The Air We Breathe
A Public Health Dialogue
Presented by
Nuntavarn Vichit‐Vadakan, Dr.P.H.
Presented at
Hong Kong Conven@on and Exhibi@on Centre, Hong Kong
January 9, 2009

How has Bangkok used public health
informa8on in formula8ng policy for be:er air
quality?
• Phasing out leaded gasoline
• Phasing out leaded
gasoline
Policy Maker
• Mi@ga@on measures for PH
par@culate maMer Information
(World-wide
Studies)
Government Community
Sector
Dr. Wasi’s Policy development model “Triangle that moves the mountain”

Blood Lead Levels in Thai Population
1980 -1996
35 Gasoline lead content
.84 .45 .40 Complete phase out
30
Pb Levels (ug/dl)
25
Adults
Children
20
bus driver
police men
15
cord blood
Threshold level
10
5
0
80 82 84 86 88 90 92 94 96 98 100
Year

Current State and Trends of the Air Quality in BKK
PM10
Annual standard 50 µg/m3

Mi8ga8on measures for par8culate ma:er
Policy Maker
PH
Information Policy
(BMA Commissioned study )
1996
Government Community
Sector
Dr. Wasi’s Policy development model “Triangle that moves the mountain”

Comparison of PM10 Health Effects in Bangkok
(Mortality)
RR per 10 ug/m3 PM 10 Annual
PM10 Level
(ug/m3)
All Causes Cardiovascular Respiratory
Vichit‐Vadakan et.al,
(1992 to 1995)
1.0 % 3.0% 1.6% 65
Vichit‐Vadakan
et.al,(PAPA)
1.3% 1.9% 1.0% 52
(1999 – 2003)

Drivers for Policy Development:
Better Air Quality
Policy Maker
Economics
• Economics
• Technological Feasibility
• Health
Government Sector Community
Technological Feasibility Health
Dr. Wasi’s Policy development model “Triangle that moves the mountain”