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
a
Department of Environmental Sciences, Faculty of Science and Environmental Studies, University Putra Malaysia 43400 UPM,
Serdang Selangor D.E., Malaysia
b
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

Abstract

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
impacts.
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

Malaysia has enjoyed one of the least polluted urban
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
of industrial pollution and the degradation of urban
environment. Depletion of fisheries, air and water
pollution, and contamination by industrial wastes have
become more serious in Malaysia in recent years.
Among them, air pollution is the major issue that has
been affecting human health, agricultural crops, forest
species, and ecosystems. Monitoring data and studies on
ambient air quality show that some of the air pollutants
in several large cities are increasing with time and are
not always at acceptable levels according to the national
ambient air quality standards. Data on air pollution and
case studies are very limited in Malaysia. This paper

Corresponding author.
E-mail address: raafroz@hotmail.com (R. Afroz).
and studies related to air pollution in Malaysia and its
impact on human health.
2. Sources of air pollution
The three major sources of air pollution in Malaysia
are mobile sources, stationary sources, and open
burning sources. For the past 5 years, emissions from
mobile sources (i.e., motor vehicles) have been the major
source of air pollution, contributing to at least 70–75%
of the total air pollution. Emissions from stationary
sources generally have contributed to 20–25% of the air
pollution, while open burning and forest fires have
contributed approximately 3–5%. According to the
Department of the Environment (DOE, 1996), Malay-
sia, in 1996, the percentages, of the air emission load by
type were motor vehicles, 82%; power stations, 9%;
industrial fuel burning, 5%; industrial production
processes, 3%; domestic and commercial furnaces,

0013-9351/03/$ - see front matter r 2003 Elsevier Science (USA). All rights reserved.
doi:10.1016/S0013-9351(02)00059-2
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,
0.8% (Fig. 1).
Mobile sources include motor vehicles such as
personal cars, commercial vehicles, and motorcycles.
By the end of 2000, there were 10.6 million vehicles
registered in Malaysia, compared to 7.7 million in 1996,
an increase of almost 2.9 million vehicles or 26%
(Department of Environment (DOE), 2001). The federal
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
and corridors, especially in the central business areas,
and inevitably the environment in these areas has
deteriorated due to exhaust emissions from motor
vehicles. The DOE found that after the economic
recession of 1986–1988, the number of registered
vehicles increased at a faster rate, i.e., from a 3.3%
increase in 1987 to a 9.5% increase in 1990. During the
same period of time, the study revealed that the level of
air pollutants in Kuala Lumpur and Selangor increased
rapidly after the economic recession. In Malaysia,
private cars are the most important contributor of
atmospheric pollutants. They contribute about 75% of
the total CO and SPM, as well as about 76–79% of the
oxides of sulfur and nitrogen (DOE, 1991). Two recent
accomplishments will reduce the negative impact of
mobile sources on air quality: the approval of new
environmental regulation amendments the Environmen-
tal Quality Act (EQA), and the phase-out of leaded
gasoline sales. A significant first step toward implement-
ing Malaysia’s Clean Air Plan was achieved in 1996 with
the approval of two regulations designed to reduce
emissions from mobile sources: The Environmental
Quality (Control of Emissions from Diesel Engines)
Regulations 1996 and the Environmental Quality
(Control of Emissions from Petrol Engines) Regulations
1996. The new regulations focus on prevention by
controlling vehicular emissions at the manufacturing or
assembly stage. The emissions standards in the new
Table 1
Percentage of market share, leaded/unleaded gasoline
Retail sales 1994 1995 1996 1997 Year-end
1998
Leaded gasoline unleaded 52 32 24 20 0a
Gasoline (ULG) 48 68 76 80 100
a
Leaded gasoline sales phased out by year-end 1998. Source:
Department of the Environment (2001).
regulations are based on the European Economic
Commission on Standards.
The nation-wide retail sale of leaded gasoline has been
declining as a percentage of total sales over the past few
years, as shown in Table 1. This reduced market share
combined with the availability of appropriate additives
has allowed fuel suppliers to agree to cease the sales of
leaded gasoline altogether. Officially, all petroleum
companies in Malaysia must stop the production and
sale of leaded gasoline by the year 2000. Reduced leaded
gasoline sales are believed to be responsible for a steady
decrease in lead levels throughout the western side of
peninsular Malaysia. Over the next few years, this
reduction may be offset by the increase in the sheer
number of motor vehicles on the road, especially in
urban areas.
Stationary sources are related to industry, power
stations, industrial fuel burning processes, and domestic
fuel burning. Most of the stationary sources in Malaysia
reside in Selagor, followed by a significant number of
sources in Sarawak, Johor, Sabah, Perak, and Pahang.
Increased activity from the industrial sector has been
accompanied by an increased use of energy and
commodities traffic.
Most of the small and mid-sized industries do not
install pollution control equipment. This increases the
emission of pollutants, especially in the industrial areas,
which in some cases contributes specific pollutants to the
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
following standards for stack gas emissions (Table 2).
Open burning sources of air pollution in Malaysia
include the burning of solid wastes and forest fires. This
is common at some poorly managed disposal sites and
results in smoke and fly ash problems. Over the last
several years between July and September significant
amounts of particle matter have been transported by
south-westerly winds from a neighboring country due to
uncontrolled biomass burning activities. As a conse-
quence, serious haze events were recorded in peninsular
Malaysia, Sabah, and Sarawak in 1991, in 1994, and,
most recently, during September and October of 1997.
The cause of the 1997 haze was large-scale forest and
plantation fires, particularly in southern Sumatra and
central Kalimantan, both in neighboring Indonesia.
Haze conditions are aggravated by local emissions from
motor vehicles, industries, and open burning activities.
At its worst, the haze limits visibility to less than 500 m
and produces respirable particles of concentrations
up to 500 g/m3 (five times the level considered
‘‘unhealthy’’).
The DOE is considering an amendment to the EQA
to implement stiffer penalties for open burning. The
maximum fine would be raised from RM 100,000 to RM
500,000 (US$ 25000 to US$1250,00). The bill would go
beyond industrial responsibility, making landowners
and land occupiers responsible for open burning on their
property. The bill would also do away with the DOE’s
Ambient air quality standards identify individual
pollutants and the concentrations at which they become
harmful to the public health and the environment. The
standards are typically set without regard to economic
feasibility for attainment. Instead, they focus on public
health, including the health of ‘‘sensitive’’ populations
such as asthmatics, children and the elderly, and public
welfare, including protection against decreased visibility
and damage to animals, crops, vegetation, aquatic
resources, and buildings. The Malaysian air pollution
index (API) is obtained from the measurement of fine
particles (below 10 mm) and several gases: carbon
monoxide, sulfur dioxide, and nitrogen dioxide. Table
3 shows the API for Malaysia. Based on API readings
throughout the country, the air quality has been
considered generally good. In the urban environment
of the Klang Valley, the index also has generally been
between good and moderate, except for serious haze
events in September and October. The bad air days of
1997 combined with the hosting of the Commonwealth
Games in September 1998 provided as incentive for the
installation of eight more air quality monitoring
stations, bringing the new total to 39. Table 4 lists the
recommended Malaysian Air Quality Guidelines (Am-
bient Standards) and compares them with the National
Ambient Air Quality Standards currently enforced in
the United States and WHO guidelines. The Malaysian
guidelines are fairly consistent with the standards of the
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
Ozone (O3)
8-h average 120 — 100
1-h average 200 240
Particulate matter
Annual 90 50
24-h average 150 150
Sulfur dioxide (SO2)
Annual — 80
24-h 105 365
Source: Department of the Environtment (1996).
4. Ambient air quality monitoring
In the early days of Malaysia, development and
growth were not planned; they were initiated according
to the needs and pressures of the time. Consequently,
this haphazard development has resulted in negative
impacts on the environment as a whole and on air
quality in particular (Sham, 1994). Earlier, Sham (1979)
pointed out that the atmospheric pollution problem is
becoming more serious, as there is always a potential for
the occurrence of inversion in the valley. In anticipation
of the potential severity and magnitude of the problem,
the government enacted into law the Environmental
Quality Act in 1974; subsequently, the Division of the
Environment was established and the Clean Air
Regulations were formerly gazetted in 1978.
The first ‘‘long-term’’ air quality monitoring project
emphasizing suspended particulate and sulfur dioxide
was carried out by the DOE and the Meteorological
Service Department (MMS) at the industrial and
residential zones in Petaling Jaya in 1978. Results of
the study suggested that the suspended particulates
exceeded 93% of the time in the industrial zone (the
previously proposed standard was a 24-h average of
100 mg/m3) and 95% of the time in the residential zone
(the then-proposed standard was 50 mg/m3 (DOE, 1997).
Sulfur dioxide was generally low near the industrial site.
In April 1995, Alam Sekitar Malaysia Sdn Bhd (ASMA)
was awarded a 20-year privatization concession to
install, operate, and maintain a network of 50 contin-
uous air quality monitoring stations (and 10 water
stations) throughout Malaysia for the DOE. Alam
—
In Malaysia, few studies have been conducted on air
pollution. Most of them are related to the 1997 haze
episode. In most years, the Malaysian air quality was
150 dominated by the occurrence of dense haze episodes.
From July to October 1997, Malaysia was badly affected
— by smoke haze caused by land and forest fires. Previous
— incidents of severe haze in the country were reported in
April 1983 (Chow and Lim, 1983), August 1990
(Cheang, 1991; Sham, 1991), June and October 1991
—
(Cheang, 1991), and August to October 1994 (Yap,
—
1995). The severity and extent of the 1997 smoke haze
pollution were unprecedented, affecting some 300
million people across the region. The actual amount of
economic losses suffered by countries in the region
during this environmental disaster were enormous and
are yet to be fully determined.
During nonhaze episodes, vehicular emissions ac-
counted for more than 70% of the total emissions in the
urban areas. Air quality studies conducted in the Klang
Valley during the nonhaze episodes between 1986 and
1989, December 1991 to November 1992, and January
1995 to December 1997 demonstrated two distinct daily
peaks in the diurnal variations in the concentrations of
sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon
monoxide, and particulate matter. The morning hour
peak was due mainly to vehicle emissions and the late
evening peak was attributed mainly to meteorological
conditions, including atmospheric stability and wind
speed. Total suspended particulate matter was the main
pollutant; the concentrations at a few sites in the Klang
Valley often exceeded the Recommended Malaysian Air
Quality Guidelines. A comprehensive study conducted
by the Department of the Environment, Japan Interna-
tional Cooperation Agency, the Malaysian Meteorolo-
gical Service, and University Putra Malaysia between
December and August 1993 gave clear indications that
air pollution in the Klang Valley was becoming worse.
This study also indicated that if no effective counter-
measures were introduced, the emissions of sulfur oxides
(SO), nitrogen oxides (NO), particulate matter, hydro-
carbons, and carbon monoxides (CO) in the year 2005
would increase by 1.4, 2.12, 1.47, and 2.7 times,
respectively, the 1992 levels (Awang et al., 1997).
A separate study of air quality in Kuala Lumpur
found that the smoke haze was associated with high
levels of suspended microparticulate matter, but with
 R. Afroz et al. / Environmental Research 92 (2003) 71–77
relatively low levels of other gaseous pollutants such as
carbon monoxide, nitrogen dioxide, sulfur dioxide, and
ozone (Awang et al., 2000; Noor, 1998). During this
period, the PM10 concentration rose beyond the
Malaysian Air Quality Guideline (MAQG, 1989) level
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
Department of the environment to determine the origin,
formation, and composition of aerosol haze in Malaysia
(Department of the Environment, 1997), approximately
200 representative samples collected by the Malaysian
Meteorological Service for total suspended particulate
and PM10 measurements during the haze episode in 1994
and in the nonhaze years 1995 and 1996 were analyzed
by particle-induced X-ray emission at NERI in Den-
mark. The objective of the study was to apportion the
sources of the 1994 haze episode based on two
mechanism that had been proposed for the explanation
of the haze episode. The first mechanism relates to the
more stable atmospheric conditions that exist in the dry
season. This would allow the rather continuous emis-
sions from traffic and industry to build up high local
concentrations of pollutants. This could explain why the
heavily industrialized Klang Valley during haze epi-
sodes, often was more polluted than other parts of the
country, during haze episodes, but it does not explain
why some localities with little traffic and industries, such
as Kuching in Sarawak, in some years were polluted
with suspended particulate matter at levels of the same
magnitude as in the Klang Valley or even higher. The
second mechanism relates to fire in South Sumatra and
the Kalimantan forests, which reoccur every year in the
dry season but in some years, tend to get out of control.
The results of the analysis ruled out the first
mechanism, as there was a poor correlation with lead,
which are the marker for local pollution. The good
correlation with sulfur supports, on the other hand, the
casual relation with forest fires or other biomass
burning, as sulfur and potassium are the essential
constituents in biomass. The Suspended Particulate
Matter (SPM)/sulfur ratios found at geographically
widespread locations in peninsular Malaysia (Penang,
Kuantan, Klang Valley, and Johor) were very much the
same, corresponding to almost constant contents of
sulfur in the SPM (mass ratio 7–8%). This pointed to
a common origin (and/or type) of source, possibly the
reported forest fires in South Sumatra. The high levels
found in the Klang Valley could have been due to the
combined effects of the geographical vicinity of the
source area, an unfortunate position in the prevailing
direction of the wind flow, and possibly some trapping
of the biomass burning plume (4%). This pointed to
a different biomass burning source, probably fires in
Kalimantan. The results also showed that pollution not
related to biomass burning was not imperceptible in
75
Kuantan and Kuchhing, as the intercept SPM values
were not significantly different from zero. The highest
level of nonbiomass related pollution was found in
Petaling Jaya with an intercept level of 5078 mg/m3
(Awang, 1998).
6. Health impacts of air pollution in Malaysia
There are possible short-term and long-term health
effects of exposure to air pollution. In the short term,
high levels of air pollution lead to an acute condition. In
addition, blockage of sunlight may promote the spread
of harmful bacteria and viruses that would otherwise
be killed by ultraviolet B (Beardsley et al., 1997). The
possible long-term health effects of exposure to air
pollution are unknown and difficult to detect. Compo-
nents of smoke haze, including polycyclic aromatic
hydrocarbons, are known carcinogens the effects of
which may not be apparent for years. The consequences
may be more severe for children, for whom the
particulates inhaled are high relative to body size.
There are a very limited number of studies that relate
air pollution to its health impact in Malaysia. The lack
of data gathering for environmental epidemiological
analysis makes it difficult to estimate the health impact
of air pollution. Recent studies in this country have
examined possible health effects of the 1997 forest fires.
For example, outpatient visits in Kuching, Sarawak
increased between two and three times during the peak
period of smoke haze and respiratory disease outpatient
visits to Kuala Lumpur General Hospital increased
from 250 to 800 per day (World Health Organization,
1998). Data were assembled that indicated an increase
in cases of asthma, acute respiratory infection, and
conjunctivitis during August–September 1997 at a
number of major hospitals in Kuala Lumpur (Brauer,
M., and Jamal, H.H., 1998). For respiratory diseases,
Selangor recorded a significant increase in the total
number of cases during the September haze. Asthma
cases increased from only 912 in June to more than 5000
in September. The total number of acute respiratory
infection cases increased from about 6000 to more than
30,000 during the same period. Apart from respiratory
diseases, conjunctivitis increased significantly during the
haze period. In Selangor, the total number of increased
from only 207 cases in June to as high as 3496 cases
in October. The same trend was observed in Sarawak.
In addition, the daily incidence of conjunctivitis in
Sarawak during September was found to have a positive
correlation with the API (representing PM10 concentra-
tion). However, the number of cases gradually decreased
toward the June value as the concentration of PM10
began to decrease after September. When the air quality
was almost back to the values of a nonhaze period 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
of PM10 was detrimental to human health (Awang et al.,
2000). Effects were found to be greatest in children, the
elderly, and people with pre-existing respiratory pro-
blem; youngsters are among the most resistant. A
preliminary survey carried out among secondary school
children in Kuala Lumpur and Klang revealed that less
than 50% of these school children sought medical
treatment each time they fell sick (Awang et al., 2000).
A study conducted by Nasir et al. (2000) suggested
that in the 1997 haze episode the total health effects were
estimated to include 285,227 asthma attacks, 118,804
cases of bronchitis in children, 3889 cases of chronic
bronchitis in adults, 2003 respiratory hospital admis-
sion, 26,864 emergency room visits, and 5,000,760
restricted activity days. The whole population from all
states in the country was at risk except Perlis, Kelantan,
and Sabah. The total health damage cost was signifi-
cantly high due to the long duration of the haze. The
results show that restricted activity days accounted for
about 79.3% of the health damage cost while asthma
attack contributed 10.7% to the total health damage
cost (Fig. 2). The contributions of the other three health
effects such as respiratory, hospital admission, emer-
gency room visits, and chronic bronchitis were insigni-
ficant. Each of the above-mentioned effects actually
contributed less than 1% of the total health damage
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.
Among the 11 states of Malaysia, Sarawak was badly hit
by the particulate pollution with the largest number of
health effects, which comprised 23.8% of the total
health effect during the haze. The estimated health
90
80
70
60
Percentage(%)
50
40
30
20
10
0.88 0.94
0
Respiratory Emergency
Hospital Room
Admission Visits
Fig. 2. Percentage distribution of health damage costs. Source: Nasir et al. (2000).
effects for Kuala Lumpur and Selangor during the haze
were also high, since both states recorded an average
PM10 of 170.6 and 131.22 mg/m3, respectively.
Another study conducted by Othman and Shahwahid
(1999) revealed that in the 1997 haze episode the
population at risk was from all states of the country
except in Kelantan, Terengganu, and Pahang; this
population is estimated to be 18 million people. But
the incidence of risk varied among states in terms of
intensity and length of the haze. The incremental cost
incurred by the population at risk for treatment of haze-
related illnesses from both public and private clinics and
hospitals and for self-treatment (mainly the purchasing
of medicine) was estimated to be RM 5.02 million
during the period August–October 1997. The incremen-
tal cost incurred for hospital admissions was estimated
to be RM 1.18 million during the same period. This
study also revealed that the country incurred productiv-
ity losses as a result of haze-related illnesses. These
productivity losses occurred in foregone production
opportunities during the idled workdays when workers
were in hospital and on sick leave. Those not
hospitalized and not granted sick leave, who managed
to continue working are believed to have experienced
reduced activity days arising from the haze-related
illnesses they suffered. These sources of haze-related
productivity losses are estimated to be RM 4.3 million.
7. Conclusions
Studies related to air pollution conducted in Malaysia
have been few. It is already 23 years since the
Environmental Quality (Clean Air) Regulations 1978
79.34
10.7
5.67
2.28
0.19
Restricted Bronchitis in Asthma Attack: Asthma Attack: Chronic Bronchitis
Activity Children Adult Children
Day
Health Effects
 R. Afroz et al. / Environmental Research 92 (2003) 71–77
were introduced in the country. Many strategies, such as
recycling, changes in engineering control equipment,
and air cleaning systems, have been applied to improve
air quality. Many studies can be conducted to evaluate
the strengths, weaknesses, the impacts of the country’s
adopted, regulations, programs, and strategies.
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