Qualitative research about public health risk perceptions on ambient air pollution. A review study

Unveiling the health consequences of air pollution in the world's most polluted nations

Air pollution poses a persuasive threat to global health, demonstrating widespread detrimental effects on populations worldwide. Exposure to pollutants, notably particulate matter with a diameter of 2.5 µm (PM2.5), has been unequivocally linked to a spectrum of adverse health outcomes. A nuanced understanding of the relationship between them is crucial for implementing effective policies. This study employs a comprehensive investigation, utilizing the extended health production function framework alongside the system generalized method of moments (SGMM) technique, to scrutinize the interplay between air pollution and health outcomes. Focusing on a panel of the top twenty polluted nations from 2000 to 2021, the findings yield substantial insights. Notably, PM2.5 concentration emerges as a significant factor, correlating with a reduction in life expectancy by 3.69 years and an increase in infant mortality rates by 0.294%. Urbanization is found to increase life expectancy by 0.083 years while concurrently decreasing infant mortality rates by 0.00022%. An increase in real per capita gross domestic product corresponds with an improvement in life expectancy by 0.21 years and a decrease in infant mortality rates by 0.00065%. Similarly, an elevated school enrollment rate is associated with a rise in life expectancy by 0.17 years and a decline in infant mortality rates by 0.00032%. However, a higher population growth rate is found to modestly decrease life expectancy by 0.019 years and slightly elevate infant mortality rates by 0.000016%. The analysis reveals that per capita greenhouse gas emissions exert a negative impact, diminishing life expectancy by 0.486 years and elevating infant mortality rates by 0.00061%, while per capita energy consumption marginally reduces life expectancy by 0.026 years and increases infant mortality rates by 0.00004%. Additionally, economic volatility shock presents a notable decrement in life expectancy by 0.041 years and an increase in infant mortality rates by 0.000045%, with inflationary shock further exacerbating adverse health outcomes by lowering life expectancy by 0.70 years and elevating infant mortality rates by 0.00025%. Moreover, the study scrutinizes the role of institutional quality, revealing a constructive impact on health outcomes. Specifically, the institutional quality index is associated with an increase in life expectancy by 0.66% and a decrease in infant mortality rates by 0.0006%. Extending the analysis to examine the nuanced dimensions of institutional quality, the findings discern that economic institutions wield a notably stronger positive influence on health outcomes compared to political and institutional governance indices. Finally, the results underscore the pivotal moderating role of institutional quality in mitigating the deleterious impact of PM2.5 concentration on health outcomes, counterbalancing the influence of external shocks, and improving the relationships between explanatory variables and health outcome indicators. These findings offer critical insights for guiding evidence-based policy implications, with a focus on fostering resilient, sustainable, and health-conscious societies.

Geo-visualizing the hotspots of smog-induced health effects in district Gujranwala, Pakistan: a community perspective

This study aims to examine the health effects of smog on different age groups in Gujranwala and its associated health effects. To achieve this, primary data was gathered through a questionnaire survey focused on health issues faced by elderly individuals during the smog season. The results of the survey revealed that older adults in Gujranwala are particularly vulnerable to a range of health problems during this period, including coughing, throat infections, irritated eyes, runny noses, shortness of breath, chest pain while breathing, wheezing, asthma, heart problems, and respiratory issues. In order to analyze the spatial distribution of these health concerns, spatial and geo-statistical methods were employed utilizing ArcGIS 10.5. By integrating field data and secondary sources, hotspot and cold spot zones were identified. Employing the statistical model within ArcMap 10.5, hotspot analysis was performed to determine areas with elevated air quality index (AQI) values and associated health problems. The application of the inverse distance weighted approach, incorporating the Z value, facilitated a visual representation of areas with heightened and reduced AQI and health-related issues. The study's outcomes underscore the prevalence of health challenges among older adults during the winter months in Gujranwala, particularly linked to smog-induced throat infections, irritated eyes, and runny noses. The research identified zones with escalated AQI values, encompassing regions such as Gujranwala, Chandaqella, Alam Chowk, Khali Shahpur, Sialkot Bypass, and Pindi Bypass. It was established that industrial pollutants and vehicular emissions are the primary contributors to smog in the area. Given the detrimental consequences of pollution on individuals of all age groups, it is imperative to take action to mitigate its impact. This can be achieved through addressing pollution sources, implementing effective emission control measures, and fostering public awareness. By adopting proactive measures, the adverse health effects of pollution can be minimized, thereby fostering a healthier and safer environment for the entire population. This study offers valuable insights for policymakers and environmentalists to implement targeted interventions and improve air quality, ultimately safeguarding the health of local populations.

Assessment of air pollution and air quality perception mismatch using mobility-based real-time exposure

Air pollution poses a threat to human health. Public perceptions of air pollution are important for individual self-protection and policy-making. Given the uncertainty faced by residence-based exposure (RB) measurements, this study measures individuals' real-time mobility-based (MB) exposures and perceptions of air pollution by considering people's daily movement. It explores how contextual uncertainties may influence the disparities in perceived air quality by taking into account RB and MB environmental factors. In addition, we explore factors that are related to the mismatch between people's perceived air quality and actual air pollution exposure. Using K-means clustering to divide the PM2.5 values into two groups, a mismatch happens when the perceived air quality is poor but the air pollution level is lower than 15.536μg/m3 and when the perceived air quality is good but the air pollution level is higher than 15.608μg/m3. The results show that there is a mismatch between air pollution exposure and perception of air pollution. People with low income are exposed to higher air pollution. Unemployed people and people with more serious mental health symptoms (e.g., depression) have a higher chance of accurately assessing air pollution (e.g., perceiving air quality as poor when air pollution levels are high). Older people and those with a higher MB open space density tend to underestimate air pollution. Students tend to perceive air quality as good. People who are surrounded by higher MB transportation land-use density and green space density tend to perceive air quality as poor. The results can help policymakers to increase public awareness of high air pollution areas, and consider the health effects of landscapes during planning.

Air pollution perception bias: Mismatch between air pollution exposure and perception of air quality in real-time contexts

Air pollution perception biases hinder the public's awareness of actual air quality. Past studies that examined the association and mismatch between actual and perceived air quality neglected individuals' dynamic exposure and their activity, travel, spatial, temporal, and social contexts. Using data collected with real-time air pollutant sensors and ecological momentary assessment (EMA), this study investigated the association and mismatch between momentary air pollution exposure and perceived air quality. It also examined how activity type, travel mode, spatial and temporal contexts, and social factors contribute to this disparity. The results show that exposure to air pollution is significantly higher in residential areas (1.777 μg/m3) and transportation land-use areas (2.863 μg/m3) compared to commercial areas. Exposure in the evening is 1.308 μg/m3 higher than in the afternoon. Working or studying activities are associated with 2.863 μg/m3 lower exposure, and individuals perceive air quality as good when working or studying and in residential areas. Conversely, individuals assess air quality as poor in railway travel contexts and being accompanied by friends. This study also reveals the nonstationary association between air pollution exposure and perceived air quality. The odds of underestimating air pollution are 1.8-2.7 times as high as that in residential areas and 2.1 to 2.6 times that in transportation land-use areas when compared to commercial areas. Implementing targeted mitigation measures in these contexts can enhance public awareness of air pollution.

Perceptions of the health risk from hot days and the cooling effect of urban green spaces: a case study in Xi'an, China

Background

Hot days are one of the typical threats to human health and sustainable cities. The exploration of residents' perceptions of thermal environment and its mitigation measures will support the health risk prevention.

Methods

A survey with a combination of closed-ended and open-ended questions was conducted in July 2021 among 13 urban parks in Xi'an City, China. With the help of ANOVA and ordinal logistic regression, this study investigated the influencing factors both on residents' health risk perception of hot days and their perception of the effect of urban ecological landscape on reducing the thermal risk. The relationship between health risk perception and residents' needs of urban ecological construction was also explored.

Results

According to 325 valid questionnaires, the male-female ratio of respondents was found to be 1:0.87, young people aged 18-29 (26.46%), the retirees (27.08%) and the ones with undergraduate education (33.23%) were, relatively, the largest groups. The results show that 92.31% of the respondents believed that their daily lives were under the influence of hot days. Housing types, occupation, cooling equipment at work, and outdoor working hours all had a significant impact on their high temperature perceptions. The proportion of respondents who were under a huge health risk and sought medical treatment due to hot days was 30.16% and 44.92%, respectively. Women were 18.52 and 2.33 times more likely to suffer health threats and experience discomforts than men. Furthermore, 73.23% of the respondents believed that the urban ecological landscapes in Xi'an had an enhanced cooling effect in recent years. Compared with the morphological characteristics, residents' recognition of the restriction of landscape's area on its cooling effect was higher, and the residence duration showed a significant influence.

Conclusion

The cooling effect of green spaces and water effectively resisted urban thermal threats, and residents' needs of the urban ecological landscapes was associated with their health risk perceptions of hot days. In the future, it is necessary to promote the early warning of hot days, meanwhile, the optimization of landscape patterns of green infrastructures should be implemented in urban planning for the purposes of residents' health risk prevention.

"Our bodies are not strong anymore": a focus group study on health risk perceptions of ambient air pollution near a petrochemical industry

Background

Ambient air pollution has persisted in lessendowed communities, resulting in exposure to unhealthy pollutants. Epidemiological studies on air pollution have been mainly quantitative, with a dearth of information on community health risk perception, a key component of risk management.

Objectives

The aim of this focus group study was to highlight the health risk perception of ambient air pollution among people residing near a petrochemical industry and to determine their perceptions of the existing control measures and ideas for more effective control.

Methods

Participants were purposefully selected based on age, sex, long-term residence near a petroleum refinery, and occupation. Three 90-minute face-to-face focus groups and one individual interview were conducted. The moderator guided discussions using a pre-formed topic guide. Discussions were audio-recorded, transcribed manually, and coded using NVivo software. The data analysis was conducted using reflexive thematic analysis.

Results

Six themes were generated: negative perception of the environment; the refinery is to blame; air pollution is seen or smelled; air pollution is associated with health and non-health risks; poor response to air pollution- everyone is to blame and the government is primarily responsible for healthy air quality. The participants were not aware of the extent of air pollution's health risks. Suggestions for air pollution control included regulating gas flaring, environmental health education, and incentives for community members.

Conclusion

Participants perceived that their ambient air was unhealthy. However, concerns about the health risks were shaped by contextual factors. The key barriers to effective mitigation were poor environmental health literacy and political factors.

Housing Supply and How It Is Related to Social Inequalities-Air Pollution, Green Spaces, Crime Levels, and Poor Areas-In Catalonia

We carried out a search of over 12,000 houses offered on the rental market in Catalonia and assessed the possibility of families below the poverty threshold being able to rent these homes. In this regard, we wanted to evaluate whether the economic situation of families is able to influence their social environment, surroundings, and safety. We observed how their economic situation can allow families the possibility of developing a life without exposure to health risks, and how economic constraints result in disadvantages in several areas of life. The results show how families at risk of poverty live in less favourable conditions and experience a widening of different gaps, with current prices leading to a possible poverty trap for the most disadvantaged groups. The higher the percentage of the population below the threshold, the lower the possibility of not being able to rent a house compared to areas with a lower prevalence of population below the threshold. This association was observed both when considering the risk linearly and non-linearly. Linearly, the probability of not renting a house was reduced by 8.36% for each 1% increase in the prevalence of population at risk of extreme poverty. In the second, third and fourth percentage quartiles, the probability of not being able to rent a house decreased by 21.13%, 48.61%, and 57.79%, respectively. In addition, the effect was different inside and outside of metropolitan areas, with the former showing a decrease of 19.05% in the probability of renting a house, whereas outside metropolitan areas the probability increased by 5.70%.

Model predicting social acceptance behavior to implement ELV policy: Exploring the role of knowledge toward ELV policy on social acceptance in Malaysia

Effective management of end-of-life vehicles (ELVs) represents a sound strategy to mitigate global climate change. ELVs are contaminants that pollute water, air, soil, and landscape. This waste flow must be adequately treated, but no proper rule oversees the disposal of ELV waste in Malaysia. This study aims to determine the extent of implementing the ELV policy and the social readiness in implementing environmentally friendly ELV disposal in Malaysia. The questionnaire seeks public input on critical ELV concerns such as public perception of the phenomena, environmental and safety standards, and recycling and treatment facilities. This research uses a cross-sectional design with 448 respondents in the survey. Fit models in structural equation modeling are evaluated using a variety of goodness-of-fit indicators to ensure an actual hypothesis. This study's advantages include the availability of representative samples and allowing for comparable and generalizable conclusions to larger communities throughout Malaysia. It is found that personal experience is significantly correlated with social readiness. The cause of ELV vehicles knowledge was the vital mediator, along with recycling costs knowledge. Thus, knowledge regarding ELV management costs is the most decisive mediation variable to predict public acceptance. The recommended strategy to reduce resentment and rejection of ELV policy is to disseminate information about the negative ELV impact on environmental and social sustainability.

Understanding perceptions of neighborhood health and non-communicable disease risk in urban contexts in Ghana

Global health surveillance reports show Africa's epidemiologic transition from one dominated by higher burdens of nutritional, maternal, and communicable diseases to one increasingly dominated by non-communicable diseases (NCDs). Debates on the increasing cases of NCDs in the African context have focused on individualistic risk factors to the neglect of other similar important determinants such as the living environment. Drawing on theoretical tenets of the protection motivation theory and using cross-sectional data, we examined neighborhood risk perceptions and self-rated risk of developing NCDs in Ghana. The dependent variable 'self-rated risk of developing NCDs' was measured as a binary outcome and the focal independent variable - perceived neighborhood health risk - as an index. We fitted multivariate multilevel regression models to a sample of 1376 individuals across 9 neighborhoods. Results show that respondents who perceived their neighborhoods as risky were more likely to rate their risk of developing NCDs high. A unit increase in neighborhood violence was associated with 8% likelihood of self-rated risk of developing NCDs. However, a unit increase in the aesthetic quality of respondent's neighborhood was associated with lower likelihood of self-rated risk of developing NCDs. Engaging in regular physical activity, and non-tobacco use were associated with a lower likelihood of perceived NCDs risk. We suggest policy agendas intended for reducing the burden of NCDs in Ghana and other LMICs could incorporate programs that target improving environmental characteristics to minimize risks and offer people the opportunity to make healthy choices.

Informing about the invisible: communicating en route air pollution and noise exposure to cyclists and pedestrians using focus groups

Active mobility and public transport are considered beneficial for health and wellbeing and valuable for climate change mitigation. However, cyclists and pedestrians have high air pollution and noise exposure alongside traffic, which adversely impact health and wellbeing. The measured exposure can differ from the perceived exposure, hence, communicating en route exposure is crucial. Therefore, this study investigates how to communicate route-based exposure to cyclists and pedestrians and explores if exposure communication, e.g. via smartphones, is worthwhile for healthy and pleasant commute. It is investigated how exposure feedback influences the motivation to protect oneself and how exposure information should be designed. Three focus groups with 20 cyclists/pedestrians living in Berlin, Germany, were conducted. Based on Protection Motivation Theory and Environmental Health Literacy concept, (1) experiences and practices after recognizing exposure were discussed and (2) information needs and communication strategies were developed. The results reveal a feeling of helplessness regarding the ubiquity and uncertainty of pollution and a heightened threat appraisal. Anger, anxiety and rejection were stated. Making sense of pollution levels and protective alternatives were central. A healthy routing app, including also pleasant route factors, was desired. However, information provision was also denied. Participants argued the responsibility should not be left to the commuters and planning for exposed road users would be crucial. Information provision may not be worthwhile if planning authorities do not provide healthy alternatives. People-centered approaches for tackling air pollution and noise exposure en route should be investigated further.

Visualization and Analysis of Air Pollution and Human Health Based on Cluster Analysis: A Bibliometric Review from 2001 to 2021

Bibliometric techniques and social network analysis are employed in this study to evaluate 14,955 papers on air pollution and health that were published from 2001 to 2021. To track the research hotspots, the principle of machine learning is applied in this study to divide 10,212 records of keywords into 96 clusters through OmniViz software. Our findings highlight strong research interests and the practical need to control air pollution to improve human health, as evidenced by an annual growth rate of over 15.8% in the related publications. The cluster analysis showed that clusters C22 (exposure, model, mortality) and C8 (health, environment, risk) are the most popular topics in this field of research. Furthermore, we develop co-occurrence networks based on the cluster analysis results in which a more specific keyword classification was obtained. These key areas include: "Air pollutant source", "Exposure-Response relationship", "Public & Occupational Health", and so on. Future research hotspots are analyzed through characteristics of the cluster groups, including the advancement of health risk assessment techniques, an interdisciplinary approach to quantifying human exposure to air pollution, and strategies in health risk assessment.

The Public's Perceptions of Air Pollution. What's in a Name?

Air pollution is a major global health threat. There is growing evidence for a negative effect of air pollution on health and well-being. Relationships between air pollution and health are mediated by health risk perceptions and play a crucial role in public response to it. Air pollution in the public's mind is often different from air pollution defined by the scientific community. Therefore, in order to develop successful prevention and alleviation strategies, an understanding of public risk perceptions is key. The central question of this paper is: 'How does "the public" (in Brussels) perceive air pollution?' This research is an attempt to enrich the limited body of qualitative research in the field, approaching the topic of perception from 4 different, complementary angles: definition, association, categorisation and problematisation. About 51 interviews were conducted in the Brussels-Capital Region. Consistent with earlier research, this research illustrates that perceptions of air pollution are diverse, subjective, context-dependent and often deviate from conceptualisations and definitions in the scientific community. Respondents underestimate the potential harm and problematisation depends on comparative strategies and perceived avoidability. The novel aspect of this paper is the identification of 5 mental schemes by which specific elements are categorised as being air pollution: (1) the source of the element, (2) its health impact, (3) its climate impact, (4) its functionality and (5) sensory perceptions. The insights gained from this research contribute to the field of environmental epidemiology through a better understanding of how 'the public' perceives air pollution and in what way this may deviate from how it is perceived by experts. We hope to raise the awareness among experts and policy makers that air pollution perceptions are far from universal and consensual but on the contrary individual and contested.

Engaging communities in addressing air quality: a scoping review

BACKGROUND

Exposure to air pollution has a detrimental effect on health and disproportionately affects people living in socio-economically disadvantaged areas. Engaging with communities to identify concerns and solutions could support organisations responsible for air quality control, improve environmental decision-making, and widen understanding of air quality issues associated with health. This scoping review aimed to provide an overview of approaches used to engage communities in addressing air quality and identify the outcomes that have been achieved.

METHODS

Searches for studies that described community engagement in air quality activities were conducted across five databases (Academic Search Complete, CABI, GreenFILE, MEDLINE, Web of Science). Data on study characteristics, community engagement approach, and relevant outcomes were extracted. The review process was informed by a multi-stakeholder group with an interest in and experience of community engagement in air quality. Thirty-nine papers from thirty studies were included in the final synthesis.

CONCLUSION

A range of approaches have been used to engage communities in addressing air quality, most notably air quality monitoring. Positive outcomes included increased awareness, capacity building, and changes to organisational policy and practice. Longer-term projects and further exploration of the impact of community engagement on improving air quality and health are needed as reporting on these outcomes was limited.

Government Trust, Environmental Pollution Perception, and Environmental Governance Satisfaction

Environmental governance is related to the healthy living standard of human beings and the sustainable development of an economic society. It is of great significance to explore the influence of government trust and environmental pollution perception on environmental governance satisfaction to improve the performance of government environmental governance. Based on the CSS2019 survey data, 3872 survey samples were statistically analyzed, and the optimal scale regression model was used to analyze the relationship between government trust, environmental pollution perception, and environmental governance satisfaction. The results showed that 52.27% of the respondents believed that the satisfaction of environmental governance was good, and both government trust and environmental pollution perception had significant positive effects on the satisfaction of environmental governance. The trust level of the central government, district and county governments, and township governments shows a "differential government trust" state, which is pyramidal. However, the impact of government trust on environmental governance satisfaction shows an inverted pyramid structure, and the township government has the largest effect, which is not matched with the distribution of government trust level. The influence effect of air pollution perception is relatively large, and the public is sensitive to air pollution. Government trust has an impact on the satisfaction of environmental governance through the "expectation-response" path. People are close to the township government and have the opportunity to contact and interact with the township government and its staff. They can directly observe the governance performance and share the public goods of environmental governance. Therefore, it is necessary to further improve the trust level of township governments, strengthen the control of air pollution and improve the township government's environmental governance ability.