The increase in pollution levels in the city is not to be underestimated, argues Dena Rashed With every breath we take we fill our lungs with cornucopia of pollutants. There might be different types or levels in Alexandria, Aswan or Sharm El-Sheikh, but they are all up to the limit in Cairo. In the streets of this city of almost 15 million permanent residents and another three million commuters roam three and a half million cars -- and the number increases by 10 per cent each year. Pollution is taken for granted. Cairo alone hosts 50 per cent of the total number of industries of Egypt, and in many instances industrial waste is not disposed of properly. Although the environment question is not high on the agenda of every resident, it creeps into their daily lives whether or not they are aware of environmental issues. However, many Cairenes are complaining, and the strain on public health is manifesting itself in different ways. Sufferers from bad chests face seasonal breathing problems caused by the annual "black cloud" that has appeared for nigh to eight years. Sulphur dioxide, a result of the burning of fuel in energy plants, factories and vehicles using diesel, poses a high risk. The latest 2005 Egypt's State of the Environment Report issued by the Ministry of State for Environmental Affairs (MSEA) last Decemer, analysed the causes of pollution in Egypt and stated the successes and the drawbacks. Although the quality of the air has improved by 13 per cent, regarding the concentration of sulphur dioxide in residential areas, many areas in greater Cairo have experienced a 34 per cent increase above the average limit. The MSEA report states that Egypt's dry weather naturally allows for the proliferation of air pollution, while the scarcity of rain does not allow for the purification of the air as might be expected. Also the "close to the surface" wind is not that strong and the pollutants are thus allowed to stay low, making the short autumn season the month when the black cloud -- resulting form rice straw burning -- is felt much more. In addition to that, deserts constitute 90 per cent of the country's surface area, allowing for more dust and sand to blow to residential areas. Nature, however, seems to be playing a small role in comparison with the man-made creation and conserving of pollution. The report states that the increasing population in Egypt, 73 million so far, has met with a high cost: the more people, the more industries. Two important studies assessed the gravity of air pollution on public health. One was conducted by the Ministry of Health and Population in cooperation with Ain Shams University's Society and Environment Medicine and Industries Medicine Sections on the correlation between air pollution and deaths resulting from heart and chest diseases between 1995 and 2001. The second study was conducted to find out how this related to the number of hospital visits for these diseases from 1999 to 2001. The study showed a certain effect between the rise in the sulphur dioxide level in the air and the deaths resulting from heart and chest diseases. It also found a correlation between the increase of smoke in the air and the deaths resulting from lung cancer, heart and chest diseases. Chest consultant Ayman Abdel-Hamid argues that the past 10 years have witnessed an increase in what are called environmental diseases. "The chest is one of the main organs that is directly exposed to pollution. On average we inhale and exhale eight litres per minute, and unfortunately our weather is contaminated with polluting materials like carbons, causing many chronic obstructive diseases," Abdel-Hamid says. However he says that the use of asbestos in factories is now considered the most worrying of all pollutants and a major cause of lung cancer in Egypt. "The government is already supervising the materials used in many factories, and one infamous factory that was using this material was closed down years ago but not without affecting many of its workers," he says. "The problem is that we get many patients with lung cancer, and in many cases they work at factories that still use asbestos." Abdel-Hamid says lung cancer sometimes attacks these workers after 20 or 30 years of exposure to this dangerous material. "Sadly their wives could be affected too," he says, recalling one worker's wife who used to wash her husband's clothes which carried the particles of the asbestos. After years she, too, was found to be suffering from lung cancer. Safety measures and periodical check-ups for workers is what Abdel-Hamid hopes for, especially in private sector factories. Most importantly, people should not ignore the symptoms of chest pain or any new, inexplicable ones. "If a cough persists for more than a week despite treatment then it is better to check with a doctor," he says. The effect of the depletion of the ozone layer is another worrying environmental issue. According to the MESA report, while Egypt has been working on reducing the use of the chemicals that deplete the ozone layer, with a notable decrease in 2005, the use of methyl chloroform has not yet decreased. Even so, this year a cut of 85 per cent in the import and use of chlorofluorocarbons substances is expected, and their use will finally be abandoned by 2010. In addition there will be regular check-ups by the ministry on factories that use substances that add to the depletion of the ozone layer. Sherif Abdel-Azim, a dermatologist and skin surgeon who has been treating patients for more than two decades, also believes there has been a noticeable increase in skin diseases. "The depletion of the ozone layer has allowed harmful ultraviolet rays to affect our skin, and over the past 20 years we have been witnessing an increase in skin cancer cases," he says. Abdel-Azim said that at one time white- skinned people were commonly found to be more prone to skin cancer, but that recently skin cancer had also been affecting dark- skinned people. The main problem, as he sees it, is that people are not aware of the risks they take when they expose themselves to the sun rays, especially from noon to 3pm. The damage done to the skin is irreversible. "Sun burn could in the long run, lead to skin cancer, so people should not take the issue lightly," Abdel-Azim says. He advises people to avoid sitting in the sun, to wear reliable sun protection with a protection rate of no less than 15 SPF, and most importantly not to ignore changes that occur in the skin. "Skin cancer could take the form of a non-healing ulcer that grows gradually, and people could ignore it or be misdiagnosed because it is not associated with pain," he said. Cancer could also appear in the form of an aggressive type that grows into the skin and into the blood vessels, and affects the bones if it occurs, for example, near the skull. Early detection is the answer, Abdel-Azim points out. If a skin problem persists and resists treatment within a month, especially in areas exposed to the sun, then it is best to see a tumor surgeon or a skin surgeon who has the ability to reconstruct the skin.
