Building and operating a petrochemical complex in a poor community:

Not in my backyard (Nimby) or expecting positive economic benefits (Yimby)

Comparison of health status of neighborhood

residents
before and after PC Complex

National Health Research Institutes, Taiwan

Distinguished professor

Chi Pang Wen,

MD DrPH,

Assistants
Min Kuang Tsai, MS
Mu-Lin Chiu, MS

Background
Residents near petrochemical complex (PC)

were concerned with health risks from PC

Occasional fires or explosions aggravated
such concerns
Perceptions of the general public regarding

neighboring residents

cancer mortality
Life expectancy shortened
Environmental injustice as a result?
Increased

Taiwan
Yun-lin County

PC Complex
In Mailiao
Land filled off-shore site
Year built: 1995-2000
Employment related to PC:
Direct:
22,000
Indirect:
240,000
Annual revenue: US$ 50 billion
% national GDP contribution: 9.2%

Offshore land-filled site

Population changes
before and after
Population surrounding the plant
Mailiao township:
31,722 (1994) ;
Yunlin County:
753,791 (1994) ;

All neighboring townships

exception of
Mailiao where

39,000 (2011)
713,000 (2011)

decreased with the

PC complex located

Increased by 23%

The issue: Health of the residents

before and after the complex

Before the complex:

Life expectancy of PC residents ranked near the bottom

among cities and counties in Taiwan

PC residents

Residents

Health status prior to PC are poor

Poor life style habits:
High smoking rate in males but not in females
increased lung cancer and all cause
mortality

Known for

High

betel nut chewing

Known for

High

rate in males only

increased oral cancer

hepatitis C

increased liver cancer

High motorcycle ownership
Known for increased accidents and injuries
Known for

Standardized Mortality Ratios (SMR) of Yunlin, 1971 2011, for

all cause, all cancer and for selected cancer, with 2011 Taiwan as
reference. SMR trend for Taiwan is shown with the same
reference.

Mortality rate of residents

Before and after
Lung cancer in males were high, but not in females, reflecting smoking effect
But rates started to decline after PC

Mortality rate of residents

Before
Oral cancer were high, but only in males, reflecting chewing betel nut effect

Mortality rate of residents

Before and After
for All

cancer

All cancer in males were high, but not so in females, reflecting lifestyle effect
But rates started to decline after PC

Liver Cancer
Liver cancer were high, in both males and females,
reflecting hepatitis C prevalence
But rates started to decline after

PC

Leukemia
The cancer best known for most related to PC exposure
No increase

Multiple Myeloma

Brain Cancer

Cardiovascular Disease

rates started to decline after PC

COPD

rates started to decline after PC

Motor Vehicle Accidents

Suicide

No difference from Taiwan after PC

Life expectancy
before and after
Residents accelerated improvement in life

expectancy,

more than counterparts in

metropolitan cities
PC residents

PC residents

Health changes
before and after
Excess health risks from petrochemical

pollution were not demonstrated.

Poor health existed prior to the PC, from
poor life style risks, from motor vehicle
accidents, and from poor medical care.
After the PC, residents started to improve
their health in an accelerated manner.

Other changes
after PC complex
1) Population increased, reflecting increased

employment, income and reduced unemployment, in

the midst of population decrease in surrounding areas
2) Financially poor residents crawled out of their
poverty status, with robust economic benefits
forthcoming.
3) A 200-bed hospital was added next to the PC
complex
Medical services made available to poor residents
Free medical screenings offered to all residents

4) A new elementary school was built for quality

education and for convenience of residents

5) Corporate Social Responsibility (CSR)

Funding and donation for neighborhood projects in 8 years:

US $270 million for 39,000 township residents and 700,000

county residents
Examples: meals on wheels, school lunch, subsidy for medical
insurance premium, city development, low income group
support, forestation, and building schools, and hospitals.

Conclusion

Residents near PC site were poor in health and in financial status

prior to PC
After PC, poor health of residents started to have a ray of hope. By
coincidence or by design, accelerated improvement in life
expectancy and slowed cancer increase or decreasing cancer rates
were found, contrary to pre-conceived notion.
No health risks from PC as feared was demonstrated within the time
frame. As stated by FDR in his inaugural speech, There is nothing to fear but fear itself.
Financially, relatively poor residents saw variable improvement.
However, despite efforts of CSR, the perception of inequality
persisted in many.

Not in my backyard (Nimby) or expecting

positive economic benefits (Yimby)
Comparison of health status of neighborhood
residents
before and after PC Complex

Thank you for your attention

Chi Pang Wen
CWENGOOD@NHRI.org.TW
Just say Wen