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National Health Research Institutes, TaiwanDistinguished professor
Chi Pang Wen, MD DrPH,
AssistantsMin Kuang Tsai, MS
Mu-Lin Chiu, MS
Building and operating a petrochemical complex in a poor community: Not in my backyard (Nimby) or expecting positive economic benefits (Yimby)
Comparison of health status of neighborhood residents
before and after PC Complex
Background
Residents near petrochemical complex (PC) were concerned with health risks from PC
Occasional fires or explosions aggravated such concernsPerceptions of the general public regarding
neighboring residentsIncreased cancer mortalityLife expectancy shortened
Environmental injustice as a result?
PC ComplexIn Mailiao
Yun-lin County
Taiwan
Land filled off-shore siteYear built: 1995-2000Employment related to PC: Direct: 22,000 Indirect: 240,000
Annual revenue: US$ 50 billion% national GDP contribution: 9.2%
Offshore land-filled site
Population changesbefore and after
Population surrounding the plant Mailiao township: 31,722 (1994) ; 39,000 (2011)Yunlin County: 753,791 (1994) ; 713,000 (2011)
All neighboring townships decreased with the exception of Mailiao where PC complex located
Increased by 23%
The issue: Health of the residents before and after the complex
Before the complex: Life expectancy of PC residents ranked near the bottom
among cities and counties in Taiwan
PC residents
Residents’Health status prior to PC are poor
Poor life style habits:High smoking rate in males but not in females
Known for increased lung cancer and all cause mortality
High betel nut chewing rate in males only Known for increased oral cancer
High hepatitis C Known for increased liver cancer
High motorcycle ownership Known for increased accidents and injuries
Standardized Mortality Ratios (SMR) of Yunlin, 1971 – 2011, for all cause, all cancer and for selected cancer, with 2011 Taiwan as reference. SMR trend
for Taiwan is shown with the same reference.
Mortality rate of residentsBefore and after
Lung cancer in males were high, but not in females, reflecting smoking effect
But rates started to decline after PC
Mortality rate of residentsBefore
Oral cancer were high, but only in males, reflecting chewing betel nut effect
Mortality rate of residentsBefore and After
for All cancer
But rates started to decline after PC
All cancer in males were high, but not so in females, reflecting lifestyle effect
Liver Cancer
Liver cancer were high, in both males and females, reflecting hepatitis C prevalence
But rates started to decline after PC
Leukemia
The cancer best known for most related to PC exposureNo increase
Multiple Myeloma
Brain Cancer
Cardiovascular Disease
rates started to decline after PC
COPD
rates started to decline after PC
Motor Vehicle Accidents
Suicide
No difference from Taiwan after PC
Life expectancy
before and after Residents accelerated improvement in life
expectancy, more than counterparts in metropolitan cities
PC residentsPC residents
Health changes before and after
Excess health risks from petrochemical pollution were not demonstrated.
Poor health existed prior to the PC, from poor life style risks, from motor vehicle accidents, and from poor medical care.
After the PC, residents started to improve their health in an accelerated manner.
Other changes after PC complex
1) Population increased, reflecting increased employment, income and reduced unemployment, in the midst of population decrease in surrounding areas
2) Financially poor residents crawled out of their poverty status, with robust economic benefits forthcoming.
3) A 200-bed hospital was added next to the PC complexMedical services made available to poor residentsFree medical screenings offered to all residents
4) A new elementary school was built for quality education and for convenience of residents
5) Corporate Social Responsibility (CSR)Funding and donation for neighborhood projects in 8
years:US $270 million for 39,000 township residents and 700,000
county residents Examples: meals on wheels, school lunch, subsidy for medical
insurance premium, city development, low income group support, forestation, and building schools, and hospitals.
Conclusion
Residents near PC site were poor in health and in financial status prior to PC
After PC, poor health of residents started to have a ray of hope. By coincidence or by design, accelerated improvement in life expectancy and slowed cancer increase or decreasing cancer rates were found, contrary to pre-conceived notion.
No health risks from PC as feared was demonstrated within the time frame. As stated by FDR in his inaugural speech, “There is nothing to fear but fear itself.”
Financially, relatively poor residents saw variable improvement. However, despite efforts of CSR, the perception of inequality persisted in many.
Thank you for your attention
Chi Pang [email protected]
Just say Wen
Not in my backyard (Nimby) or expecting positive economic benefits
(Yimby) Comparison of health status of neighborhood residen
ts before and after PC Complex