Ensuring indoor air quality during occurrence of haze

On 8 July 2013, Parliament debated the Government’s response to the perennial haze problem. These are the questions I asked the Minister for National Development and Minister for the Environment and Water Resources, and their responses (Part 3 of 3).

On 8 July 2013, Parliament debated the Government’s response to the perennial haze problem. These are the questions I asked the Minister for National Development and Minister for the Environment and Water Resources, and their responses (Part 3 of 3).

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Mr Gerald Giam Yean Song asked the Minister for National Development during this haze period, whether BCA is taking any steps to inspect the air-conditioning and mechanical systems of commercial and industrial buildings to ensure that the indoor air in these buildings does not contain an unhealthy level of contaminants.

The Senior Minister of State for National Development (Mr Lee Yi Shyan) (for the Minister for National Development): Mdm Speaker, under the Building Control Act and Regulations, building designs are required to comply with the performance requirements for fresh air intake and air change specified in the Singapore Standard called SS553. This is the Code of Practice for Air-conditioning and Mechanical Ventilation in Buildings. The design standard in SS553, such as air change and fresh air intake, are based on the standards published by the American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE), which are internationally recognised standards.

After any buildings are completed, building owners are responsible for the operation and maintenance of the buildings. For office buildings, building owners may refer to NEA’s “Good Indoor Air Quality in Office Premises” guidelines and Singapore Standards SS554, which is the Code of Practice for Indoor Air Quality for Air-conditioned Buildings. The SS554’s requirements are also aligned with international best practice. For example, guidelines on filters to protect building occupants from airborne particulate matter are aligned with test methods published by ASHRAE.

The recent extreme haze level was unprecedented. The 24-hour PSI hit a high of 246, while the previous high was 142 in 1994. At such a high level of outdoor pollution, the building owners may have to monitor its indoor air quality and take steps to minimise open contact with the outdoor fresh air and also to take steps to maintain air filters more frequently if the haze is a prolonged situation.

We have earlier commissioned a multi-agency team – involving NEA, BCA, MOM, MOH and MSF and local research institutes – to review the indoor air quality of various premises to determine if the current Codes of Practice need to be further refined. More measures may be introduced based on this study.

Mr Gerald Giam Yean Song: Mdm Speaker, I appreciate the Senior Minister of State’s explanation of the regulations in place. My question was: During this period of the haze, were there any extra steps to enforce or monitor building owners to ensure that they actually do what they are supposed to do.

Mr Lee Yi Shyan: Mdm Speaker, I would just like to clarify that, currently, both BCA and NEA have no regulations on indoor air quality per se. What NEA has introduced is a code of best practices that building owners would want to adhere to for maintaining their air conditioning in office buildings. These are guidelines.

Instead of running the risk of over-legislation, we have to, in this instance, depend on the indoor users — the office workers and those people working in the air-conditioning environment — to take some responsibility and make sure that they provide feedback to the owners and the facility managers for building maintenance.

So this is a premise that we are working on and it has worked well. Whether we would want to refine subsequent best practices for indoor air quality, we will have to wait for the technical study that is being carried out. Necessarily, we would require quite a bit of data support to establish the difference between outdoor and indoor air quality. And, of course, as a technical standard, the Member will appreciate that it has to be implementable and also measurable when we publish the standards.

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ADVICE ON WAYS TO REDUCE LEVEL OF INDOOR AIR POLLUTION

Mr Gerald Giam Yean Song asked the Minister for the Environment and Water Resources (a) whether the Ministry can provide more advice to parents with young children (including newborns) and pregnant women on how to reduce indoor air pollution levels; and (b) what advice can the Ministry provide to households, childcare centres, kindergartens and schools on the appropriate types of air cleaning devices that may be needed to reduce the level of indoor air pollutants during the haze period.

Dr Vivian Balakrishnan: During the smoke haze episodes, the main air pollutant of concern is particulate matter.

When the outdoor haze situation deteriorates, young children and pregnant women are advised to stay indoors and reduce their activities. Doors and windows should be closed to reduce the entry of outdoor air pollutants. Fans and air conditioners could be helpful for air circulation. Any activity that generates more particles and particulate matter indoors such as cigarette/cigar/pipe-smoking, burning of candles, vacuuming, dry dusting and sweeping should be avoided.

During the periods of haze, air cleaners may be helpful in households, kindergartens and childcare centres. There are three main types of air cleaners which remove particulate matter: mechanical air filters, electrostatic precipitators and ionisers. Ozone-generating cleaners should be avoided as ground-level ozone is a harmful pollutant. As soon as the outdoor air quality improves to healthy levels, windows could be opened to enhance natural ventilation.

More information is available at the NEA Haze website at www.haze.gov.sg.

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Source: Singapore Parliament Reports (Hansard)

Safeguarding Singaporeans’ health during occurrence of haze

On 8 July 2013, Parliament debated the Government’s response to the perennial haze problem. These are the questions I asked the Health Minister and his responses (Part 2 of 3).

On 8 July 2013, Parliament debated the Government’s response to the perennial haze problem. These are the questions I asked the Health Minister and his responses (Part 2 of 3).

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Mr Gerald Giam Yean Song asked the Minister for Health (a) what is the increase in the weekly number of respiratory, heart, eye and skin problems reported at polyclinics, private clinics and hospitals since the onset of the current haze situation compared to the weekly average in the month before; (b) how many private clinics have signed up for the Government scheme which offers subsidised treatment for haze-related illnesses; (c) what is the Ministry doing to ensure that more private clinics participate in this scheme so that more Singaporeans can benefit from it; and (d) what are the details of the Ministry’s contingency plans to cope with the expected surge of patients with illnesses caused by the haze.

The Minister for Health (Mr Gan Kim Yong): Mdm Speaker, may I have your permission to take Question Nos 21 to 23 together?

Mdm Speaker: Yes, please.

Mr Gan Kim Yong: Madam, Dr Lam asked about the short and long-term effects of air pollution. For healthy individuals, short-term exposure to haze may cause temporary minor irritation of the eyes, nose, throat and skin. Such irritation typically resolves on its own in most cases.

However, the haze particles can aggravate lung diseases, cause asthma attacks and acute bronchitis in people who already have chronic lung diseases, and trigger off heart attacks and irregular heartbeat in people with heart problems. Thus far, there has been no clear evidence of long-term health effects of short-term haze, like that we have experienced.

Mr Gerald Giam asked about the impact of the haze on healthcare services. So far, the impact has been manageable. When the haze was more severe in the week of 17 to 23 June, we saw a 16% increase in polyclinic attendances for relevant conditions compared to the week before, but attendances at hospital accident and emergency department did not show any significant increase. The air quality improved in the last week of June and polyclinic attendances correspondingly decreased to just 4% higher than the level before the onset of haze. Attendance at A&E departments for the relevant conditions actually decreased by 23% in the last week of June.

Ms Lee asked about N95 masks. The N95 masks are not specifically designed for use by children, nor have they been certified for effectiveness for such use. To be effective, N95 masks need to maintain a well-fitted seal at all times, which may be difficult to achieve in young children who are smaller and of varying sizes. It is possible for the older children who may be able to fit smaller sized N95 masks for adults. Parents who wish to buy these masks for their children should ensure proper fit and usage of the mask.
When haze reaches unhealthy levels, children should really be kept indoors as much as possible. This has been communicated to the public through various platforms including the mass media and online media. Since schools reopened last week, MOH has been working with the Ministry of Education and schools on the various mitigation measures, based on the health advisory of the day.

Dr Lam and Mr Giam asked about long-term measures to protect the health of Singaporeans. The Ministry of Health has worked with our healthcare institutions to put in place plans in three areas, to ensure that we are “haze ready”.

First, managing the expected surge of patients at our polyclinics and hospitals for haze-related conditions. The Ministry has already implemented a special scheme where those who suffer from respiratory problems or conjunctivitis because of the haze need only pay $10 when they seek treatment at participating GPs. The scheme applies to Singaporeans aged 18 years and below, or 65 years and above, and those in low-income groups. The scheme will enhance the accessibility and affordability of primary care for haze-related conditions.

There are now more than 600 GP clinics participating in this scheme. Information on the participating GP clinics is on the MOH website, and also shared through community organisations. The Agency of Integrated Care (AIC) has been actively reaching out to individual GP clinics to encourage them to sign on. To increase awareness amongst members of the public, posters have been distributed to GPs so that the participating clinics can be easily identified.

The Ministry of Health had also earlier worked with the hospitals to retrofit suitable spaces within the hospital campuses to ready additional bed capacity in the event of a demand surge due to an increase in dengue cases. We have stepped up efforts to transfer stable patients from the hospitals into community hospitals and nursing homes to free up acute bed capacity.

Should the haze worsen and there is a need to free up bed capacity further, non-urgent services and elective cases at the hospitals may be scaled back.

Secondly, we will take care of the patients in our public sector hospitals and healthcare institutions so that they are not adversely affected by the haze. If the haze situation is bad, these institutions will close their windows and doors to reduce the inflow of dust particles. And if necessary, air coolers and fans will also be used to improve the ventilation for patients in non-air conditioned wards.

For especially vulnerable patients, we will put in place air purifiers to help reduce the impact of the haze on these patients during significant haze.

We will also facilitate home delivery of medication for chronic patients if necessary so that they can get their needed medication without having to visit our clinics.

Third, our hospitals and polyclinics have adequate equipment and supplies, including adequate medication stocks, on standby to support the continuation of critical services. Our hospitals also have plans in place to ensure adequate manpower to staff critical services such as the A&E, Intensive Care Unit and operating theatres.

At the national level, we are re-building our stockpile of N95 masks so that we will be ready should there be a disease outbreak during this period.

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Mr Gerald Giam Yean Song: Madam, now that the haze seems to be behind us at least for this year, will the scheme offering subsidised treatments for haze-related illnesses continue or will it be revived when the haze comes back again? Is there a certain threshold PSI that will trigger off the scheme and will the GPs who have signed up this year continue to be on the scheme next year?

Mr Gan Kim Yong: Mdm Speaker, I would hesitate to say that the haze is over for this year as I think Dr Vivian Balakrishnan has reminded us all that the dry season is not yet over so we have to remain vigilant and to be well prepared. So, for the time being, the scheme will still remain in place and will be reviewed again at the end of the dry season to see whether it is necessary to be continued, whether we will re-introduce it next year or we could refine the scheme to make it a better scheme when the haze does return. We hope it does not, but in the event that it does return, whether we will need the scheme or whether we need a different scheme. We will look at the situation at that point in time but for the time being, this being the dry season, the scheme will remain in place.

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Source: Singapore Parliament Reports (Hansard)

Long-term strategies for dealing with environmental aspects of haze

One of the big causes of anxiety among Singaporeans was the unavailability of N95 masks at the height of the haze. How will the Government ensure in the future that its stockpile of face masks gets to the distribution points faster? Since the Minister said that the ratification of the ASEAN Haze Agreement is being held up not by the Indonesian central government, but by the Indonesian House of Representatives, the DPR, are there any plans to engage the Indonesian legislators directly to persuade them to ratify the agreement expeditiously, for example, by engaging them at the upcoming ASEAN Inter-Parliamentary Assembly?

On 8 July 2013, Parliament debated the Government’s response to the perennial haze problem. These are the questions I asked the Ministers and their responses (Part 1 of 3). The other two parts will be published over the next few days, together with questions and answers to my other Parliamentary questions during this sitting.

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Mr Gerald Giam Yean Song (Non-Constituency Member): Madam, I have two questions for the Minister of Defence. First, one of the big causes of anxiety among Singaporeans was the unavailability of N95 masks at the height of the haze. How will the Government ensure in the future that its stockpile of face masks gets to the distribution points faster? Secondly, are there any laws in place that require retailers to ration the sale of essential products the moment such emergencies break out, rather than a few days after the fact, so as to mitigate the effects of hoarding, and to ensure that the genuinely vulnerable people get the necessary protection that they need?
Dr Ng Eng Hen: They are relevant questions. In terms of anti-hoarding laws, I will leave it to MTI to answer, because there are some Parliamentary Questions based on that subject. What have we learnt from the run on masks or the panic buying of masks: if you look at what happened, based on that particular day – 21 June — the number of people that really ought to have been wearing masks was nowhere near the masks that were sold. This was anticipated demand, exactly as the Member has said. They were thinking, “What if the haze lasts for week and I am the last one without a mask in Singapore?” That fed into a frenzy. Why was there a difficulty in getting the masks from these warehouses where we had 9 million to the distributors: there was a reason. The masks that were stocked up by MOH were not for the public. They were for their healthcare workers. By the way, that stockpile is quite important, in case the Middle East Respiratory Syndrome (MERS) viruses come here and infect us. So they were meant for health workers to make sure that there was sustainability and the way that they were stored, and so on and so forth, assumptions were made on a particular rate of use. There are very few systems that are prepared for a situation where from one day to the next, your demand of masks is 5,000 and the next day, 1 million. Very few distributors will stock that amount. If they do that as a business model, many of you would say that they would not survive. There are reasons for it.

Back to the Member’s question on how do we plan ahead: first, we have stocked up our masks, not only for the haze, but for contingencies like MERS or SARS or other infectious diseases. Secondly, MOH will be looking at packaging and see how we can roll it out in terms of our distributorship chains. All in all, it did not reflect badly on our system that we were able to react fairly quickly, including using the SAF to move the masks from the warehouses to the constituencies and retailers like NTUC Fairprice activating their supply chain to get the masks straight from the warehouses to their retail outlets including to other retailers, shows that there is a certain nimbleness or robustness in our system. We can do better but we did not do that badly.

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Mr Gerald Giam Yean Song: On the subject of engaging all levels of government in Indonesia, since the Minister said that the ratification of the ASEAN Haze Agreement is being held up not by Indonesians’ central government, but by the Indonesian House of Representatives, the DPR, are there any plans to engage the Indonesian legislators directly to persuade them to ratify the agreement expeditiously, for example, by engaging them at the upcoming ASEAN Inter-Parliamentary Assembly?

Dr Vivian Balakrishnan: Unfortunately, my colleague from Foreign Affairs is not here but certainly, if Members of this House meet your colleagues in DPR, by all means, please persuade them of the wisdom of ratifying that agreement.

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Source: Singapore Parliament Reports (Hansard)