I have just emerged from a problem I have from time to time. My nose reacts furiously to something, and fills with gunk. Soon my head feels as if it was bursting and the gunk finds its way down the back of my throat, producing a lot of coughing and a sore throat.

Nobody seems to know what causes this. It has only happened in the last few years. My doctor maintains a scientific reluctance to come to any conclusion in the absence of conclusive evidence. My wife thinks changes in temperature have something to do with it. My theory is that the pollution in urban Hong Kong is to blame - on New Year's Eve I was running around Central shopping.

Whatever the truth of this matter, it means that I regard the question of Hong Kong's polluted air with a certain amount of emotional engagement. There is no doubt about the facts: In the more crowded parts of Hong Kong the air routinely fails to meet the most tolerant safety standards, and this causes death or illness.

Under the circumstances you would think that policy-makers would accord this a high priority. They may not be able to bring us wealth and happiness, but they could at least keep us alive. Yet this does not happen.

As it happens I am writing this in London. London used to be notorious for its fog. The passage at the beginning of "Bleak House" about a thick fog getting everywhere is not a poetic metaphor by Charles Dickens. It is an accurate description of what used to happen.

This went on until the early 1950s, when a particularly spectacular example provoked action. The problem, it was widely believed, was the amount of smoke belched out because domestic heating was in those days universally provided by open coal fires. So the government banned coal. Everyone had to switch to a smokeless fuel called Coalite and the fog stopped.

Hong Kong's problem is not from coal. At street level it seems to be mostly a result of ill-adjusted and elderly diesel engines. There is an interesting sidelight from London on this too. Most of the diesel engines in London are in taxicabs. But you do not get elderly or ill-adjusted ones wandering about, because there is a compulsory retirement age for the cabs (as well as a rigorous annual inspection) and it is five years.

Of course your retired cab is not scrapped. It is put out to pasture in some provincial city where street pollution is not a serious problem. So in distant country towns you often find London cabs of a model outlawed in the capital decades ago.

In the light of this it is disappointing that the Hong Kong government's approach to this problem is to pay people large sums of money to replace aging diesel vehicles. This is progress, but not much progress. It is a pussyfooting approach to the problem which may have been justified when it was regarded as a largely aesthetic matter. Pollution spoiling the view? We cannot interrupt the serious business of wealth creation to please a few tourists.

But this is not an aesthetic matter. It is causing death and suffering. It is also becoming the most commonly cited reason for leaving Hong Kong, at least for families with kids. And we still cannot get an official pollution index worthy of the problem. Instead we have a private one from HKU, the Hedley Index.

This is a major source of horrifying information. The name honors Professor Anthony Hedley, for many years professor of Public Health at HKU. This is appropriate. One cannot help thinking that if Professor Hedley had devoted to air pollution a mere fraction of the time he spent bitching about smokers we would not now be in the ludicrous position of standing in bus queues being marinated in carcinogens and entertained with notices sternly warning us not to smoke.

What is to be done? This is not rocket science. Vehicles which belch poison should be banned from Hong Kong roads. Those which are found belching poison should be confiscated without compensation. There is no human right to kill people with your tailpipe.

No doubt this would disrupt some people's business models. But I am suspicious of the bleating which could be expected if something of this kind was introduced. The old vehicles could still be exported to less fussy places. If everyone has an extra expense then nobody's competitive position is changed. An operation which depends on running decrepit vehicles might be better shut down anyway.

The author's work in journalism has won him honors in the Hong Kong News Awards and the International Radio Festival of New York. He is well known as a columnist, reviewer and broadcaster.

(HK Edition 01/09/2014 page1)