Examination of Witnesses (Questions 140
WEDNESDAY 23 JANUARY 2002
BENDER CB, MR
140. So, in fairness, you have only had a few
weeks. So we can expect to see an early burst of action from the
Department now that all the information has flowed in?
(Mr Bender) We are still considering the responses
but there will be recommendations to Ministers soon.
141. That is okay, I know the standard answers!
Coming back to the point we raised before about deaths brought
forward and the 24,000, as Mr Gibb established with you, this,
in fact, is only a very small part of the health cost. Are you
able to give either any absolute figure or any qualitative figure,
approximate percentage, of the impact of the deaths in relation
to the wider impact?
(Mr Williams) You mean the wider impact of the pollution
damage in its broader sense?
142. Yes, damage to health?
(Mr Williams) No. The main health impacts of particles
are the two that are quantified here. There are other measures
that have been looked at, things like use of asthma treatments,
that might be associated and so on, but these are the two biggest.
143. Getting back to the attempt at the cost
benefit, I quite welcome what you are trying to do, I am not trying
to knock what you are trying to do, I am trying to see how realistically
near we are to getting anywhere. If you carry out a cost benefit
assessment of whether it is worth taking action or not, someone
would have to put some sort of price on them, if you excuse the
phrase, but what about the exacerbated damage to health, the loss
of quality of life of people suffering from severe bronchial illnesses
and how on earth, statistically, are you going to be able to deal
and quantify these in a cost benefit analysis?
(Mr Williams) With difficulty. There are some numbers
that have been produced in the scientific literature of association
between particles and asthma relief use and also what are called
in the jargon "restricted activity days" where people
might feel discomfort so they do not go out or run around in they
way they might otherwise have done. These are not felt by the
Department of Health Committee that came up with the numbers here
soundly enough based to put into a hard cost benefit calculation.
Nonetheless, what we can do is recognise that there are associations
and what that allows you to do when you are assessing the policy
tie up is to guess that your damage costs are probably, if anything,
144. Do you have any regional distribution pattern
for the 24,000 deaths? I assume that it would be effectively a
London, Birmingham, Manchester type of table, would it?
(Mr Williams) Given that we do not know what the geographical
spread of susceptibility is at the moment, the only answer to
that is they go proportionately with the different levels of particles
in the UK, so where you have got the highest levels you can predict
the highest incidence of deaths brought forward.
145. You say the highest levels. How would the
three major connurbations compare with the rest of the country?
If we were looking at the total of 24,000 for example, would you,
on your spread relating it to particles, expect that to mean that
12,000 or 6,000 of the 24,000 would be in the three major connurbations
or most of them would be in the three major conurbations?
(Mr Williams) Most of them probably would. As a very
rough back-of-the-evelope calculation we could take the population
of Greater London of round about ten million in a national total
of about 60 million as about a sixth so that, of that 24,000,
4,000 would be in London. That is a very crude calculation.
146. That cannot be right because a lot of the
people do not live in urban areas so it would be significantly
higher than that because there are large areas of the country
where pollution levels, from what you said a short while ago,
will be significantly lower and, therefore, the number of people
affected in London would be significantly higher, and the same
in Manchester and the same in Birmingham. It follows logically,
does it not? You cannot just say that it is 24,000 and it is concentrated
particularly in urban areas and then say because one in six live
in London only one-sixth of the effect would be in London. That
is a self-contradictory statement.
(Mr Williams) We could talk at length on this.
147. We do not need to talk at length, it is
statistically obvious I would have thought. This is the least
complicated piece of statistics you have. It is bound to be far
greater than one in six. We will leave that great mathematical
puzzle. To a layman like myselfand you will gather that
they do not come much more layif you take this unavoidable
ozone problem we have (unavoidable because most of it is not generated
from our own country) is there a cocktail effect between these
pollutants? Obviously to have one pollutant is a problem; to have
two pollutants might be a greater problem. Is there a mix of these
pollutants that is particularly lethal and have you drawn up any
grid of the country to show where the potent mixes are greatest?
Coming back to ozone, which is outside our control, does that,
mixed with any of the others, exacerbate it?
(Mr Williams) That is a question that has been asked
for a long time, certainly several times in the last ten years,
and whenever expert assessments have been done they have always
come up with the answer that it is too difficult to tell. Nobody
has yet anywhere in the world, as far as I know, come up with
any clear answer to that question. You feel intuitively that there
ought to be. The nearest people have got is to do experiments
like exposing people to, for example, nitrogen dioxide and it
is shown that that enhances the response to allergens like pollen
in people who are sensitive to those things.
148. If you look at Table 12 on Page 27, it
looks difficult enough statistically to draw any conclusion even
from what is said there, but in the light of what you have just
said about the mix being unquantifiable and unidentiable, it makes
policy decisions even worse. Here what we have got is on the one
hand you talk about a spread and you talk of a 40 per cent error
but, in fact, it is an 80 per cent spread, is it not, it is plus
or minus 40 per cent, which is 80 per cent? The best of them is
lead which is plus or minus 14 per cent, so there is a spread
of 28 per cent in the uncertainty area as far as the statistics
are concerned. That is taking these as individual elements.
(Mr Williams) Let me just backtrack. When I said we
had no idea what the effect of mixtures was, the best we can say
at present is the effects are additive of the individual components
taken together. We do not know whether there are any synergies
or value added. The other thing I should say in relation to what
you said in terms of table 12 is when we talk about an uncertainty
of plus or minus 40 per cent it does not mean that there is an
equal probability of it being plus 40 per cent in the middle or
minus 40 per cent, we assume some sort of statistical distribution
on that, so the central estimate is the most likely.
149. My time is more than up, I am afraid. Can
I ask you, if you have such a thing, to submitThat is not
meant in that sense but in the sense I understand the statistical
problems that you face. Is it possible to submit to us something
in map form or written form indicating the concentrations, as
far as you are able to identify them, the regional or area concentrations
of the various elements listed here?
(Mr Bender) We will provide an explanation of the
picture on the front cover. Can I also say, Chairman, we also
undertook to provide the note Mr Gibb asked for but I have found
a little more data. We spend £2.5 million a year, including
the Local Government Finance Settlement, for local authorities
to spend on air quality management duties and an additional £2.5
million to help with the purchase of the equipment. That is a
first answer, £5 million in total for the expertise and equipment.
I will provide the note I offered to you.
Mr Williams: Thank you. I expect Mr Gibb thanks
Chairman: Thank you very much, Mr Williams and
Mr Bender. There is nothing more important as far as public health
is concerned than the protection of the environment. It is a very
difficult subject because of the difficulties in working out cost
benefit analysis, but you have made a very good fist of it. Thank
you very much. Before the session closes may I just formally welcome
the Public Accounts Committee of South Africa who have been attending
very assiduously at the back of the room and we look forward to
having a private word with you in a moment. Thank you.
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