Summary OCR A-level Geography Disease Dilemmas case studies
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Disease Dilemmas (H481)
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OCR A Level Geography Second Edition
Highly detailed overviews of all 7 case studies required for the OCR A-level Geography Disease Dilemmas topic: air pollution in China, cholera in Haiti and the success of the Red Cross in the region, cancer in the UK, malaria in Ethiopia, guinea worm in Ghana, GSK's benefits and ethical drawbacks, ...
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Disease Dilemmas (H481)
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How does air pollution cause cancer in China?
Geographical Pattern of Pollution in China:
1. Particulate matter (eg: black carbon, NaCl, ammonia): affects more people than any other pollutant.
<10microns is most dangerous as small enough to lodge deep inside lungs = CVD & respiratory disease +
cancer
2. Ozone: ground level petrochemical smog formed from sunlight reacting with pollutants (eg: VOCs) = worse on
sunny days = breathing problems/asthma/reduced lung function + lung diseases
3. NO2: created by combustion of impure fuel sources = long-term exposure causes bronchitis in asthmatic
children due to inflammation + reduced lung function/growth
4. SO2: created by combustion of fossil fuels (eg: sulphur-coal) = reduced lung function, eye irritation, chronic
bronchitis + asthma, increased respiratory tract infection
Cancer Incidence & Mortality in China:
o Lung cancer: most common incident cancer + leading cause of cancer-death
o 4,292,000 new cancer cases every year
o 213.6/100,000 rural cancer incidence vs 191.5/100,000 urban
o 7500 cancer deaths per day
o Gender plays a role: breast most common for women, liver among the commonest for men, lung,
bronchus + stomach common in both
o Lung, stomach, liver + oesophageal = 57% of Chinese cases but 18% in USA (AC)
• Hourly air pollution data available from >1500 sites
• Particulate matter, SO2, NO2 & ozone recorded
• Greatest pollution in east, but widespread across northern & central
regardless of urban/rural
• Highest particulate concs. south of Beijing as this is where the largest
sources are (more localised emissions in urban areas Eg: Handan)
Evaluative: Are all cancers in China caused by air pollution?
• Not surprising as particulate matter can remain airborne for days-
weeks & travel 1000s km Key Idea 2a Case Study: ▪ Pop. growth & ageing demographic; increased cancer-related lifestyle
• 92% of pop. experience >120hrs of unhealthy air Air Pollution in China choices (Western); improved detection services, data sets & awareness
• Contributes to 17% of all annual deaths in China ▪ Data is unreliable: Chinese govt. + WB report = 350-400,000 premature
deaths from air pollution whereas Global Burden of Disease Study report =
How is air pollution created in China? 1.2mil premature deaths in China in 2010
▪ Air pollution causes diseases other than cancer (eg: COPD): asthma rates up
- Increasingly urbanised/westernised lifestyle (globalisation)
40% in last 5yrs
- Indoors: heating/cooking with coal + biomass
- 80% electricity + 70% total energy from coal (mostly high-sulphur) Evaluative: Is control of air pollution possible?
- Heavy industry around cities: metal smelters/power plants = fast economic growth
- Increasing car ownership with 400mil expected by 2030 (only 62mil in 2009) ▪ Growing discontent at air pollution since 2014 APEC summit when 125-mile
- Shipping boom contributing to 18,000 premature deaths per year radius of Beijing was essentially shut down to ensure ‘APEC blue’ skies for
- Problems exasperated by heavier winter air (temporal variation)/Gobi desert sands storms near Beijing high-profile world leaders
(spatial variation) ▪ ½ cars banned from roads, schools closed, public-sector workers given
- Increased smoking with 75% of cancer-deaths attributed to 12 smoking-related cancers and impacts holidays, no cremations or burials
having late onset = continued increase despite tobacco-control programs ▪ Kind of climatic façade typical of the Chinese government
, Global Solutions for Dealing with Air Pollution China: National Solutions for Dealing with Air Pollution in China:
Overall – international agreement is necessary as air pollution doesn’t respect political Reducing reliance on coal
boundaries BUT large spatial & temporal scale = difficult to hold players accountable/enact
➢ 2013: construction of new coal-fired power plants in Beijing, Shanghai & Guangzhou
effective change
banned
69th World Health Assembly ➢ Use more natural gas & nuclear power
➢ Close down worst factories
❖ 4 year roadmap created ➢ Beijing: limit on yearly average of PM2.5 to 60mg/m3 by 2017 – still above national
❖ Air pollution is the world’s largest single environmental risk standard of 35 and WHO limit of 10
❖ 98% of low- and middle- income cities have exceeded WHO guideline pollution limits
Limitations:
Paris Climate Agreement
➢ Plan hasn’t worked! – PM2.5 levels are higher than in 2013 in all 3 locations
❖ Part of UNFCCC’s CoP 21 to prevent more than 1.5°C of global warming (eg: 121mg/m3 in Beijing)
❖ Ratified by China in September 2016: peak CO2 emissions by 2030 at the latest, increase ➢ High resistance from local govts. & industrial sectors
forest stock volume by 4.5bil cubic metres from 2005 levels & lower carbon intensity of ➢ Mostly focuses on reduces CO2 which is less of a health risk
GDP by 60-65% from 2005 levels by 2030 ➢ Coal use in China still predicted to increase
Limitations:
❖ Voluntary ‘nationally determined contributions’ = depends too much on Technology
goodwill of world leaders that may not be in office to oversee implementation ➢ Advanced air purifiers: limits exposure while indoors but not outside, inspired global
(eg: Obama – Trump withdrawal from agreement – Biden return + Inflation art projects to raise awareness around pollution crisis (eg: ‘Breathing Bicycle’ by
Reduction Act 2022) Matt Hope, UK)
❖ Relies on technology that does not exist yet ➢ Electronic vacuum cleaners: buried coils of copper to attract smog particles and suck
❖ Leaves future timetable for actual emissions reduction in hands of largest them into the ground to make them into diamonds to sell
polluters with no enforcement system ➢ Air Quality Index: real-time updates on air quality in China’s biggest cities with
PM2.5, PM10, SO2, NO2, O3 & CO levels recorded – monitored by China’s Ministry of
Environmental Protection (MEP) & publicly accessible
➢ Airtight domes: Used to cover sports pitches at Dulwich College Beijing to protect
students from air pollution after they were kept indoors for 20 days – only possible
because the school is a wealthy fee-paying international school.
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