Nigeria has the highest maternal mortality in the world. It’s the country with highest number of extremely poor people in the world and now, it has the highest burden of fatalities from air pollution in Africa and 4th globally. By Shola Ogundipe, Health Editor There is a silent rage of air pollution in Nigeria. These days, the air quality is so bad it kills. Almost every breath taken is like the breath of death. Literally, air pollution is choking the life out of Nigerians. Indoors and outdoors, air pollution is killing more urban residents today than ever before. The air people breathe in Nigeria is more likely to cause harm than the air in any other country in Africa because Nigeria currently has the highest burden of fatalities from air pollution in Africa and 4th highest in the world with 150 deaths per 100,000 people attributable to pollution. According to the just released annual State of the Global Air Report published by the Health Effects Institute (HEI), air quality in Nigeria and at least 10 other countries is among the deadliest anywhere on earth with higher than ambient air pollution death rates as a result of the environmental hazards combined with extreme pollution sources like generator fumes, vehicle emissions and crop burning among others. The HEI chart notes that there were 150 deaths per age-standardized deaths per 100,000 people attributable to air pollution in Nigeria in 2016 (the latest year of available data), compared to high industrialised countries like China, 117 deaths per 100,000 people; Russia, 62 deaths per 100,000 people; Germany, 22 deaths per 100,000 people; United Kingdom, 21 deaths per 100,000 people; the United States, 21 deaths per 100,000 people; Japan 13 deaths per 100,000 people and Canada, 12 deaths per 100,000 people. Only Afghanistan with 406; Pakistan, 207, and India, 195 deaths per 100,000 people per country, exceed the Nigerian figure. The chart showcases a striking gap between the most and least polluted air around the world. While developed countries have experienced success in reducing emissions and air pollution levels, poorer nations have fallen behind, although it should be noted that tougher pollution controls are being introduced in some of the countries. In 1990, 3.5 billion people were exposed to it and that has now fallen to 2.4 billion despite an increase in the global population. The report notes that 95 percent of the world’s population is breathing unhealthy air. It said long-term exposure to air pollution contributed to just over 6 million deaths in 2016 with strokes, lung disease, lung cancer and heart attacks linked to many of them. After smoking, high blood pressure and poor diet, air pollution is the fourth-highest cause of death worldwide with most deaths occurring in developing countries. Air sustains life, but air could also snuff out life. With air you live, and with air you could die. In a number of the big Nigerian cities, when people present at the hospital with health problems including chest pain, dry throat, nausea, aggravated respiratory disease such as emphysema, bronchitis, lung damage, and asthma among other respiratory problems, it often turns out that they’ve been exposed to the effects of poor air quality. Symptoms such as irritation to the eyes, nose and throat, and upper respiratory infections such as bronchitis and pneumonia are also suspect. Air pollution increases the risk of cancer. There are two types of air pollutants – gas pollutants (e.g. carbon monoxide, sulphur dioxide, etc.) and particles in the air. Air particles can accumulate in the lungs. Air pollution is hardly listed among causes of death on death certificates in Nigeria, yet the health conditions linked to air pollution exposure, such as lung cancer and emphysema, are often fatal. According to a 2016 World Health Organisation report, Onitsha, Kaduna, Aba and Umuahia were among four of the 20 African cities with the worst air quality in the world. The WHO measured air quality by examining the annual mean concentration of particulate matter in nearly 3,000 cities across the world with populations of at least 100,000. Onitsha’s average annual PM10 was 594 – nearly 30 times greater than the WHO-recommended annual level of 20. Kaduna, Aba, and Umuahia cities were ranked among the top 20 worst cities measured by PM10, ranking 8th, 9th, and 19th, respectively. Air pollution is now the fourth-highest cause of death worldwide, trailing smoking, high blood pressure and diet, with the majority of deaths recorded in poorer nations with India and China leading the world in the total number of deaths attributable to air pollution in 2016 with 1.61 million and 1.58 million respectively. Data from the report show that ambient levels of unsafe air continue to exceed the Air Quality Guideline established by the World Health Organisation, WHO. In a typical scenario thick clouds of blackened smoke usually envelope large areas within Nigerian city suburbs as many smoky and noisy generators run throughout the day and all night. It’s a routine residents are familiar with – clouds of particulate-tinged smoke spreading, setting the pace for generator-induced illnesses and even death. Generator fumes comprise a lethal cocktail of poisonous and environmentally unfriendly gases, including carbon monoxide and other noxious products. Carbon monoxide could be a serious health hazard. Indoors or in close proximity, the gas quickly infiltrates living spaces and incapacitates occupants. All over town, worn out generators and vehicles with poorly-tuned engines are belching out smoke of noxious emissions, making the air as toxic on the streets as it is unhealthy in the kitchen at home where a kerosene stove burns sooty flames almost around the clock. A combination of incomplete combustion and lack of ventilation leads to high concentrations of particulate matter and other pollutants in the home and the resulting burden of household air pollution on human health. Rather than dispose refuse and some other wastes or unwanted materials some Nigerians burn them within their neighborhood. The problem is also manifesting in the rural areas due to burning of firewood and coal for cooking. Globally the estimated population relying on solid fuels has reduced but Nigeria remains among countries with populations exposed to household air pollution from dependence on solid fuel. Worse still, over 70 percent of the fuel in the country is generated from fossil fuel. Most Nigerians are thus exposed to household air pollution with fine particulate matter levels exceeding air quality guidelines by as much as 20 times. Air pollution from indoor sources is recognised as the single largest contributor to the negative health effects of air pollution in Nigeria.
While developed nations have been taking action to clean their air, Nigeria is still among the countries that have fallen behind as revealed in the death rate. Nigeria produces more than 3 million tons of waste annually, and uncontrolled waste burning is one of the practices that contribute to deteriorating air quality. Almost every Nigerian is exposed to air pollution levels exceeding WHO guidelines and inflicting significant air pollution damage costs. In Lagos for instance, an estimated seven million people died from diseases related to indoor and outdoor air pollution in 2012 according to the WHO. Part of the problem is that environmental regulations and enforcement are lax; people are more exposed to air pollution but less able to protect themselves from exposure either in the open, in the workplace or at home. No doubt, Nigeria requires tougher pollution controls if it hopes to effectively combat indoor air pollution by producing safer and more environmentally friendly alternatives. How clean the air is matters to your health. Increasing public awareness of air pollution and the burden of diseases that it imposes on individuals, families, and society is an essential step toward making the changes that will improve public health.