Health Impacts of Kathmandu’s Air Pollution

1. Health Impacts of Kathmandu’s Air Pollution Summary of Presentation • Kathmandu’s air quality • Data from hospitals • Results from use of dose-response functions • Valuation of Impacts Bhushan Tuladhar Clean Energy Nepal; cen@mos.com.np Better Air Quality 2004 Presentation based on a 2003 study commissioned by KEVA

2. Kathmandu Valley • Population: 1.8 million • Vulnerable to air pollution because of topography, climate and rapid growth • Main sources: vehicles, brick kilns • Vehicles increasing at 14% per year

3. Kathmandu’s Air Quality • Main problem is Particulate Matter • PM10 increased by 3 folds in the past 10 years • High PM2.5 to PM10 ratio • In dry season, PM10 in Putali Sadak (heavy traffic) is above national standards 99 % & in Thamel (residential area) 90 % of the days • PM10 levels in 2004 is about 7% lower than 2003 • SOx, NOx, levels generally below WHO guideline • Benzene & PAH levels may be a problem • Main concern is vehicle emission

4. Monthly Average PM10 from Nov. 2002 to Oct. 2004

5. Health Effects in Kathmandu Valley’s PM10 in 1990 Very few studies on health effects of Kathmandu’sair pollution

6. No. of COPD Patients in Major Hospitals No of COPD patients increasing, specially over the past 5 years

7. COPD Patients as % of Total Medical Patients Discharged from Major Hospitals % of COPD Patients Increasing Slightly in the Past Five Years

8. COPD Patients in 2059 (2001/02) No. of COPD Patients is Higher in the Winter Months

9. Survey of Patients visiting OPD & Emergency • 2-Week survey patients visiting OPD & Emergency units of Bir, TUTH and Kanti Hospitals • Total of 331 people surveyed • Address: 69% from Kathmandu Valley • Age: 51-75 yrs - 52%; 1-10 yrs. - 19 % • Mode of transport: bus/tempo - 79 % Patients visiting the hospitals with respiratory problems are mostly elder residents of Kathmandu valley who are regularly exposed to air pollution

10. Dose-Response Functions (WHO, 2003)

11. Estimated Health Benefit of Reducing KTM Valley’s Annual Avg PM10 from 137 to 50 μg/m3 • Assumptions: • Population of Kathmandu in 2003 is 1.8 million • Percent of population over 18 years is 52 percent • Percent of population that has asthma is 5 percent • Percent of population over 25 years is 40 percent

12. % Change in Hospital Admissions as Function of PM concentration Source: WHO, 2003

13. Change in Health Effects due to Improved Air Quality • If we reduce PM2.5 in Kathmandu Valley by half (by 44 g/m3), reduction in mortality by 7% and hospital admission by 22% • If we reduce PM2.5 in Kathmandu City by half (by 58 g/m3 ), mortality will go down by 9% and hospital admissions by 29%

14. Cost of Hospital Admission • Average expense per hospital admission for respiratory illness = Rs. 14,321 - ITDG, 2002 • 1879 cases of hospital admission avoided per year is equivalent to Rs. 27 million • World Bank - Health effects of PM10 levels in 1990 amounts to approximately Rs. 210 million. Out of this only 0.2 % is cost of hospital admissions. Cost of pollution is very high. Reducing vehicle emission is the most effect way to reduce this huge economic burden

15. Conclusion • Hospital data and dose-response functions indicate that Kathmandu’s air pollution is having serious effects on public health. • Urgent action is required to control pollution, particularly vehicle emission. Thank you