The Hunter Region remains a national air pollution hot spot with communities regularly exposed to harmful levels of oxides of nitrogen, despite warnings about the pollutant's long-term health effects.
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A government committee that is reviewing Australia's national air pollution standards will visit Newcastle this month to hear from those affected by the poisonous gases.
Oxides of nitrogen, which include nitrogen dioxide and nitric oxide, are ranked at the top of the National Pollutant Inventory's list of toxic substances.
The inventory shows 55,000 tonnes of oxides of nitrogen (NOx) were emitted in the Muswellbrook local government area in 2017/18 and 25,000 tonnes were emitted in Lake Macquarie.
Coal-fired power stations produced most of the pollution.
By comparison, 3,900 tonnes of the gas were produced in the City of Sydney and 4,700 tonnes were produced in Newcastle.
Research over the last decade has shown the health effects of NOx and related gases sulphur dioxide (SO2) and Ozone (O3) are more severe than first thought.
A Commonwealth Department of Health fact sheet warns that breathing raised levels of nitrogen dioxide increases the likelihood of respiratory problems, particularly for children, pregnant women, the elderly and those with chronic diseases.
"Nitrogen dioxide inflames the lining of the lungs, and it can reduce immunity to lung infections. This can cause problems such as wheezing, coughing, colds, flu and bronchitis," it says.
A research project involving health researchers from the universities of Sydney, Newcastle and Indiana examined air pollution levels for urban areas, especially Sydney, compared to rural areas in the Upper Hunter, which had a smaller population but extensive coal mining and burning activities.
The research team analysed 2017 data from 46 air quality monitoring stations.
Pollutants analysed included fine and coarse particulate matter, sulfur dioxide, nitric oxide, nitrogen dioxide, and oxides of nitrogen.
"Without adjustment, daily mean pollutant levels were significantly highest in the Lower and Upper Hunter regions, and they were significantly higher than the metropolitan regions of Sydney or Illawarra on all five pollutants.
"The Upper Hunter area was significantly higher than every other region for fine particulates, nitric oxide and nitrogen dioxide," the study, published in the April edition of the Journal of Rural Health, found.
The review of ambient air pollutants is occurring 21 years after Australia's national air pollution standards were introduced.
NSW Health statistics show about 279 people die prematurely in NSW each year as a result of poor air quality.
Other health impacts attributed to poor air quality include 233 babies born with reduced birthweight, 361 people developing type 2 diabetes and 2614 years of life lost each year due to poor air quality.
Doctors for the Environment has raised concerns that health statistics show there are a greater proportion of people with respiratory illnesses in the Upper Hunter than elsewhere in the state.
The group issued a report in February that showed coarse particle pollution had worsened in many parts of NSW over the past 12 months, including the Hunter Valley.
Environmental Justice Australia clean air campaigner Max Smith said stricter national ambient air pollution standards were urgently needed.
"Without better pollution monitoring and enforcement of stricter standards, many communities will continue to be put at risk," Mr Smith said.
"The review is about Australia catching up with the rest of the world on pollution control. Much stricter standards have been adopted in most other countries.
"The World Health Organisation guidelines recommend a standard for SO2 which is 11 times stronger than the Australian standard.
"The proposed future standard for SO2 would still be almost three times higher than the WHO standard. The WHO standard would be exceeded regularly in the Newcastle basin."
Anyone with an interest in air quality is invited to have their say on the proposed new standards.
The Newcastle forum will be held at Newcastle Town Hall on Tuesday July 23 between 5.30 to 7.30pm.