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Water, pollution, and public health in China
limit industrial discharges, municipal jumped at the opportunity for a sewage treatment systems are often leisurely day-long excursion to too expensive for us to build”, Hongfeng Lake in the southwestern explained Han Lanquan, director of a Guizhou Province. “This lake is an local Guizhou research institute. In example of how healthy our environmany Chinese cities, even when the ment is”, boasted my Chinese collocal government is able to finance the leagues. As I gazed out over construction of treatment facilities, Hongfeng’s serene waterscape, my eye operating costs was relentlessly are so high that drawn to the fac“over 30 billion tons of urban the plant often sits tory at the water’s sewage are discharged into idle or runs below edge; not only did China’s rivers, lakes, and seas capacity at a rate it haze the air with determined not by putrid fumes, it each year, with between 2·7 public-health conalso discharged a and 10% receiving no prior siderations, but steady stream of treatment” by budget conuntreated pollustraints. tants directly into Studies show that over 30 billion the lake. The stark difference between tonnes of urban sewage are discharged my impressions of this scene and into China’s rivers, lakes, and seas those of my Chinese colleagues each year, with between 2·7 and 10% underscores the challenges in awarereceiving no prior treatment. On ness and expectation presented by Aug 8 this year, the World Bank China’s severe water pollution probreported that despite double-digit lems and their link to human health. growth of municipal wastewater With 22% of the world’s populatreatment capacity over the last tion, but only 8% of its fresh water, decade, Chinese cities continue to be estimates indicate that 700 million underserved by sewers and wasteChinese people drink water that does water treatment plants. Untreated not meet their government’s minisewage contains large numbers of mum safety standards. The summer pathogenic micro-organisms such as 2000 China Environment Series Journal schistosomial ova, cercaria, and ova reported that the condition of China’s of parasitic flukes and worms. Many public water supply exacerbates of China’s wastewater treatment waterborne infections and parasitic plants must serve at least 1·5 million diseases such as hepatitis A, diarpeople per day. This situation conrhoeal diseases, typhoid, roundworm, trasts with the UK and Germany, guinea worm, leptospirosis, schistosomiasis, ascaris, hookworm, trachoma, and dracunculiasis. Rapid and unregRights were not granted ulated industrial growth, urbanisation without adequate investment in water to include this image in supply infrastructure, and electronic media. Please increased use of pesticides and fertilisers in conjunction with untreated refer to the printed human and animal waste-based irrijournal. gation compromise the critical role that water plays in Chinese public health. The Chinese Journal of Hygiene Health reported in 1992 that lead concentrations in seven major Dirty water Chinese cities were 3600–5216% where a single facility serves higher than the legally permissible 7000–8000 people per day. Until the standard. late 1990s in the Huai River Basin in As our pleasure craft slid across Henan Province, for example, there Hongfeng Lake, clumps of human was only one municipal wastewater faeces dotted the water’s surface as treatment plant to handle a populauniformly as an embossed pattern on tion of 150 million. Epidemiological smooth rice paper—even in those research done by the Henan areas farthest from the shore. Provincial Medical College revealed Embarrassed colleagues admitted that that 70% of some parts of the Huai the municipal waste facilities were not river is wastewater. Scientists believe adequate to deal with industrial disthis figure has contributed to a charges and waste from rapidly urbanregional death rate that is 30% higher ising towns nearby. “While we are than the national average. improving our ability to monitor and
I
THE LANCET • Vol 358 • September 1, 2001
Polluted groundwater is a related and burgeoning public health threat. Groundwater supplies are increasingly contaminated with nitrite and ammonia from sewers and overflowing septic systems. Pesticides and fertilisers from agricultural fields also seep underground, polluting the only available source of drinking water for millions, especially in rural areas where dependence on well water is absolute. Regional experts assert that in the Hai River Basin, pollutants started to seep into groundwater supplies in the 1990s due to the heavy concentration of industry in the area. Residents complained of a layer of oil on the top of groundwater they pumped up, and intestinal and liver ailments in the region began to rise. Improper and unsupervised disposal of hazardous waste and leaking underground storage tanks have made groundwater pollution more severe. The Chinese leadership is aware that something needs to be done. Nearly every day, Chinese newspapers report either ambitious new plans for treatment facilities or more stringent rules to curb industrial effluents. The ministry of construction has threatened to withhold operating permits from companies not complying with regulations. Wastewater fees have also begun to be imposed on urban citizens, although the amounts are insufficient. National and local governments are now recognising the need to explore new ways to finance infrastructure construction and expansion. Enforcement of laws is often ineffective because priority is consistently placed on economic development. What is pushing the government to act is the mounting public pressure to improve filthy and unsanitary drinking water conditions and the sobering economic-loss projections stemming from lack of industrial water supply and a labour force in poor health. According to some sources, over 50% of total government spending for environmental protection in the coming years will be devoted to wastewater treatment in an effort to improve water quality. But even this will fall woefully short of demand. Beyond incentives and disincentives to curb water usage, waste, and pollution, more sorely needed is a more friendly financing system that allows public funds to be used in response to local needs to develop local facilities.
Panos Pictures
BEIJING
Marilyn Beach
735
For personal use. Only reproduce with permission from The Lancet Publishing Group.
Water, pollution, and public health in China
limit industrial discharges, municipal jumped at the opportunity for a sewage treatment systems are often leisurely day-long excursion to too expensive for us to build”, Hongfeng Lake in the southwestern explained Han Lanquan, director of a Guizhou Province. “This lake is an local Guizhou research institute. In example of how healthy our environmany Chinese cities, even when the ment is”, boasted my Chinese collocal government is able to finance the leagues. As I gazed out over construction of treatment facilities, Hongfeng’s serene waterscape, my eye operating costs was relentlessly are so high that drawn to the fac“over 30 billion tons of urban the plant often sits tory at the water’s sewage are discharged into idle or runs below edge; not only did China’s rivers, lakes, and seas capacity at a rate it haze the air with determined not by putrid fumes, it each year, with between 2·7 public-health conalso discharged a and 10% receiving no prior siderations, but steady stream of treatment” by budget conuntreated pollustraints. tants directly into Studies show that over 30 billion the lake. The stark difference between tonnes of urban sewage are discharged my impressions of this scene and into China’s rivers, lakes, and seas those of my Chinese colleagues each year, with between 2·7 and 10% underscores the challenges in awarereceiving no prior treatment. On ness and expectation presented by Aug 8 this year, the World Bank China’s severe water pollution probreported that despite double-digit lems and their link to human health. growth of municipal wastewater With 22% of the world’s populatreatment capacity over the last tion, but only 8% of its fresh water, decade, Chinese cities continue to be estimates indicate that 700 million underserved by sewers and wasteChinese people drink water that does water treatment plants. Untreated not meet their government’s minisewage contains large numbers of mum safety standards. The summer pathogenic micro-organisms such as 2000 China Environment Series Journal schistosomial ova, cercaria, and ova reported that the condition of China’s of parasitic flukes and worms. Many public water supply exacerbates of China’s wastewater treatment waterborne infections and parasitic plants must serve at least 1·5 million diseases such as hepatitis A, diarpeople per day. This situation conrhoeal diseases, typhoid, roundworm, trasts with the UK and Germany, guinea worm, leptospirosis, schistosomiasis, ascaris, hookworm, trachoma, and dracunculiasis. Rapid and unregRights were not granted ulated industrial growth, urbanisation without adequate investment in water to include this image in supply infrastructure, and electronic media. Please increased use of pesticides and fertilisers in conjunction with untreated refer to the printed human and animal waste-based irrijournal. gation compromise the critical role that water plays in Chinese public health. The Chinese Journal of Hygiene Health reported in 1992 that lead concentrations in seven major Dirty water Chinese cities were 3600–5216% where a single facility serves higher than the legally permissible 7000–8000 people per day. Until the standard. late 1990s in the Huai River Basin in As our pleasure craft slid across Henan Province, for example, there Hongfeng Lake, clumps of human was only one municipal wastewater faeces dotted the water’s surface as treatment plant to handle a populauniformly as an embossed pattern on tion of 150 million. Epidemiological smooth rice paper—even in those research done by the Henan areas farthest from the shore. Provincial Medical College revealed Embarrassed colleagues admitted that that 70% of some parts of the Huai the municipal waste facilities were not river is wastewater. Scientists believe adequate to deal with industrial disthis figure has contributed to a charges and waste from rapidly urbanregional death rate that is 30% higher ising towns nearby. “While we are than the national average. improving our ability to monitor and
I
THE LANCET • Vol 358 • September 1, 2001
Polluted groundwater is a related and burgeoning public health threat. Groundwater supplies are increasingly contaminated with nitrite and ammonia from sewers and overflowing septic systems. Pesticides and fertilisers from agricultural fields also seep underground, polluting the only available source of drinking water for millions, especially in rural areas where dependence on well water is absolute. Regional experts assert that in the Hai River Basin, pollutants started to seep into groundwater supplies in the 1990s due to the heavy concentration of industry in the area. Residents complained of a layer of oil on the top of groundwater they pumped up, and intestinal and liver ailments in the region began to rise. Improper and unsupervised disposal of hazardous waste and leaking underground storage tanks have made groundwater pollution more severe. The Chinese leadership is aware that something needs to be done. Nearly every day, Chinese newspapers report either ambitious new plans for treatment facilities or more stringent rules to curb industrial effluents. The ministry of construction has threatened to withhold operating permits from companies not complying with regulations. Wastewater fees have also begun to be imposed on urban citizens, although the amounts are insufficient. National and local governments are now recognising the need to explore new ways to finance infrastructure construction and expansion. Enforcement of laws is often ineffective because priority is consistently placed on economic development. What is pushing the government to act is the mounting public pressure to improve filthy and unsanitary drinking water conditions and the sobering economic-loss projections stemming from lack of industrial water supply and a labour force in poor health. According to some sources, over 50% of total government spending for environmental protection in the coming years will be devoted to wastewater treatment in an effort to improve water quality. But even this will fall woefully short of demand. Beyond incentives and disincentives to curb water usage, waste, and pollution, more sorely needed is a more friendly financing system that allows public funds to be used in response to local needs to develop local facilities.
Panos Pictures
BEIJING
Marilyn Beach
735
For personal use. Only reproduce with permission from The Lancet Publishing Group.