physical scales. This is particularly the case with urban air pollution, which has, in
recent decades, become a worldwide public health problem. That is, although
it does not constitute an integrated ‘global’ environmental change, its widespread
occurrence as a locally generated and locally acting health hazard makes it, now,
a ‘worldwide’ problem. An estimated 130 000 premature deaths and 50—70
million incidents of respiratory illness occur each year due to episodes of urban
air pollution in developing countries, half of them in East Asia. An even greater
toll of chronic disease is attributable to long-term exposures to urban air pollution.
A recent analysis of three European countries estimated that 6% of total
mortality (over 40 000 attributable cases per year) was caused by air pollution.
This study also demonstrated that air pollution resulting from motorized traffic
accounted for over 16 million person-days of restricted activities. For the world
as a whole, it has been estimated that if there were worldwide compliance with the
Kyoto Protocol on climate change, the concomitant reduction in particulate-matter
exposure, due to reduced fossil fuel combustion, would result in approximately
seven million premature deaths being avoided by 2020.
Indoor air pollution is also a cause of concern, especially where biomass fuels
or coal, are used for heating and cooking, and where ventilation, including
chimneys, is poor. About half the world’s population still relies on unprocessed
solid fuels (coal and biomass — wood, animal dung and crop residues) for
household cooking and heating, often producing pollution that is orders of
magnitude more health-damaging per unit of energy than liquid or gaseous
fuels. Rough estimates by WHO indicate that, worldwide, as many as 2.5
million people die prematurely each year from exposure to the combustion
products of solid household fuels. These estimates indicate that dirty household
air has a similar magnitude of health impact to that attributed to contaminated
water at the household level, that is, about 6—7% of the global burden of disease —
considerably more than the 0.5% attributed to urban ambient air pollution in
some widely-cited estimates.
Microbial Water Pollution and Sanitation
Water plays an important role in many of the Earth’s systems. Covering over
70% of the planet’s surface, oceanic waters play an important stabilization role in
World Bank, World Development Report. Development and the Environment, Oxford University
Press, Oxford, 1992.
World Resources Institute, World Resources 1998—99: A Guide to the Global Environment;
Environmental Change and Human Health, Oxford University Press, Oxford, 1998.
D. Maddison, A Meta-analysis of Air Pollution Epidemiological Studies, Centre for Social and
Economic Research on the Global Environment, University College, London, 1997.
A. J. McMichael, H. R. Anderson, B. Brunekreef and A. Cohen, Int. J. Epidemiol., 1998, 27, 450.
N. Kunzli, R. Kaiser, S. Medina, M. Studnicka, O. Chanel, P. Filliger, M. Herry, F. Horak, V.
Puybonnieux-Texier, P. Quenel, J. Schneider, R. Seethaler, J. C. Vergnaud and H. Sommer,
Lancet, 2000, 356, 795.
Working Group on Public Health and Fossil Fuel Combustion, Lancet, 1997, 350, 1341.
N. Bruce, R. P. Padilla and R. Albalak, Bull. World Health Org., 2000, 78, 1078.
A. Reddy and T. Johannsen, Energy since Rio, United Nations Development Programme, 1997.
World Health Organisation, Health and Environment in Sustainable Development, Document
WHO/EHG/97.8, WHO, Geneva, 1997.
M. J. Ahern and A. J. McMichael
142
recent decades, become a worldwide public health problem. That is, although
it does not constitute an integrated ‘global’ environmental change, its widespread
occurrence as a locally generated and locally acting health hazard makes it, now,
a ‘worldwide’ problem. An estimated 130 000 premature deaths and 50—70
million incidents of respiratory illness occur each year due to episodes of urban
air pollution in developing countries, half of them in East Asia. An even greater
toll of chronic disease is attributable to long-term exposures to urban air pollution.
A recent analysis of three European countries estimated that 6% of total
mortality (over 40 000 attributable cases per year) was caused by air pollution.
This study also demonstrated that air pollution resulting from motorized traffic
accounted for over 16 million person-days of restricted activities. For the world
as a whole, it has been estimated that if there were worldwide compliance with the
Kyoto Protocol on climate change, the concomitant reduction in particulate-matter
exposure, due to reduced fossil fuel combustion, would result in approximately
seven million premature deaths being avoided by 2020.
Indoor air pollution is also a cause of concern, especially where biomass fuels
or coal, are used for heating and cooking, and where ventilation, including
chimneys, is poor. About half the world’s population still relies on unprocessed
solid fuels (coal and biomass — wood, animal dung and crop residues) for
household cooking and heating, often producing pollution that is orders of
magnitude more health-damaging per unit of energy than liquid or gaseous
fuels. Rough estimates by WHO indicate that, worldwide, as many as 2.5
million people die prematurely each year from exposure to the combustion
products of solid household fuels. These estimates indicate that dirty household
air has a similar magnitude of health impact to that attributed to contaminated
water at the household level, that is, about 6—7% of the global burden of disease —
considerably more than the 0.5% attributed to urban ambient air pollution in
some widely-cited estimates.
Microbial Water Pollution and Sanitation
Water plays an important role in many of the Earth’s systems. Covering over
70% of the planet’s surface, oceanic waters play an important stabilization role in
World Bank, World Development Report. Development and the Environment, Oxford University
Press, Oxford, 1992.
World Resources Institute, World Resources 1998—99: A Guide to the Global Environment;
Environmental Change and Human Health, Oxford University Press, Oxford, 1998.
D. Maddison, A Meta-analysis of Air Pollution Epidemiological Studies, Centre for Social and
Economic Research on the Global Environment, University College, London, 1997.
A. J. McMichael, H. R. Anderson, B. Brunekreef and A. Cohen, Int. J. Epidemiol., 1998, 27, 450.
N. Kunzli, R. Kaiser, S. Medina, M. Studnicka, O. Chanel, P. Filliger, M. Herry, F. Horak, V.
Puybonnieux-Texier, P. Quenel, J. Schneider, R. Seethaler, J. C. Vergnaud and H. Sommer,
Lancet, 2000, 356, 795.
Working Group on Public Health and Fossil Fuel Combustion, Lancet, 1997, 350, 1341.
N. Bruce, R. P. Padilla and R. Albalak, Bull. World Health Org., 2000, 78, 1078.
A. Reddy and T. Johannsen, Energy since Rio, United Nations Development Programme, 1997.
World Health Organisation, Health and Environment in Sustainable Development, Document
WHO/EHG/97.8, WHO, Geneva, 1997.
M. J. Ahern and A. J. McMichael
142