Environment and Health in China: Challenges and Opportunities

As the largest developing country in the world, China has achieved rapid economic development, averaging an annual gross domestic product (GDP) growth rate of 10% over the past two decades. But this success comes at the cost of deterioration of the environment. China's environmental problems, including outdoor and indoor air pollution, water shortages and pollution, desertification, and soil pollu tion, have become more pronounced and are subjecting Chinese residents to significant health risks. In Chinese cities, outdoor air pollution is the biggest environ mental challenge for public health. The source of air pollution in Chinese cities has gradually changed from conventional coal combustion to a mixture of coal-combustion and motor-vehicle emissions. Generally, China's current air pollution situation is similar to to that of developed countries in the 1960s. The annual average concentrations of inhalable particles [particles < 10 µm in aero dynamic diameter (PM 10)], sulfur dioxide (SO 2), and nitrogen dioxides (NO 2), the three criteria pollutants in China, were 89 µg/m 3 , 48 µg/m 3 , and 34 µg/m 3 , respectively, in 113 medium to large Chinese cities (Ministry of Environmental Protection of China 2009). Many studies have documented the adverse health effects of outdoor air pollution in China, including increases in respiratory symptoms, hospitalization, and premature mortality (Chen et al. 2004). The World Health Organization (WHO) estimated that outdoor air pollution was associated with approximately 300,000 premature deaths per year in China (Cohen et al. 2005), and Chinese scientists have given similar estimates (Zhang et al. 2008). In rural areas of China, coal and biomass fuels are still widely used in stoves and produce substantial indoor air pollution. The evidence for adverse health effects of solid fuels is strong, including lung cancer, acute respiratory infection, and chronic obstructive pulmonary disease (Zhang and Smith 2007). The WHO estimated that solid fuels used in Chinese households cause approximately 420,000 premature deaths annually (Smith et al. 2004). Water pollution is another cause for serious health concern in China, especially in rural areas. From 2000 to 2008, the quality of surface water worsened in northern China, where it improved slightly in southern China (Ministry of Environmental Protection of China 2009). In 2008, among 200 major rivers in China, water quality in 20.8% of 409 monitored sections was below grade V, the worst grade in the Chinese National Standard for Water Quality; water of this grade is virtually of no …