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786GEOFILE
© Oxford University Press 2019 GeoFile, Series 37 Issue 3, April 2019 1
Extension
Pollution and health: two case studies
By Rebecca Priest
SynopsisThere is a clear link between pollution and health. Both air pollution and water pollution are major causes of mortality and disease globally. Rapidly developing and industrialising countries, such as India, suffer from poor air quality and are seeing a rise in deaths from respiratory illnesses and cancers, which are both linked to outdoor air pollution.
The least developed countries in the world, such as Tanzania, are still struggling to provide universal access to clean drinking water and adequate sanitation which is influencing the mortality from treatable waterborne diseases, such as diarrhoea and cholera.
There are national and global responses to both health issues, which are attempting to increase knowledge on the link between pollution and health and reduce mortality from preventable disease caused by pollutants.
Key termsCarcinogenic, communicable, DALYs, disease vectors, epidemiological transition, NGOs, particulate matter.
Learning objectivesAfter working through this unit, you will be able to:
●● explain the link between pollution and health
●● explain the causes of air and water pollution
●● assess the impacts of air pollution on the health of
the population of India, and the impacts of water
pollution on the health of the population of Tanzania
●● explain the responses to health issues caused by air
and water pollution.
LinksExam board Link to specification
AQA
AS
A2
3.3.2 Contemporary urban environments
3.2.2.4 Air quality: particulate and photo-chemical pollution; Urban climate: pollution reduction policies
3.3.2.7 Other contemporary urban issues: atmospheric and water pollution page 21
Click here
3.3.2.9 Case studies: the nature and impact of physical environmental conditions page 22
Click here
3.2.3 Contemporary urban environments
3.2.3.4 Urban climate: pollution reduction policies
3.2.3.7 Other contemporary urban environmental issues: atmospheric and water pollution
3.2.3.9 Case studies : the nature and impact of physical and environmental conditions page 26
Click here
3.2.4 Population and the environment
3.2.4.3 Environment, health and well-being
Global paths of health; air quality and health; water quality and health page 27
Click here
Edexcel
AS
A2
Topic 3 Globalisation
3.4b Some communities in developing countries have experienced major environmental problems ..... which impact on people’s health and well-being page 34
Click here
Topic 3 Globalisation
3.4b (as above in AS) page 30
Click here
OCR
AS
A2
Topic 2.2 Disease dilemmas
2 Is there a link between disease and levels of economic development?
2a Case study of one country experiencing air pollution page 29
Click here
Topic 3.2 Disease dilemmas
2/2a (as above in AS) page 41
Click here
Eduqas 3.5 Weather and climate
3.5.6 Impacts of urban areas on air quality, including particulate pollution, photochemical smog and acid rain page 38
Click here
WJEC 4.4
Energy challenges and dilemmas
4.4.5 Problems associated with the extraction, transfer and use of energy: Environmental problems page 40
Click here
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GEOFILE
© Oxford University Press 2019 GeoFile, Series 37 Issue 3, April 2019 2
Extension ● 786
the hydrological system from
domestic, industrial and agricultural
sources have resulted in a growing
proportion of water being unfit for
human consumption. Due to a lack
of basic sanitation or clean water
sources, around one in nine people
globally are consuming unsafe,
polluted water. As a result,
waterborne diseases, such as
cholera, cause around 1.5 million
deaths a year, and diarrhoeal
disease is the second biggest cause
of mortality under the age of five.
The provision of adequate
sanitation and clean water, and the
prevention of deaths from diseases,
is an important global challenge.
Air pollution and healthThe main source of air pollution is
the burning of fossil fuels for energy
and vehicle emissions. In 2016,
ambient (outdoor) air pollution was
estimated to have caused 4.2 million
the environment. Human activity is
responsible for high levels of
pollution entering and affecting the
quality of air, water and the land.
In the 1970s, average daily levels of
air pollution were believed to be at
a level which did not pose a danger
to human health. Since then, as
concentrations of hazardous
particulate matter in the air have
increased, so has research into the
link between air pollution and
health. Particulate matter can enter
the lungs and the bloodstream,
impairing cardiovascular (the
heart and its blood vessels),
cerebrovascular (blood vessels in
the brain) and respiratory (lungs
and breathing) health. Air pollution
is now a major environmental
health issue and the World Health
Organisation (WHO) attributes air
pollution to 7 million deaths a year.
Water is essential to human life.
However, water pollutants entering
Pollution and health: two case studiesIs there a link between pollution and health?In December 1952, cold and
windless weather prevented the
natural dispersion of the airborne
pollutants which were rising from
the coal-burning factories and
power stations across London. This
famous Great Smog of London
caused major disruption due to
reduced visibility. In the weeks that
followed, however, government
reports began to link the smog,
which mainly consisted of sulphur
dioxide, to the death of around 6000
Londoners, and respiratory illnesses
and lung infections affecting around
100,000 more. These events raised
an interest in the link between
pollution and disease, and resulted
in the introduction of the Clean Air
Act in 1956 in an attempt to reduce
urban air pollution.
Pollution refers to the presence of
harmful materials, or pollutants, in
Figure 1 The number of DALYs per 100,000 (2013)
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© Oxford University Press 2019 GeoFile, Series 37 Issue 3, April 2019 3
Impacts of air pollution in IndiaThe high levels of air pollution are
having devastating impacts on
people’s health. In 2015, air
pollution was linked to the deaths
of over 1 million Indian people, the
most in any country. Respiratory
difficulties and asthma are 1.7 times
higher in Delhi than in the rural
areas of India, and lung function of
the urban residents is seriously
reduced. Indoor air pollution causes
around 2 million premature deaths
a year, with nearly half of those
deaths due to pneumonia. Women
and children are particularly at risk,
as they spend more time indoors.
Recent research has shown clear
links between air pollution and
higher rates of mortality from heart
disease, lung cancer, respiratory
tract infections, leukaemia,
tuberculosis and asthma.
Reducing mortality from air pollution in IndiaIndia’s air quality has worsened as
the country has developed
economically, and environmental
legislation has been unable to keep
up with the pace of industrial
growth. Whilst trying to cope
with the challenges of poverty,
population growth and
industrialisation, India has made
some attempts to improve its air
quality.
●● A draft National Clean Air
Programme (NCAP) has been
proposed. It outlines multiple
ways to reduce air pollution,
such as closing brick kilns, raising
parking fees in cities, stopping
hotels from using coal and
firewood, and banning garbage
burning.
●● A two-week ‘Clean Air
Campaign’ in February 2018
involved checking vehicle
Causes of air pollution in IndiaThere are four main sources of
hazardous pollutants in India:
1. Industry – many of the most
polluting industries (metals,
chemicals, compost and petrol)
do not abide by the regulations
in place to limit their emissions.
2. Motor vehicles – traffic
congestion is a problem in urban
areas due to volume of vehicles
and poor traffic sense. When
travelling slowly, vehicles burn
fuel more inefficiently and
pollute the air with carbon
monoxide and nitrogen
oxides.
3. Domestic – fuelwood and
biomass cakes are used for
cooking and heating on a chullah
cooking stove in the home, most
commonly in low-income
households. When burnt, they
release high levels of smoke
containing dangerous particulate
matter.
4. Power generation – India relies
on inefficient coal, oil and
natural gas-fired thermal power
plants which release harmful
substances into the air.
premature deaths worldwide, the
majority occurring in developing
countries. 91% of the world’s
population lives in areas where
hazardous particulate matter in the
air (mostly nitrogen dioxide and
sulphur dioxide) exceeds the WHO’s
limits, a major risk factor for
cardiovascular and respiratory
disease. In 2013, the WHO
confirmed that particulate matter in
air pollution is carcinogenic and
can increase the risk of lung and
bladder cancers. Whilst air pollution
is at hazardous levels in the majority
of countries across the world, the
number of DALYs (disability-
adjusted life years) lost due to air
pollution varies (Figure 1).
Air pollution in IndiaNew Delhi, India, is the most
polluted city in the world
(Figure 2). Concentrations of the
most dangerous airborne
particulate matter (PM2.5) are
between 15 and 32 times higher
than the WHO guidelines and are
predicted to increase (Figure 3).
Rural indoor air pollution is also a
major problem due to people’s
reliance on burning wood for fuel
inside their homes.
Figure 2 In thick smog, a Delhi Transportation Corporation bus in Old DelhiSource: Richard Sowersby/Alamy Stock Photo
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© Oxford University Press 2019 GeoFile, Series 37 Issue 3, April 2019 4
Water pollution and healthWaterborne diseases such as
diarrhoea, cholera, dysentery,
typhoid, schistosomiasis and polio
can be spread through a country’s
water supply. Globally, 842,000
people die each year from
preventable diarrhoea. The
pathogens can enter the water
supply through contact with
untreated sewage. In countries
without adequate sanitation,
human defecation in rivers and
lakes pollutes the drinking water
supply with bacteria. Globally,
2 billion people drink from a
source which is contaminated
with human waste. In the tropics,
stagnant water also attracts
disease vectors such as the
anopheles mosquito, which
spreads malaria.
Water pollution in TanzaniaAlthough Tanzania has a rapidly
growing economy, uneven
development across rural and urban
areas means that access to clean
water and sanitation is still poor for
much of the population. The
waterborne disease, cholera, is a
particular problem. People who
drink water contaminated with the
Vibrio cholerae bacterium develop
diarrhoea and severe dehydration,
which can quickly lead to death if
left untreated.
Causes of water pollution in TanzaniaAround 40% of the population of
Tanzania do not have access to safe
water, and around two-thirds do
not have access to improved
sanitation (Figure 4). Most of the
rural population relies on
groundwater wells which are often
located next to toxic drainage
systems which pollute the
the second Kyoto Protocol in 2013,
which commits them to reduce
harmful emissions to at least 18%
below 1990 levels. In 2016, 195
countries signed the Paris
Agreement, which aims to keep the
increase in global average
temperature to below 2°C above
pre-industrial levels.
Each signing country must
determine a plan and report on its
progress towards the Agreement’s
aim. For example, Norway will ban
the sale of petrol and diesel cars by
2025. In 2017 however, President
Trump, announced his intention to
withdraw the USA from the
agreement in 2020.
In 2015, the WHO produced a draft
road map to enhance the global
response to the link between air
pollution and ill-health. The
four-year plan aims to expand
knowledge on the link between
air pollution and health and to
improve monitoring and
reporting.
pollution, inspecting power
plants and raising awareness of
how to avoid indoor air
pollution.
●● Cities such as Nagpur and
Bengaluru are encouraging the
use of electric vehicles through
tax incentives and lower fares for
electric buses.
●● An emphasis is being put on
improved education and
increasing awareness about
avoiding indoor air pollution,
such as improving ventilation
and retrofitting cooking stoves to
make them more fuel efficient
and less smoky.
Global solutions to air pollutionThere are a number of international
agreements which are aimed at
cutting down on emissions to
mitigate climate change, which will
also have benefits for human
health. 38 developed countries,
including those of the EU, signed
Figure 3 Ambient air pollution (for the majority of India, PM 2.5 is above the WHO guidelines of 10 µ/m3)Source: The Times of India
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Extension Pollution and health: two case studies ● 786GEOFILE
© Oxford University Press 2019 GeoFile, Series 37 Issue 3, April 2019 5
groundwater through leaks. The
alternative surface water is often
polluted with bacteria or human
waste. The spread of waterborne
disease is also influenced by poor
personal hygiene and lack of hand
washing, particularly among food
vendors in larger cities.
Impacts of water pollution in Tanzania
●● 32,098 cases of cholera including
532 deaths being reported since
the beginning of the most recent
cholera outbreak in August 2015.
Between January 2018 and July
2018, the number of cases was
double that of the same period
for the previous year.
●● 70% of Tanzania’s health
expenditure is directed towards
treating preventable,
communicable diseases caused
by poor water, sanitation and
hygiene.
●● Absences from school or work due
to illness from diarrhoeal disease is
costing the Tanzanian economy
US$1.6 million each year.
Reducing mortality from water pollution in TanzaniaA number of NGOs (non-
governmental organisations) are
working to improve access to clean
water. Cholera is easily treatable by
oral rehydration solution (ORS). In
Tanzania, there is a lack of access to
ORS and education on the
symptoms and treatment of cholera,
which raises mortality rates.
UNICEF is working to control
cholera epidemics through the
construction of toilets and by
increasing the number of trained
healthcare professionals in the
worst affected areas. Another
important aspect of reducing
mortality is to increase community
education and awareness of good
hygiene practices, through school
meetings and in the local media.
UNICEF is helping to close down
restaurants which do not abide by
regulations to prevent the
contamination of food.
The semi-autonomous island of
Zanzibar, where 30% of the
population have no access to clean
and safe water, has implemented a
10-year cholera elimination plan,
aiming to end deaths from cholera
by 2027 through mass vaccinations
and improving sanitation facilities.
The government on the Tanzanian
mainland has an ambitious goal to
provide 24 million people with
clean water and half of all
households with toilets by 2020
with the help of NGO, WaterAid.
Global solutions to water pollutionThe United Nations Sustainable
Development Goal 6 has the aim of
ensuring access to water and
sanitation for all by 2030. This
target involves ending open
defecation and improving drinking
water quality by reducing water
pollution. In 2017, the WHO’s
Global Task Force on Cholera
Control announced a strategy,
‘Ending Cholera: A roadmap to
2030’, which aims to reduce
cholera deaths worldwide by 90%.
However, climate change,
population growth, urbanisation
and industrialisation will increase
the number of countries living in
water-stressed areas, and create
further challenges for the provision
of safe water and the prevention of
the spread of waterborne disease.
ConclusionPollution has an impact on
health at all stages of economic
development. Abdel Omran’s
model of the epidemiological transition shows the relationship
between development and the
prevalence of different types
of disease. In less developed
countries, communicable diseases
are more prevalent. Cholera is a
more common cause of death in
countries in the earlier stages of
epidemiological transition, as
they are more likely to be unable
to provide good sanitation and
uncontaminated drinking water
to its population. As a country
develops, man-made diseases
become more common causes of
death, including those caused by
air pollution. More industrialised
countries will discharge waste
products from industry and
transport into the air and water
sources, causing a greater
incidence of respiratory illnesses
and cancers. This means that
pollution affects health in both
the early and later stages of
epidemiological transition.
Figure 4 Women with inadequate facilities in their homes use a river to wash clothes and collect drinking water, increasing their risk of contracting waterborne diseasesSource: Charlotte Thege/Alamy Stock Photo
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© Oxford University Press 2019 GeoFile, Series 37 Issue 3, April 2019 6
Learning checkpoint
When reading through this unit you should consider the following questions:
1. What are the causes of air pollution in India?
2. What are the impacts of air pollution on health in India?
3. What are the causes of water pollution in Tanzania? Explain each one clearly.
4. What are the impacts of water pollution on health in Tanzania? Consider impacts on people and the economy.
5. What are the main strategies to deal with diseases caused by air and water pollution? Briefly discuss examples.
6. What is the link between pollution, health and development?
Focus questions
1. Referring to examples, evaluate the impacts of pollution on health.
2. Assess the extent to which economic causes are the most influential for mortality from air and water pollution.
3. Assess the extent to which the impacts of air pollution on health can be mitigated against.
4. Essay: Evaluate how the impact of NGOs on the prevention and treatment of diseases is linked to water pollution. Research examples to illustrate your points.
Web linksWHO air pollution website
Click here
WHO air pollution in India
Click here
India’s National Clean Air Programme (NCAP)
Click here
WaterAid in TanzaniaClick here
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