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Singapore, Malaysia to monitor impact of haze

By Liang Hwee Ting, The Straits Times,
6 August 2000

Both countries to put in place systems to check what effect the haze has had on the rise in asthma and other respiratory infections.

PHUKET - THE worst may have been over when the 1997 haze did not make a comeback with similar fury. But the Singapore and Malaysian health ministries are not taking any chances.

The two authorities will be setting up systems to monitor the incidence of asthma in their countries as a result of the haze.

Malaysia will establish a monitoring system to keep track of the extent to which the haze contributes to an increase in cases of asthma and infections of the upper respiratory tract.

Singapore will study asthma deaths related to the haze.

An understanding of the relationship between the two will help both countries prepare for any future haze better.

Spearheading the effort is the Department of Respiratory and Critical Care Medicine at the Singapore General Hospital (SGH), together with the Ministry of Health's (MOH) Department of Epidemiology, Dr Philip Eng, head and senior consultant of SGH's Department of Respiratory and Critical Care Medicine said yesterday.

He was speaking at a two-day conference on asthma control, which is being attended by 120 chest specialists, GPs and paediatricians from Singapore, Malaysia, Thailand, Hongkong and Vietnam.

The study was initiated by the SGH and the ministry to validate a report published by Dr Shanta Emmanuel, Director of Family Health Services, MOH, earlier this year. Dr Emmanuel stated in her article in the medical journal, Respirology, that the haze problem has had no major impact on asthma in Singapore.

There were no asthma deaths or hospitalisation related to the haze. There was only an increase of about 10 per cent to 15 per cent in outpatient clinic attendance, and this too was confined to government polyclinics.

The problem is that it is difficult to study the real effects of the haze, said Dr Eng. The haze has lasted about three months in varying degrees of intensity each time it has hit the region since 1997.

There is a need to study its impact on asthma incidence and to classify the specific types of death due to the haze, as asthma deaths, deaths from lung diseases or deaths from heart-lung diseases.

He said: There is general reluctance among doctors to classify people as having died from asthma when asthma is actually quite treatable.

The team will draw their data from the Registry of Deaths by looking at recurring factors. Funding for the study was already in place and the study would be completed in three months, said Dr Eng.

Generally, there is no major cause for concern as long as the situation does not worsen and PSI levels do not exceed those recorded in 1997, he added.

There may not be a great cause for concern right now but Malaysia was not going to be caught unprepared again like it did when the haze hit the peninsula in 1997, said Dr I Kuppusamy, Director of the Institute of Respiratory Medicine, Kuala Lumpur.

Malaysia was one of the worst hit when forest fires, aggravated by the El Nino dry-weather phenomenon, shrouded much of South-East Asia with thick smoke from August that year to early 1998. During that period, said Dr Kuppusamy, there were no proper mechanisms to monitor the impact of the haze on asthma.

This should change within the next couple of months once the monitoring system is put in place starting with the Malaysian Ministry of Health hospitals and large polyclinics, he added.

The haze watch has become a yearly affair in Singapore since 1997. But so far this year, Singapore has been spared the smoke from the Sumatra fires.

For Malaysia too, the air has been relatively haze-free this year. Fortunately, the little bit of haze we've had here has been dampened by bouts of rain, said Dr Kuppusamy.