BOOKS & ELETRONIC MEDIA

Air pollution and health in rapidly developing countries

Sumi Mehta

Policy analyst, Evidence for Health Policy, World Health Organization, 1211 Geneva 27, Switzerland (email: mehtas@who.int)

Editors: Gordon McGranahan and Frank Murray
Publisher: London: Earthscan; 2003
ISBN: 1 85383 985 X, PB. Price: £19.95
1 85383 966 3, HB. Price: £50

In this publication from the Stockholm Environment Institute, academics, researchers and policy experts have collaborated to construct a com-prehensive overview of air pollution and health in developing countries. Emphasizing the importance of linking action and research, they make the latest technical and scientific information accessible to a broad readership.

Placing air pollution within its historical context, the authors emphasize that low- and middle-income countries today need not follow directly in the footsteps of high-income countries. The problem is also presented within a risk transition framework, in which economic development can shift the scale of environmental risks from the household to the community level and then on to the regional and global environment. This helps policy-makers see the importance of tackling both short-term and long-term health effects of air pollution, ranging, for instance, from respiratory problems to climate change.

There is a useful summary of the studies on air pollution and health in industrialized countries. Fewer comparable data on developing ones exists. This underscores the need for more research. Case studies from Hong Kong suggest that air pollution there has a bigger impact on health than in other industrialized areas. This raises the important question of the generalizability of research done in industrialized countries. The authors think that while policy should be based on the best available information, decisions should not be deferred on the grounds of uncertainty. A case study on Santiago, Chile, therefore uses local evidence in conjunction with information from North America and Europe to measure the health impacts of air pollution.

Tools for managing air pollution include international guidelines and local regulations. One approach, called URBAIR, uses air quality management systems to develop action plans in Asian cities. A chapter on rapid assessment techniques tries to show how decision-makers can set policies on the basis of limited information. The result, however, is more like a description of methods used in environmental health research: epidemiology, exposure assessment, and risk assessment, none of which are typically rapid. Finally, a case study on Johannesburg, South Africa, shows how inadequate transport infrastructure can result in a disproportionate burden of exposure for people living in informal urban settlements.

The book as a whole provides a well-organized, readable and valuable synthesis of existing knowledge on how air pollution affects health. Technical information is presented in a comprehensible and straightforward manner. Most importantly, the book shows that although low- and middle-income countries cannot always adopt the same policies as their richer counterparts, there are many things they can do without delay to control and reduce air pollution. In other words, they need not wait until they attain a certain level of economic development before bringing in policies for clean air.