1
|
Wang J, Alli AS, Clark SN, Ezzati M, Brauer M, Hughes AF, Nimo J, Moses JB, Baah S, Nathvani R, D V, Agyei-Mensah S, Baumgartner J, Bennett JE, Arku RE. Inequalities in urban air pollution in sub-Saharan Africa: an empirical modeling of ambient NO and NO 2 concentrations in Accra, Ghana. ENVIRONMENTAL RESEARCH LETTERS : ERL [WEB SITE] 2024; 19:034036. [PMID: 38419692 PMCID: PMC10897512 DOI: 10.1088/1748-9326/ad2892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 02/04/2024] [Accepted: 02/12/2024] [Indexed: 03/02/2024]
Abstract
Road traffic has become the leading source of air pollution in fast-growing sub-Saharan African cities. Yet, there is a dearth of robust city-wide data for understanding space-time variations and inequalities in combustion related emissions and exposures. We combined nitrogen dioxide (NO2) and nitric oxide (NO) measurement data from 134 locations in the Greater Accra Metropolitan Area (GAMA), with geographical, meteorological, and population factors in spatio-temporal mixed effects models to predict NO2 and NO concentrations at fine spatial (50 m) and temporal (weekly) resolution over the entire GAMA. Model performance was evaluated with 10-fold cross-validation (CV), and predictions were summarized as annual and seasonal (dusty [Harmattan] and rainy [non-Harmattan]) mean concentrations. The predictions were used to examine population distributions of, and socioeconomic inequalities in, exposure at the census enumeration area (EA) level. The models explained 88% and 79% of the spatiotemporal variability in NO2 and NO concentrations, respectively. The mean predicted annual, non-Harmattan and Harmattan NO2 levels were 37 (range: 1-189), 28 (range: 1-170) and 50 (range: 1-195) µg m-3, respectively. Unlike NO2, NO concentrations were highest in the non-Harmattan season (41 [range: 31-521] µg m-3). Road traffic was the dominant factor for both pollutants, but NO2 had higher spatial heterogeneity than NO. For both pollutants, the levels were substantially higher in the city core, where the entire population (100%) was exposed to annual NO2 levels exceeding the World Health Organization (WHO) guideline of 10 µg m-3. Significant disparities in NO2 concentrations existed across socioeconomic gradients, with residents in the poorest communities exposed to levels about 15 µg m-3 higher compared with the wealthiest (p < 0.001). The results showed the important role of road traffic emissions in air pollution concentrations in the GAMA, which has major implications for the health of the city's poorest residents. These data could support climate and health impact assessments as well as policy evaluations in the city.
Collapse
Affiliation(s)
- Jiayuan Wang
- Department of Environmental Health Sciences, School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA, United States of America
| | - Abosede S Alli
- Department of Environmental Health Sciences, School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA, United States of America
| | - Sierra N Clark
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, United Kingdom
| | - Majid Ezzati
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, United Kingdom
- Regional Institute for Population Studies, University of Ghana, Accra, Ghana
- Abdul Latif Jameel Institute for Disease and Emergency Analytics, Imperial College London, London, United Kingdom
| | - Michael Brauer
- School of Population and Public Health, The University of British Columbia, Vancouver, Canada
| | | | - James Nimo
- Department of Physics, University of Ghana, Accra, Ghana
| | | | - Solomon Baah
- Department of Physics, University of Ghana, Accra, Ghana
| | - Ricky Nathvani
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, United Kingdom
| | - Vishwanath D
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, United Kingdom
| | - Samuel Agyei-Mensah
- Department of Geography and Resource Development, University of Ghana, Accra, Ghana
- Department of Civil and Environmental Engineering, Imperial College London, London, United Kingdom
| | - Jill Baumgartner
- Institute for Health and Social Policy, McGill University, Montreal, Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Canada
| | - James E Bennett
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, United Kingdom
| | - Raphael E Arku
- Department of Environmental Health Sciences, School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA, United States of America
| |
Collapse
|
2
|
Eriksson A, Abera A, Malmqvist E, Isaxon C. Characterization of fine particulate matter from indoor cooking with solid biomass fuels. INDOOR AIR 2022; 32:e13143. [PMID: 36437670 PMCID: PMC9828024 DOI: 10.1111/ina.13143] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 10/09/2022] [Accepted: 10/10/2022] [Indexed: 05/06/2023]
Abstract
Household burning of solid biomass fuels emits pollution particles that are a huge health risk factor, especially in low-income countries (LICs) such as those in Sub-Saharan Africa. In epidemiological studies, indoor exposure is often more challenging to assess than outdoor exposure. Laboratory studies of solid biomass fuels, performed under real-life conditions, are an important path toward improved exposure assessments. Using on- and offline measurement techniques, particulate matter (PM) from the most commonly used solid biomass fuels (charcoal, wood, dung, and crops residue) was characterized in laboratory settings using a way of burning the fuels and an air exchange rate that is representative of real-world settings in low-income countries. All the fuels generated emissions that resulted in concentrations which by far exceed both the annual and the 24-hour-average WHO guidelines for healthy air. Fuels with lower energy density, such as dung, emitted orders of magnitude more than, for example, charcoal. The vast majority of the emitted particles were smaller than 300 nm, indicating high deposition in the alveoli tract. The chemical composition of the indoor pollution changes over time, with organic particle emissions often peaking early in the stove operation. The chemical composition of the emitted PM is different for different biomass fuels, which is important to consider both in toxicological studies and in source apportionment efforts. For example, dung and wood yield higher organic aerosol emissions, and for dung, nitrogen content in the organic PM fraction is higher than for the other fuels. We show that aerosol mass spectrometry can be used to differentiate stove-related emissions from fuel, accelerant, and incense. We argue that further emission studies, targeting, for example, vehicles relevant for LICs and trash burning, coupled with field observations of chemical composition, would advance our understanding of air pollution in LIC. We believe this to be a necessary step for improved air quality policy.
Collapse
Affiliation(s)
- Axel Eriksson
- Division of Ergonomics and Aerosol TechnologyLund UniversityLundSweden
| | - Asmamaw Abera
- Ethiopia Institute of Water ResourcesAddis Ababa UniversityAddis AbabaEthiopia
| | - Ebba Malmqvist
- Division of Occupational and Environmental MedicineLund UniversityLundSweden
| | - Christina Isaxon
- Division of Ergonomics and Aerosol TechnologyLund UniversityLundSweden
| |
Collapse
|
3
|
Flanagan E, Oudin A, Walles J, Abera A, Mattisson K, Isaxon C, Malmqvist E. Ambient and indoor air pollution exposure and adverse birth outcomes in Adama, Ethiopia. ENVIRONMENT INTERNATIONAL 2022; 164:107251. [PMID: 35533531 DOI: 10.1016/j.envint.2022.107251] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 04/14/2022] [Accepted: 04/15/2022] [Indexed: 06/14/2023]
Abstract
Air pollution poses a threat to human health, with pregnant women and their developing fetuses being particularly vulnerable. A high dual burden of ambient and indoor air pollution exposure has been identified in Ethiopia, but studies investigating their effects on adverse birth outcomes are currently lacking. This study explores the association between ambient air pollution (NOX and NO2) and indoor air pollution (cooking fuel type) and fetal and neonatal death in Adama, Ethiopia. A prospective cohort of mothers and their babies was used, into which pregnant women were recruited at their first antenatal visit (n = 2085) from November 2015 to February 2018. Previously developed land-use regression models were utilized to assess ambient concentrations of NOX and NO2 at the residential address, whereas data on cooking fuel type was derived from questionnaires. Birth outcome data was obtained from self-reported questionnaire responses during the participant's postnatal visit or by phone if an in-person meeting was not possible. Binary logistic regression was employed to assess associations within the final study population (n = 1616) using both univariate and multivariate models; the latter of which adjusted for age, education, parity, and HIV status. Odds ratios (OR) and their corresponding 95% confidence intervals (CI) were reported. Within the cohort, 69 instances of fetal death (n = 16 miscarriages; n = 53 stillbirths) and 16 cases of neonatal death were identified. The findings suggest a tendency towards an association between ambient NOX and NO2 exposure during pregnancy and an increased risk of fetal death overall as well as stillbirth, specifically. However, statistical significance was not observed. Results for indoor air pollution and neonatal death were inconclusive. As limited evidence on the effects of exposure to ambient air pollution on adverse birth outcomes exists in Sub-Saharan Africa and Ethiopia, additional studies with larger study populations should be conducted.
Collapse
Affiliation(s)
- Erin Flanagan
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Faculty of Medicine, Lund University, Lund, Sweden.
| | - Anna Oudin
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Faculty of Medicine, Lund University, Lund, Sweden
| | - John Walles
- Clinical Infection Medicine, Department of Translational Medicine, Faculty of Medicine, Lund University, Malmö, Sweden
| | - Asmamaw Abera
- Ethiopia Institute of Water Resources, Addis Ababa University, Addis Ababa, Ethiopia
| | - Kristoffer Mattisson
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Faculty of Medicine, Lund University, Lund, Sweden
| | - Christina Isaxon
- Division of Ergonomics and Aerosol Technology, Department of Design Sciences, Faculty of Engineering, LTH, Lund University, Lund, Sweden
| | - Ebba Malmqvist
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Faculty of Medicine, Lund University, Lund, Sweden
| |
Collapse
|
4
|
Balidemaj F, Isaxon C, Abera A, Malmqvist E. Indoor Air Pollution Exposure of Women in Adama, Ethiopia, and Assessment of Disease Burden Attributable to Risk Factor. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:9859. [PMID: 34574780 PMCID: PMC8472573 DOI: 10.3390/ijerph18189859] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 09/02/2021] [Accepted: 09/14/2021] [Indexed: 11/16/2022]
Abstract
INTRODUCTION AND AIM Air pollution, a major environmental threat to human health, contributes to the premature deaths of millions of people worldwide. Cooking with solid fuels, such as charcoal and wood, in low- and middle-income countries generates very high emissions of particulate matter within and near the household as a result of their inefficient combustion. Women are especially exposed, as they often perform the cooking. The purpose of this study was to assess the burden of disease attributable to household air pollution exposure from cooking among women in Adama, Ethiopia. METHODS AirQ+ software (WHO Regional Office for Europe, Copenhagen, Denmark) was used to assess the health impact of household air pollution by estimating the burden of disease (BoD) including Acute Lower Respiratory Infections (ALRI), Chronic Obstructive Pulmonary Disease (COPD), Ischemic Heart Disease (IHD), lung cancer, and stroke, among a cohort of women in Adama. Household air pollution exposure estimated by cooking fuel type was assessed through questionnaires. RESULTS Three-quarters (75%) of Adama's population used solid fuel for cooking; with this, the household air pollution attributable mortality was estimated to be 50% (95% CI: 38-58%) due to ALRI, 50% (95% CI: 35-61%) due to COPD, 50% (95% CI: 27-58%) due to lung cancer, (95% CI: 23-48%) due to IHD, and (95% CI: 23-51%) due to stroke. The corresponding disability-adjusted life years (DALYs) per 100,000 women ranged between 6000 and 9000 per disease. CONCLUSIONS This health impact assessment illustrates that household air pollution due to solid fuel use among women in Adama leads to premature death and a substantial quantity of DALYs. Therefore, decreasing or eliminating solid fuel use for cooking purposes could prevent deaths and improve quality of life.
Collapse
Affiliation(s)
- Festina Balidemaj
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, 222 42 Lund, Sweden;
| | - Christina Isaxon
- Division of Ergonomics and Aerosol Technology, Department of Design Sciences, Lund University, 223 62 Lund, Sweden;
| | - Asmamaw Abera
- Water and Public Health Department, Ethiopia Institute of Water Resources, Addis Ababa University, Addis Ababa, Ethiopia;
| | - Ebba Malmqvist
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, 222 42 Lund, Sweden;
| |
Collapse
|