FEATURE Traffic jams: The silent killer

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ROAD TO PERDITION: Motorists and commuters are caught in traffic after authorities implemented a lockdown at the Cavite Expressway (Cavitex), near the venue of the Asia-Pacific Economic Cooperation (APEC) summit, in Manila on Nov. 16 – 20, 2015. PHOTOS BY MIKE DELIZO

A MAN was gasping for air inside a public utility van packed with 20 passengers stuck in traffic on Park Ave. Ext., in Metro Manila’s Pasay City.

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It was 9:45 p.m., Nov. 18, 2015. Twenty-one world leaders were in Manila for the 23rd summit of the Asia-Pacific Economic Cooperation (APEC). Traffic had been on a standstill for hours. Thousands of commuters were stranded on the road. Many decided to walk home.

The man in the van, later identified as Elmer Agaray, 57, of Paliparan III, Dasmariñas City, Cavite, was having a cardiac arrest.

Responding village watchman Abubacar Sultan, 29, together with two bystanders, rushed Agaray in a patrolling tricycle to the nearest hospital, the San Juan de Dios Hospital, along Roxas Blvd., also in Pasay City.

From where the van was stuck in traffic to hospital was about one kilometer and would have taken only four minutes of travel time.

The Pasay City police said Aragay arrived at the hospital after almost an hour, dead.

Attending physician Dr. Reginaldo Panopio said Agaray died of cardio respiratory arrest. He, however, added that Aragay could have been saved had he been attended to much earlier.

Aragay’s case belied the statement of Transportation Secretary Joseph Emilio Abaya that the much-complained-about Metro Manila traffic “is not fatal.”

What happened to Aragay is an extreme case. But studies reveal that long hours on the road put a lot of pressure on a person’s health.

Data from Numbeo, the largest database of user-contributed data about cities and countries worldwide, puts Manila as the world’s fifth city with worst traffic condition this year with a Traffic Index of 309.37.

In the top four are Kolkata and Mumbai, both in India; Dhaka, Bangladesh; and Nairobi, Kenya.

Traffic Index is a composite index of time consumed in traffic due to job commute, estimation of time consumption dissatisfaction, carbon-dioxide consumption (CO2) estimation in traffic and overall inefficiencies in the traffic system.

Killer traffic fumes

Manila is also fifth in CO2 Emission Index, an estimation of CO2 consumption due to traffic time, according to Numbeo.

Livestrong, a health website, says at normal levels, CO2’s presence has no measurable adverse effects on the body, but if your breathing is compromised or you are exposed to large amounts of this gas, you can experience a wide range of side effects, some of which include permanent injury and death.

Data from the Department of Environment and Natural Resources’ Environmental Management Bureau (DENR-EMB) reveals worsening air quality in the National Capital Region (NCR).

A 2015 report stated that the air pollutant concentration in NCR has already reached 130 micrograms per normal cubic meter (µg/Ncm) in terms of total suspended particulates (TSP) from 106 µg/Ncm in 2014. Maximum safe level of air pollutant concentration is only at 90 µg/Ncm.

Air pollution finds its way deep into the hearts and lungs, slowly killing 4.3 million people every year, according to the World Health Organization (WHO).

In the Philippines, DENR said 12 percent of premature deaths in Metro Manila are caused by poor air quality, especially particulate matter.

“Air pollution is a major environmental health problem affecting everyone,” WHO said. “Whether in Manila, Sao Paulo or London, air pollution is a problem from exhaust fumes from cars, domestic combustion or factory smoke,” WHO said.

Inhalation and ingestion of these pollutants can cause various respiratory and cardiovascular diseases such as asthma, chronic obstructive pulmonary disease, heart disease and stroke.

“Exposure to air pollutants is largely beyond the control of individuals and requires action by public authorities at the national, regional and even international levels,” WHO added.

Commuting is stressful

People exposed to the daily hassles of horrendous traffic easily get stressed. This is another aspect that develops health problems such as heart disease, asthma, obesity, aging and gastrointestinal problems, among other diseases.

Dealing with long queues as passengers, competing for a spot in the vehicle and waiting for the traffic to move greatly trigger the stress.

A cross-sectional study published in the American Journal of Preventive Medicine in 2012 revealed that the farther people commute, the greater the metabolic and cardiovascular risks are.

A survey among 4,297 adults who had a comprehensive medical examination between 2000 and 2007 showed that those who commute longer have less physical activity, thus they develop higher blood pressure and body-mass index.

Along Epifanio de los Santos Avenue, or EDSA, data from the Metro Manila Development Authority (MMDA) shows about 350,000 people use this major thoroughfare daily—156,000 vehicles, with a density of 565 vehicles/kilometer—quoting a 2013 study by Yves Boquet for the United Nations Economic and Social Commission for Asia and the Pacific.

Francis Tolentino, former MMDA chairman, said in an interview the average speed a motorist can travel along the 23.8-kilometer EDSA is 26 – 27 kilometers per hour.

It’s not unusual for traffic in Metro Manila to standstill for hours, turning the roads into huge parking lots. A 20-minute ride from Quezon City to Manila could take more than an hour.

‘Sitting is the new smoking’

Dr. James Levine, director of the Mayo Clinic-Arizona State University Obesity Solutions Initiative, coined the term “sitting is the new smoking.”

He noted that long periods of sitting are more dangerous than smoking, “which kills more people than HIV and is more treacherous than parachuting,” Lavine told the Los Angeles Times.

“[There’s] a growing number of studies that show that prolonged sitting—whether traveling by car, train or bus, at school or work, and watching television—may be associated with increased risk of all-cause mortality, cardiovascular mortality and cardiovascular diseases, and increased risk of diabetes,” said Dr. John Juliard Go, WHO’s national professional officer for road safety and non-communicable diseases.

A 2010 study in the American Journal of Epidemiology found people, regardless of gender, who sat more than six hours a day died earlier than those who have sitting time of three hours a day or less.

The researchers surveyed 123,216 individuals—53,440 men and 69,776 women—who were healthy at the start of the study and over the course of the 14-year follow-up, from 1993 to 2006.

Researchers saw a higher rate of cardiovascular disease mortality among those who sit longer. MICHAEL JOE T. DELIZO

(This story was produced under the Bloomberg Initiative Global Road Safety Media Fellowship implemented by the World Health Organization, Department of Transportation and Communications, and VERA Files. #SafeRoadsPH)

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