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 WenCWENGOOD@NHRI.org.TW

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