Air Pollution Has Long-Lasting Effects on Health Across Kazakhstan

When one thinks of air pollution in Kazakhstan, the image that pops to mind is the thick layer of smog that engulfs Almaty for about six months every year. In a recent academic article written for the International Journal of Chronic Obstructive Pulmonary Disease, researchers from Al-Farabi Kazakhstan National University showed that air pollution is a problem that extends beyond Almaty and could cause long-lasting respiratory effects on the population.

Chronic obstructive pulmonary disease (COPD) is one of the leading causes of mortality in the world.

Vlast sat down with professor Denis Vinnikov, head of the environmental health lab at Al-Farabi Kazakhstan National University, to talk about the most recent scientific findings on air pollution in Kazakhstan.

Photo: Zhanara Karimova.

Let’s start by talking about the challenges of researching air pollution. What kind of questions are relevant?

Air pollution combines health issues, administration, and policy. But also finance, policy, and socio-economic aspects. Researching air pollution is always a very complex task, because it involves a wide range of stakeholders. When doing health-related research in the field of air pollution, we face a lot of barriers, because when you find something, you have to fit it into the current socio-economic context and you also have to think about the consequences that it may entail.

So you can look at mortality, or more widely at chronic and acute diseases, but in fact air pollution affects everything in the human body, from the lungs to mental health. At our lab, we focus on respiratory diseases.

Importantly, we have to keep in mind that the issue is not only ambient or atmospheric air pollution. We need to also consider other factors, such as smoking and exposure to second-hand smoke, or indoor air pollution. And for each specific source there could be a set of specific policies.

This particular study assesses the combined effect of smoking, workplace exposure to air pollution, and a past medical history of tuberculosis as predictors of the probability of getting COPD.

What does it actually mean to get COPD?

COPD is a progressive disease. Once it develops, you cannot do anything about it. You can only try to stop its progression, for example by quitting smoking. But the burden of COPD is tremendous, colossal. On a societal level, people tend to underestimate the burden of COPD.

Several factors contribute to this: very poor access to high-quality spirometry in our country translates into underdiagnosis, which in turn undermines awareness. We estimate that underdiagnosis means that the reported cases are 17 times lower than the real number, which we find. That’s massive.

In Kazakhstan's social context, I see that people do not appreciate health as the most important asset in their lives. But another, worrisome, systemic issue is poor financing of the medical services, which in turn is correlated with relatively low qualification of medical personnel. Add to this the low socioeconomic status of the population, and you have higher incidence of diseases and higher mortality.

Photo courtesy of Denis Vinnikov.

When it comes to air pollution sources, where do we begin?

We know all of the sources of air pollution. We don’t know the specific proportion of their individual impact. The components of air pollution vary between seasons, according to a specific location or exposure.

But this is a matter of scientific and political debate. This is because, for politicians, it is extremely uncomfortable to acknowledge that the main source of air pollution in Almaty is poverty. Poor people cannot gain access to gas or other cleaner sources of energy, because these are expensive.

Officially, 100% of the Almaty population is linked to the gas grid for heating. In fact, however, people don’t use gas, because they simply don't have money to pay for it. If all these residents were connected to the gas lines, where would all this pollution come from? People who cannot afford gas burn coal to heat their homes and all that smoke travels to Almaty.

And that’s a political issue. Because the authorities would have to acknowledge that poverty results in the use of biomass for heating. Instead, the government insists that the major source of ambient air pollution in Almaty is transportation.

“It is extremely uncomfortable to acknowledge that the main source of air pollution is poverty.”

They recently announced that they want to limit cars to either odd or even number plates on certain days in Almaty. That’s another sign that the authorities don’t have a clue. They don't understand what the sources of air pollution are.

Let me clearly state this: We have completely distinct pictures according to the season. In the winter, when the city-wide heating system is on, and in summer, when it’s off. This is a scientific assessment, not a political claim. There is clear evidence of this.

In winter, ambient air pollution of particulate matter is very high (the so-called PM2.5 levels we see recorded in services such as IQAir – V.). In this context, transportation does not really contribute that much to that pollution, because the major pollutant is the smoke from burning biomass.

We consider the summer “the clean season” because of the absence of air pollution from biomass combustion. But here we do see a greater contribution of transportation in overall air pollution levels.

And transport also carries different kinds of polluting components.

We have to keep in mind that the chemical composition and the structure of the pollutants matters, not just the season.

Transportation pollutes the air not with particulate matter, but with gaseous pollutants such as NOx and SOx. Diesel engines produce ultra-fine particulate matter, which is very small, less than 0.8 micrometers.

But biomass and fossil fuel combustion in winter contribute much more than diesel emissions from transport in the overall composition of air pollution. In the summer, the picture is different. Therefore, there’s no straightforward source of pollution to blame. It’s all of it, the coal power plants, coal use in private housing, transportation… they interact with each other.

But still, the high burden of respiratory and cardiovascular diseases and mortality comes from these high winter levels of particulate matter, because it’s constant and the levels of pollution are so high.

Is there a discrepancy between official data and data collected by scientists?

Our data show that the concentration of pollutants is several times higher than officially reported by [state meteorological service] Kazhydromet. But they never acknowledge that, in fact, they dispute other scientific evidence as well.

When you arrive in Almaty by plane in the month of January or February, when landing, you see that the city is completely covered with a carpet of air pollution. On those days, Kazhydromet says that the concentration is just twice the maximum level. But double concentration does not affect visibility. That means that pollution is several times higher than reported.

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