Environmental Research 92 (2003) 7177

Review of air pollution and health impacts in Malaysia

Raa Afroz,a, Mohd Nasir Hassan,a and Noor Akma Ibrahimb
a

Department of Environmental Sciences, Faculty of Science and Environmental Studies, University Putra Malaysia 43400 UPM, Serdang Selangor D.E., Malaysia b Institute for Mathematical Research, University Putra Malaysia, Serdang Selangor D.E., Malaysia Received 7 June 2001; received in revised form 28 October 2002; accepted 31 October 2002

Abstract In the early days of abundant resources and minimal development pressures, little attention was paid to growing environmental concerns in Malaysia. The haze episodes in Southeast Asia in 1983, 1984, 1991, 1994, and 1997 imposed threats to the environmental management of Malaysia and increased awareness of the environment. As a consequence, the government established Malaysian Air Quality Guidelines, the Air Pollution Index, and the Haze Action Plan to improve air quality. Air quality monitoring is part of the initial strategy in the pollution prevention program in Malaysia. Review of air pollution in Malaysia is based on the reports of the air quality monitoring in several large cities in Malaysia, which cover air pollutants such as Carbon monoxide (CO), Sulphur Dioxide (SO2), Nitrogen Dioxide (NO2), Ozone (O3), and Suspended Particulate Matter (SPM). The results of the monitoring indicate that Suspended Particulate Matter (SPM) and Nitrogen Dioxide (NO2) are the predominant pollutants. Other pollutants such as CO, Ox, SO2, and Pb are also observed in several big cities in Malaysia. The air pollution comes mainly from land transportation, industrial emissions, and open burning sources. Among them, land transportation contributes the most to air pollution. This paper reviews the results of the ambient air quality monitoring and studies related to air pollution and health impacts. r 2003 Elsevier Science (USA). All rights reserved.
Keywords: Air pollution; Sources of air pollution; Air quality; Ambient air quality guideline; Health Impact

1. Introduction Malaysia has enjoyed one of the least polluted urban environments in Asia. The goal of achieving industrial country status by the year 2020 and the associated rapid economic growth have started to impose costs in terms of industrial pollution and the degradation of urban environment. Depletion of sheries, air and water pollution, and contamination by industrial wastes have become more serious in Malaysia in recent years. Among them, air pollution is the major issue that has been affecting human health, agricultural crops, forest species, and ecosystems. Monitoring data and studies on ambient air quality show that some of the air pollutants in several large cities are increasing with time and are not always at acceptable levels according to the national ambient air quality standards. Data on air pollution and case studies are very limited in Malaysia. This paper

reviews the results of ambient air quality monitoring and studies related to air pollution in Malaysia and its impact on human health.

2. Sources of air pollution The three major sources of air pollution in Malaysia are mobile sources, stationary sources, and open burning sources. For the past 5 years, emissions from mobile sources (i.e., motor vehicles) have been the major source of air pollution, contributing to at least 7075% of the total air pollution. Emissions from stationary sources generally have contributed to 2025% of the air pollution, while open burning and forest res have contributed approximately 35%. According to the Department of the Environment (DOE, 1996), Malaysia, in 1996, the percentages, of the air emission load by type were motor vehicles, 82%; power stations, 9%; industrial fuel burning, 5%; industrial production processes, 3%; domestic and commercial furnaces,

Corresponding author. E-mail address: raafroz@hotmail.com (R. Afroz).

0013-9351/03/$ - see front matter r 2003 Elsevier Science (USA). All rights reserved. doi:10.1016/S0013-9351(02)00059-2

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Fig. 1. Sources of air pollution in Malaysia, 1996. Source: Department of the Environment (1997).

0.2%; and open burning at solid waste disposal sites, 0.8% (Fig. 1). Mobile sources include motor vehicles such as personal cars, commercial vehicles, and motorcycles. By the end of 2000, there were 10.6 million vehicles registered in Malaysia, compared to 7.7 million in 1996, an increase of almost 2.9 million vehicles or 26% (Department of Environment (DOE), 2001). The federal territory of Kuala Lumpur has the highest vehicle population followed by Johor, Selangor, Perak, and Pulau Pinang. These conditions have caused severe congestion in almost all parts of the highway network and corridors, especially in the central business areas, and inevitably the environment in these areas has deteriorated due to exhaust emissions from motor vehicles. The DOE found that after the economic recession of 19861988, the number of registered vehicles increased at a faster rate, i.e., from a 3.3% increase in 1987 to a 9.5% increase in 1990. During the same period of time, the study revealed that the level of air pollutants in Kuala Lumpur and Selangor increased rapidly after the economic recession. In Malaysia, private cars are the most important contributor of atmospheric pollutants. They contribute about 75% of the total CO and SPM, as well as about 7679% of the oxides of sulfur and nitrogen (DOE, 1991). Two recent accomplishments will reduce the negative impact of mobile sources on air quality: the approval of new environmental regulation amendments the Environmental Quality Act (EQA), and the phase-out of leaded gasoline sales. A signicant rst step toward implementing Malaysias Clean Air Plan was achieved in 1996 with the approval of two regulations designed to reduce emissions from mobile sources: The Environmental Quality (Control of Emissions from Diesel Engines) Regulations 1996 and the Environmental Quality (Control of Emissions from Petrol Engines) Regulations 1996. The new regulations focus on prevention by controlling vehicular emissions at the manufacturing or assembly stage. The emissions standards in the new

Table 1 Percentage of market share, leaded/unleaded gasoline Retail sales Leaded gasoline unleaded Gasoline (ULG)
a

1994 52 48

1995 32 68

1996 24 76

1997 20 80

Year-end 1998 0a 100

Leaded gasoline sales phased out by year-end 1998. Source: Department of the Environment (2001).

regulations are based on the European Economic Commission on Standards. The nation-wide retail sale of leaded gasoline has been declining as a percentage of total sales over the past few years, as shown in Table 1. This reduced market share combined with the availability of appropriate additives has allowed fuel suppliers to agree to cease the sales of leaded gasoline altogether. Ofcially, all petroleum companies in Malaysia must stop the production and sale of leaded gasoline by the year 2000. Reduced leaded gasoline sales are believed to be responsible for a steady decrease in lead levels throughout the western side of peninsular Malaysia. Over the next few years, this reduction may be offset by the increase in the sheer number of motor vehicles on the road, especially in urban areas. Stationary sources are related to industry, power stations, industrial fuel burning processes, and domestic fuel burning. Most of the stationary sources in Malaysia reside in Selagor, followed by a signicant number of sources in Sarawak, Johor, Sabah, Perak, and Pahang. Increased activity from the industrial sector has been accompanied by an increased use of energy and commodities trafc. Most of the small and mid-sized industries do not install pollution control equipment. This increases the emission of pollutants, especially in the industrial areas, which in some cases contributes specic pollutants to the air. Moreover, small industries are generally located in

R. Afroz et al. / Environmental Research 92 (2003) 7177 Table 2 Stack gas emission standards Emission source Dark smoke Solid fuel equipment Other fuel types Dust Metal and metallic compounds Mercury Cadmium Lead Antimony Arsenic Zinc Gases Acid gases Sulfuric acid mist, SO3 Chlorine gas HCl Florine Hydrogen sulde NOx Standard Ringlemann Chart No. 2 Ringlemann Chart No. 1 0.10.4 gm/Nm3 (source dependent) 0.01 gm/Nm3 Table 3 The Malaysia air pollution index API 050 50100 101200 201300 301500 Source: Department of the Environtment (1996). 0.015 gm/Nm3 0.025 gm/Nm3 0.025 gm/Nm3 0.025 gm/Nm3 0.1 gm/Nm3 0.1 gm/Nm3 Diagnosis

73

Good Moderate Unhealthy Very unhealthy Hazardous

3.5 g of SO3/Nm3 0.2 g of SO3/Nm3 0.2 g of Hcl/Nm3 0.4 g of Hcl/Nm3 0.3 hydrouoric acid g /Nm3 5 ppm (vol%) 1.72.0 g of SO3/Nm3 (source dependent)

Source: Department of the Environtment (1996).

power to issue contravention licenses for burning. Instead, there would be a specic list of prescribed activities authorized for open burning. The palm oil industry would receive further pressure to adopt technology to achieve zero burning in their land-clearing operations. Airborne surveillance is provided to the DOE through a joint airborne surveillance program with the police Air Wing. The objective is to conduct useful and speedy surveillance on activities violating the EQA, such as excessive smoke emissions from industries, cases of open burning at dumpsites, and uncontrolled forest res (US Department of Commerce, 1998).

3. Air quality in Malaysia populated areas where emission control is more problematic. To overcome the problem, the EQA lists the following standards for stack gas emissions (Table 2). Open burning sources of air pollution in Malaysia include the burning of solid wastes and forest res. This is common at some poorly managed disposal sites and results in smoke and y ash problems. Over the last several years between July and September signicant amounts of particle matter have been transported by south-westerly winds from a neighboring country due to uncontrolled biomass burning activities. As a consequence, serious haze events were recorded in peninsular Malaysia, Sabah, and Sarawak in 1991, in 1994, and, most recently, during September and October of 1997. The cause of the 1997 haze was large-scale forest and plantation res, particularly in southern Sumatra and central Kalimantan, both in neighboring Indonesia. Haze conditions are aggravated by local emissions from motor vehicles, industries, and open burning activities. At its worst, the haze limits visibility to less than 500 m and produces respirable particles of concentrations up to 500 g/m3 (ve times the level considered unhealthy). The DOE is considering an amendment to the EQA to implement stiffer penalties for open burning. The maximum ne would be raised from RM 100,000 to RM 500,000 (US$ 25000 to US$1250,00). The bill would go beyond industrial responsibility, making landowners and land occupiers responsible for open burning on their property. The bill would also do away with the DOEs Ambient air quality standards identify individual pollutants and the concentrations at which they become harmful to the public health and the environment. The standards are typically set without regard to economic feasibility for attainment. Instead, they focus on public health, including the health of sensitive populations such as asthmatics, children and the elderly, and public welfare, including protection against decreased visibility and damage to animals, crops, vegetation, aquatic resources, and buildings. The Malaysian air pollution index (API) is obtained from the measurement of ne particles (below 10 mm) and several gases: carbon monoxide, sulfur dioxide, and nitrogen dioxide. Table 3 shows the API for Malaysia. Based on API readings throughout the country, the air quality has been considered generally good. In the urban environment of the Klang Valley, the index also has generally been between good and moderate, except for serious haze events in September and October. The bad air days of 1997 combined with the hosting of the Commonwealth Games in September 1998 provided as incentive for the installation of eight more air quality monitoring stations, bringing the new total to 39. Table 4 lists the recommended Malaysian Air Quality Guidelines (Ambient Standards) and compares them with the National Ambient Air Quality Standards currently enforced in the United States and WHO guidelines. The Malaysian guidelines are fairly consistent with the standards of the United States.

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Table 4 Ambient air quality standards-Malaysia and the United States Air pollutants Carbon monoxide 8-h average 1-h average Nitrogen dioxide (NO2) Annual 1-h average Ozone (O3) 8-h average 1-h average Particulate matter Annual 24-h average Sulfur dioxide (SO2) Annual 24-h Malaysia (mg/m3) 10,000 35,000 USA (mg/m3) 10,000 40,000 WHO (mg/m3) 10,000 30,000

Sekitar Malaysia Sdn Bhd (ASMA) also manages the Environmental Data Center, which provides environmental data to the DOE and other interested parties. In 1996, 10 new fully automated ambient air quality monitoring stations with telemetric systems were installed, bringing the total number of stations up to 31.

320

100

400

5. Air pollution studies in Malaysia In Malaysia, few studies have been conducted on air pollution. Most of them are related to the 1997 haze episode. In most years, the Malaysian air quality was dominated by the occurrence of dense haze episodes. From July to October 1997, Malaysia was badly affected by smoke haze caused by land and forest res. Previous incidents of severe haze in the country were reported in April 1983 (Chow and Lim, 1983), August 1990 (Cheang, 1991; Sham, 1991), June and October 1991 (Cheang, 1991), and August to October 1994 (Yap, 1995). The severity and extent of the 1997 smoke haze pollution were unprecedented, affecting some 300 million people across the region. The actual amount of economic losses suffered by countries in the region during this environmental disaster were enormous and are yet to be fully determined. During nonhaze episodes, vehicular emissions accounted for more than 70% of the total emissions in the urban areas. Air quality studies conducted in the Klang Valley during the nonhaze episodes between 1986 and 1989, December 1991 to November 1992, and January 1995 to December 1997 demonstrated two distinct daily peaks in the diurnal variations in the concentrations of sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide, and particulate matter. The morning hour peak was due mainly to vehicle emissions and the late evening peak was attributed mainly to meteorological conditions, including atmospheric stability and wind speed. Total suspended particulate matter was the main pollutant; the concentrations at a few sites in the Klang Valley often exceeded the Recommended Malaysian Air Quality Guidelines. A comprehensive study conducted by the Department of the Environment, Japan International Cooperation Agency, the Malaysian Meteorological Service, and University Putra Malaysia between December and August 1993 gave clear indications that air pollution in the Klang Valley was becoming worse. This study also indicated that if no effective countermeasures were introduced, the emissions of sulfur oxides (SO), nitrogen oxides (NO), particulate matter, hydrocarbons, and carbon monoxides (CO) in the year 2005 would increase by 1.4, 2.12, 1.47, and 2.7 times, respectively, the 1992 levels (Awang et al., 1997). A separate study of air quality in Kuala Lumpur found that the smoke haze was associated with high levels of suspended microparticulate matter, but with

120 200

240

100 150

90 150

50 150

105

80 365

Source: Department of the Environtment (1996).

4. Ambient air quality monitoring In the early days of Malaysia, development and growth were not planned; they were initiated according to the needs and pressures of the time. Consequently, this haphazard development has resulted in negative impacts on the environment as a whole and on air quality in particular (Sham, 1994). Earlier, Sham (1979) pointed out that the atmospheric pollution problem is becoming more serious, as there is always a potential for the occurrence of inversion in the valley. In anticipation of the potential severity and magnitude of the problem, the government enacted into law the Environmental Quality Act in 1974; subsequently, the Division of the Environment was established and the Clean Air Regulations were formerly gazetted in 1978. The rst long-term air quality monitoring project emphasizing suspended particulate and sulfur dioxide was carried out by the DOE and the Meteorological Service Department (MMS) at the industrial and residential zones in Petaling Jaya in 1978. Results of the study suggested that the suspended particulates exceeded 93% of the time in the industrial zone (the previously proposed standard was a 24-h average of 100 mg/m3) and 95% of the time in the residential zone (the then-proposed standard was 50 mg/m3 (DOE, 1997). Sulfur dioxide was generally low near the industrial site. In April 1995, Alam Sekitar Malaysia Sdn Bhd (ASMA) was awarded a 20-year privatization concession to install, operate, and maintain a network of 50 continuous air quality monitoring stations (and 10 water stations) throughout Malaysia for the DOE. Alam

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relatively low levels of other gaseous pollutants such as carbon monoxide, nitrogen dioxide, sulfur dioxide, and ozone (Awang et al., 2000; Noor, 1998). During this period, the PM10 concentration rose beyond the Malaysian Air Quality Guideline (MAQG, 1989) level in almost all areas monitored. It increased 4-fold higher in the Klang Valley and up to 20-fold in Kuching (Awang et al., 2000). In a study coordinated by the Department of the environment to determine the origin, formation, and composition of aerosol haze in Malaysia (Department of the Environment, 1997), approximately 200 representative samples collected by the Malaysian Meteorological Service for total suspended particulate and PM10 measurements during the haze episode in 1994 and in the nonhaze years 1995 and 1996 were analyzed by particle-induced X-ray emission at NERI in Denmark. The objective of the study was to apportion the sources of the 1994 haze episode based on two mechanism that had been proposed for the explanation of the haze episode. The rst mechanism relates to the more stable atmospheric conditions that exist in the dry season. This would allow the rather continuous emissions from trafc and industry to build up high local concentrations of pollutants. This could explain why the heavily industrialized Klang Valley during haze episodes, often was more polluted than other parts of the country, during haze episodes, but it does not explain why some localities with little trafc and industries, such as Kuching in Sarawak, in some years were polluted with suspended particulate matter at levels of the same magnitude as in the Klang Valley or even higher. The second mechanism relates to re in South Sumatra and the Kalimantan forests, which reoccur every year in the dry season but in some years, tend to get out of control. The results of the analysis ruled out the rst mechanism, as there was a poor correlation with lead, which are the marker for local pollution. The good correlation with sulfur supports, on the other hand, the casual relation with forest res or other biomass burning, as sulfur and potassium are the essential constituents in biomass. The Suspended Particulate Matter (SPM)/sulfur ratios found at geographically widespread locations in peninsular Malaysia (Penang, Kuantan, Klang Valley, and Johor) were very much the same, corresponding to almost constant contents of sulfur in the SPM (mass ratio 78%). This pointed to a common origin (and/or type) of source, possibly the reported forest res in South Sumatra. The high levels found in the Klang Valley could have been due to the combined effects of the geographical vicinity of the source area, an unfortunate position in the prevailing direction of the wind ow, and possibly some trapping of the biomass burning plume (4%). This pointed to a different biomass burning source, probably res in Kalimantan. The results also showed that pollution not related to biomass burning was not imperceptible in

Kuantan and Kuchhing, as the intercept SPM values were not signicantly different from zero. The highest level of nonbiomass related pollution was found in Petaling Jaya with an intercept level of 5078 mg/m3 (Awang, 1998).

6. Health impacts of air pollution in Malaysia There are possible short-term and long-term health effects of exposure to air pollution. In the short term, high levels of air pollution lead to an acute condition. In addition, blockage of sunlight may promote the spread of harmful bacteria and viruses that would otherwise be killed by ultraviolet B (Beardsley et al., 1997). The possible long-term health effects of exposure to air pollution are unknown and difcult to detect. Components of smoke haze, including polycyclic aromatic hydrocarbons, are known carcinogens the effects of which may not be apparent for years. The consequences may be more severe for children, for whom the particulates inhaled are high relative to body size. There are a very limited number of studies that relate air pollution to its health impact in Malaysia. The lack of data gathering for environmental epidemiological analysis makes it difcult to estimate the health impact of air pollution. Recent studies in this country have examined possible health effects of the 1997 forest res. For example, outpatient visits in Kuching, Sarawak increased between two and three times during the peak period of smoke haze and respiratory disease outpatient visits to Kuala Lumpur General Hospital increased from 250 to 800 per day (World Health Organization, 1998). Data were assembled that indicated an increase in cases of asthma, acute respiratory infection, and conjunctivitis during AugustSeptember 1997 at a number of major hospitals in Kuala Lumpur (Brauer, M., and Jamal, H.H., 1998). For respiratory diseases, Selangor recorded a signicant increase in the total number of cases during the September haze. Asthma cases increased from only 912 in June to more than 5000 in September. The total number of acute respiratory infection cases increased from about 6000 to more than 30,000 during the same period. Apart from respiratory diseases, conjunctivitis increased signicantly during the haze period. In Selangor, the total number of increased from only 207 cases in June to as high as 3496 cases in October. The same trend was observed in Sarawak. In addition, the daily incidence of conjunctivitis in Sarawak during September was found to have a positive correlation with the API (representing PM10 concentration). However, the number of cases gradually decreased toward the June value as the concentration of PM10 began to decrease after September. When the air quality was almost back to the values of a nonhaze period in October, the number of cases returned to normal. The

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trend indicated that short-term exposure to high levels of PM10 was detrimental to human health (Awang et al., 2000). Effects were found to be greatest in children, the elderly, and people with pre-existing respiratory problem; youngsters are among the most resistant. A preliminary survey carried out among secondary school children in Kuala Lumpur and Klang revealed that less than 50% of these school children sought medical treatment each time they fell sick (Awang et al., 2000). A study conducted by Nasir et al. (2000) suggested that in the 1997 haze episode the total health effects were estimated to include 285,227 asthma attacks, 118,804 cases of bronchitis in children, 3889 cases of chronic bronchitis in adults, 2003 respiratory hospital admission, 26,864 emergency room visits, and 5,000,760 restricted activity days. The whole population from all states in the country was at risk except Perlis, Kelantan, and Sabah. The total health damage cost was signicantly high due to the long duration of the haze. The results show that restricted activity days accounted for about 79.3% of the health damage cost while asthma attack contributed 10.7% to the total health damage cost (Fig. 2). The contributions of the other three health effects such as respiratory, hospital admission, emergency room visits, and chronic bronchitis were insignicant. Each of the above-mentioned effects actually contributed less than 1% of the total health damage costs. The total health damage costs were estimated to be RM 129 million, with a lower estimate of RM 36 million and a higher estimate of RM 258 million. Among the 11 states of Malaysia, Sarawak was badly hit by the particulate pollution with the largest number of health effects, which comprised 23.8% of the total health effect during the haze. The estimated health
90 79.34 80 70 60 Percentage(%) 50 40 30 20 10 0 Respiratory Hospital Admission Emergency Room Visits Restricted Activity Day

effects for Kuala Lumpur and Selangor during the haze were also high, since both states recorded an average PM10 of 170.6 and 131.22 mg/m3, respectively. Another study conducted by Othman and Shahwahid (1999) revealed that in the 1997 haze episode the population at risk was from all states of the country except in Kelantan, Terengganu, and Pahang; this population is estimated to be 18 million people. But the incidence of risk varied among states in terms of intensity and length of the haze. The incremental cost incurred by the population at risk for treatment of hazerelated illnesses from both public and private clinics and hospitals and for self-treatment (mainly the purchasing of medicine) was estimated to be RM 5.02 million during the period AugustOctober 1997. The incremental cost incurred for hospital admissions was estimated to be RM 1.18 million during the same period. This study also revealed that the country incurred productivity losses as a result of haze-related illnesses. These productivity losses occurred in foregone production opportunities during the idled workdays when workers were in hospital and on sick leave. Those not hospitalized and not granted sick leave, who managed to continue working are believed to have experienced reduced activity days arising from the haze-related illnesses they suffered. These sources of haze-related productivity losses are estimated to be RM 4.3 million.

7. Conclusions Studies related to air pollution conducted in Malaysia have been few. It is already 23 years since the Environmental Quality (Clean Air) Regulations 1978

10.7 5.67 0.88 0.94 Bronchitis in Children 2.28 0.19

Asthma Attack: Asthma Attack: Chronic Bronchitis Adult Children

Health Effects

Fig. 2. Percentage distribution of health damage costs. Source: Nasir et al. (2000).

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were introduced in the country. Many strategies, such as recycling, changes in engineering control equipment, and air cleaning systems, have been applied to improve air quality. Many studies can be conducted to evaluate the strengths, weaknesses, the impacts of the countrys adopted, regulations, programs, and strategies.

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