Air Pollution, Poverty and Air Pollution, Poverty and Health in Ho Chi Minh CityHealth in Ho Chi Minh City

Nguyen Dinh TuanNguyen Dinh TuanHCMC Environmental Protection AgencyHCMC Environmental Protection Agency

BAQ 2006BAQ 2006Yogyakarta - IndonesiaYogyakarta - Indonesia

Ho Chi Minh cityHo Chi Minh city

Ho Chi Minh City, the former Saigon, the Ho Chi Minh City, the former Saigon, the largest city in Vietnam, has more than 6 largest city in Vietnam, has more than 6 million peoplemillion people

Northeast of the Mekong river, 910 square Northeast of the Mekong river, 910 square miles of flat land. miles of flat land.

Mean temperature between the high 80 to Mean temperature between the high 80 to high 90 degrees Farenheithigh 90 degrees Farenheit

Ho Chi Minh cityHo Chi Minh city

The urban area occupies 10% of total land and is divided into 19 The urban area occupies 10% of total land and is divided into 19 urban districts and 5 rural districts. The main industries consist urban districts and 5 rural districts. The main industries consist of production of sea food, textiles, chemicals, plastics, and of production of sea food, textiles, chemicals, plastics, and building materials, food processing.building materials, food processing.

There are more than 1,000 large-scale enterprises, and over There are more than 1,000 large-scale enterprises, and over 30,000 small factories. Rapid economic development has also 30,000 small factories. Rapid economic development has also brought more migrants to the city, contributing to the traffic brought more migrants to the city, contributing to the traffic congestion and urban crowdingcongestion and urban crowding

There are more than 2.5 millions motorcycles, and 260,000 There are more than 2.5 millions motorcycles, and 260,000 automobiles. The city has 38 hospitals and clinics, and there are automobiles. The city has 38 hospitals and clinics, and there are about 9 medical doctors per 100,000 peopleabout 9 medical doctors per 100,000 people

Ho Chi Minh cityHo Chi Minh city

Map of air quality monitoring sites in HCMC

Air PollutantsAir Pollutants

Mannual air quality monitoring

Three sites were installed since 1993: Hang Xanh cross road, Dinh Tien Hoang – Dien Bien Phu corner, Phu Lam cross road.

Three sites were installed since 2005: Go Vap cross road, Tan Thuan cross road, An Suong cross road.

Monitoring frequency: 10 days per month.

Monitoring times: Samples were collected in 7 am, 10 am and 3 pm.

Measured variables: CO, TSP, Pb, NO2, noise

Urban background air quality (residential areas)

0.00

20.00

40.00

60.00

80.00

100.00

Pm10 O3 NO2 SO2

Annual average

(residential aeas) 2000

2001

2002

2003

2004

2005

01-06/2006

The annual average PM10 concentration The annual average PM10 concentration

measured at rmeasured at road side- traffic stations have reduced have reduced

lightly through yearslightly through years

Roadside air quality (Automatic)

Annual average PM10 from 2002 to 06/2006

020406080

100120140

Thoáng Nhaát Bình Chaùnh

ug/m3

2002 2003 2004 2005 2006

Roadside air quality (Automatic)

Annual average CO from 2002 to 06/2006

0

1

2

3

4

5

6

DOSTE HB Thoáng Nhaát Bình Chaùnh

mg/m3

2002 2003 2004 2005 2006

The annual average CO concentration measured at road side- traffic stations have increased lightly through years

Roadside air quality Ä CO concentration

(2000-2006)

0.00

5.00

10.00

15.00

20.00

VX HX ÑTH - ÑBP VX PL Ngaõ tö AS Ngaõ saùuGV

NVL - HTP

mg/m3

2000 2001 2002 2003 2004 2005 6 thaùng ñaàu 2006

The CO The CO concentration concentration measured at the measured at the manual air quality manual air quality monitoring sites monitoring sites fluctuated from 9.4 fluctuated from 9.4 –16mg/m3 that met –16mg/m3 that met the Vietnam the Vietnam Standard. (TCVN Standard. (TCVN 5937 – 1995 CO: 40 5937 – 1995 CO: 40 mg/m3)mg/m3)

Roadside air quality

TSP concentration (2000-2006)

0.00

300.00

600.00

900.00

VX HX ÑTH - ÑBP VX PL Ngaõ tö ASNgaõ saùu GVNVL - HTP

ug/m3

2000 2001 2002 2003

2004 2005 7 thaùng ñaàu 2006 TCVN

The TSP concentration The TSP concentration measured at the manual air measured at the manual air quality monitoring sites quality monitoring sites fluctuated from 0.45 – 0.96 fluctuated from 0.45 – 0.96 mg/m3. All the TSP mg/m3. All the TSP concentration exceeded the concentration exceeded the Vietnam Standard Vietnam Standard (300mg/m3).(300mg/m3).

Roadside air quality

Ä NO2 concentration (2000-2006)

0.00

100.00

200.00

300.00

VX HX ÑTH - ÑBP VX PL Ngaõ tö AS Ngaõ saùu GV NVL - HTP

ug/m3

2000 2001 2002 2003 2004 2005 6 thaùng ñaàu 2006

The NO2 The NO2 concentration concentration measured at manual measured at manual air quality monitoring air quality monitoring sites fluctuated from sites fluctuated from 0.12 – 0.26 mg/m3. 0.12 – 0.26 mg/m3. All the NO2 All the NO2 concentration met concentration met the Vietnam the Vietnam Standard Standard (400mg/m3).(400mg/m3).

Roadside air quality

The Pb concentration measured at manual air quality The Pb concentration measured at manual air quality monitoring sites have reduced remarkable from monitoring sites have reduced remarkable from 06/2001. All the Pb concentration met the Vietnam 06/2001. All the Pb concentration met the Vietnam Standard (5ug/m3).Standard (5ug/m3).

Pb concentration (2000-2006)

0.00

0.50

1.00

1.50

2.00

2.50

3.00

3.50

VX HX ÑTH - ÑBP VX PL Ngaõ tö AS Ngaõ saùu GV NVL - HTP

ug/m3

2000 2001 2002 2003 2004 2005 6 thaùng ñaàu 2006

Admissions for Respiratory Illness, HCMC Admissions for Respiratory Illness, HCMC Children’s Hospital 1Children’s Hospital 1

0

2000

4000

6000

8000

10000

12000

14000

96 97 98 99 00 01 02 03 04 05

AsthmaPneumoniaOtitis media

There was relation between diseases and air pollution There was relation between diseases and air pollution

Asthma increased quicklyAsthma increased quickly

casescases

year

DISTRIBUTION BY AGE - DISEASES DISTRIBUTION BY AGE - DISEASES RELATED TO AIR POLLUTIONRELATED TO AIR POLLUTION

0

10

20

30

40

50

60

70

80

90

Common Asthma Pneumonia

< 5 year5 - 10 year> 10 year

%

PovertyPoverty District-level poverty status was derived using mid-term census District-level poverty status was derived using mid-term census

data and data from the longitudinal Vietnam Household and data and data from the longitudinal Vietnam Household and Living Standard Survey (VHLSS), and small-area estimation Living Standard Survey (VHLSS), and small-area estimation methodmethod

Studying Air Pollution, Poverty, Studying Air Pollution, Poverty, and and

Health in HCMCHealth in HCMCOverall Objectives:Overall Objectives:

1.1. Develop feasible approaches to studying air pollution, Develop feasible approaches to studying air pollution, poverty, and health poverty, and health

• Methods appropriate for HCMC contextMethods appropriate for HCMC context• Methods suitable for use in other cities - promote Methods suitable for use in other cities - promote

building an evidence base across Asian citiesbuilding an evidence base across Asian cities

2.2. Develop infrastructure for future studies of the health Develop infrastructure for future studies of the health effects of air pollution in HCMCeffects of air pollution in HCMC

• Technical capacity (epidemiologic methods, Technical capacity (epidemiologic methods, exposure assessment, analysis)exposure assessment, analysis)

• Resources (data integration, equipment) Resources (data integration, equipment)

Proposed MethodsProposed MethodsComponent 1 (C1): Hospital-based studyComponent 1 (C1): Hospital-based study

• Estimate the effect of short-term exposure to air pollution Estimate the effect of short-term exposure to air pollution on hospital admissions for ALRI in young children (<5 on hospital admissions for ALRI in young children (<5 years) in HCMCyears) in HCMC

• Compare the magnitude of the effect of air pollution on Compare the magnitude of the effect of air pollution on poor children vs. other childrenpoor children vs. other children

Component 2 (C2): Household-based studyComponent 2 (C2): Household-based study• Estimate personal exposures to air pollution among the Estimate personal exposures to air pollution among the

poor and the non-poorpoor and the non-poor ambient air pollution ambient air pollution other sources (cooking with solid fuels, cottage industries)other sources (cooking with solid fuels, cottage industries)

• Estimate prevalence of respiratory symptoms in HCMCEstimate prevalence of respiratory symptoms in HCMC• Survey of perceptions and economic costsSurvey of perceptions and economic costsComponent 3 (C3): Component 3 (C3): Policy Analysis; Capacity Building; Policy Analysis; Capacity Building;

Awareness BuildingAwareness Building

Hypotheses to be testedHypotheses to be tested

HH11:: the poor experience greater health impacts the poor experience greater health impacts from ambient air pollution (C1 and C2)from ambient air pollution (C1 and C2)

HH22:: the poor are more exposed to air pollution the poor are more exposed to air pollution (C2)(C2)

HH33:: exposures of the poor are more correlated exposures of the poor are more correlated with ambient air pollution (C2)with ambient air pollution (C2)

HH44:: the poor are more vulnerable to ambient the poor are more vulnerable to ambient air air pollution (C1)pollution (C1)

Methods development and Methods development and disseminationdissemination

This is the first project of its kind in Asia!This is the first project of its kind in Asia! Targeted technical assistance and capacity Targeted technical assistance and capacity

building will be providedbuilding will be provided Necessary infrastructure will be provided Necessary infrastructure will be provided

(example: equipment for air quality monitoring (example: equipment for air quality monitoring and analysis)and analysis)

Collaborators will make presentations at Collaborators will make presentations at international workshops and conferences (CAI-international workshops and conferences (CAI-Asia, technical conferences)Asia, technical conferences)

Researchers from other Asian cities will be Researchers from other Asian cities will be invited to learn more about the studyinvited to learn more about the study

Motivation and Structure of CollaborationMotivation and Structure of Collaboration Vietnam serves as a good model for future Vietnam serves as a good model for future

studies in similar regions (including capacity studies in similar regions (including capacity building)building)

HEI & ADB

HCMC Health Department International Collaborators

HCMC HEPA HCMC HospitalsHCMC Bureau

of StatisticsHCMC

DOLISA

Interdisciplinary team of Interdisciplinary team of collaboratorscollaborators

Organization(s)Organization(s) ResponsibilitiesResponsibilities

Department of Public Department of Public Health (DPH)Health (DPH)

Local leadership, management, and Local leadership, management, and coordinationcoordination

Other local Other local collaborating agencies: collaborating agencies:

CH1, CH2, HEPA, CASE, CH1, CH2, HEPA, CASE, Bureau of Statistics, Bureau of Statistics, DOLISA DOLISA

Provide retrospective data, assess Provide retrospective data, assess respiratory health prevalence, respiratory health prevalence, exposure monitoring and modeling, exposure monitoring and modeling, environmental sample analysis, environmental sample analysis, administer household survey, administer household survey, assessment of socio-economic assessment of socio-economic positionposition

Health Effects Institute Health Effects Institute (HEI)(HEI)

Overall study management and Overall study management and technical assistance (study design, technical assistance (study design, epidemiologic methods, exposure epidemiologic methods, exposure assessment)assessment)

International Scientific International Scientific Oversight Committee Oversight Committee (ISOC)(ISOC)

Technical guidance and scientific Technical guidance and scientific oversightoversight

External ConsultantsExternal Consultants Technical assistance (biostatistics)Technical assistance (biostatistics)

Thank you very much for your attention