Thursday, May 31, 2012

Air pollution in the Philippines. Asthma in the Philippines? COPD in the Philippines?

Air pollution asthma copd in the Philippines

Air Pollution in the Philippines

Air pollution will probably not be a problem for short term visitors or tourists who do not already have asthma or Chronic Obstructive Pulmonary Disease (COPD). I had no problems with it until I had lived there for two years.

If you have an asthma attack or a COPD flare-up in the Philippines you can get a ride to a hospital and visit the emergency room. You might ask a tricycle driver to take you to the nearest taxi or jeepney. Then ride to a hospital. 

Visit my hospital page to find hospitals.
Read tips about riding in taxis.

If you need an inhaler use the following links to find a drugstore near you.
Mercury Drug stores, Watson's drug stores, Generics Pharmacy (scroll down the Generics page).

Air pollution and Asthma in the Philippines.
Asthma Inhaler prescribed as a result of
 air pollution in Metro Manila, Philippines.

If you have asthma or COPD and are planning to travel in the Philippines I can pass along some advice. Doctor Sadili, a pulmonologist at Makati Medical Center in Manila advised us to live on or near a beach to avail of the fresh air breezes from the sea. Most of the cities in the Philippines have heavy pollution from vehicular exhaust. Angeles City and Metro Manila are heavily polluted. In addition to vehicular exhaust, many people cook outdoors with wood stoves. Farmers burn fields. And in rural areas homeowners burn household trash on an almost daily basis (including plastic packaging). The smoke and hazardous fumes drift to neighboring homes and apartments. Having lived in a rural area I have experienced this.

I have read that the number one cause of death in the Philippines is lung disease.

"LONDON: Air pollution has emerged as the world's single largest environmental health risk, having caused seven million deaths in 2012 — 80% of which were from heart attacks and stroke."
From an article by By Kounteya Sinha, TNN | 26 Mar, 2014, 05.31AM IST

Air pollution in the Philippines. Air polluting bus in the Philippines
Air pollution in the Philippines. Can you imagine riding behind one of the many smoke belching buses in the Philippines?
I have been behind buses, jeepneys and tricycles that pollute like this.

I had never had problems when I was in the USA, before living in Metro Manila; however, after living in the Philippines for almost 4 years I was diagnosed as having COPD.

(Note: after returning to Florida, USA and staying there for 2 years I visited a doctor and mentioned that I had been diagnosed with COPD in the Philippines. She checked me out and said "your breathing sounds fine. You don't have COPD." So, it appears that my breathing problem in the Philippines was directly related to air pollution.

Air Pollution in Angeles City and Metro Manila

We lived in Metro Manila for 2 years and near the end of the two years I had difficulty breathing several times. We moved out to a province, Pampanga, North of Metro Manila, to get away from the heavy air pollution. Moved into an apartment in a rural area. It is about 500 meters (or 1,640 feet) from the two lane road that is fairly heavily trafficked. The air is so much cleaner. No smell of vehicle exhaust here. My Filipina wife, who has asthma, had no problems or attacks while living in this rural area.

However, whenever we need to go to the mall or to town it is necessary to travel in traffic. Many jeepneys, tricycles and trucks are "smoke belchers."

We have traveled by jeepney and tricycle in several cities in the Philippines and have found pollution in almost every city. Some cities we have visited are: Angeles City, Argao, Cagayan de Oro, Cavite, Cebu City, Bataan, Batangas, General Santos City, Lapu Lapu, Magalang, Manila, Olongapo, Paranaque, Quezon City, San Fernando, Subic City and more. The two cities that had the least pollution, in my opinion, were Cagayan de Oro and General Santos City; both on the island of Mindanao. The third city with cleaner air would be Cebu City on the island of Cebu.

Jeepney in Philippines
One of the many "smoke belching" jeepneys.

See this video about the forthcoming "Comet" electric jeepneys that are coming to Metro Manila.

An annual registration and an emissions test are required for all vehicles. I asked someone why there are still "smoke belchers" and was told that it is because "those people just do not register their vehicles."

Here in the Angeles City area the pollution is not as heavy as in Makati or Metro Manila, but it still exists.

Cloth and Foam mask sold at SM Department Stores in Philippines
Cloth motorcycle mask sold at SM Department Stores in Philippines. Like the one I wear.

In Manila I had purchased a cloth motorcycle or motorbike mask to wear when riding in public transportation and I have been wearing one almost every time I am traveling. On occasion I have forgotten to take the mask along. Inevitably, by the time I arrive back home I am coughing. Warning, with this type of mask you can still smell the odor of exhaust so you are probably still being subjected to a lot of pollutants reaching your lungs. I do not wear it when riding in air conditioned cars, taxis or buses. My breathing is okay then.

Usually one must travel into the heavier polluted downtown areas to go to a hospital to visit a doctor. Many malls in the Philippines have medical clinics serving the public. But, to reach a specialist I have found it always necessary to go to a larger hospital or Medical center in a polluted area.

In Manila we visited doctors who have clinics in Makati Medical Center. It was there that I was, for the first time in my life, prescribed an asthma inhaler. When I fly back to the USA, from the time I board the plane, I no longer need an inhaler or a mask.

Most jeepneys are open-air and the pollution enters freely into the jeepney and into your lungs. I thought of wearing a gas mask, but I could not find where to buy one anyplace. And, I would have felt quite self conscious wearing one seeing as no one else did. Filipinos just live with this on a daily basis. Some will, very ineffectively cover their mouth and nose with their hand. Some hold a handkerchief over their nose when the smoke is extra heavy. I did find a motorcycle type cloth mask that has velcro on straps which fasten behind ones head. It seems to help a little. When I wash it with soap in a clear glass jar, about every 3 weeks, the water turns dark gray after I let it stand for a few hours.

Can you believe, there is a law against smoking cigarettes in jeepneys and in some public places? How insignificant cigarette smoke is compared to pollution caused by the MANY smoke belching buses,  jeepneys and tricycles.

In Metro Manila there have been days when, from a distance, I could barely see the outlines of the skyscrapers because the pollution was so thick. In a city of almost 18 million people I am sure enforcement of anti-pollution laws is a daunting task.

If you have asthma, I advise you to bring your inhaler, do not stay too long in the big cities, visit beach areas, and travel only in air conditioned taxis and buses. True, the air outside is polluted but at least the heaviest black exhaust won't enter your taxi or bus as it would enter a jeepney, tricycle or open car.

We were advised, by a Filipino pulmonologist, to go live in a place by the sea to get away from air pollution. So, if you are planning to live in the Philippines I suggest you take that advice. Visit the big cities but live elsewhere.

"Breathing Metro Manila air now risky - DOH"

I read once that just breathing the air in Mexico City is equivalent to smoking two packs of cigarettes a day! Would it be one, two or three packs a day in Metro Manila?

Read how one Filipino cured himself of asthma by moving to Canada.

Motorcycle Masks, Motorbike Masks

In my opinion the only logical solution would be to wear an actual gas mask whenever riding in any form of transportation. However, if I had worn one I would have been the only one in the country wearing one! The desire to "conform" affects everyone! Well I did, at least, purchase cloth "motorcycle" type masks for myself, my wife and daughter. They trap a lot of the oil and other pollutants. We would wash them every two weeks or so, with laundry detergent, in a clear glass bottle. You should see how dark gray the water would be after each washing. At least the masks stopped some of the pollutants from reaching our lungs. These masks are available in the Auto Supply areas of SM Department Stores. SM Malls can be found in most major cities in the Philippines.

Today, I just found a web site where they sell a mask which is probably much better than the ones we used. I suggest you visit the site I Can Breath and order one or more before you travel. See users' comments about these charcoal filter masks, at the site. If you are planning an extended stay inquire of them as to how long a mask can be used and still remain effective. Then you will know how many masks you may need during your stay.

Mask for air pollution in the Philippines
Honeycomb ACF Pollution Mask

I recommend that you check out this mask and order one or a few before traveling to the Philippines.

If you are planning an extended stay in the Philippines you might want to be sure you are in an area serviced by air conditioned taxicabs and buses. Many cities, like Angeles City, have very few or no taxis. The only place in Angeles City where I have seen a taxi stand is at the large SM Clark City Mall in the Balibago area. There you should be able to find 4 or 5 taxis in a row during mall hours (10 a.m. til 9 p.m.).

It is not easy to pick up a phone and call a taxi in the Philippines. Taxis usually are found only in the largest cities like Manila, Quezon City, Cebu, etc.

We visited the city of Batangas, about a one hour ride from Manila. Batangas is a fairly large city. Saw no taxis there. Only jeepneys and tricycles.

Cebu City and Lapu Lapu on the island of Cebu and Cagayan de Oro, on the island of Mindanao have taxis.

In Metro Manila there are taxis everywhere. One may hail a cab there fairly easily, 24 hours a day. Compared to the USA Philippine taxi and bus fares are LOW and thus very affordable for the average foreign tourist. A five or ten mile ride will set you back about $3.75 US. But, near the city center malls, like SM Mall and Glorietta Mall,  you must wait in line at taxi stands, without exception, and in the evening when many are leaving the malls you may wait for up to 45 minutes for your turn to get in a cab. These taxi stands are monitored by mall security guards, they will note the ID number of the taxi on a slip of paper and hand it to you. This is for your security, you can call a trusted friend and notify them of which cab you are in so in the event you are hijacked they can report it to the authorities. And it probably discourages drivers from trying anything funny.

The way to avoid standing in line is to arrange for a car and driver. The driver will stay with the car and pick you up when you call him on his cell phone.

As far as I can see smoke belching is a nationwide problem; a hazard to health and a major hindrance to tourism, commerce and development.

I have read that Puerto Princessa has very little air pollution because it has a very progressive mayor.

A Solution to Pollution in the Philippines?

100,000 Electric Tricycles are planned for the Philippines.

My  personal thought is that if the Philippines could eliminate smoke belching jeepneys, tricycles, buses and trucks the number of tourists would rise dramatically. The number of retirees who move to the Philippines would also rise dramatically.

There are over 61,000 jeepneys in Metro Manila alone. Many are smoke belchers.

I have an idea: the government of the Philippines could provide loans for new smoke free engines for all jeepneys and could outlaw two stroke motorcycle engines or provide loans for owners to upgrade to motorcycles equipped with 4 stroke engines. With a provision that all old two stroke engines and worn out jeepney, bus and truck engines be rebuilt, destroyed or melted down and used to manufacture new cars in the Philippines.

"A single two-stroke engine produces pollution equivalent to that of 30 to 50 four-stroke automobiles.
(from an article at the "two stroke motorcycle engines" link in the paragraph above).

The government could somehow effectively enforce the pollution laws it already has on the books and take all the smoke belching vehicles off the road until it is proven they have been fixed and are no longer emitting smoke. Maybe the government could look outside the Philippines for countries which strictly enforce anti-pollution regulations and implement those methods.

"The secretary of the environment stressed...'We will be popularizing the use of electric tricycles not only in Metro Manila but in other major cities. The ultimate aim is for our country’s five million tricycles, of which 2.8 million are in Metro Manila, to become zero-emission vehicles,' he said."

(from a article dated June 20, 2011

Sounds good, but how many years will it take?

Here is an article from USA Today dated July 29, 2014 which tells about how the Philippines is leading the way in Asia to convert to electric vehicles for public transport.

If you know of cities in the Philippines which do not have significant air pollution from vehicular traffic please share with other readers by making a comment below.

Other sources of pollution are pig farms in the Philippines and poultry farms. Living near chicken farms will subject you to a virtual plague of flies whenever the farms are cleaned. Click on the link to get advice about how to locate pig and poultry farms.

What percentage of people in the Philippines have asthma? This is an unverified answer.

Check the GlobalAsthmaReport for more detailed information about asthma in the Philippines and other countries. Scroll down to Figure 4 on page 12.

Find out about Asthma in the USA (See charts and information). Approximately 8% of the US population have asthma. The link is to the Center For Disease Control (CDC).

Check out pollution in various cities in the Philippines and around the world.

If you are a foreigner in the Philippines please tell us about your experiences while you are in the Philippines by making comments below.

You may want to submit your opinion about pollution in the Philippines at There you can find statistics about air, water and other types of pollution gathered from a survey of visitors and residents of the Philippines.


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This article will be expanded. Check back for more information about asthma, COPD and air pollution in the Philippines. This article last updated December 4, 2016