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Environmental Research 92 (2003) 71–77

Review of air pollution and health impacts in Malaysia

Rafia Afroz,a, Mohd Nasir Hassan,a and Noor Akma Ibrahimb
Department of Environmental Sciences, Faculty of Science and Environmental Studies, University Putra Malaysia 43400 UPM,
Serdang Selangor D.E., Malaysia
Institute for Mathematical Research, University Putra Malaysia, Serdang Selangor D.E., Malaysia
Received 7 June 2001; received in revised form 28 October 2002; accepted 31 October 2002


In the early days of abundant resources and minimal development pressures, little attention was paid to growing environmental
concerns in Malaysia. The haze episodes in Southeast Asia in 1983, 1984, 1991, 1994, and 1997 imposed threats to the environmental
management of Malaysia and increased awareness of the environment. As a consequence, the government established Malaysian Air
Quality Guidelines, the Air Pollution Index, and the Haze Action Plan to improve air quality. Air quality monitoring is part of the
initial strategy in the pollution prevention program in Malaysia. Review of air pollution in Malaysia is based on the reports of the
air quality monitoring in several large cities in Malaysia, which cover air pollutants such as Carbon monoxide (CO), Sulphur
Dioxide (SO2), Nitrogen Dioxide (NO2), Ozone (O3), and Suspended Particulate Matter (SPM). The results of the monitoring
indicate that Suspended Particulate Matter (SPM) and Nitrogen Dioxide (NO2) are the predominant pollutants. Other pollutants
such as CO, Ox, SO2, and Pb are also observed in several big cities in Malaysia. The air pollution comes mainly from land
transportation, industrial emissions, and open burning sources. Among them, land transportation contributes the most to air
pollution. This paper reviews the results of the ambient air quality monitoring and studies related to air pollution and health
r 2003 Elsevier Science (USA). All rights reserved.

Keywords: Air pollution; Sources of air pollution; Air quality; Ambient air quality guideline; Health Impact

1. Introduction reviews the results of ambient air quality monitoring

and studies related to air pollution in Malaysia and its
Malaysia has enjoyed one of the least polluted urban impact on human health.
environments in Asia. The goal of achieving industrial
country status by the year 2020 and the associated rapid
economic growth have started to impose costs in terms 2. Sources of air pollution
of industrial pollution and the degradation of urban
environment. Depletion of fisheries, air and water The three major sources of air pollution in Malaysia
pollution, and contamination by industrial wastes have are mobile sources, stationary sources, and open
become more serious in Malaysia in recent years. burning sources. For the past 5 years, emissions from
Among them, air pollution is the major issue that has mobile sources (i.e., motor vehicles) have been the major
been affecting human health, agricultural crops, forest source of air pollution, contributing to at least 70–75%
species, and ecosystems. Monitoring data and studies on of the total air pollution. Emissions from stationary
ambient air quality show that some of the air pollutants sources generally have contributed to 20–25% of the air
in several large cities are increasing with time and are pollution, while open burning and forest fires have
not always at acceptable levels according to the national contributed approximately 3–5%. According to the
ambient air quality standards. Data on air pollution and Department of the Environment (DOE, 1996), Malay-
case studies are very limited in Malaysia. This paper sia, in 1996, the percentages, of the air emission load by
type were motor vehicles, 82%; power stations, 9%;

Corresponding author. industrial fuel burning, 5%; industrial production
E-mail address: (R. Afroz). processes, 3%; domestic and commercial furnaces,

0013-9351/03/$ - see front matter r 2003 Elsevier Science (USA). All rights reserved.
72 R. Afroz et al. / Environmental Research 92 (2003) 71–77

Fig. 1. Sources of air pollution in Malaysia, 1996. Source: Department of the Environment (1997).

0.2%; and open burning at solid waste disposal sites, Table 1

0.8% (Fig. 1). Percentage of market share, leaded/unleaded gasoline
Mobile sources include motor vehicles such as Retail sales 1994 1995 1996 1997 Year-end
personal cars, commercial vehicles, and motorcycles. 1998
By the end of 2000, there were 10.6 million vehicles Leaded gasoline unleaded 52 32 24 20 0a
registered in Malaysia, compared to 7.7 million in 1996, Gasoline (ULG) 48 68 76 80 100
an increase of almost 2.9 million vehicles or 26% a
Leaded gasoline sales phased out by year-end 1998. Source:
(Department of Environment (DOE), 2001). The federal Department of the Environment (2001).
territory of Kuala Lumpur has the highest vehicle
population followed by Johor, Selangor, Perak, and
Pulau Pinang. These conditions have caused severe
congestion in almost all parts of the highway network regulations are based on the European Economic
and corridors, especially in the central business areas, Commission on Standards.
and inevitably the environment in these areas has The nation-wide retail sale of leaded gasoline has been
deteriorated due to exhaust emissions from motor declining as a percentage of total sales over the past few
vehicles. The DOE found that after the economic years, as shown in Table 1. This reduced market share
recession of 1986–1988, the number of registered combined with the availability of appropriate additives
vehicles increased at a faster rate, i.e., from a 3.3% has allowed fuel suppliers to agree to cease the sales of
increase in 1987 to a 9.5% increase in 1990. During the leaded gasoline altogether. Officially, all petroleum
same period of time, the study revealed that the level of companies in Malaysia must stop the production and
air pollutants in Kuala Lumpur and Selangor increased sale of leaded gasoline by the year 2000. Reduced leaded
rapidly after the economic recession. In Malaysia, gasoline sales are believed to be responsible for a steady
private cars are the most important contributor of decrease in lead levels throughout the western side of
atmospheric pollutants. They contribute about 75% of peninsular Malaysia. Over the next few years, this
the total CO and SPM, as well as about 76–79% of the reduction may be offset by the increase in the sheer
oxides of sulfur and nitrogen (DOE, 1991). Two recent number of motor vehicles on the road, especially in
accomplishments will reduce the negative impact of urban areas.
mobile sources on air quality: the approval of new Stationary sources are related to industry, power
environmental regulation amendments the Environmen- stations, industrial fuel burning processes, and domestic
tal Quality Act (EQA), and the phase-out of leaded fuel burning. Most of the stationary sources in Malaysia
gasoline sales. A significant first step toward implement- reside in Selagor, followed by a significant number of
ing Malaysia’s Clean Air Plan was achieved in 1996 with sources in Sarawak, Johor, Sabah, Perak, and Pahang.
the approval of two regulations designed to reduce Increased activity from the industrial sector has been
emissions from mobile sources: The Environmental accompanied by an increased use of energy and
Quality (Control of Emissions from Diesel Engines) commodities traffic.
Regulations 1996 and the Environmental Quality Most of the small and mid-sized industries do not
(Control of Emissions from Petrol Engines) Regulations install pollution control equipment. This increases the
1996. The new regulations focus on prevention by emission of pollutants, especially in the industrial areas,
controlling vehicular emissions at the manufacturing or which in some cases contributes specific pollutants to the
assembly stage. The emissions standards in the new air. Moreover, small industries are generally located in
R. Afroz et al. / Environmental Research 92 (2003) 71–77 73

Table 2 Table 3
Stack gas emission standards The Malaysia air pollution index

Emission source Standard API Diagnosis

Dark smoke 0–50 Good

Solid fuel equipment Ringlemann Chart No. 2 50–100 Moderate
Other fuel types Ringlemann Chart No. 1 101–200 Unhealthy
Dust 0.1–0.4 gm/Nm3 (source dependent) 201–300 Very unhealthy
0.01 gm/Nm3 301–500 Hazardous
Metal and metallic
compounds Source: Department of the Environtment (1996).
Mercury 0.015 gm/Nm3
Cadmium 0.025 gm/Nm3
Lead 0.025 gm/Nm3 power to issue contravention licenses for burning.
Antimony 0.025 gm/Nm3 Instead, there would be a specific list of prescribed
Arsenic 0.1 gm/Nm3 activities authorized for open burning. The palm oil
Zinc 0.1 gm/Nm3
industry would receive further pressure to adopt
Gases technology to achieve zero burning in their land-clearing
Acid gases 3.5 g of SO3/Nm3 operations. Airborne surveillance is provided to the
Sulfuric acid mist, SO3 0.2 g of SO3/Nm3 DOE through a joint airborne surveillance program
Chlorine gas 0.2 g of Hcl/Nm3 with the police Air Wing. The objective is to conduct
HCl 0.4 g of Hcl/Nm3
useful and speedy surveillance on activities violating the
Florine 0.3 hydrofluoric acid g /Nm3
Hydrogen sulfide 5 ppm (vol%) EQA, such as excessive smoke emissions from indus-
NOx 1.7–2.0 g of SO3/Nm3 (source dependent) tries, cases of open burning at dumpsites, and uncon-
trolled forest fires (US Department of Commerce, 1998).
Source: Department of the Environtment (1996).

3. Air quality in Malaysia

populated areas where emission control is more proble-
matic. To overcome the problem, the EQA lists the Ambient air quality standards identify individual
following standards for stack gas emissions (Table 2). pollutants and the concentrations at which they become
Open burning sources of air pollution in Malaysia harmful to the public health and the environment. The
include the burning of solid wastes and forest fires. This standards are typically set without regard to economic
is common at some poorly managed disposal sites and feasibility for attainment. Instead, they focus on public
results in smoke and fly ash problems. Over the last health, including the health of ‘‘sensitive’’ populations
several years between July and September significant such as asthmatics, children and the elderly, and public
amounts of particle matter have been transported by welfare, including protection against decreased visibility
south-westerly winds from a neighboring country due to and damage to animals, crops, vegetation, aquatic
uncontrolled biomass burning activities. As a conse- resources, and buildings. The Malaysian air pollution
quence, serious haze events were recorded in peninsular index (API) is obtained from the measurement of fine
Malaysia, Sabah, and Sarawak in 1991, in 1994, and, particles (below 10 mm) and several gases: carbon
most recently, during September and October of 1997. monoxide, sulfur dioxide, and nitrogen dioxide. Table
The cause of the 1997 haze was large-scale forest and 3 shows the API for Malaysia. Based on API readings
plantation fires, particularly in southern Sumatra and throughout the country, the air quality has been
central Kalimantan, both in neighboring Indonesia. considered generally good. In the urban environment
Haze conditions are aggravated by local emissions from of the Klang Valley, the index also has generally been
motor vehicles, industries, and open burning activities. between good and moderate, except for serious haze
At its worst, the haze limits visibility to less than 500 m events in September and October. The bad air days of
and produces respirable particles of concentrations 1997 combined with the hosting of the Commonwealth
up to 500 g/m3 (five times the level considered Games in September 1998 provided as incentive for the
‘‘unhealthy’’). installation of eight more air quality monitoring
The DOE is considering an amendment to the EQA stations, bringing the new total to 39. Table 4 lists the
to implement stiffer penalties for open burning. The recommended Malaysian Air Quality Guidelines (Am-
maximum fine would be raised from RM 100,000 to RM bient Standards) and compares them with the National
500,000 (US$ 25000 to US$1250,00). The bill would go Ambient Air Quality Standards currently enforced in
beyond industrial responsibility, making landowners the United States and WHO guidelines. The Malaysian
and land occupiers responsible for open burning on their guidelines are fairly consistent with the standards of the
property. The bill would also do away with the DOE’s United States’.
74 R. Afroz et al. / Environmental Research 92 (2003) 71–77

Table 4 Sekitar Malaysia Sdn Bhd (ASMA) also manages the

Ambient air quality standards-Malaysia and the United States Environmental Data Center, which provides environ-
Air pollutants Malaysia USA WHO mental data to the DOE and other interested parties. In
(mg/m3) (mg/m3) (mg/m3) 1996, 10 new fully automated ambient air quality
monitoring stations with telemetric systems were in-
Carbon monoxide
8-h average 10,000 10,000 10,000 stalled, bringing the total number of stations up to 31.
1-h average 35,000 40,000 30,000

Nitrogen dioxide (NO2) 5. Air pollution studies in Malaysia

Annual — 100 —
1-h average 320 — 400
In Malaysia, few studies have been conducted on air
Ozone (O3) pollution. Most of them are related to the 1997 haze
8-h average 120 — 100 episode. In most years, the Malaysian air quality was
1-h average 200 240 150 dominated by the occurrence of dense haze episodes.
From July to October 1997, Malaysia was badly affected
Particulate matter
Annual 90 50 — by smoke haze caused by land and forest fires. Previous
24-h average 150 150 — incidents of severe haze in the country were reported in
April 1983 (Chow and Lim, 1983), August 1990
Sulfur dioxide (SO2) (Cheang, 1991; Sham, 1991), June and October 1991
Annual — 80 —
(Cheang, 1991), and August to October 1994 (Yap,
24-h 105 365 —
1995). The severity and extent of the 1997 smoke haze
Source: Department of the Environtment (1996). pollution were unprecedented, affecting some 300
million people across the region. The actual amount of
economic losses suffered by countries in the region
4. Ambient air quality monitoring during this environmental disaster were enormous and
are yet to be fully determined.
In the early days of Malaysia, development and During nonhaze episodes, vehicular emissions ac-
growth were not planned; they were initiated according counted for more than 70% of the total emissions in the
to the needs and pressures of the time. Consequently, urban areas. Air quality studies conducted in the Klang
this haphazard development has resulted in negative Valley during the nonhaze episodes between 1986 and
impacts on the environment as a whole and on air 1989, December 1991 to November 1992, and January
quality in particular (Sham, 1994). Earlier, Sham (1979) 1995 to December 1997 demonstrated two distinct daily
pointed out that the atmospheric pollution problem is peaks in the diurnal variations in the concentrations of
becoming more serious, as there is always a potential for sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon
the occurrence of inversion in the valley. In anticipation monoxide, and particulate matter. The morning hour
of the potential severity and magnitude of the problem, peak was due mainly to vehicle emissions and the late
the government enacted into law the Environmental evening peak was attributed mainly to meteorological
Quality Act in 1974; subsequently, the Division of the conditions, including atmospheric stability and wind
Environment was established and the Clean Air speed. Total suspended particulate matter was the main
Regulations were formerly gazetted in 1978. pollutant; the concentrations at a few sites in the Klang
The first ‘‘long-term’’ air quality monitoring project Valley often exceeded the Recommended Malaysian Air
emphasizing suspended particulate and sulfur dioxide Quality Guidelines. A comprehensive study conducted
was carried out by the DOE and the Meteorological by the Department of the Environment, Japan Interna-
Service Department (MMS) at the industrial and tional Cooperation Agency, the Malaysian Meteorolo-
residential zones in Petaling Jaya in 1978. Results of gical Service, and University Putra Malaysia between
the study suggested that the suspended particulates December and August 1993 gave clear indications that
exceeded 93% of the time in the industrial zone (the air pollution in the Klang Valley was becoming worse.
previously proposed standard was a 24-h average of This study also indicated that if no effective counter-
100 mg/m3) and 95% of the time in the residential zone measures were introduced, the emissions of sulfur oxides
(the then-proposed standard was 50 mg/m3 (DOE, 1997). (SO), nitrogen oxides (NO), particulate matter, hydro-
Sulfur dioxide was generally low near the industrial site. carbons, and carbon monoxides (CO) in the year 2005
In April 1995, Alam Sekitar Malaysia Sdn Bhd (ASMA) would increase by 1.4, 2.12, 1.47, and 2.7 times,
was awarded a 20-year privatization concession to respectively, the 1992 levels (Awang et al., 1997).
install, operate, and maintain a network of 50 contin- A separate study of air quality in Kuala Lumpur
uous air quality monitoring stations (and 10 water found that the smoke haze was associated with high
stations) throughout Malaysia for the DOE. Alam levels of suspended microparticulate matter, but with
R. Afroz et al. / Environmental Research 92 (2003) 71–77 75

relatively low levels of other gaseous pollutants such as Kuantan and Kuchhing, as the intercept SPM values
carbon monoxide, nitrogen dioxide, sulfur dioxide, and were not significantly different from zero. The highest
ozone (Awang et al., 2000; Noor, 1998). During this level of nonbiomass related pollution was found in
period, the PM10 concentration rose beyond the Petaling Jaya with an intercept level of 5078 mg/m3
Malaysian Air Quality Guideline (MAQG, 1989) level (Awang, 1998).
in almost all areas monitored. It increased 4-fold higher
in the Klang Valley and up to 20-fold in Kuching
(Awang et al., 2000). In a study coordinated by the 6. Health impacts of air pollution in Malaysia
Department of the environment to determine the origin,
formation, and composition of aerosol haze in Malaysia There are possible short-term and long-term health
(Department of the Environment, 1997), approximately effects of exposure to air pollution. In the short term,
200 representative samples collected by the Malaysian high levels of air pollution lead to an acute condition. In
Meteorological Service for total suspended particulate addition, blockage of sunlight may promote the spread
and PM10 measurements during the haze episode in 1994 of harmful bacteria and viruses that would otherwise
and in the nonhaze years 1995 and 1996 were analyzed be killed by ultraviolet B (Beardsley et al., 1997). The
by particle-induced X-ray emission at NERI in Den- possible long-term health effects of exposure to air
mark. The objective of the study was to apportion the pollution are unknown and difficult to detect. Compo-
sources of the 1994 haze episode based on two nents of smoke haze, including polycyclic aromatic
mechanism that had been proposed for the explanation hydrocarbons, are known carcinogens the effects of
of the haze episode. The first mechanism relates to the which may not be apparent for years. The consequences
more stable atmospheric conditions that exist in the dry may be more severe for children, for whom the
season. This would allow the rather continuous emis- particulates inhaled are high relative to body size.
sions from traffic and industry to build up high local There are a very limited number of studies that relate
concentrations of pollutants. This could explain why the air pollution to its health impact in Malaysia. The lack
heavily industrialized Klang Valley during haze epi- of data gathering for environmental epidemiological
sodes, often was more polluted than other parts of the analysis makes it difficult to estimate the health impact
country, during haze episodes, but it does not explain of air pollution. Recent studies in this country have
why some localities with little traffic and industries, such examined possible health effects of the 1997 forest fires.
as Kuching in Sarawak, in some years were polluted For example, outpatient visits in Kuching, Sarawak
with suspended particulate matter at levels of the same increased between two and three times during the peak
magnitude as in the Klang Valley or even higher. The period of smoke haze and respiratory disease outpatient
second mechanism relates to fire in South Sumatra and visits to Kuala Lumpur General Hospital increased
the Kalimantan forests, which reoccur every year in the from 250 to 800 per day (World Health Organization,
dry season but in some years, tend to get out of control. 1998). Data were assembled that indicated an increase
The results of the analysis ruled out the first in cases of asthma, acute respiratory infection, and
mechanism, as there was a poor correlation with lead, conjunctivitis during August–September 1997 at a
which are the marker for local pollution. The good number of major hospitals in Kuala Lumpur (Brauer,
correlation with sulfur supports, on the other hand, the M., and Jamal, H.H., 1998). For respiratory diseases,
casual relation with forest fires or other biomass Selangor recorded a significant increase in the total
burning, as sulfur and potassium are the essential number of cases during the September haze. Asthma
constituents in biomass. The Suspended Particulate cases increased from only 912 in June to more than 5000
Matter (SPM)/sulfur ratios found at geographically in September. The total number of acute respiratory
widespread locations in peninsular Malaysia (Penang, infection cases increased from about 6000 to more than
Kuantan, Klang Valley, and Johor) were very much the 30,000 during the same period. Apart from respiratory
same, corresponding to almost constant contents of diseases, conjunctivitis increased significantly during the
sulfur in the SPM (mass ratio 7–8%). This pointed to haze period. In Selangor, the total number of increased
a common origin (and/or type) of source, possibly the from only 207 cases in June to as high as 3496 cases
reported forest fires in South Sumatra. The high levels in October. The same trend was observed in Sarawak.
found in the Klang Valley could have been due to the In addition, the daily incidence of conjunctivitis in
combined effects of the geographical vicinity of the Sarawak during September was found to have a positive
source area, an unfortunate position in the prevailing correlation with the API (representing PM10 concentra-
direction of the wind flow, and possibly some trapping tion). However, the number of cases gradually decreased
of the biomass burning plume (4%). This pointed to toward the June value as the concentration of PM10
a different biomass burning source, probably fires in began to decrease after September. When the air quality
Kalimantan. The results also showed that pollution not was almost back to the values of a nonhaze period in
related to biomass burning was not imperceptible in October, the number of cases returned to normal. The
76 R. Afroz et al. / Environmental Research 92 (2003) 71–77

trend indicated that short-term exposure to high levels effects for Kuala Lumpur and Selangor during the haze
of PM10 was detrimental to human health (Awang et al., were also high, since both states recorded an average
2000). Effects were found to be greatest in children, the PM10 of 170.6 and 131.22 mg/m3, respectively.
elderly, and people with pre-existing respiratory pro- Another study conducted by Othman and Shahwahid
blem; youngsters are among the most resistant. A (1999) revealed that in the 1997 haze episode the
preliminary survey carried out among secondary school population at risk was from all states of the country
children in Kuala Lumpur and Klang revealed that less except in Kelantan, Terengganu, and Pahang; this
than 50% of these school children sought medical population is estimated to be 18 million people. But
treatment each time they fell sick (Awang et al., 2000). the incidence of risk varied among states in terms of
A study conducted by Nasir et al. (2000) suggested intensity and length of the haze. The incremental cost
that in the 1997 haze episode the total health effects were incurred by the population at risk for treatment of haze-
estimated to include 285,227 asthma attacks, 118,804 related illnesses from both public and private clinics and
cases of bronchitis in children, 3889 cases of chronic hospitals and for self-treatment (mainly the purchasing
bronchitis in adults, 2003 respiratory hospital admis- of medicine) was estimated to be RM 5.02 million
sion, 26,864 emergency room visits, and 5,000,760 during the period August–October 1997. The incremen-
restricted activity days. The whole population from all tal cost incurred for hospital admissions was estimated
states in the country was at risk except Perlis, Kelantan, to be RM 1.18 million during the same period. This
and Sabah. The total health damage cost was signifi- study also revealed that the country incurred productiv-
cantly high due to the long duration of the haze. The ity losses as a result of haze-related illnesses. These
results show that restricted activity days accounted for productivity losses occurred in foregone production
about 79.3% of the health damage cost while asthma opportunities during the idled workdays when workers
attack contributed 10.7% to the total health damage were in hospital and on sick leave. Those not
cost (Fig. 2). The contributions of the other three health hospitalized and not granted sick leave, who managed
effects such as respiratory, hospital admission, emer- to continue working are believed to have experienced
gency room visits, and chronic bronchitis were insigni- reduced activity days arising from the haze-related
ficant. Each of the above-mentioned effects actually illnesses they suffered. These sources of haze-related
contributed less than 1% of the total health damage productivity losses are estimated to be RM 4.3 million.
costs. The total health damage costs were estimated to
be RM 129 million, with a lower estimate of RM 36
million and a higher estimate of RM 258 million. 7. Conclusions
Among the 11 states of Malaysia, Sarawak was badly hit
by the particulate pollution with the largest number of Studies related to air pollution conducted in Malaysia
health effects, which comprised 23.8% of the total have been few. It is already 23 years since the
health effect during the haze. The estimated health Environmental Quality (Clean Air) Regulations 1978







10 5.67
0.88 0.94 2.28
Respiratory Emergency Restricted Bronchitis in Asthma Attack: Asthma Attack: Chronic Bronchitis
Hospital Room Activity Children Adult Children
Admission Visits Day

Health Effects
Fig. 2. Percentage distribution of health damage costs. Source: Nasir et al. (2000).
R. Afroz et al. / Environmental Research 92 (2003) 71–77 77

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