1

Analysis of

HEALTH IMPACT DUE TO INDUSTRIAL AIR POLLUTION IN LUMBINI

HERITAGE PLACE

A cross sectional study

By:

Chhabi Ranabhat

Chief Researcher

Lumbini Air pollution project

Submitted to

WHO UN House

Pulchowk Lalitpur

November 2011

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Acknowledgement

I would like to sincere respect to those who are involve in this study as study population by

spending their valuable time for us. Without their help this study is hardly possible to do.

I am indebt with Environment and Public health unit and especially to National Planning Officer

(NPO) Mr Nama Raj Khatri of WHO who provide me the research opportunity and suggestion,

feedback, consultation meetings in each steps of study pattern.

I would like to sincere thanks to Sarada Pandey, Minisry of Health and population for the

valuable suggestion and feedback in tool development and report analysis.

Similarly my thank goes on Yuba Raj Pandey, Puspa Pandey and Bhagawan Karki as a local

facilitator and enumerator who helped me during the survey and whole study.

I would like to appreciate to the IUCN and UNESCO team who had done EIA study about

Lumbini Heritage place by multiple perspective and such report was helpful for my study also.

Chhabi Ranabhat

Chief researcher

(Master in Public Health, Sociology and Health education)

Lumbini Industrial Air Pollution Impact Project

UN House Pulchowk

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List of the contents

TITLE PAGE NO.

Chapter 1 Introduction 7

Chapter 2 Literature scenario 10

Chapter 3 Methodology 14

Chapter 4 Results 17

Chapter 5 Discussion and analysis 34

Chapter 6 Summary conclusion and recommendation 36

Reference

Annex

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List of the Table Page No.

Table no.1 General findings 18

Table no. 2 Socio demographic status 18

Table no. 3 Health problems in the community 19

Table no. 4 Industrial impact on public 20

Table no. 5 Risk factor assessment 22

Table no. 6 Comparative status of socio economic status 23

Table no. 7 ARI situation 25

Table no. 8 Situation of other disease 26

Table no. 9 Assessment of risk factors 26

Table no. 10 Morbidity Pattern of local health institution 29

Table no. 11 Relation between community type and children affected by diseases 30

Table no. 12 Community type and overall health problems 30

Table no. 13 Community type and ARI prevalence 31

Table no. 14 Relation between 2 communities and all types of health problems 31

Table no. 14 Health Problems and type of kitchen fuel 32

Table no. 15 Health Problems and ventilation in kitchen 32

Table no. 16 ARI and ventilation in kitchen 33

Table no. 17 Relation between chest problems and smokers in the family 33

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Executive summary

Environmental pollution is the most challenging for global society. It is scaring issues in world

heritage sector because they cannot be reconstructed in certain period of time like projects, office

and public place. Lumbini is the place of world heritage protected by UNESCO and it is the

civilization of Nepal since 27th

century

The Lumbini World Heritage (LWH) Site located in Rupandehi district of Lumbini Zone is

covered within the Master Plan prepared by Kenzo Tange in 1978. The master plan covers area

1X3 sq miles (7.77 sq km) around the main archaeological remains. The rapid and uncontrolled

growth of carbon emission industries around Lumbini heritage ( 15 Km east, west, north, &

south from the boundary of the core are-Lumbini Garden) and along the Bhairahwa-Lumbini

Road now threatens the very existence of this World Heritage site.

A cross sectional study was done with sample size 152 within the 12 kilometer near Lumbini

Protected Zone (LPZ). It was community based study and different 3 clusters were selected

purposively assuming that near the highway and industry, near the industry only and far from the

industry communities. Pretested semi-structured questionnaire, focus group discussion schedule

and individual case forms were used as tools to find the result. Verbal consent was taken with

informants and concern authorities.

Within 151 households 1/5th (21%) were housewives, more than 1.3

rd (38%) had health

problems, 1/4th (25%) children were affected by ARI, most of the household (63%) experienced

foul and pungent type of smoke by the industries, most of the HH (65%) felt that the disease

pattern were increased by industrial pollution. ARI pattern was high in that community which

was adjoining to the industries (11%) where far community had only 5%. Tuberculosis was 2

those communities which were near the industries and the highway and no found in the far

community. disease prevalence, ARI prevalence and other lungs related diseases were more in

polluted community in comparison with far from the industry and highway and there was

association between those variables (p = <0001). Risk factors (kitchen fuel, ventilation etc) were

not statistically significant with disease pattern. Study found that there was positive relationship

with industrial pollution and disease prevalence in the community specially the respiratory

disease and skin disease.

In conclusion, industries have some nominal positive impact in employment and business but

terrible effects to the communities like public health, ecology, climate change and social capital

and more threat to the Lumbini Protected Zone which is world heritage property for human

civilization and better to transfer to another areas; making industrial corridor far from the

community.

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Acronyms

ARI Acute Respiratory Infection

CO Carbon Mono oxide

COPD Chronic Obstructive Pulmonary Disease

EIA Environmental Impact Assessment

FGD Focus Group Discussion

HF Health Facilities

LPG Liquid Petroleum Gas

LPZ Lumbini Protected Zone

LWH Lumbini World Heritage

SPM Suspended Particulate Matter

SPSS Statistical Package in Social Science

SSI Semi Structured Interview

UN United Nations

UNESCO United Nations Educational, Scientific and Cultural Organization

WHO World Health Organization

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Chapter 1 Introduction

Situation:

Environmental hazard is the most challenging for global society. It is scaring issues in

world heritage sector because they cannot be reconstructed in certain period of time like

projects, office and public place. Lumbini is the place of world heritage protected by

UNESCO and it is the civilization of Nepal since 27th century. If the originality is lost,

the history of Buddhism, Peace and the civilization may be lost. Studies show that the

industrial pollution, that are emitted by different industry adjoining the Lumbini are great

threat for this historical place.

Within ten years Lumbini has experienced exponential industrial growth. The result of

this industrialization has often been overcrowded cities, dense pollution etc.

Extrapolating this development into the future could mean that the World Heritage Site

Lumbini will soon be surrounded by a cement production industrial park creating an

environmental catastrophe and threatening the very existence of Lumbini.

Increasing numbers of children around the world are suffering from respiratory problems

– coughing, wheezing and asthma attacks and the key external causes of these diseases

were identified a long time ago by industrial air pollution. (Science Daily July 23, 2009)

Rationale:

The World Heritage Alliance for Sustainable Tourism engages the travel industry,

facilitating collaboration with the UN, governments and civil society, promoting

environmentally and economically sustainable business practices around World Heritage

sites, educating travelers about the importance of responsible tourism around the sites,

and supporting sustainable development of local communities. (World heritage alliance

report 2009)

The Lumbini World Heritage (LWH) Site located in Rupandehi district of Lumbini Zone

is covered within the Master Plan prepared by Kenzo Tange in 1978. The master plan

covers area 1X3 sq miles (7.77 sq km) around the main archaeological remains. The rapid

and uncontrolled growth of carbon emission industries around Lumbini heritage ( 15 Km

east, west, north, & south from the boundary of the core are-Lumbini Garden) and along

the Bhairahwa-Lumbini Road now threatens the very existence of this World Heritage

site. If the Industrialization around the heritage site does not get checked soon national

pride as well as the most important cultural values of Nepal in terms of tourism will be

surrounded by smoke stacks of many carbon emissions through cement and brick

factories. Also, it causes adverse impacts including threats to the biodiversity as well as

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health hazard to the locals. Integration of environmental issues especially problems

caused by industrial hazards around the world heritage site need to be addressed in order

to preserve quietness and sacredness of Lumbini and and be free of industrial pollution.

This requires: comprehensive information about the sitting industries; multi-dimensional

impacts caused by the industries; land use planning for the promotion of livelihoods

(using non-carbon emissions sources of income generation for the local) and preservation

of cultural values of the Lumbini.

In this regards, as per Environmental Protection Regulation 1997 and its subsequent

amendments, Environmental Impact Assessment (EIA) is mandatory for the protection,

conservation and sustainable management of the heritage properties. EIA is mandatory

and empowers the sustainable development of the world heritage. The scope of the work

mentioned above include only the assessment study of sitting industries and its impacts

on the study area around the center area of the Lumbini heritage. The aim of the study is

to protect and safeguard Nepal’s Lumbini from the growing impacts of environmental

pollution.

Health impact of specific air pollutants

Some of these gases can seriously and adversely affect the health of the population and should be

given due attention by the concerned authority. The gases mentioned below are mainly outdoor

air pollutants but some of them can and do occur indoor depending on the source and the

circumstances. From the industry, the following types of pollutants are emitted and they causes

the health problems

Tobacco smoke. Tobacco smoke generates a wide range of harmful chemicals and

is a major cause of ill health, as it is known to cause cancer, not only to the smoker but

affecting passive smokers too. It is well-known that smoking affects the passive smoker

(the person who is in the vicinity of a smoker and is not himself/herself a smoker)

ranging from burning sensation in the eyes or nose, and throat irritation, to cancer,

bronchitis, severe asthma, and a decrease in lung function.

Biological pollutants. These are mostly allergens that can cause asthma, hay fever,

and other allergic diseases.

Volatile organic compounds. Volatile compounds can cause irritation of the eye, nose

and throat. In severe cases there may be headaches, nausea, and loss of coordination. In

the longer run, some of them are suspected to cause damage to the liver and other parts

of the body.

Formaldehyde. Exposure causes irritation to the eyes, nose and may cause allergies in

some people.

Lead. Prolonged exposure can cause damage to the nervous system, digestive

problems, and in some cases cause cancer. It is especially hazardous to small children.

Radon. A radioactive gas that can accumulate inside the house, it originates from the

rocks and soil under the house and its level is dominated by the outdoor air and also to

some extent the other gases being emitted indoors. Exposure to this gas increases the

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risk of lung cancer.

Ozone. Exposure to this gas makes our eyes itch, burn, and water and it has also been

associated with increase in respiratory disorders such as asthma. It lowers our resistance

to colds and pneumonia.

Oxides of nitrogen. This gas can make children susceptible to respiratory diseases in

the winters.

Carbon monoxide. CO (carbon monoxide) combines with haemoglobin to lessen the

amount of oxygen that enters our blood through our lungs. The binding with other

haeme proteins causes changes in the function of the affected organs such as the brain

and the cardiovascular system, and also the developing foetus. It can impair our

concentration, slow our reflexes, and make us confused and sleepy.

Sulphur dioxide. SO2 (sulphur dioxide) in the air is caused due to the rise in

combustion of fossil fuels. It can oxidize and form sulphuric acid mist. SO2 in the air

leads to diseases of the lung and other lung disorders such as wheezing and shortness of

breath. Long-term effects are more difficult to ascertain as SO2 exposure is often

combined with that of SPM.

SPM (suspended particulate matter). Suspended matter consists of dust, fumes, mist

and smoke. The main chemical component of SPM that is of major concern is lead,

others being nickel, arsenic, and those present in diesel exhaust. These particles when

breathed in, lodge in our lung tissues and cause lung damage and respiratory problems.

The importance of SPM as a major pollutant needs special emphasis as a) it affects more

people globally than any other pollutant on a continuing basis; b) there is more

monitoring data available on this than any other pollutant; and c) more epidemiological

evidence has been collected on the exposure to this than to any other pollutant.

(http://edugreen.teri.res.in/explore/air/health.htm)

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Chapter 2 Literature scenario

Pollution, a form of weather condition is the presence of one or more contaminable substances in

the atmosphere resulting from gaseous, liquid or solid wastes or by-products that is detrimental

or tends to be detrimental to human health or welfare, or can attack infrastructures. Air pollution

on the other hand refers to the discharge of harmful substances into the air to the extent that it

can reduce visibility or produce undesirable odor.

Air pollution results from both the natural and anthropogenic causes. The emissions from

volcanoes, desert dust storms, sea spray, plants (spores and pollens) and smoke from forest fires

which constitutes particulate matters are natural causes of air pollution. Anthropogenic (man-

made) sources which include industrial plants), motor vehicles, power generation, mining, smoke

emissions from bush burning, quarrying, gas from waste/refuse combustion, agricultural sprays

and chemical processing, exerts higher proportion than the natural factors. Anthropogenic

pollutants are the most toxic and are generally emitted where people live, work and play. It

typically causes the greatest health problem and exacerbates respiratory problems and other

health complications

Air pollution’s impact on health is very complex as there are many different sources. The

individual effects vary from one to another, and it is especially harmful to the young children and

the elderly, and those with existing respiratory problems. Children are at risk because their lungs

are not fully developed; they breath faster, and they spend lots of time outdoors (Kenneth et al,

1999).

3. POLLUTION (WEATHER) AND SOCIO-ECONOMIC ACTIVITIES

Air pollution is widely considered to be one of the serious threats to the sustainability of the

planet’s environment, the well being of its people and the economic power. The world’s

economy is increasing sensitivity to weather; hence it is not possible to divorce the environment

and the socio-economic issues. Based on this, there is need to consider the effect of pollution

extremes on some of the weather-sensitive economic sectors.

A. Tourism and recreation resources:

Changes to the environmental features will have a direct impact on many tourism destinations

which could have far reaching implications not just for the tourism industry, but for other

economic sectors. Air pollution put tourism at risk at coastal zones and mountain regions.

Coastal tourism is likely to suffer damage from most of the effect of pollution which are evident

from turbidity, visibility reduction and undesirable odour. It is obvious that tourism plays an

important role in the socio-economic development of many countries. Hence, for sustainable

development, accurate weather forecasts and warnings with effective information on air pollution

which are essential for planning and for ensuring safe and environmentally sound tourism

activities should be made known to tourism industry.

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B. Agriculture:

The impact of air pollution can put a stress on Nigeria agricultural sector with a feed- back on

other sectors of the economy. Agricultural practice in Nigeria is rain-fed. This implies that

farmers depend solely on precipitation or rainfall for optimal productivity. The adventure of

technology resulting in modernization, industrialization and urbani-zation has contributed in a

great way to the level of pollutants (CO, O3, NOX, SO2, and PM2.5) suspended in our

environment. The pollutants interacts with other components of the air (e.g. vapour) and

chemical transformations occur to form chemical acids (e.g. carbonic, sulphuric, nitric acids, etc)

which are absorbed by water droplets in clouds. The droplets fall as acid rain (pH < 5),

(Brimblecombe, 1996). The consequence of acid rain is evidence on the poor agricultural output.

The poor agricultural output can lead to excessive increases in food price. This in turn can put

pressure on economy policy leading to higher interest rates.

C. Communication:

Particulate matters (PM) suspended in the atmosphere directly affect communications at all

levels. Fine particulate matters (PM2.5) have a longer duration in the atmosphere and act as

condensation nuclei upon which other substances may be deposit. It attenuates and scatters radio

signals from space, thus it can prevent high frequency (HF) radio wave communication signals

completely from being transmitted to ground stations. The net effect is that it may cause

interruptions in Radio, Cable and Television signals. For effective sustainability, accurate

weather forecasts of this phenomenon should be made available to the industry. Accurate

forecasts of these effects can give operators more time to find alternate means of communication.

D. Water resources:

Water is an essential social, economic and environmental good that is largely dependent on the

weather. Water, invaluable natural resources is essential for agriculture, power production,

recreation, transport, drinking and sanitation. It is particularly useful for marine ecosystems. The

key variables controlling water availability are temperature, precipitation, runoff, and aquifer.

Toxic substances are released into the atmosphere in several ways e.g. industries, agricultural

sprays, etc. They undergo chemical transformations and are washed into oceans and lakes by

precipitations. The dissolved substances decrease the concentration of nutrients available to fish

and other aquatic lives. Therefore, the marine ecosystems are endangered. The provisions of

accurate, integrated weather forecast on pollution information are critical to optimal resource

management.

E. Public health

Public health is liked with tourism, agriculture, water resources, communication etc because

public health goal cannot be achieved if there is no progress of all sectors indirectly. The

pollutant content in air is directly affects in our health by producing many disease and illness

which was already described in situation analysis part (page no. 5, 6)

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The health effect of air pollution is a complicated and technical subject involving the

sciences of epidemiology, toxicology, and clinical medicine, to name only three. It is clear,

however, that ozone one of the pollutants for which stricter standards are proposed-causes

health problems in humans because it damages lung tissue, reduces lung function, and

sensitizes the lungs to other irritants. Scientific evidence indicates that outdoor levels of

ozone affect not only people with impaired respiratory systems such as asthmatics, but also

healthy adults and children. Exposure to ozone for 6 to 7 hours at relatively low

concentrations has been found to significantly reduce lung function and induce respiratory

inflammation in normal healthy individuals during periods of moderate exercise. For human

populations exposed to particle pollution, the major areas of concern include: effects on

breathing, aggravation of existing respiratory and heart disease, damage to lung tissue, and cancer.

The major subgroups of the population that appear likely to be the most sensitive to the

effects of particulate matter include individuals with heart disease and asthma, as well as the

elderly and children. (JOURNAL OF THE NATIONAL MEDICAL ASSOCIATION, VOL. 89, NO. 6 Howard University Cancer Center and the Council of Medical Legislation, National Medical Association, Washington, DC)

In Lumbini area there is increasing in numbers of cement, automobiles, paper and other factories.

Not only these, there is also increasing numbers of vehicles and due to under construction of

road, the people must have suffering from any kind of health problems.

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Objectives:

To find out the possible health effects due to air pollution within study area

To find out the health problems in another matching community

To compare the health problems within two communities

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Chapter 3 Methodology

Existing information analysis:

1) Literature review: The industrial hazard and its implication in world heritage

place which had already studied so that the shadow and hidden area can be

explored more.

2) Secondary data review: The study, data and research papers about Lumbini were

reviewed because of making more study valid and reliable.

Survey tools/technique:

Semi structure interview schedule: Different aspects of SSI/questionnaire were

prepared to the target population (Health impact to children and women, culture and

biodiversity impact with senior citizens, Socio-economic impacts with the civil

society within purpose cluster/community)

Focus group discussion: it was done with local community leaders, civil societies,

teachers and students.

In depth Interview: It was done with the persons who were/are suffering from health

problems like skin problems, Tuberculosis, Asthama and ARI in children

Concern authorities meetings: To make more effective of the study consultation,

meetings, discussion was done with WHO team, Ministry of Health and Population,

Nepal health research council experts with biostatistician and environmental health

experts, sociologists etc.

Study population

The communities which are within 15 km from the industry as well as the Lumbini

heritage zone will be the study population. It was divided in 2 parts. One is near the

highway which has vehicle and industrial pollution and another community is adjoining

to the industry community and quite far from highway but still there was dusty and

muddy road. Another community was taken for control which will be similar

characteristics of the cluster and far from the industries and highway.

Sampling: purposive sampling was done for qualitative information. For quantative

information, cluster sampling was adapted for public health and socioeconomic impacts.

Three clusters was taken having different characteristics, which were, near highway and

the industry, quite far from highway and near industry and for comparasion, far from

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highway and industry both. To reduce extraneous factors, community was matched as far

as possible.

Sampling Unit:

Households were the sampling units. Similarly the person who was/is suffering from

health problems related to air pollution were study population.

Sample size:

For this study there was no scientific formula to calculate but representative sample size

were taken 151 household and diseased person who were suffering from pollution

related health problems

Target population: It had been different to get and verify the resources. For public

health impact people >45 years age and the school children were target population within

15 km of Lumbini heritage having different industries. For comparisons similar type of

community, out of 15km were used after matching for analysis. The disease scenario of

local community was assessed by observing the last 3 years morbidity pattern of local

health institution.

Data collection way: The relevant data were collected by principle investigator in field

and concern authorities. Local facilitators were hired with double blinding, for the field

that was known about field, community and local custom.

Data Analysis Plan:

Qualitative information were summarized and written in narrative form with specific

importance like FGD, In-depth interview and workshop. Quantitative information were

written by SPSS software. Statistical relationship was shown in different variables. Data

were taken by subject experts not respondents.

Report dissemination and publish: Final report was submitted to the WHO, UNESCO

and Lumbini development trust so that it will be a resource for another study.

Conceptual frame work

Air Pollution

Biological pollution

Organic compound

Chemical compounds

Vehicle pollution

Smoke

Health problems

ARI in children

COPD in adults

Allergic

Vehicle pollution

Bronchitis

Asthma

Burn etc

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Comparison frame work

Community B

Far from the 15 km from

highway and industry

Community A

Near the industry cluster

Near the highway cluster

Near the highway and

industry cluster

Health problems

No

Yes

o 1

o 2

o 3

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Chapter 4 Results

Findings from the industrial air pollution near Lumbini Heritage Place

MAP

List of industries within 10 km of Lumbini Heritage place

1) Supreme cement 2) Jagadamba cement 3) Goyenka cement 4) Ambe Cement 5)

Reliance Cement 6) Mayos Noodles 7) Nepal Ambuja cement 8) Shyam plywood 9)

Dynastry industry 10) Ambe steel 11) Sidhartha Cement 12) Brij Cement 13) Agni

Cement 14) Kailash Cement 15) Sidhartha Oil Industries 16) Relance paper mills 17)

Goinka Steel

Picture: Google earth

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A. Result from the survey

Total 151 household were taken during the study period where there is 1022 population and

545(53.3%) was male population. (Table no. 1). Beside this survey, individual case study and

key informants discussion was done for complementary findings and detailed report page 16.

Table no.1 General findings

General findings No. of households 151

Total population 1022

Male 545

Female 477

School children 271

Affected school children 73

Average monthly income in Rs 32996

Average land in Kattha 26

The above table signifies that male population is higher than female which is greater than

national census 2068 and the average per capita income is also higher than national. Average

land per household is also greater than national.

The table no. 2 shows that about one third of population (30.1%) was illiterate and very few

(2.9%) has only higher education. Similarly most of the women were house wives and the

young population was student.

Table no. 2 Socio demographic status

Education

N = 1022

Characteristics Frequency Percentage

Illiterate 308 30.13

Literate 36 3.52

Informal education 17 1.66

Primary 336 32.87

Secondary 169 16.53

Higher secondary 17 1.66

Graduation 30 2.93

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Continue table no. 2

Occupation

N = 1022

Characteristics Frequencies Percentage

House wives 214 20.93

Labor 161 15.75

Farmer 102 9.98

Business 11 1.01

Student 291 28.47

Private job 35 3.42

Business 53 5.18

The various type of health problems were found during the survey, most of the health

problems were related to Respiratory related like ARI, Tuberculosis, Asthama etc and skin

and eye problems were also in significant number (Table no. 3)

Table no. 3 Health problems in the community

Health problems Characteristics Frequencies Percentage

Total health problems

(N=1022)

386 37.76

Total ARI cases in school

children (N=271)

69 25.46

Total expenditure of ARI per year is Rs 115310

Skin problems 51 13.21

Eye problems 29 7.51

Lungs related problems 110 28.49

Tuberculosis 4 1.03

Asthama 16 4.14

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Headache 95 24.61

Health problems not related to

air pollution

26 6.73

Total expenditure in health per

year in Rs

1496910

Average expenditure per year

per household in Rs

9913

Average expenditure per year

per person in Rs.

1465

The above table revels that majority of health problems were related to air pollution

and huge amount of economic loss in above problems. People don’t assess such loss

but if they calculate and analyze they have expended large amount from their pocket

every year.

Findings related to the industry

The table no. 4 express that the industry air smoke foul and pungent smoking (64.8%) and

the health problems were increasing (64.9%), about 1/5th are getting employment and

majority 2/3rd

population have no any advantage from the industries.

Table no. 4 Industrial impact on public

Type of smell of

industrial smoke

Characteristics Frequency Percentage

Foul smelling 48 31.7

Pungent smelling 50 33.1

Don’t know 53 35.0

Prevalence of illness

after establishment of

industry

As usual 53 35.1

More 98 64.9

Positive impact after

establishment of

industry

Employment 29 19.2

Easy in transport 2 1.3

Increasing in business 18 11.9

No Advantage 51 33.8

Far from the industry 51 33.8

Negative impact after

establishment of

industry

Increasing in number

of sickness

51 33.8

Change in climate 6 4.0

Decreasing in flora and Fauna

6 4.0

Increasing in theft and 11 7.3

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robbery

More than 2 effects 25 16.5

Don’t know 52 34.8

Different experience in

climate change

Drought 12 7.9

Rise in temperature 41 27.2

Decrease in

productivity

38 25.2

More than 2 effects 59 39.1

Not known 1 0.7

Suggestion for industry Transfer the industry 69 45.7

Establishment the non

pollutant industry

30 19.9

Add other industry 1 0.7

Don’t know 51 33.8

By the above table, some conclusion can be drawn that the industries have negative impact in

their health and they want to either establish non pollutant industry or transfer the industry in

another place. There is some positive impact to the local population with some employment

and business opportunities.

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Risk factors Assessment

Risk factors were assessed during the survey which would be responsible for health impact of

individual people. For air pollution, type of kitchen fuel, application of ventilation, smoking

in family, vehicle movement and the road with dust level. About 1/5th people used the safety

fuel (LPG), about 2/3rd

(74.2%) had no ventilation in the kitchen, about 1/3rd

(28.5%)

household have family members of doing smoking (Table no. 5)

Table no. 5 Risk factor assessment

Type of kitchen fuel Characteristics Frequency Percentage

Firewood 28 18.8

Cow dung 94 62.3

Leaves and stems 1 0.7

LPG 28 18.5

Ventilation in the

kitchen

Yes 39 25.8

No 112 74.2

Smoking person in the

family

Yes 43 28.5

No 108 71.5

Smoking place

(N=43)

Outside the home 13 30.2

Any places 30 69.7

Average smoking

sticks per day (N=227) 5.27

Vehicle movement around the home

Yes 110 72.8

No 41 27.2

Type of road Pitch 30 19.8

Cracked pitch 6 3.9

Gravel 4 2.6

Dusty and muddy 111 73.5

Level of dust at the

road

Nominal 55 36.4

High 76 50.2

Very high 20 13.2

The above table indicates that there are enough risk factors to get diseases for people,

because most of use cow dung as kitchen fuel, having no ventilation and vehicle pollution

either in concrete road or dusty road.

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Data analysis and comparison

i. Socio economic situation

Socioeconomic factors are major determinants in every sector precisely in health sector too.

As this study’s methodology the community was divided in 3 group which could be compare

each other. In compare 3 communities community A is good socioeconomic indicators than

other 2 communities where per capita income is more than 3 times higher (Rs 4682) than

community B (Rs 1326) and C (Rs 1378). Illiterate population is high (33%) in community A

and low (26.3%) in community A (Table 6)

Table 6 Comparative status of socio economic status

Community

type

Per capita

income in Rs

Land in

Kattha

Total

Employment

Illiteracy rate Total

population

Near road side

and industry A

4682. 18.36 36 (10%) 89 (26.3%) 338

Near industry

and far from high way B

1326 13.4 67 (20%) 106 (30.9%) 342

Far from

highway and

industry C

1378 9 55 (16%) 113 (33.0%) 342

The above table indicates that the trend of socio economic status of community A is far better

than other 2 communities B and C, however the total employment is comparatively low and

it is due to high proportion involve in business and other 2 communities people were

involved in low grade employment such as labor in high proportion.

ii. Occupational status of the communities

Occupational situation is the major factor of socio economic status. Studies shows 1/5th

population was on housewives and similar figure in student too but they are not economically

productive occupation. The following figure shows majorities of people based on farmer and

labor within the factories. Comparatively community A had on self business other than labor

and private job. That’s why, disease pattern is low in community A in comparison with

community B because of sustainable economic status.

24

0

5

10

15

20

25

30

35

Community A

Labor

Farmer

private job

Business

N = 338

0

10

20

30

40

50

60

70

80

Community B

Labor

Farmer

private job

Business

N =342

0

10

20

30

40

50

60

70

Community C

Labor

Farmer

private job

Business

N =342

Figure: comparison of occupational status of three communities

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iii. Diseases pattern

ARI is the main health impact due to air pollution. Table 7 indicates that community B which

is near the industry but far from the high way had high prevalence of disease cent percent and

90% with community A and 86% in community B. Total affected children, ARI prevalence,

ARI expenditure and total attacks is more in community B.

Table 7 ARI situation

Community

type

Findings health

problems HH

Children in HH ARI

prevalence

ARI

expenditure

in Rs

Total ARI

attack in

year

Yes

No Total children

Affected children

Near road

side and industry

45

(90%)

5

(10%)

40 20

(50%)

26 (7%) 19310 47

Near industry

and far from

high way

50

(100%)

0 35 26

(74%)

38 (11%) 93800 126

Far from

highway and

industry

43

(86%)

7

(14%)

34 3 (8%) 5 (1%) 2200 8

It can be concluded that the more health problems are more in that communities’ which are

most affected by industrial pollution. In community C the ARI scenario is low than other 2

communities however there are sensitive poverty indicators. So industrial air pollution

grossly affected in those two communities. In comparison of community A and B, B is most

affected because the socio economic status is far better in community A and dust pollution is

high is community B also.

Other diseases

The consequence of air pollution as a disease are skin diseases, eye problems, chest related

problems, Asthama, headache etc. The health problems were, skin disease (9%), eye

problems 3%), chest related problems (22%), TB (0.5%) and headache (4%) were high in

community B and similar figure in community A, where all disease were in low figure in C

except other diseases (15%).

26

Table no. 8 Situation of other disease

Community

type Disease pattern

Skin

disease

Eye

problems

Chest

problems

TB Asthama Headache Non related

health

problems

Near road side and industry

14 (4%)

11(3%) 21(6%) 2(0.5%) 9 (2%) 11 3%) 3(1%)

Near industry

and far from high way

32

(9%) 11(3%) 76(22%)

2

(0.5%) 5 (1%) 14 (4%) 42 (12%)

Far from

highway and

industry

5(1%) 7(2%) 13(3%) 0 2(0.5%) 1(0.2%) 50(15%)

The above table clearly reflects the impact of air pollution in health problems. It is shown

that people near the industry, high amount of health problems and far the industry

comparatively low amount of health problems and the reasons were same as described above.

iv. Risk factors comparison

Smoking pattern, kitchen fuel application and availability of ventilation were categorized as

risk factors. No. of smokers were high (6%) in community B household, safe fuel was more

utilized (32%) and ventilation is high (26%) in community A (Table 9).

Table 9 Assessment of risk factors

Community type Smoking pattern Kitchen fuel type Ventilation

No of

smokers

Average

stick per day

firewood Cow

dung

Leave

s and

stems

LPG Yes No

Near road

side and

industry A

13(4%) 1.6 10(20%) 23(46%) 1(2%) 16

(32%) 13

(26%) 37

(74%)

Near industry and far from

high way B

21(6%) 6.4 2(4%) 43 (86%) 0 5(10%) 16 34

(68%)

Far from highway and

industry C

13(4%) 5.9 16(31%) 28 (55%) 0 7(14%) 10

(20%)

41

(82%)

The above pattern signifies that there is similarity of risk factors and not significantly

different either community A, B or C.

27

B. Report of Focus group discussion

Concept of air pollution:

The different group like students, teachers, senior citizens, mothers group did not know the

theoretical definition of air pollution but they expressed their view of air pollution basically

the smoke production by the industries and their effects in the environment. The dust and

smoke production by the industries and the vehicles through the smoke and they experienced

difficulties in respiration, daily activities, and teaching learning activities in school home,

road, farming, business and relevant job may be air pollution.

Sources of air pollution in the community:

They thought that the main source of air pollution is the smoke produce by the industries.

The complementary sources are vehicle’s smoke, dust in road, pungent and foul smelling

from the waste, cigarette smokes and smoke produced by kitchen fuels like firewood, cow

dung, etc. The secondary sources are different because in village the kitchen fuel are the

secondary sources where as in highway, vehicles would be in second number.

Health Impact due to air pollution:

In community:

Tuberculosis, Asthama, chronic cough, skin allergies are the main effects of air pollution.

Restlessness, headache, irritation are the symptoms of air pollution in their community. Loss

of appetite and laziness in daily work are the other effects which they expressed during the

discussion.

In the school children

The school children experienced both industrial and vehicle pollution in their health hazard.

The school children expressed that tearing of eyes, delay on concentration, vehicle accidents,

food unsafe, food poisoning etc specially due to dust. Beside these, common cold, allergic

rhinitis, throat problems, are occurring any of them in classroom. “Akriti Adhikari got victim

of accident due to vehicle pollution during the cross of highway because she didn’t take

proper decision where she had to go due to smoke of vehicle” said her classmate.

The Teachers and staff of school

The teachers experienced the health effects due to air pollution as like the students. During

the classroom they suffer from sneezing and cough due to the smoke of both industrial and

road vehicle smoke. They claimed that the vision problems within 2 teachers are due to the

air pollution. Being the local people of the community also they measured decrees in

productivity higher proportion of malnutrition. At the gate of school, factories dump the

28

ashes of factory waste products break the environment and promote the accidents. The

teachers had affected from common cold, skin allergies, and throat problems consistently.

They had been afraid from lungs cancer due to air pollution in long run.

Categorization the level of air pollution

There was no any scientific tool for the measuring the degree of air pollution for this study

but ranking of public opinion during focus group discussion. They expressed that industrial

air pollution is number one in severity. Similarly in second severity, different group

expressed different sources. The highway people measured vehicle air pollution in second

number where as community people took second priority of indoor air pollution.

Other effects of industrial air pollution in the community

People of local community aggressively expressed the effect of air pollution in the

community as a whole. They have been victimized from deceasing productivity year by year.

One participant shared that he lost “Ten Maan” rice last year in comparison with previous

year. During ploughing time, there is a layer of cement in rice too. Female expressed that

washing clothing becomes dustful within 4/5 hours by the particles of cement and smoke.

Relation with industrial owner:

There is no dynamic relationship with industrial owner and the local community. They never

interact with local people’s livelihood their health and economic status. Neither had they

given opportunities to the local people nor any compensation but the waste product near the

field which decline the soil productivity. Even labor are imported from India, Bihar and such

labor terror to the community people specially the women. The industrial owners capture

some feudal group of community, the local government agencies like VDC and police post.

They badly suppressed to the local community and they don’t want to share all the events to

this team also. By the double pressure some people migrate from this community.

Other consequence to the community:

Public expressed that the crow are dying by the dark smoke during burning of plastics

packets. Some domestic animals like oxen are dying by chewing the plastic products. They

are suffering from other effects like drought, increasing warming and landslide due to climate

change effects. The numbers of mosquito are growing year by year said one female teacher

during the discussion. Moreover, the plants are delay growing, drastically decreasing the

production of mangos and fruit winter time. The leaves of plant can not be recognized and

there is a layer of cement of air pollution. Some people said that there is a cement product on

Ashoka pillar in Lumbini.

29

Action taken by community:

They have not taken any action till now but they forward the application more than one

dozen in district administration office but no response behind them.

C. Assessment of morbidity pattern of local health institution:

It was assumed that the people who are suffering from any problems, they would visit the

local health institution which would be government health institution. That’s why, the

information was collected with Kamaharia Sub health post in-charge. Being small health

institution and lack of provision to prepare annual report, the information was taken on his

experience and the OPD register. However, to analyze the yearly OPD in the limited time is

not possible. So the information was collected on his own experience. So there was a system

of at least categorize top five disease with in the year.

The scenario of top 5 diseases:

Table no. 10 Morbidity Pattern of local health institution

Disease

ranking

Year

2064/65 2065/66 2066/67 2067/68

1st Skin

disease

ARI Falls and

injuries

Skin disease

2nd

ARI Skin diseases Acute upper respiratory

infection

Acute upper respiratory

infection

3rd

Falls and

injuries

Gastritis Skin disease Falls and

injuries

4th

Fever of

unknown

causes

Fever of

unknown cause

Gastritis Nutritional

deficiencies

5th Gastritis Nutritional deficiencies

Nutritional deficiencies

Gastritis

Source: Sub health post Kamarahia

By the above table it can be assumed that most of the disease categories are related with any

kind of air pollution. The literatures shows that skin disease, Acute Respiratory Infection and

some sorts of fever are directly associated with air pollution. Nutritional deficiencies and

falls and injuries are indirectly related with vehicles and low fertility in the community.

30

Relation between variables:

A. Relation between two community and children affected by the

disease

Statistical test was done within two variables which are related to industrial air pollution

and health problems. The community was merged into two which was categorized as

polluted and non polluted community. Within 2 communities polluted community has

affected children with comparison with non polluted community (p = <0.0001)

Table no. 11

Table no. 11 relation between community type and children affected by diseases

Community type

Affected children by disease Total App. test P value Result

yes No

Polluted community

46 54 100

Fisher

exact χ2

<0.0001 Highly

Significant

Non polluted

community 3 48 51

Total 49 102 151

B. Relation between two community and suffering from all disease

The consequence of air pollution is only certain disease not overall disease in the community.

So without certain problems all diseases are not significant (p = 0.06). So it can be concluded

only certain health problems are related with air pollution not all type of health problems

that’s why no statistically significant. (Table no. 12)

Table no. 12 Community type and overall health problems

Community type

Health problems Total App. test

P

value Result

yes no

Polluted community

95 5 100 Pearson

χ2

0.06 7

Slightly significant

Non polluted

community 43 8 51

138 13 151 Total

31

C. Relation between two community and ARI prevalence in

children Acute respiratory infection is caused by air pollution. The following table no. statistically

proves that ARI prevalence is high in polluted community than non polluted community (p =

<0.0001) (Table no. 13)

Table no. 13 Community type and ARI prevalence

Community type

ARI prevalence Total App. test P value Result

yes no

Polluted

community 44 56 100 Fisher

exact

Test χ2

<0.001

Highly

significa

nt

Non polluted

community 4 47 51

48 103 151 Total

D. Relation between two community and overall chest diseases

Another consequence of air pollutants are to form other respiratory related problems by their

noxious gases. Respiratory problems would be high in polluted community in comparison

with non polluted community (p = <0.0001). Such theory has been proved by the following

table no. 14.

Table no. 14 Relation between 2 communities and all types of health problems

Community type

Prevalence of chest

problems Total App. test P value Result

yes no

Polluted

community 56 44 100

Pearson

χ2

<0.001 Highly

significant

Non polluted

community 11 34 45

67 78 145

Total

32

Risk factors and health problems relationship

1. Relation between health problems and kitchen fuels

Without industrial, air pollution is possible by indoor air pollution also. There is no

significantly difference (p = 0699) with health problems and safe and risky fuel (table

no. 15)

Table no. 15 Health Problems and type of kitchen fuel

Health problems

Kitchen fuel

Total App.

test

P

value Result

Safe fuel Pollutant

fuel

Yes 23 115 138 Fisher

exact

Test χ2

0.699 Not

significant

No 3 10 13

26 125 151

Total

2. Relation between health problems and Ventilation in kitchen Ventilation is another factor responsible for air pollution. In kitchen ventilation is

coincided with health problems but no significant difference between these variables

(p = 0.742) (Table no. 15)

Table no. 16 Health Problems and ventilation in kitchen

Health problems

Ventilation Total

App.

test P value Result

Yes No

Yes 35 103 138 Fisher

exact

Test χ2

0.742 Not

significant

No 4 9 13

39 112 151

Total

33

3. Relation between ARI in children and ventilation in kitchen

Ventilation in kitchen would be one responsible factor for ARI but the following table no.

16 shows that ARI in children and availability was not statistically responsible to get ARI

in children (p = 0.810) Table no. 17 Children don’t exposure long time in kitchen but

they play outside the home where there is high exposure of industrial air pollution.

Table no. 17 ARI and ventilation in kitchen

ARI

Ventilation in

kitchen Total App.

test P value Result

Yes No

Yes 13 35 48

Test χ2

0.810 Not

significant

No 26 77 103

39 112 151

Total

4. Relation between Chest problems and smoking in family member

Obviously chest problems are associated with smoking. The table no. 18 shows that who are

smokers in the family have more chest problems than who were not smokers in the family

and that is proved statistically (p = 0.04)

Table no. 18 Relation between chest problems and smokers in the family

Chest problems

Smoking in family Total

App.

test P value Result

Yes No

Yes 23 44 67

Test χ2

0.04

Significant

No 20 64 84

43 108 151

Total

34

Chapter 5 Discussion and analysis

1. History of the factories which are in near Lumbini Heritage place

The almost factories except Jagadamba Steel, cement and other noodles industries all

were taken out from Agra Taj Mahal Palace (Based on conversation with the Lumbini

Development Trust Authorities 2068) because Indian government felt that Agra

would be one world heritage place and they would be threaten for this historic place.

During the time of 2051 BS such factories were safe landing during this place easily.

History explains that Lumbini is the older heritage place than the Agra Taj Mahal.

Here it can be understood that by the decision of keeping industry within Lumbini

Protected Zone either such Indian factories make pressure to the Nepal’s Government

or the Indian government and companies felt less important than Lumbini. If there is

double standard to see the establishment in LPZ, Nepal government should revised

such decision and immediately transfer the industry for the importance of Lumbini or

to improve the health status of local people because the air pollution by the industry

has grossly affected people’s health

2. Air pollution responsible for health problems

There is very much complexity to measure the level of factory air pollution by any

scientific equipment so that how much percent is responsible for making health

problems of public. Even during the diagnosis of diseases of patient, health worker

cannot predict the bulk of involvement. When the communities were matched and

compare each other the health problems have high magnitude which are near the

factories. During the statistical analysis, industrial air pollution consequences were

highly significant with health problems of two communities. This study indirectly

proves that increasing amount of health problems and the consequence of climate

change are linked with industrial air pollution.

3. Great dilemma on factory for society or society for factory

During the survey of this study, a focus group discussion was done in community

which was adjoining with factories, they were fed up with the air pollution produced

by those industries and had interested to migrate from there. After the development of

human civilization Stone Age is converted into agriculture age, then agriculture age

was converted into industrial age and now, industrial age is converting into

information technology age but they were from human welfare and to improve the

society not to destroy the society. Such public opinion raised a serious question that

the society is for factory. So to preserve human culture and history, such society

should not migrate but the factory must be migrated.

35

4. Role of factories on economic development

Obviously, there is a great role of industries for economic development. The

importance of industries and their production is more beneficial as our developing

country and political instability. For employment opportunities, gross National

Production etc industries are necessary but the place (LPZ) is not fertile place for

industrial development (Neither for industries nor the public and Lumbini heritage

place). Similarly there was no individual ego to the industrial owners but rational is

the economic progress is compulsory but this place is not fruitful by those reason.

5. Possible solutions

Such survey focus that industries can be transfer but Lumbini Heritage place should

not be transfer. So such industries should be transfer to the adequate place making

industrial corridor and there non pollutant industries can be replaced. Another

opportunity is to develop such place by making tourism and religious tourism for

Buddhist as Makka Madina in Saudi Aurabia, Chardham in India for Hindus and

Vatican City for Christian. Developing sophisticated hotel and resorts can be another

best option.

36

Chapter 6 Summary conclusion and recommendation

This study was done to find out the health impact by the industrial air pollution within

Lumbini Protected Zone (LPZ; 15 km within the radius of Lumbini area). It was assessed the

health problems of children, elderly people by survey, focus group discussion, morbidity

pattern of local health institution. Such study was more important because there is great

threat due to industrial pollution on world heritage place; Lumbini too. The following

findings can be listed below:

1. Within 151 HH, male population is high (53%) than female, primary education and

illiterate population was about 1/3rd

and few populations was very few (3%), female

were high proportion, i.e. 20% were housewives, government job for those HH was

hardly possible. It indicates that people were not sensitized about their health, ecology

and future impact of industrial pollution

2. In the study area, 38% people were affected any kind of health problems, 1/4th

(25%)

school children were affected by ARI, 28% people were affected by any kinds of

lungs related diseases and eye, skin diseases, tuberculosis Asthama around 10%,

which are related with air pollution and there was significant role of industrial

pollution.

3. There were 3 study populations to measure the air pollution named community A, B

and C. The community which was adjoining with factory and highway had more

health problems specially the ARI, Asthama, COPD, eye and skin problems in

comparison with far from the industry and highway community. Community B was

very sensitive because of poor socio economic status and highly smoking pattern in

comparison with community A and C.

4. There was statistical association between polluted community with children affected,

ARI problems, prevalence of chest problems and smoking person in the family (p

=<0.005) and no association between community and risk factors like fuel type,

ventilation and vehicle movement around the household. Similarly, the top 5 disease

pattern of local health institution was pollution related disease. So it can be concluded

that there is association between air pollution and health problems.

5. There was little positive impact by the industry to the local people but most of the

people (62%) want to transfer the industry to another area because the agricultural

productivity was going to be deceased, importing the Indian labor for the industry and

fed up by the pollution. (want to migrate by the effect of air pollution in focus group

discussion)

37

6. So by the study, it can be recommended that such industry should be transfer in

adequate place with minimum compensation to reduce health impact and preserve

Lumbini Heritage place. For the economic benefit of the local community, non

pollutant industries can be promoted like Hotel, Resort, Professional agriculture,

horticulture, Fish pond, poultry form etc so that economic progress will be promoted

as well as industrial pollution would be minimized.

7. Regular health check up of local people and factory worker should be checked by

government effort periodically and modern scientifically air pollution free equipment

should be used in those industries.

Limitation of the study

1. This study was based on observation, survey, 2ndry data review and public opinion of

local people other than scientific measurement of air pollution. So exact cause and

consequence cannot be specified; but estimated only.

2. The time period was very short to detect everything in those communities. To verify

every variable it would be better to take 6 month.

3. The study time was not so suitable in August and September because that was still

rainy season but the more air pollution could be measured in spring season (May,

April etc)

4. Due to the lack of adequate resource, health problems could not detect properly. It

would be better to find out the health problems by health check up campaigning by

health worker and diagnostic tools (X ray, lab test etc)

By the above limitation it can be suggested that further study will be done more widely

taking enough time and resources.

38

Annex World Health organization

HEALTH IMPACT DUE TO INDUSTRIAL AIR POLLUTION IN LUMBINI

HERITAGE PLACE

Semi structured Questionnaire

District: Rupendehi Date:

A. General Information:

Municipality/VDC………… Interviewer……

Ward……. Household no……..

Name of Informant: Ethnicity….. Religion…….

B. Background Information: Per month

1 Family Income: Land………. Properties………..

2 No of employed…… Total Income: Total Expenditure:

3 Type of House:

i) Kachha ii)Pakka: iii) semi-pakka

Analyze and tick (Categories: very poor Poor Semi rich

Rich)

39

4 Detailed Family Information

S.

N

Name of family

member

Age/

Sex

Education Occupation Health problems

within 12 months

Lay/

Diagnosis

Frequencies

of attack

History/Evidence of

chronic Diseses

Amount of loss

per attack in Rs

…………………………

…………………………

…………………

…………………

…………………

…………………

…………………………

…………………………

…………………

…………………

…………………

…………………

…………………………

…………………………

…………………

…………………

…………………

…………………

…………………………

…………………………

…………………

…………………

…………………

…………………

…………………………

…………………………

…………………

…………………

…………………

…………………

…………………………

…………………………

…………………

…………………

…………………

…………………

…………………………

…………………………

…………………

…………………

…………………

…………………

…………………………

…………………………

…………………

…………………

…………………

…………………

…………………………

…………………………

…………………

…………………

…………………

…………………

…………………………

…………………………

…………………

…………………

…………………

…………………

Total Family no…. No of Female…….

Total no. of school children ------- No. of affected School children -------

Total no. of ARI cases: Total no. of Skin and eye problems

Others-----------

40

Total no of chronic cases

Type: No.

----------- ---------

------------ ----------

------------ ----------

------------ -----------

For detail fill the individual history form (Annex 2)

C. Specialized Questions:

1. Near your home what type of industry are here?

Factory Approx Distance in KM since when

A. Cement ------------- ----------

B. Cloth ------------- ----------

C. Textile ------------- ----------

D. Garments ------------- ----------

E. Other

a. (Specify--------) -------------

2. In which time do the industries throw the smoke?

a) Morning time b) Day time c) Evening time d) other (specify….)

3. Is the smoke foul smelling? Yes---- No-----

4. What is the situation of being victim of becoming ill after established industry?

a) As usual b)More c)less d)With epidemic

5. What positive effects are you feeling after establishment of such industries?

a) Opportunities of employment c) Opportunities of transport

b) Opportunities of tourism d) Opportunities of business

e) Other (specify----------------)

6. What negative are you feeling after establishment of such industries?

41

a) Increasing in number of sickness c) Destruction of flora and fauna

b) Change in climate d) Destruction of forest

e) Increasing in theft and robbery f) others (Specify…………)

7. What kind of climate change effects are you feeling here?

a) Drought b) Rising in temperature c) Increasing of epidemic and disaster

d) Decrease in productivity e) others (Specify-----------)

8. What suggestion do you want to give to those industries?

a) Transfer the industries b) establishment of non pollutant industry

c) Add such type of industries d) others (Specify-------------)

D. Risk factors assessment

1. What kind of kitchen fuel are you using?

i) Firewood ii) Cow dung iii) Leaves and small stems

iv) Kerosene stove v) LPG vi) Electric heater

vii) Others…….

2. Are there Pipe and/or ventilation on Kitchen?

i) Yes ii) No

3. Is there somebody who is smoking in your family?

i) Yes ii) No

4. If yes,

No. of people Stick per day place of smoking

--------------- -------------- --------------------

5. Are there motor vehicles moves daily?

42

i) Yes ii) No

6. If Yes, how many vehicles per day?? -------------

7. What type of road is here? (Write by observation also)

a) Pitch road b)Districted pitch road c) Gravel

d) Dusty/Muddy road

8. What is the level of dust? (Write by observation also)

a) Nominal b) High c) very high

43

Annex -2

World Health organization

HEALTH IMPACT DUE TO INDUSTRIAL AIR POLLUTION IN LUMBINI

HERITAGE PLACE

Date --------------------- Name of Researcher------------------------

Name: Age: Sex Address:

1. What type of health problems are you suffering?

1. ------------

2. ------------

3. ------------

4. ------------

5. ------------

2. How long it was started?

a) < 6 months b) 1 -3 years c) >5 years

3. How many attacks by this disease per year? ----------------

4. Habit of

Smoking drinking chewing tobacco

------------ ------------ --------------------

1. How long? ----------

2. What are the factors responsible of this problem?

a) Pathogenic micro organism

b) Smoking

c) Air pollution

d) All of the above

3. What is the contribution of air pollution for your health problem?

a) Nominal

44

b) High

c) Very high

4. What is the contribution of industrial air pollution for your health problems?

a) Nominal b)High c)Very high

45

Annex 3

World Health organization

HEALTH IMPACT DUE TO INDUSTRIAL AIR POLLUTION IN LUMBINI

HERITAGE PLACE

Focus group discussion guidelines: Date---------- Place-----------

Number of participants: 8-12 person Level of participants: Member of mother group,

FCHVs, Teachers, Industrial workers etc.

Reporter: Local facilitator and Principle researcher Time: 1-1:30 hours

Program type: Informal

Program section:

Introduction

Content discussion: Health Impact due to air pollution

Closing

Tea snacks

Content discussion (They are requested to discuss with evidence and examples with date)

1. How do you feel the air pollution? Tell with examples and some evidence if you

have.

2. In your opinion, what are the sources of air pollution in your community?

46

3. Share and discuss on health impact due to air pollution based on your practical

problems with date and time

4. Categories the air pollution level on your health (Industrial, vehicles, dust etc)

5. What effects are you bearing by industrial air pollution in your community as

common?

6. What is the relationship with the community and Industrial owner? Are they

conscious with your problems? What kind of help are they providing?

7. What other effects are you feeling by industrial air pollution? (Biodiversity,

natural disaster, tourism, Lumbini heritage, climate change etc)

47

8. What suggestion do you give to industrial owner, government and local

organization?

9. What type of action are you taking to reduce pollution till now?

Thank you for your good participation!!!!

(Such information will be the qualitative and complementary for questionnaire)

48

Picture result

Interaction with LDT Authorities Haphazard throwing of plastic and pollution

Air pollution Impact to the Ecology

Air pollution Impact to the Atmospheres

Air pollution Impact to the Source of water

Researcher with Local facilitators

49

Air pollution Impact to the Athmosphere

Data collection in the community Interaction within Local school

Interaction with local people Satellite map of study area

Skin disease after prolong exposure on Steel Factory Child affected by ARI near cement factory