Hong Kong has suffered the most from ship emissions in the Pearl River Delta, with locals accounting for 75 per cent of deaths related to sulphur dioxide released from vessels…think tank [Civic Exchange] found…[T]he city saw 385 of the 519 deaths directly related to sulphur dioxide from ship emissions…The chemical can cause cancer and diseases in heart and blood vessels. The think tank…suggested the government make it compulsory that ships switch their fuel to 0.5 per cent sulphur at berth...Roberto Giannetta, secretary of the Hong Kong Liner Shipping Association, said it would cost a shipping line US$2 million a year to switch from conventional bunker fuel to low-sulphur clean fuel…[and] it was uncommon for ships in Hong Kong to use low-sulphur fuel because it was not available in the city.