The Bi-regional Workshop on Health Impacts of Haze-related Air Pollution was conducted in Kuala Lumpur, Malaysia from 1 to 4 June 1998 by the World Health Organization Regional Offices for South-East Asia and the Western Pacific.
The objectives of the workshop were:
to review and summarize research findings and other relevant information concerning the impacts of haze-related air pollution on health;
to identify needs for further technical information and research to support future haze-related decision-making; and
to develop draft health impact reduction measures and strategies, addressing intercountry cooperation issues, for consideration by affected countries and external support agencies.
The workshop was attended by 17 participants and five observers from seven countries of South-East Asia and Papua New Guinea; four temporary advisers; ten representatives from seven international partner agencies; and four WHO staff serving as the workshop secretariat. The proceedings comprised presentations of country reports and haze-related health effects research activities by the participants; presentations of working papers by temporary advisers and representatives of international partner agencies; and plenary and group discussions on future research needs, health impact reduction measures, and intercountry cooperation.
The workshop deliberations produced conclusions in the following four major areas:
A. Conclusions in relation to haze-related air pollution problems and research findings
The haze episodes in South-East Asia in 1997 and early 1998 constituted a substantial health risk to the public.
The main constituent of the haze that adversely affects health is particulate matter.
From the existing body of knowledge that associates a range of adverse, non-cancer health impacts with urban particulate air pollution mixtures, there is no evidence that particles from different combustion sources have different impacts on health.
The risk of long-term health effects due to a single air pollution episode is difficult to detect, but repeated exposures to haze episodes merit attention.
To help ensure data comparability, it is desirable that consistent protocols be followed in relation to health effects monitoring, ambient air quality monitoring, and data analysis
There are a number of valuable health-related research studies currently being carried out in the region.
B. Conclusions in relation to further research needs
In addressing priority environmental health research needs, underlying emphasis always needs to be placed on research and public health monitoring capacity building. The priority needs identified in the region include:
Research on new mitigation approaches:
assessment the feasibility of different arrangements for “haze shelters”
evaluation of the most effective approaches to management of a future haze emergency in terms of arranging transport to “haze shelters” for vulnerable groups, and other mitigation methods;
evaluation of the effectiveness of remaining indoors; and
evaluation of the effectiveness of early health care interventions, as well as public information and awareness efforts, in reducing health impacts.
Research on the impacts of the 1997 haze, primarily using data that has been routinely collected:
evaluation of short-term health impacts, including the identification of susceptible population groups;
a regional study of short-term health impacts using standardized methodologies and routinely-collected data;
assessment of any long-term effects in selected groups of exposed people in areas where comprehensive mortality and morbidity data are continuously maintained and
identification of sources of particulate air pollution exposure, especially the relative contributions of biomass and motor vehicle-related urban air pollution mixture sources.
Future research requiring the development of substantial new data:
an assessment of the real effectiveness of the use of dust masks by the general population;
an investigation of the availability of alternatives to masks which could be effective as personal protective equipment in mitigating health impacts;
the delineation of the health impact mechanisms associated with biomass air pollution; and
an evaluation of the impact of specific pollutants on health (e.g., specific aspects of particulate composition, polycyclic aromatic hydrocarbons, and volatile organic compounds).
C. Conclusions in relation to health impact reduction measures/strategies
Priority emphasis must be given to preventing and extinguishing fires.
With regard to air quality monitoring and episode forecasting, from the health sectors perspective, information on the nature and extent of human exposure to environmental pollutants is essential to impact assessment.
With regard to environmental control, for rural areas, individuals should reduce their level of physical activity and use masks when outdoors in the absence of other available measures. If possible, the infiltration of outdoor air should be reduced by closing windows, doors, etc.
With regard to personal protection, properly sized and fitted respirators can provide protection for essential workers who must remain outdoors for extended periods of time during haze episodes. However, the use of masks for the general population should be the lowest priority in terms of health mitigation measures.
Public health monitoring needs to be considered as a routine component of health sector operations during and after haze episodes.
D. Conclusions in relation to intercountry and interorganizational cooperation and coordination
Intercountry cooperation needs to be implemented through existing regional coordination mechanisms.
Areas in which regional cooperation is suggested include the following:
the development of air pollution epidemiology guidelines to harmonize research methodologies and data collection and analysis;
the implementation of joint studies on the health impacts of the 1997 haze, including the assessment of needs for air quality monitoring data from a public health point of view;
the strengthening of human resources and national capacity in air pollution epidemiology and air pollution and public health monitoring;
the establishment of a regional information clearing house on haze-related health impact research; and
the organization of regional forums and participation in international meetings.
Proposals for specific projects in the above areas of cooperation will be prepared by participants from countries with interest and expertise.
International and bi-lateral partner agencies are encouraged to take up and support, in a coordinated fashion, the issues reflected in the deliberations of this meeting and summarized in these conclusions.