Olympic challenges
Authors: Tessa Richards
Journal: BMJ (2008)

January is the month for making, and by now often breaking, New Year resolutions. For those of us whose pledges extend only to flaky self improvement such as taking more exercise, their breaking is of little import. But we expect better of others. As the days lengthen, hope triumphs over experience. Maybe Gordon Brown’s new enthusiasm for preventive health will pay somedividend. Maybe the recent deal in Bali will accelerate the global response to climate change.

On the exercise front, we can be sure that there is one cohort who will have kept their resolutions. For aspiring participants of this year’s Olympic Games in Beijing it is now only six months before years of hard training are put to the test. Whether new world records will be set is under debate—for reasons that underline the link between climate change and health.

Among the already extensive media coverage of the games, comment about Beijing’s poor air quality has been as prominent as the tongue in cheek admiration for the new, games related architectural “behemoths” that have been put up. An article in Der Spiegel in July entitled “Pollution Dangers Cast Shadow over 2008 Olympics” (www.spiegel.de/international/world/0,1518,491184,00.html) expresses what seems to be a widely held view that smog in Beijing may impair the performance of some athletes, particularly distance runners and cyclists. It calls for greater openness about the harm caused by air pollution, and it questions whether short term measures, such as moving factories and restricting the number of cars driving into the city, will be effective.

Concern about the impact of poor air quality on athletes competing in the Olympic Games is not new. The issue was raised in Athens in 2004 and Los Angeles in 1984, where Steve Ovett collapsed after the 800 metres and subsequently blamed pollution for it. One can sympathise with the athletes, but they can fly in and out of Beijing. This is not an option for the 11 million or so people who live there permanently, nor the hundreds of millions who live in the world’s top 20 polluted cities.

The need to document and promote public understanding of the adverse and inequitable impact of environmental pollution is underlined in this issue by Tony McMichael and colleagues (doi: 10.1136/bmj.39392.473727.AD). In fairness, China has made some progress on this front, although a recent landmark study commissioned by the Chinese government was mired in controversy.

Cost of Pollution in China: Economic Estimates of Physical Damages (http://tinyurl.com/2vomm5) encapsulates the findings of a three year collaborative research effort between Chinese and international research institutes and the World Bank. The report makes sober reading, for it charts worrying levels of air and water pollution. Data on pollution and health status in many different cities and regions throughout the country are used to calculate the health costs of pollution. The methods used are interesting and innovative. In the first calculation the economic cost of pollution is based on lost earnings and reduced productivity due to premature death and disease. The figure comes out at 362 billion yuan, or 2.7% of gross domestic product. In the second calculation the costs are based on what people said they were willing to pay to avoid the excess health risks associated with pollution. In this scenario the figure rises to 781 billion yuan or 5.8% of GDP.

The information contained in the report should inform the new policies that China is drawing up to tackle its environmental problems. It should also further the important debate on the economic costs of poor health. It is therefore regrettable that the publicity the report generated was for what was left out rather than what it contained. The final report, which was circulated only briefly before being put on the web, was appreciably thinner than the original draft. By way of explanation, the executive summary states that “certain physical impact estimations . . . have been left . . . due to [still] some uncertainties about calculation methods.” The media reported that the information which was left out included the statistic that each year 750 000 people in China die prematurely from air pollution, and that it was removed because of government fears that it might provoke “social unrest” (http://tinyurl.com/yo3hkz).

Public unrest is the last thing the organisers of the Beijing Olympics want as they relentlessly pursue their quest to make the games a high profile success. The Financial Times’ Asian correspondent commented on 28 December that it is “tempting to see 2008—the year of China’s ‘coming out’ party [the Beijing Olympics] as a turning point in world affairs.” Along with India, he predicts that this year China will succeed in putting Asia back into its pre industrial revolution position of global economic dominance.One equally safe prediction is that it will take a struggle of Olympian proportions to counter the environmental impact of the continents economic success.

But to recapture some New Year optimism: there are signs that China is beginning to confront its environmental problems. Meanwhile, if public concern about the health of our elite athletes helps spur countries to implement effective policies to tackle climate change, those athletes will doubly deserve their medals.