Deaths and medical visits attributable to environmental pollution in the United Arab Emirates

Burden of disease from contaminated drinking water in countries with high access to safely managed water: A systematic review

The vast majority of residents of high-income countries (≥90%) reportedly have high access to safely managed drinking water. Owing perhaps to the widely held perception of near universal access to high-quality water services in these countries, the burden of waterborne disease in these contexts is understudied. This systematic review aimed to: identify population-scale estimates of waterborne disease in countries with high access to safely managed drinking water, compare methods to quantify disease burden, and identify gaps in available burden estimates. We conducted a systematic review of population-scale disease burden estimates attributed to drinking water in countries where ≥90% of the population has access to safely managed drinking water per official United Nations monitoring. We identified 24 studies reporting estimates for disease burden attributable to microbial contaminants. Across these studies, the median burden of gastrointestinal illness risks attributed to drinking water was ∼2,720 annual cases per 100,000 population. Beyond exposure to infectious agents, we identified 10 studies reporting disease burden-predominantly, cancer risks-associated with chemical contaminants. Across these studies, the median excess cancer cases attributable to drinking water was 1.2 annual cancer cases per 100,000 population. These median estimates slightly exceed WHO-recommended normative targets for disease burden attributable to drinking water and these results highlight that there remains important preventable disease burden in these contexts, particularly among marginalized populations. However, the available literature was scant and limited in geographic scope, disease outcomes, range of microbial and chemical contaminants, and inclusion of subpopulations (rural, low-income communities; Indigenous or Aboriginal peoples; and populations marginalized due to discrimination by race, ethnicity, or socioeconomic status) that could most benefit from water infrastructure investments. Studies quantifying drinking water-associated disease burden in countries with reportedly high access to safe drinking water, focusing on specific subpopulations lacking access to safe water supplies and promoting environmental justice, are needed.

Air pollution burden of disease over highly populated states in the Middle East

Background

Recent epidemiological research has proven that air pollution triggers the risk of morbidity and mortality due to respiratory and cardiovascular-related diseases. More specifically, fine particulate matter with a diameter of <2.5 μm (PM2.5) can penetrate deeply into the lung and bloodstream, causing critical adverse effects on human health.

Objective

It is found that there is inadequate published research related to the health impact of ambient air pollution in the Middle East region. Some states are well studied, while others are not. This work aims to evaluate the health impact of long-term exposure to PM2.5 in the nine most populated countries in the Middle East region, with a total population of about 363 million (in 2012).

Methods

In this study, the human health impacts in terms of total mortality and the estimated attributable proportion (AP) due to long-term exposure to ambient PM2.5 were estimated using the World Health Organization method and software (AirQ+).

Results

In 2012, the annual median PM2.5 concentrations ranged from 34 μg/m3 in Turkey and Syria to 108 μg/m3 in Saudi Arabia. The total estimated mortalities in the nine most populated countries in the Middle East due to long-term exposure to fine particulate matter was about 152,925 (half of which were residents in Egypt). Moreover, the relative risk (RR) was the highest for Saudi Arabia at 1.8031 and the lowest for Turkey and Syria at a value of 1.1553. The highest AP (central value) was 44.5% in Saudi Arabia, while the lowest was 13.4% in Turkey and Syria.

Conclusions

The results indicate a significant impact of air pollution due to long-term exposure to fine particles resulting in early mortality. This urges the collaboration between the governments and different sectors to adopt stringent regulations to control the anthropogenic sources related to traffic and industrial emissions in the Middle East in order to reduce the health burden of air pollution.

Impact of Air Pollution on Residents' Medical Expenses: A Study Based on the Survey Data of 122 Cities in China

Background: With the development of the social economy, air pollution has resulted in increased social costs. Medical costs and health issues due to air pollution are important aspects of environmental governance in various countries.

Methods: This study uses daily air pollution monitoring data from 122 cities in China to empirically investigate the impact of air pollution on residents' medical expenses using the Heckman two-stage and instrumental variable methods, matching data from the 2018 China Health and Retirement Longitudinal Study (CHARLS) survey.

Results: The study found that poor air quality, measured by the air quality index (AQI), significantly increased the probability of chronic lung disease, heart disease, and self-rated poor health. Additionally, the AQI (with an effect of 4.51%) significantly impacted health-seeking behavior and medical expenses. The medical expenditure effects of mild, moderate, severe, and serious pollution days were 3.27, 7.21, 8.62, and 42.66%, respectively.

Conclusion: In the long run, residents' health in areas with a higher air pollution index, indicating poor air quality, is negatively impacted. The more extreme the pollution, the higher the probability of residents' medical treatment and the subsequent increase in medical expenses. Group and regional heterogeneity also play a role in the impact of air pollution on medical expenses. Compared with the existing literature, this study is based on individuals aged 15 years and above and produces reliable research conclusions.

Cardiovascular Diseases and Long-term Self-reported Exposure to Pollution: RESULTS OF A NATIONAL EPIDEMIOLOGICAL STUDY IN LEBANON

BACKGROUND

Cardiovascular diseases (CVDs) are linked to high mortality and morbidity, particularly in developing countries. Some studies have linked indoor and outdoor pollution to CVD, but results are inconsistent. Our objective was to assess this association in Lebanon, a Middle Eastern country.

METHODS

A national cross-sectional study was conducted across Lebanon. CVD prevalence, which included prevalent ischemic heart and cerebrovascular diseases, was assessed. Moreover, in addition to self-reported items of pollution exposure, we assessed potential predictors of CVD, including sociodemographic characteristics, self-reported health information, and biological measurements.

RESULTS

We assessed the dose-effect relationship of pollution items in relation with CVD. Self-reported indoor and outdoor pollution exposures were associated with CVD, with or without taking biological values into account. Moreover, we found a dose-effect relationship of exposure with risk of disease (44% increase in risk of CVD for every additional pollution exposure item), after adjustment for sociodemographic and biological characteristics.

CONCLUSION

Although additional studies would be necessary to confirm these findings, interventions should start to sensitize the population about the effect of pollution on chronic diseases and the work of reducing pollution and improving air quality should be implemented to decrease the disease burden on the population and health system.

Potential causes of asthma in the United Arab Emirates: drawing insights from the Arabian Gulf

There is considerable concern on the rise in the incidence of asthma worldwide with statistics in the United Arab Emirates (UAE) indicating that at least 13% of schoolchildren, particularly of Emirati descent, suffer from asthma. With its high rates of hospital admissions, negative socioeconomic impact and significant morbidity, this is a disease that requires optimal guidelines for control and awareness. In this article, we review the current knowledge of asthma in the UAE and draw on studies, especially from the surrounding region, to identify its contributing factors within this population. The most frequently identified agents pertinent to the UAE include outdoor and indoor environmental causes exacerbated by the country's rapid urbanization, genetic factors aided in transmission by consanguineous marriage, the patient's socioeconomic status and a rise in vitamin D deficiencies. This evidence aims to inform healthcare professionals and governmental agencies in order to best create guidelines for controlling the burden of this debilitating disease.

The Effects of Urban Form on Ambient Air Pollution and Public Health Risk: A Case Study in Raleigh, North Carolina

Since motor vehicles are a major air pollution source, urban designs that decrease private automobile use could improve air quality and decrease air pollution health risks. Yet, the relationships among urban form, air quality, and health are complex and not fully understood. To explore these relationships, we model the effects of three alternative development scenarios on annual average fine particulate matter (PM2.5 ) concentrations in ambient air and associated health risks from PM2.5 exposure in North Carolina's Raleigh-Durham-Chapel Hill area. We integrate transportation demand, land-use regression, and health risk assessment models to predict air quality and health impacts for three development scenarios: current conditions, compact development, and sprawling development. Compact development slightly decreases (-0.2%) point estimates of regional annual average PM2.5 concentrations, while sprawling development slightly increases (+1%) concentrations. However, point estimates of health impacts are in opposite directions: compact development increases (+39%) and sprawling development decreases (-33%) PM2.5-attributable mortality. Furthermore, compactness increases local variation in PM2.5 concentrations and increases the severity of local air pollution hotspots. Hence, this research suggests that while compact development may improve air quality from a regional perspective, it may also increase the concentration of PM2.5 in local hotspots and increase population exposure to PM2.5 . Health effects may be magnified if compact neighborhoods and PM2.5 hotspots are spatially co-located. We conclude that compactness alone is an insufficient means of reducing the public health impacts of transportation emissions in automobile-dependent regions. Rather, additional measures are needed to decrease automobile dependence and the health risks of transportation emissions.