Beijing pollution is becoming a “public health catastrophe,” expert says

BMJ 2013; 346 doi: (Published 16 January 2013) Cite this as: BMJ 2013;346:f305
  1. Jane Parry
  1. 1Hong Kong

The heavy smog blanketing Beijing and other major cities in central and eastern China highlights the public health catastrophe accompanying the country’s rapid economic development, a leading expert on air pollution has said.

“The levels we have seen in the last few days are approaching those of the catastrophic London fog in 1952, which killed 4500 people in five days,” said Anthony Hedley, honorary professor at the University of Hong Kong’s School of Public Health.

Pollution levels in Beijing started climbing late last week, with the level of particulate matter with an aerodynamic diameter of less than 2.5 micrometres (PM2.5), which can penetrate deep into the lungs, peaking at 993 micrograms per cubic metre, 40 times the World Health Organization’s maximum limit for safe exposure. Although such peaks make the headlines and are a significant health hazard in their own right, average ambient pollution levels at 20-25% of the current peaks are still over 200 micrograms per cubic metre, 700% above the WHO safe limit.

Local Beijing residents have become accustomed to dangerously high levels of pollution. Like many foreign and local residents, Celia Yeung, a Hong Kong professional who lives in Beijing, relies on pollution readings from the US embassy in the capital, which measures levels of PM2.5 rather than the official readings (until 2012 the official Chinese pollution monitoring was based on levels of PM10), and said that she had been shocked by the recent peaks.

“I have seen the PM2.5 pollution level hit 500 micrograms per cubic metre many times since I moved to Beijing in 2011, but it’s the first time I’ve seen it go off the charts,” she said. “I flew back into Beijing on Sunday, and even the air inside the airport terminal building was thick and smoggy. I can normally see the sunrise from my bedroom window, but the sky has been dark at 7 am these last two days. I’ve never seen it so bad before, and of course I’m concerned for my health.”

A study jointly conducted by Greenpeace East Asia and Peking University’s School of Public Health found an estimated 8572 premature deaths in 2012 in four major cities (Beijing, Guangzhou, Shanghai, and Xian) that could be attributed to high levels of PM2.5 pollution.1

“Pollution related deaths are just the tip of the iceberg,” said Hedley. “There are also hospitalisations for such things as heart attacks, pneumonia, and chronic obstructive pulmonary disease, doctor visits, and over the counter medication­—all of which are paid for out of pocket in China’s largely market driven healthcare system.

“Then there is all the subclinical damage to body physiology, particularly harm to lung growth and development in children. As you would predict from studies around the world, if this leads to large cohorts of children with suboptimal lung function, this works its way into a lifetime of compromised quality of life, greater need for healthcare, and shorter life expectancy.”

A 2007 World Bank report put the economic cost of pollution in China at 4.3% of gross domestic product, including the pollution related disease burden, with the country’s poorest residents disproportionately affected.2

“According to the Beijing city government’s timeline, we need more than 20 years to get better air quality,” Zhou Rong, a climate and energy campaigner with Greenpeace East Asia, told the news network Al Jazeera. “That will mean the whole generation will pay [with] their health.”

Short term measures such as the closure on Mondays of 100 factories are “laughable,” said Hedley. “Private car ownership in China is increasing at 25% a year, and I don’t know how they would even begin to turn that around. There is a lot of obfuscation by government officials, and the government refuses to do any research on the health effects of pollution. It’s very frustrating.”


Cite this as: BMJ 2013;346:f305