Georgia leads the countries with the highest mortality rate caused by air pollution

The FINANCIAL — Georgia leads the countries with the highest mortality rate caused by air pollution according to the study by The International Energy Agency (IEA). This is due to a sharp rise in the number of old, dirty diesel vehicles in Georgia, experts believe.

“In Georgia the public transport system is not sufficiently developed and as a consequence a significant proportion of the population uses private vehicles as the preferred mode of transport. As a result, the number of private vehicles has grown rapidly over the past decade and has almost doubled in the last five year period”, Tim Kovach told Vox magazine.

Around 18 000 people die each day as a result of air pollution. In fact, the number of deaths attributed to air pollution each year – 6.5 million deaths – is, according to the World Health Organization (WHO), much greater than the number from HIV/AIDS, tuberculosis and road injuries combined. Air pollution also brings major costs to the economy and damage to the environment. Energy production and use is the most important source of air pollution coming from human activity and so, for these reasons, the IEA has – for the first time – undertaken a major study on the role of energy in air pollution.

Air pollution is a major public health crisis, with many of its root causes and cures to be found in the energy sector. Around 6.5 million deaths are attributed each year to poor air quality, making this the world’s fourth-largest threat to human health, behind high blood pressure, dietary risks and smoking. Without changes to the way that the world produces and uses energy, the ruinous toll from air pollution on human life is set to rise. That is why this World Energy Outlook (WEO) Special Report is dedicated, for the first time, to the links between energy, air pollution and health. It sets out in detail the scale, causes and effects of the problem and the ways in which the energy sector can contribute to a solution.

Energy production and use, mostly from unregulated, poorly regulated or inefficient fuel combustion, are the single most important man-made sources of air pollutant emissions: 85% of particulate matter and almost all of the sulfur oxides and nitrogen oxides. These three pollutants are responsible for the most widespread impacts of air pollution, either directly or once transformed into other pollutants via chemical reactions in the atmosphere.

The solutions are well known, but the problem is far from being solved Growing attention to air pollution, together with an accelerating energy transition post- COP21, puts aggregate global emissions of the main pollutants on a slowly declining trend to 2040.

Fuel combustion increases steadily in our main scenario, to help meet a one-third rise in global energy demand. But global emissions of particulate matter are projected to fall by 7%, sulfur dioxide by 20% and nitrogen oxides by 10% over the period to 2040. This de-coupling of trends is due, in roughly equal measure, to the application of air pollution control technologies and the broader global transition to cleaner energy.

Pollution controls are applied with increasing rigour in the centres of rising energy demand, mostly in Asia, where air quality regulation has struggled to keep pace with rapid industrial development and urbanisation. In parallel, the broader transformation of the energy sector – boosted by the Paris climate agreement – means that more than one-third of the projected growth in energy use is met by sources that do not emit air pollutants: wind, solar, hydro and nuclear power. Another 30% comes from natural gas, which emits less air pollution than other fossil fuels or biomass.

Despite the intensified policy efforts, regional demographic trends and rising energy use and urbanisation, especially in developing Asia, mean that the number of premature deaths attributable to outdoor air pollution continues to grow, from 3 million today to 4.5 million in 2040.

Asia accounts for almost 90% of the rise in premature deaths: air pollution in many of the region’s growing cities continues to be a major public health hazard and, indeed, to affect a larger share of an increasingly urban population.

In China, for example, an ageing population becomes more vulnerable to the effects of air pollution on human health, even though aggregate pollutant emissions are in decline. The health impacts from household air pollution improve somewhat, but remain severe. Provision of improved cookstoves and alternatives to solid biomass means that the number of people without access to clean cooking facilities is projected to fall by almost 1billion, to 1.8billion; as a result, the number of premature deaths attributable each year to household pollution falls from around 3.5 million today to under 3 million in 2040.

High concentrations of nitrogen dioxide affect cities in both high-income and lower/higher- middle-income economies. The very steep increase in NO2 concentrations in some urban areas of China, India and the Middle East observed from satellites since the mid-1990s is attributable to the increasing number of vehicles and to the growth of power generation and industry (Hilboll, Richters and Burrows, 2013).

During the same period, NO2 concentrations tended to decrease in most of the cities of high-income economies, even though levels remained high. In 2013, annual NO2 concentrations above the WHO guideline level were reported in almost all EU cities with a population larger than 500 000 and were observed to significantly exceed the target in cities such as Paris, London and Milan (EEA,2015). In addition, and particularly for NO2, there are significant variations in pollution levels within cities, with roads acting as pollution pathways4 and airports, ports and industrial zones (or areas downwind of them) proving to be hotspots. Episodes of high ozone concentrations, which are linked to an increase in the emissions of precursors (such as NOX, O3, CO and VOCs) and are relatively frequent in high-income economies in the summer season, now largely affect emerging lower and upper-middle economies, with, due to long-range ozone transportation, regional and global consequence (for Korea, Japan and even the west coast of the United States). Sulfur dioxide concentrations have strongly declined in the high-income economies due to efficient pollution controls. Hotspots remain, however, for instance in some areas of Central and Eastern Europe (EEA, 2015). Cities in emerging and developing countries, especially those with high industrial activity, can experience very high SO2 concentrations. In coastal areas, and more particularly in ports, emissions from ships contribute to high SO2 concentrations (Merk, 2014).

Effects

Air pollution has many undesirable effects, the extent of which is determined by the levels of concentration of the different pollutants. There is a range of negative health impacts, adverse impacts on vegetation (leading to lower agricultural yields), acidification (leading to “acid rain”) and eutrophication.5 Some forms of air pollution also contribute to climate change. The characteristics of different pollutants define their particular health impacts: even relatively slight exposure may come with high health risks for vulnerable segments of the population.

Health impacts

Air pollution is the fourth-largest overall risk to health, after high blood pressure, dietary risks and smoking (WHO, 2014). It is an ongoing health crisis for which many of the causes and cures are to be found in the energy sector. Fine particulate matter (PM2.5), even at low concentrations, is associated with a range of serious illnesses and has the most significant effect on human health, due to its propensity to penetrate deep into the lungs. Ozone, nitrogen dioxide and sulfur dioxide also have negative health impacts.

Health impacts of air pollution

Damage to health can arise from both short-term (a few hours or days) and long-term (over months or years) exposure to air pollution. Particulate matter is linked to lung cancer, chronic obstructive pulmonary disease and heart diseases. The single biggest killer of children less than five-years old worldwide is pneumonia, with more than half of the almost one million premature deaths being caused by exposure to household air pollution (WHO, 2016c). Air pollution can also contribute to low birth weight, tuberculosis, cataracts and throat cancers. Ozone, nitrogen dioxide and sulfur dioxide are linked to asthma, bronchial disease, reduced lung function and lung disease. The nature and extent of the health impact of air pollution depends primarily on the level of concentration the length of exposure to the pollution a person has and their profile, with the very young and the elderly being most vulnerable.

The effects range from persistent mild personal discomfort to death. Various indicators are used to measure these impacts, but mortality is the over-riding concern. In 2012, 6.5 million premature deaths were attributed to air pollution (both household and outdoor) (WHO, 2016b) – more than one-in-every-nine deaths worldwide. Even relatively low levels of air pollution pose risks to health and, because of the large number of people exposed, it causes significant morbidity and mortality in all countries. While all parts of the population are affected by air pollution, the burden of ill health consequences falls most heavily on the poorest segments of society.

By age group, children (in particular under five- year olds) and the elderly are the most vulnerable. The countries with the largest number of premature deaths caused by air pollution are mostly in Asia, but also in Africa. However, when adjusted to take account of the size of a countries population (i.e. deaths per 100 000 people), the highest rates of mortality from air pollution can be seen to also span across other parts of the world, such as Eastern Europe.

The global impact of air pollution has increased over time, although this hides large regional disparities. Premature deaths have declined in Europe, the United States and a number of others, while they have increased in many countries in Asia and Africa in particular. Household air pollution was the cause of an estimated 4.3 million premature deaths in 2012,7 heavily concentrated in low- and middle-income countries (WHO, 2016c). Around 80% of this total was in Asia, where around 1.9 billion people rely on the traditional use of solid bioenergy for cooking, and many rely on kerosene for lighting. By country, the largest numbers of premature deaths were in China (1.5 million) and India (1.25 million), followed by Indonesia (165 000), Nigeria (130 000), Pakistan (120 000), Bangladesh (85 000), Democratic Republic of Congo, Philippines, Viet Nam and Myanmar.

Outdoor air pollution from particulate matter was responsible for 3 million premature deaths in 2012 (WHO, 2016d, forthcoming), with around 200 000 additional deaths linked to ground-level ozone (Forouzanfar, 2015). China has by far the largest number of premature deaths from outdoor air pollution related to particulate matter (more than 1 million), followed by India (620 000). In both cases, particulate emissions from coal combustion are a key underlying factor.

In the European Union, more then 175000 premature deaths were attributed to PM8 and around 16 000 to ground-level ozone exposure (EEA,2015). The next largest numbers of premature deaths are in Russia (140 000), Indonesia and Pakistan (both around 60 000), Ukraine and Nigeria (both around 50 000), Egypt and the United States (both around 40 000).

Existing studies of the economic impacts of air pollution differ in many respects (e.g. geographic and sectoral coverage, methodology), but most conclude that the costs of inaction are very large and outweigh the cost of taking mitigating steps. The costs associated with the health impacts tend to dominate any overall economic assessment.

For example, impact analysis in the EU finds that the health impact accounts for all the external costs related to PM emissions, to 95% of the costs of SO2 emissions and to 80% of the costs of NOX (Rabl, Spadaro, & Holland, 2014). As a result, there is a fairly close degree of consistency between those countries that bear the most significant health burden from air pollution and those that are judged to suffer the biggest economic impacts.

In both cases, national income levels are an influential variable and vary significantly from one country to another. As a result, the economic cost may appear low in a developing country that has relatively high health impacts and low per-capita income, while the reverse may be true for some developed countries. Using this approach, China is estimated to suffer the largest impact (high health impact, upper-middle income), followed by India (high health impact, lower-middle income), Russia (relatively low health impact, high-income), the United States, Indonesia, Japan, Germany and others. There have been several national studies into the economic impacts of air pollution. While often not comparable to one another, they confirm the high cost of air pollution across different countries and sectors, and the high benefits of policy action. In the European Union, the value of the health impacts was estimated at $440-1 250 billion in 2010 (EC, 2013).

The cost of damage from air pollution, just from the largest industrial facilities, is estimated to have been $55-155 billion in 2012, with half of the total from just 1% of industrial plants (EEA, 2014). In the United States, where the cost of compliance with the 1990 Clean Air Act Amendments are expected to rise to around $65 billion per year by 2020, the economic value of the resulting improvements in health and environmental conditions are estimated at around $2 trillion in the same year (US EPA, 2011). Other studies value the adverse health impact in the United States from fossil-fuel supply and power generation activities alone at over $160 billion in 2011 (Jaramillo and Muller, 2016).

The role of energy in air pollution — Fuel quality

Fuel quality is a very important determinant of the eventual impact on air quality. Coal, for example, contains various impurities and chemical components, such as minerals, metals, volatile matter and sulfur. During the combustion of coal, some of these components may be released into the air if the flue gas is not adequately treated. The minerals (most commonly known as ash) present in the coal largely determine the amount of PM in the flue gas, while the sulfur content is responsible for the amount of SO2 formed in the combustion process. Metallic components, such as mercury, may also be present in coal and be released into the flue gas. The chemical composition of coal depends on the conditions under which the coal was formed millions of years ago and is therefore very different by region.

In the case of oil, only around 1% of oil is used in a crude state (mainly in power generation plants in the Middle East). Worldwide almost all oil is consumed in the form of oil products coming from refineries or fractionation plants (for natural gas liquids).

Removing sulfur from oil products (via hydrogen- and energy-intensive processes such as cracking and coking) is a major part of the refining process, as governments typically regulate the sulfur content of fuels – usually starting with road transport fuels and going on to residential heating, industrial combustion (including power generation) and agriculture.

The naturally occurring sulfur in crude oil ranges between 0.2% and 4%, while specifications for gasoline and diesel for road transport can be as tight as 10 parts per million (ppm) (0.001%), such as in OECD and some developing countries, rising to above 500 ppm (0.05%) in some non-regulated markets in Asia and Africa (Figure 1.13). Fuel oils have the highest allowed sulfur content – up to 3.5% in fuels for marine shipping. Natural gas does not go through the same refining process as oil, but it is nevertheless treated in gas processing plants to remove sulfur and liquids. The naturally occurring sulfur in gas ranges from close to zero to 20-30% and even higher in some exceptional wells. Consumption of oil has some unique features that define the challenges and the specifics of pollution control policies. Unlike coal and gas, which are mostly used in relatively large- volume stationary sectors (power generation, industry), oil is mostly used in mobile applications: transport accounts for over 55% of oil demand. Small-scale stationary use, such as fuel for buildings and agriculture, covers another 10% of oil demand. Thus, only a third of oil is used in large-scale stationary sources in industry and power generation, compared to almost 95% for coal and over 70% for natural gas.

“Millions of tonnes of energy-related pollutants are released each year, be it the harmful emissions from using traditional biomass for cooking, as is still common practice today for 2.7 billion people; or the emissions from cars and trucks, factories, power plants and other sources. This is not a problem that economies can expect to grow out of as they become wealthier, but one that will endure until concerted transformative action is taken”, Dr. Fatih Birol Executive Director International Energy Agency said.

“Fortunately, there are solutions at hand. It presents a strategy – in the form of a Clean Air Scenario – in which the energy sector pushes air pollution levels into a steep decline in all countries. The technologies for doing so exist and are in widespread use today. They can be applied at great net economic benefit. Concerted efforts, across areas of responsibility and between nations are required. First and foremost, a more concentrated effort needs to be made to tackle energy poverty in developing countries. Second, steps must be taken to reduce pollutant emissions through post-combustion control technologies. And third, emissions can be avoided entirely, through promoting clean forms of energy around the world. Such actions can help avoid millions of pollution-related deaths”, Dr. Fatih Birol said.