Sankaranarayanan, an advocate at the Supreme Court of India who successfully petitioned it to ban licenses to sell fireworks in the New Delhi metropolitan area last year. Fireworks during the festival of Diwali contributed to hazardous levels of air pollution late last year.

Weak environmental regulation in India, he said, leaves India’s citizens with few alternatives other than to petition the courts to take action to protect the public’s health.

But the courts often lack the power or mechanisms to enforce their actions, he said. India’s environmental court, the National Green Tribunal, ordered farmers to stop burning their crops in the region around New Delhi in 2015, but the practice still continued last year. Smoke from the farm fires contributed about one quarter of the levels of the most dangerous air pollution in the Indian capital, environmental experts said.

“If you can’t enforce the directives of the courts — it becomes a problem,” Mr. Sankaranarayanan said. “We need practical solutions to save lives here in India.”

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Welcome to Onitsha: the city with the world’s worst air 

The Nigerian city has recorded the world’s worst levels of PM10 air pollution. But although the results are lethal, the problem is not taken seriously here

Approaching Okpoko market through thick smog on the back of an okada (motorcycle taxi), the natural reaction is to cover your nose to protect yourself from the dust storm – but the effort is futile.

When a lorry zooms past, kicking up yet another red cloud of dirt, a trader turns the head of a sleeping toddler away from the road, a protective act that is as poignant as it is pointless.

This is a typical day in the southern Nigerian port city of Onitsha – which last year gained notoriety when it was ranked the worst city in the world for the staggering levels of PM10 particulate matter in its air.

Onitsha’s mean annual concentration was recorded at 594 micrograms per cubic metre by the World Health Organization – massively exceeding the WHO’s annual guideline limit for PM10s of 20μg/m3.

PM10 refers to coarse dust particles between 10 and 2.5 micrometres in diameter, while PM2.5s are even finer and more dangerous when inhaled, settling deep in a person’s lungs. Sources of both include dust storms, gases emitted by vehicles, all types of combustion, and industrial activities such as cement manufacturing, construction, mining and smelting. Onitsha scores highly on most of the above – as do other rapidly growing Nigerian cities such as Kaduna, Aba and Umuahia, all of which also featured in the WHO’s 20 worst offenders for PM10s.

In Onitsha’s very busy Okpoko market, my air quality monitor registers 140 for PM10s and 70 for PM2.5s – all way over recommended healthy levels, but still nothing compared to the readings triggered in other parts of this densely populated commercial and industrial hub.

The entire vicinity of the market is perpetually dusty, as wood-sellers saw lumber into different shapes and sizes. The air here is made worse by all the fine sand particles that fly off the back of trucks as they visit one of the many dredging companies on the bank of the River Niger, just behind the wood market.

One female traffic warden has been working in the same spot here for two days. How does she cope with the dust? “I am just doing my job,” she replies reluctantly. “Dust does not kill people.”

But she is mistaken. According to the United Nations Environment Programme (Unep), around 600,000 deaths throughout Africa every year are associated with air pollution, while an October 2016 report by the Organisation for Economic Co-operation and Development (OECD) suggested that polluted air could be killing 712,000 people prematurely every year across the continent.

The warden’s attitude towards this invisible but deadly threat is widespread among Onitsha’s residents – but not necessarily because they are nonchalant about their health. Most are simply unaware of the issue.

Some say they have more pressing concerns, such as how to feed their family. Others have simply become accustomed to living in a dirty and polluted environment.

Onitsha is grossly polluted – not just in terms of the air quality, but also the solid waste that litters the streets, blocking drainages and canals. With not a single waste bin in sight, heaps of unregulated rubbish dumps occupy roadsides and street corners.

Ikechukwu Obizue, a businessman in the neighbourhood of Nwangene, says residents can only do so much when there is little corresponding effort by the city’s government.

“Onitsha is quite dirty, but the government is not doing anything about it. We do environmental sanitation monthly, but then the city returns to being dirty,” Obizue says. “It is the government’s responsibility to keep the city clean, not the work of the residents – people in this city are too busy hustling to make an income.”

‘We don’t take air pollution seriously’

In Nwangene, my air monitor shows 667μg/m3 for PM10s – a reading in excess of the 594 annual figure that gave Onitsha its title of the world’s most polluted city. What’s more, the smaller and even more dangerous particulate (PM2.5) reading of 290 is far in excess of the WHO’s annual figure of 66.

The air quality proves just as bad at Ochanja market, with PM10s registered at 586 micrograms and PM2.5s at 266. Yet in these highly polluted areas, few people show any sign of trying to protect themselves from the threat.

There are only a few air masks in sight. A good number of aluminium and copper recyclers are not wearing masks, even while smelting metal scraps. Worse still, most smelting activities are done in the open, releasing monstrous clouds of smoke into the core of the city.

At one of the few state-approved dump sites on Creek Road, Ikechuckwu works at a smelting workshop. He is sweating profusely as he sits on a pile of ash, taking a break from work. He explains he has been smelting iron for a little over five years – but says not to worry about his health.

“I know how to take care of myself,” he brags. “I am not wearing a nose mask because I don’t need it. I take medicine to cater for my health.”

It is hard to determine to what extent these high concentrations of particles are affecting the residents of Onitsha, since there is no official data – but the health effects attributed to sustained exposure to PMs, especially PM2.5s, are well proven.

For a state government that can barely manage its waste disposal system, however, regulating its air quality appears a far-fetched aspiration. The now defunct Anambra State Environmental Protection Agency was widely criticised for failing in its responsibility to effectively tackle environmental pollution, and in its place, the Anambra State Waste Management Agency was created – with little effect.

The state’s Ministry of Environment, Beautification and Ecology did not respond to the Guardian’s questions regarding air pollution in Onitsha.

“The major problem is that we don’t take air pollution seriously in Nigeria,” says medical practitioner Dr Nelson Aluya. “As the population increases and we become more industrialised, we ought to have active air-monitoring agencies and a federal environmental protection agency. We say they are there – but are they active?”

In truth, air quality monitoring and control is not on the radar of many African governments. Nigeria has a long list of environmental protection laws and regulations that are barely enforced.

“Even in the healthcare sector,” Aluya continues, “there is no standardised care to monitor those who have chronic obstructive pulmonary diseases resulting from exposure to bad air, and no standard procedure in hospitals to check for oxygen levels.

“So you see, we are in deep trouble. If we have not recognised the fact there’s a problem, then how do we solve it? Unfortunately, people will keep dying as stakeholders remain nonchalant.”

Source: Welcome to Onitsha: the city with the world’s worst air | Cities | The Guardian

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