China's environmental health challenges

By CESAR CHELALA Special to The Japan Times A stretch of potentially lethal polluted river water headed towards one of China's biggest cities on Thursday after an explosion at a petrochemical plant, November 24 2005. (Xinhua) NEW YORK -- The recent environmental crises in China underscore the need to improve the mechanisms for preventing environmental disasters and responding more effectively to environmental emergencies. For the past few decades, China has maintained significant economic expansion while greatly improving the health status for the majority of the population. These achievements have been a model for developing countries worldwide.

Unfortunately, gains in the health sector have been offset by the environmental consequences of economic expansion. Sustaining a rapid pace of economic development while simultaneously protecting people's health is one of the main challenges facing Chinese authorities today.

Over the last two decades, China has had an average economic growth of 9.4 percent annually. Over the past half-century, the country has made impressive advances in public health, tackling infectious diseases and demonstrating remarkably good results.

Average life expectancy is now 71.8 years, up from 35 years in 1949. Immunization coverage is over 95 percent for those under 1. From 1960 to 2003 the infant mortality rate fell from 150 to 30 per 1,000 live births, and the under-5 mortality rate dropped from 225 to 37 per 1,000 live births. Both rates are used as indicators of a population's access to basic health services.

Despite those advances, China still faces important health challenges, many of which are caused by an increasingly polluted environment. Today, coal provides over 65 percent of the country's energy and is the main source of air pollution. To keep pace with demand for growth, dirtier coal that causes more pollution is used.

Most factories built before 1980 lack pollution-control equipment. The combination of dirtier burning coal and lack of emission controls increases the likelihood of harm to the population.

Several million people burn raw coal in unvented stoves. As a result, toxic compounds permeate their homes and negatively affect the health of children and adults alike. Because children's immune system and detoxification mechanisms are not fully developed, toxic agents have a more serious impact on them than on adults.

Water pollution is another serious environmental concern. Sewage and agricultural waste contaminate water supplies, leading to a host of waterborne illnesses. In addition, rivers have become contaminated with heavy metals including lead, cadmium and arsenic from industrial discharges. Because these rivers are used as a source of drinking water, people's health may be harmed.

The consequences of growing industrial pollution in China threaten not only that country's 1.3 billion people but also its neighbors. For example, Taiwan fears that, as a result of heavy contamination in the Yangtze River, its fish stocks could be decimated. At the same time, China's carbon-dioxide emissions are an important cause of global warming. Although the United States today surpasses China as a greenhouse gas producer, if current trends continue, China may become number one by 2025.

According to Zhang Lijun, vice minister of the State Environmental Protection Administration, pollution levels in China could increase more than four times within 15 years if the country doesn't control its voracious growth in energy consumption and in the number of vehicles on its roads. It is estimated that each year 4 million to 5 million additional cars and trucks clog China's roads exacerbating already dangerous levels of air pollutants.

The World Bank estimates that by 2020 the health effects of air pollution in urban China will include: 600,000 premature deaths in urban areas, 9 million person-years lost due to pollution-related illness, 20 million cases of respiratory illness per year, 5.5 million cases of chronic bronchitis and health damages valued at 13 percent of its GDP. Those effects should be added to the intrinsic weakness of China's health system.

Chinese authorities have been trying to limit the damage caused by environmental pollution and have set guidelines in a document entitled "Priority Activities for Sustainable Development." Despite new policies and regulations, however, compliance remains low.

To adequately respond to these challenges, China needs not only strong government action but also workers and citizens' groups determined to act as watchdogs of government efforts in this area. Only through complementary actions of government agencies and citizen groups will this emerging superpower be able to lower the risks to the population caused by the pollution of its environment.

Dr. Cesar Chelala is international public health consultant and the author of "Environmental Impact on Child Health," a publication of the Pan American Health Organization.