VZCZCXRO3428
RR RUEHCN RUEHGH
DE RUEHGZ #0593/01 1810923
ZNR UUUUU ZZH
R 300923Z JUN 06 ZDK MULPTIPE SVCS
FM AMCONSUL GUANGZHOU
TO RUEHC/SECSTATE WASHDC 3923
INFO RUEHOO/CHINA POSTS COLLECTIVE
RUCPDOC/USDOC WASHDC
RUEAWJA/DOJ WASH DC
RUEAIIA/CIA WASHDC
RUEKJCS/DIA WASHDC
RHHMUNA/HQ USPACOM HONOLULU HI

UNCLAS SECTION 01 OF 04 GUANGZHOU 020593 
 
SIPDIS 
 
SENSITIVE 
SIPDIS 
 
STATE FOR EAP/CM 
STATE FOR EB/TPP FELSING, MASSINGA 
USDOC FOR 4420/ITA/MAC/MCQUEEN, DAS LEVINE 
STATE PASS USTR - STRATFORD, CELICO 
USPACOM FOR FPA 
STATE FOR OES/OGC, OES/ENV AND OES/PCI/STEWART 
DOE FOR INTERNATIONAL/PUMPHREY 
DOE ALSO FOR EERE/DIXON 
USDOC FOR NOAA/OFFICE OF GLOBAL PROGRAMS/BUIZER, 
EPA FOR OFFICE OF AIR AND RADIATION/MCLEAN 
EPA ALSO FOR INTERNATIONAL/YANG AND THOMPSON 
 
E.O. 12958: N/A 
TAGS: SENV TBIO CH SOCI PGOV
SUBJECT:  Can Pollution Harm an Unborn Child?  Despite 
Uncertain Science, Anecdotal Stories Fuel Local Concerns 
 
 
GUANGZHOU 00020593  001.2 OF 004 
 
 
(U) THIS DOCUMENT IS SENSITIVE BUT UNCLASSIFIED.  PLEASE 
PROTECT ACCORDINGLY.  NOT FOR RELEASE OUTSIDE U.S. 
GOVERNMENT CHANNELS.  NOT FOR INTERNET PUBLICATION. 
 
Ref:  05 Guangzhou 30589 
 
¶1. (SBU) SUMMARY:  The following cable describes the 
perception and the basis for the perception many residents 
in South China have that the pollution in the region is 
harming unborn babies; it does not address the hard science 
related to this issue.  Recent press reports and anecdotal 
accounts have led many local residents to believe there is a 
possible association between pollution and pregnancy-related 
complications, especially birth defects -- a hot potato 
issue given that the one-child policy has made parents 
extremely anxious about the health of their only child. 
While direct evidence linking pollution to pregnancy 
complications is limited, and most officials refuse to 
discuss the issue, one local professor who specializes in 
genetics and hereditary diseases speculated that pollution 
may be causing a rise in birth defects.  Some local media 
sources also claim that China has a relatively high 
frequency of birth defects, at about 4-6% of China's newborn 
population; although official Chinese figures show a lower 
rate of incidence. 
 
¶2. (SBU) While government officials now call for a greater 
focus on sustainable development and cleaning up 
environmental problems, corruption, mismanagement, and lack 
of funding and accountability promise to slow progress. 
However, as top leaders, such as President Hu Jintao and 
Premier Wen Jiabao, take an interest in the environment, and 
as the Chinese people become ever more sensitive to the 
possible harmful effects of pollution, pressure to address 
the problem will grow.  Post will provide a closer look at 
the current environmental situation in South China septel. 
END SUMMARY. 
 
Link Between Pollution and Pregnancy-Related Complications? 
--------------------------------------------- -------------- 
 
¶3. (SBU) Over the past year, several stories in the local 
press have suggested a link between pollution and pregnancy- 
related complications, including birth defects and 
infertility.  Furthermore, Post is aware of a number of 
anecdotal cases where pregnant women in Guangzhou 
experienced "difficult pregnancies", i.e., ones in which the 
mother experienced unusual complications requiring extra 
medical care and prolonged periods of bed rest to prevent a 
miscarriage.  Several doctors in Guangzhou commented that 
air pollution -- as well as other environmental factors such 
as toxins in food and the so-called "electrical smog" found 
in office environments -- was making bed rest pregnancies 
increasingly common.  A Hong Kong obstetrician consulted 
regarding one of these cases agreed that the phenomenon of 
pregnancies requiring long-term bed rest due to pollution 
was quite common in major Chinese cities. 
 
Is My Baby Going to Be Healthy? 
------------------------------- 
 
¶4. (SBU) In a society where a couple is generally limited to 
having only one healthy child, the concerns about delivering 
a healthy baby the first time around are understandably 
high.  Given this concern and the fact that air pollution -- 
which is literally visible on many days -- is being linked 
to health problems in local press reports and "through the 
grapevine" accounts, Econoff endeavored to learn more about 
the perceived effects of environmental pollution on the 
health of a pregnant woman and her baby.  Post will provide 
a closer look at the current environmental situation in 
South China septel. 
 
 
GUANGZHOU 00020593  002.2 OF 004 
 
 
The Sound of Silence 
-------------------- 
 
¶5. (SBU) Attempts to discuss this issue with local health 
experts proved extremely difficult.  Post's official 
requests for appointments at Sun Yat Sen University, the 
Guangzhou Number Two People's Hospital (the city's best 
obstetric hospital by most accounts), and the Guangdong 
Health Department were all denied.  In his explanation as to 
why the Chinese were denying our meeting requests, Feng 
Shaomin, the head of the Foreign Affairs Division of the 
Guangdong Health Department, said Health Department leaders 
held several meetings to discuss our request, finally 
deciding that birth defects was "too sensitive" a topic. 
Feng admitted that if the Health Department were to release 
"unaudited" information, Health Department leaders would 
"have to bear responsibility." 
 
¶6. (SBU) Econoff was able, however, to discuss the topic 
with two experts -- Professor Liang Zhicheng (strictly 
protect), a retired professor of biology at Jinan University 
who specializes in genetics and hereditary diseases, and Dr. 
Yang Dongzi (strictly protect), chief of obstetrics and 
gynecology (OB/GYN) at the Second Affiliated Hospital of Sun 
Yat Sen University and president of the Guangdong Provincial 
Association of OB/GYNs.  Dr. Yang confided to Econoff that 
the Chinese government, in her view, does "not encourage" 
information about the relationship between pollution and 
birth defects to be made available, even to local 
researchers, and that even she had difficulty finding 
information on the subject. 
 
Pollution and Birth Defects--It's Not Just the Air 
--------------------------------------------- ----- 
 
¶7. (SBU) Liang noted that air, water, and soil pollution may 
all increase a woman's risk for having a baby with a birth 
defect, although he did not elaborate.  Water resources are 
also often contaminated; reports indicate that most urban 
ground water is polluted, and most urban and rural water 
supplies are not potable.  But other factors also raise the 
probability of birth defects.  The U.S. Department of Health 
and Human Services-Centers for Disease Control and 
Prevention's (HHS/CDC) birth defects Project Director told 
Econoff that air pollution and other environmental toxins 
have been reported to be associated with an increased risk 
for birth defects and other pregnancy-related complications. 
 
Improved Awareness of Prenatal Health Requirements 
--------------------------------------------- ----- 
 
¶8. (SBU) Dr. Yang noted that the women she sees in Guangzhou 
are using their growing knowledge of prenatal health to 
proactively prevent birth defects by accessing the 
relatively good prenatal care available in the city. 
Nonetheless, Yang stressed that during the first trimester 
of pregnancy -- when the fetus is developing its internal 
organs and at greatest risk of harm -- many women may not 
yet realize they are pregnant, and thus may not take care to 
avoid harmful pollutants. 
 
Testing for Birth Defects Not Popular in Guangzhou 
--------------------------------------------- ----- 
 
¶9. (SBU) Dr. Yang said that despite women's growing 
understanding of the need for good prenatal care, many of 
her patients remain reluctant to undergo invasive testing 
for birth defects because of the risk of miscarriage the 
tests carry.  She said because of China's one-child policy, 
mothers don't want to submit their only offspring to a test 
that could harm the child. 
 
The Numbers Vary, But Birth Defects Appear to be Rising 
 
GUANGZHOU 00020593  003.2 OF 004 
 
 
--------------------------------------------- ---------- 
 
¶10. (SBU) Reports on the number of birth defects in China 
vary widely depending on the source.  Guangdong's Southern 
Metropolis Daily, citing a 1996-2004 report by "the China 
monitoring system for birth defects" reported in September 
2005 that China has a relatively high frequency of birth 
defects, with 800,000 to 1.2 million babies with birth 
defects born each year, or 4-6% of China's newborn 
population; Professor Liang agrees with this estimate.  This 
percentage is double the figure of 2-3% percent seen in many 
countries.  (Note:  The U.S. CDC estimates that roughly 3% 
of babies born in the U.S. have birth defects.  End note.) 
 
¶11. (SBU) The Chinese Ministry of Health (MOH), however, 
cites lower numbers.  The Hong Kong press reported that MOH 
figures show a 1.05% rate of birth defects in 2001; 1.11% in 
2002, and 1.29% in 2003.  (Note: Econoffs were unable to 
independently verify the MOH statistics because the MOH 
official public website does not include these statistics. 
As a result, we were also unable to clarify what types of 
defects were included in the statistics.  End Note.)  A 
website affiliated with the People's Daily reported that the 
birth defect rate was 1.28% in 2004.  The most recent 
statistics available show that Guangdong's birth defect rate 
in 2002 was 1.37%, and 2.12% in 2004, according to the China 
Population and Development Research Center.  Birth defects 
surveillance in most developing countries is incomplete at 
best, according to the HHS/CDC birth defects expert, and 
many severe cases are likely to die early without a 
diagnosis, thus they may never be reported. 
 
And Infertility is Rising Too 
----------------------------- 
 
¶12. (SBU) According to the Hong Kong press, during the past 
two decades, the infertility rate in China has climbed from 
3% -- among the lowest in the world -- to 12.5%, coming 
closer to the 15-20% range in developed countries.  (Note: 
While the article did not specify its definition of 
infertility, a common definition is one year or more of 
involuntary childlessness.  End Note.)  The director of 
infertility services at a Beijing hospital was quoted in the 
report as blaming "environmental factors" for the spike, 
although he did not elaborate.  Meanwhile, Dr. Yang 
suggested changing lifestyles may also be to blame.  She 
said that Chinese women are increasingly engaging in 
premarital sex, which may lead to sexually transmitted 
diseases that can cause fertility problems later (see 
reftel).  Meanwhile, more premarital sex has led to an 
increase in unplanned pregnancies, which in turn leads many 
young women to seek abortions, which can lead to 
complications affecting the recipient's reproductive health. 
Finally, Yang commented that many professional Chinese women 
are waiting until they are in their 30s to have a baby, when 
it becomes more difficult to conceive and to sustain a 
pregnancy. (Note: For many years the vast majority of 
Chinese married at exactly age 20, the then legal marriage 
age, and conceived immediately thereafter.  As a result, 
women avoided getting pregnant too young, as is a problem in 
many developing countries, and actually attempted to have 
children at exactly their most fertile age.  Changing 
lifestyles have led to later marriages, when the infertility 
rate is higher. End note.) 
 
Rural Women:  Slightly Higher Rates of Birth Defects 
--------------------------------------------- ------- 
 
¶13. (SBU) A website affiliated with the People's Daily 
reported a rate 1.27% birth defects in urban areas, and 
1.33% in rural areas.  Dr. Yang also commented that, in her 
experience, birth defects are higher in the countryside than 
in the city.  Dr. Yang explained that rural women may come 
 
GUANGZHOU 00020593  004.2 OF 004 
 
 
into direct contact with polluting chemicals such as 
pesticides.  Moreover, prenatal care and maternal nutrition 
in the countryside is inferior to that in the cities. 
 
Concern That Pollution May Impact Pregnancies 
--------------------------------------------- 
 
¶14. (SBU) Wang Bin, director of the women's health division 
at the MOH, said publicly in early 2005 that the increase in 
children in China diagnosed at birth with health problems is 
due to environmental pollution.  Wang acknowledged that 
improved diagnostic standards have enabled better detection 
of health problems.  Liang Zhicheng also publicly attributed 
the rise in birth defects to pollution in a Hong Kong press 
report.  Regardless of the scientific connection, or lack 
thereof, or of other factors such as poor prenatal medical 
care, genetics, bad prenatal health decisions by the mother, 
stress, etc., there is growing public concern in South China 
that high levels of air, water, and other environmental 
pollution may be contributing to a number of reproductive 
health problems. 
 
Comment 
------- 
 
¶15. (SBU) Environmental issues are of growing concern to 
both the Chinese public and the national government.  Child 
health is also a critical issue to the public.  It is 
therefore unsurprising that public attention would focus on 
the potential impact of environmental pollutants on child 
and maternal health, rather than on the more fully 
documented environmental links to adult heart, respiratory 
and other illnesses.  The rumors circulating in Guangdong 
provide an interesting window into how China's family 
planning policy and the importance of healthy children 
affects the public. 
 
¶16. (SBU) What is clear is that more data on birth defects 
and maternal and child health in general as well as on 
environmental health are needed.  China simply does not yet 
produce the quality of data needed to look at how specific 
environmental contaminants affect specific health issues, 
and this leaves the public confused and worried. 
 
¶17. (SBU) HHS/CDC has a long-standing birth defects study 
that to date has focused on improved maternal nutrition - a 
key intervention in reducing the incidence of birth defects. 
It is our understanding that this study may now address some 
environmental questions.  These studies should prove 
invaluable in shedding light in an area which thus far has 
been the purview of rumor and anecdote. 
 
¶18. (SBU) This cable has been cleared by Beijing Embassy 
ESTH. 
 
DONG