Something in the air
Updated: 2014-11-19 09:32
By Frannie Guan(HK Edition)
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One in 10 children in Hong Kong suffers from asthma. Even as the Environmental Protection Department is trying to do its bit, medical experts feel it could have set the bar higher. Frannie Guan reports.
When Lam Lam had his first asthma attack, his parents were in a panic. "He was wheezing really hard. At that time he was only one year old," recalled his father, Lee Cheuk-ho. The subsequent attacks the little boy suffered was like a knife in the heart to his parents.
They took him for swimming lessons when he was three, hoping that would help him develop strong lung function and cut down on future attacks. Making certain the boy got exercise probably was the best solution, but it does not remove the underlying problem that potentially afflicts many Hong Kong kids.
Asthma is the most common, chronic childhood disease in Hong Kong. Statistics from Hong Kong Asthma Association show that one child in 10 suffers from asthma, a significant increase from 4.8 percent in 1989.
As the findings of an ongoing research program at King's College London show, exposure to air pollution, particularly nitrogen dioxide (NO2) and particulate matter (PM) affects the young even more profoundly than previously believed.
Frank Kelly, director of Analytical and Environmental Science at King's College, told a Hong Kong audience that air pollution stunted the growth of children's lungs. An affected child might grow up with 165 ml less lung capacity compared to the standard volume.
"At nine years old, they are in a crucial period of lung capacity development, but they already have a more than 100 ml lung capacity deficit," added Alfred Tam Yat-cheung, a Hong Kong pediatrian.
Tam expressed concern over the progression of the deficit, continuing until the developmental peak - leaving victims to go through life with smaller than normal lungs. He noted that the effects of decreased lung capacity would likely affect victims most profoundly during strenuous exercise.
"Lung function typically peaks in the early twenties, around the age of 25, and then slowly goes down with age," Tam said. So when dealing with asthmatic children, in addition to controlling their conditions, another important step is to pay close attention to the lung function growth.
"We hope the lungs can reach their highest potential by the time they reach their peak, so that the decline of lung function can be slowed down," added Tam.
There are also potential long-term consequences from diminished capacity. Kelly warns that if this deficit is not corrected before children reach the age of 18, over time the victims are more likely to contract chronic lung diseases, including not only asthma but chronic obstructive pulmonary disease.
According to previous studies done by the Danish Pediatric Asthma Centre, lung function deficit both at birth and through childhood could lead to asthma in later life.
Avoid congested areas
Since Lam Lam was diagnosed with asthma, his parents have become very watchful of anything that might give him another attack. Lee says he feels lucky that the family lives at Po Lam, where the air pollution is relatively low.
The boy's parents try to avoid taking him into to heavy traffic areas like Central, Mong Kok and Causeway Bay, where pollution levels taken by the Environmental Protection Department (EPD) are consistently high. The boy has suffered from asthma attacks previously, when visiting those areas and his parents want to avoid any repetition.
"As a parent of an asthma patient, there is nothing I can do to change the situation of air pollution in Hong Kong as it is out there," said Lee, lamenting his powerlessness to protect his son completely from air pollution.
Tam pointed out the importance of taking proper care of an asthma sufferer. He cited using wrong medications, using them incorrectly or failing to take proper heed of potential triggers as likely causes of asthma attacks. These factors, coupled with polluted air, may exacerbate the stunting of lung growth.
Exercise is an effective way to build up lung capacity, but only in a healthy environment, Tam adds. "If you do sports in a seriously-polluted area, the effects would work in the opposite direction."
On Jan 1, 2014, a new air monitor index, the Air Quality Health Index, was introduced by the EPD, replacing the previous Air Pollution Index. By monitoring the concentration of major pollutants like nitrogen dioxide, ozone, sulphur dioxide and particulate matter, the EPD is able to provide data on short-term health risks from air pollutants.
The index can function as a timely and useful indicator to provide air pollution information to the public, but the long-term target is spelled out more clearly in Hong Kong's new Air Quality Objectives, upgraded at the beginning of this year. Though the program met benchmarks under the World Health Organization's (WHO) Air Quality Guidelines, it did not mollify environmentalists who heaped criticism on the guidelines.
Not among the best
The problem, said Chan Wing-kai, president of the Hong Kong Asthma Association, is that the WHO sets out several air quality standards. "Why did Hong Kong adopt the lowest standard rather than the highest?" Chan demanded.
From the perspective of Hong Kong's latest Air Quality Objectives, nitrogen dioxide and carbon monoxide emissions have been brought into compliance with the WHO's strictest standard. Annual concentrations of particulate matter like PM 2.5 however remain heavy and at the lowest standard.
A study by the University of Hong Kong in 2006 showed that with every three percentage points of increase in pollutants, the number of asthmatic children requiring hospital treatment increases 5 percent.
"Governments will not set goals beyond their ability to achieve. They are afraid of being blamed if they fail to achieve what they promise," said Tam. He agreed that over the years the overall atmospheric quality of Hong Kong has been improved considerably, but in terms of roadside pollution, the situation is not getting better.
He pointed out that governments have responded to pressure from the public and adopted measures to improve air quality, but he says governments should also do more to consider measures to reduce the effects of polluted air on those who are vulnerable.
There are 12 general stations and roadside stations monitoring air quality in Hong Kong. Tam said there should be more, especially at roadsides so parents can avoid heavily-polluted routes that entail high health risks.
Tam also suggested building more facilities in areas like the east of New Territories and southern Hong Kong Island for kids to take full benefit of clean air while they play.
The increased risks of slowing lung development due to poor air quality have placed vulnerable children and their parents in the fear of serious consequences, both short-term and long-term. Everyone hopes that someday it will be safe to breathe again without worrying about the amount of toxicity in the air, no matter what part of the city you're in.
Contact the writer at frannie@chinadailyhk.com
Air-monitoring stations in places exposed to heavy traffic, such as this one in Central, helps alert the public about short-term health risks. Provided to China Daily |
Edmond Tang / China Daily |
(HK Edition 11/19/2014 page4)