By Soon Li Wei
KUALA LUMPUR: Bank officer Siti Suriani Ahmad tends to have an asthma flare-up whenever she travels long distances by road.
“I shouldn’t be stuck in a vehicle for more than three hours, otherwise I will end up having shortness of breath caused by the exhaust fumes I inhale,” she said.
Recalling a rather traumatic experience she had whilst travelling in an express bus to her hometown in Penang from Kuala Lumpur in January this year, Siti Suriani, 32, said what was supposed to have been a three-hour trip ended up taking six hours due to traffic congestion, causing her at one point to gasp for breath as she had inhaled too much of exhaust fumes.
“Usually when I’m driving, I will make a pit stop at an R&R (Rest & Relaxation area) to take a short break every two hours before continuing the journey. (In January) I had to take the express bus but, unfortunately, it got stuck in traffic and my inhaler didn’t work as the windows couldn’t open… I vomited and fainted,” she told Bernama recently.
She was rushed to a nearby hospital and admitted for two days due to inhaling an excessive amount of fumes containing carbon monoxide (CO) emitted by the bus.
In March, she moved to a residential area in Subang Jaya from Shah Alam where she used to stay near an industrial area as she could no longer “bear the smell of the smoke” released by the factories there.
In the case of Siti Suriani and many other city dwellers who are asthmatic, their condition is aggravated when they breathe in an excessive amount of exhaust fumes, the bulk of which come from a vehicle’s tailpipe, emitted as a result of the combustion of fossil fuels such as natural gas, petrol and diesel.
Asthma is among the world’s major non-communicable diseases and, according to the World Health Organisation (WHO), it affected an estimated 262 million people and resulted in over 45,000 deaths in 2019.
Traffic-related air pollution
Columbia Hospital Puchong consultant internal medicine and respiratory medicine physician Dr Jurina Mohd Hassan said in Malaysia, the prevalence of asthma in the adult population is estimated to range from 3.4 percent to 7.5 percent.
Citing global reports, she told Bernama in an email interview that in 2022 there were nearly two million new cases of paediatric asthma caused by traffic-related air pollutants, particularly fossil fuel emissions from vehicles.
“People with asthma are at greater risk from breathing in small particles which can worsen their condition,” she said, adding that the long-term effects of air pollution, particularly CO emissions, on asthma patients include heart disease, lung cancer and respiratory diseases such as emphysema.
It can also cause long-term damage to people’s nerves, brain, kidneys, liver and other organs.
“In fact, some scientists suspect air pollutants cause birth defects. Clinically as a medical practitioner, I have seen an increase in the number of (cases pertaining to) asthma exacerbation in the urban population, more so during haze (occurrences),” she said.
Dr Jurina said haze events have also shown to cause immediate and delayed effects on mortality with more than 10,000 respiratory mortality events recorded during a total of 88 haze days between 2000 and 2007.
“Although there is an increase in overall evidence for the case of air pollution affecting human health but in Malaysia currently, there are relatively few studies focusing on asthma or respiratory illnesses,” she said.
She added people with asthma should limit their time outdoors, especially from 11 am to 8 pm, during periods when high air pollution index levels are recorded.
“Asthma patients should stay in well-ventilated, preferably air-conditioned buildings, during such periods and avoid exercising in areas situated close to industries and high-traffic roads,” she said.
Children’s respiratory health
United Nations Children’s Fund (UNICEF) Malaysia Youth Climate Champions consultant Mogesh Sababathy said there are numerous studies highlighting the vulnerability of children to respiratory illnesses caused by exposure to environmental pollutants.
“These pollutants, often resulting from the burning of fossil fuels which release CO, can be exacerbated by the effects of climate change.
“The negative effects on children’s respiratory health are alarming as it can lead to inflammation of the airways, compromised lung function and an increased risk of respiratory infections.
“Consequently, children face a higher risk of developing conditions such as asthma and bronchitis which also have immediate impacts and long-term consequences on their health and well-being,” he said.
Meanwhile, Greenpeace Southeast Asia and the Centre for Research on Energy and Clean Air (CREA) in their 2020 report found that pollutants from fossil fuels such as coal, oil and gas – mostly emitted by vehicles, industries and open burning – are attributed to approximately 4.5 million premature deaths worldwide each year, a figure that is three times higher than the number of deaths caused by road accidents globally.
Their report also stated exposure to fossil fuel-generated PM2.5 (particulate matter less than 2.5 micrometres) alone attributed to an estimated 1.8 billion days of work absences each year worldwide due to severe illness.
Commenting on the danger posed by CO emissions, Universiti Kebangsaan Malaysia Department of Earth Sciences and Environment senior lecturer Associate Prof Dr Mohd Shahrul Mohd Nadzir said what makes CO dangerous is that it is odourless and colourless, hence humans cannot detect its presence without special detectors.
He said CO is produced when fossil fuels such as petrol, gas or coal are burned incompletely.
“This gas can enter our bodies through our respiratory system and bind to the haemoglobin in our blood. When CO enters the body, it competes with oxygen to bind to the haemoglobin, as a result of which our blood cannot efficiently carry oxygen throughout our body, especially to the brain.
“If the level of CO in the blood is high, organs and tissues in our body will not receive enough oxygen to function properly, which also can lead to serious health problems including brain and internal organ damage,” he explained.
Mohd Shahrul said vehicle engines produce CO levels of over 30,000 parts per million (ppm) in the exhaust stream before catalytic conversion.
“Exhaust pipe leaks can allow CO to escape before it is converted to non-toxic CO during catalytic conversion. CO leaking from the exhaust system can enter the vehicle through openings (in the vehicle) or open windows and doors,” he added.
In Malaysia, there have been cases of deaths occurring due to carbon monoxide poisoning. One of the cases involved four 21-year-old college students who decided to take a nap in their car at a petrol station on their way back from vacationing in Pulau Jerejak, Penang, three years ago. They left their car’s air-conditioning and engine on and windows up. Little did they know there was a leak in the exhaust system which pumped CO into their car cabin. Three of them died from carbon monoxide poisoning and only one survived.
Carbon monoxide detectors
Mohd Shahrul said to avoid carbon monoxide poisoning as well as reduce the risks for those with chronic respiratory diseases such as lung infections and asthma, it is essential to install CO detectors or sensors in vehicles, homes and other places that may be exposed to this gas.
“Currently, Industry 4.0 and the Internet of Things technologies have come up with advanced sensors, allowing them to be installed in vehicles, buildings and other environments for real-time CO concentration detection.
“With this detection capability, gas leaks can be detected early and preventive actions can be taken before they reach hazardous levels,” he said, adding that UKM’s Atmospheric Science Research Group has developed an indoor CO sensor that can be installed in various types of vehicles and homes.
He added the usage of electric vehicles (EV) can have a positive impact on the respiratory health of city dwellers.
“However, although Malaysia is slowly introducing EVs and encouraging people to use them, their prices are still high and not everyone can afford them,” he said. – BERNAMA
