Health Impact Assessment Associated with Exposure to PM10 and Dust Storms in Kuwait

Identifying urban emission sources and their contribution to the oxidative potential of fine particulate matter (PM2.5) in Kuwait

In this study, we investigated the seasonal variations, chemical composition, sources, and oxidative potential of ambient PM2.5 (particles with a diameter of less than 2.5 μm) in Kuwait City. The sampling campaign was conducted within the premises of Kuwait Institute for Scientific Research from June 2022 to May 2023, covering different seasons throughout the year. The personal cascade impactor sampler (PCIS) operated at flow rate of 9 L/min was employed to collect weekly PM2.5 samples on PTFE and quarts filters. These collected samples were analyzed for carbonaceous species (i.e., elemental and organic carbon), metals and transition elements, inorganic ions, and DTT (dithiothreitol) redox activity. Furthermore, principal component analysis (PCA) and multi-linear regression (MLR) were used to identify the predominant emission sources and their percentage contribution to the redox activity of PM2.5 in Kuwait. The results of this study highlighted that the annual-averaged ambient PM2.5 mass concentrations in Kuwait (59.9 μg/m3) substantially exceeded the World Health Organization (WHO) guideline of 10 μg/m3. Additionally, the summer season displayed the highest PM2.5 mass concentration (75.2 μg/m3) compared to other seasons, primarily due to frequent dust events exacerbated by high-speed winds. The PCA identified four primary PM2.5 sources: mineral dust, fossil fuel combustion, road traffic, and secondary aerosols. The mineral dust was found to be the predominant source, contributing 36.1% to the PM2.5 mass, followed by fossil fuel combustion and traffic emissions with contributions of 23.7% and 20.3%, respectively. The findings of MLR revealed that road traffic was the most significant contributor to PM2.5 oxidative potential, accounting for 47% of the total DTT activity. In conclusion, this comprehensive investigation provides essential insights into the sources and health implications of PM2.5 in Kuwait, underscoring the critical need for effective air quality management strategies to mitigate the impacts of particulate pollution in the region.

Human biomonitoring of environmental contaminants in Gulf Countries - current status and future directions

BACKGROUND

This systematic review aimed to evaluate the status of Human Biomonitoring (HBM) in the Gulf Cooperation Council (GCC) region and provide recommendations for future research, considering the increased environmental contaminants that pose a threat to human health in this rapidly industrializing area.

METHODS

A thorough search was performed in PubMed and Web of Science databases up to February 2023 to identify biomonitoring studies on human exposure and levels in the GCC region. Two independent reviewers assessed study eligibility, conducted data extraction and risk of bias assessment. The NIH Quality Assessment Tools and PRISMA guidelines were utilized for quality evaluation and reporting of results.

RESULTS

A total of 38 eligible articles were included in this systematic review out of 662 articles screened. The majority of the publications were from Saudi Arabia (n = 24) and Kuwait (n = 10), while limited representation was found from Qatar (n = 3) and the UAE (n = 1). No articles were identified from Oman and Bahrain. The studies focused on metals, organohalogen compounds, pesticides, polycyclic aromatic hydrocarbons, and phthalates. The findings revealed elevated levels of metals and established correlations between metal exposure and adverse health effects, including infant neurodevelopmental issues, vitamin D deficiency, and oxidative stress. The presence of organohalogen compounds and pesticides was prevalent in the GCC region, with significant associations between exposure to these compounds and negative health outcomes. Notably, high levels of perchlorate were observed in the Kuwaiti population, and a study from Saudi Arabia found an association between per- and polyfluorinated substances and increased odds of osteoporosis.

CONCLUSIONS

This review emphasizes the need to address environmental health challenges in the GCC region through improved HBM research methods and strategies. Implementing biomonitoring programs, conducting cohort studies, investing in tools and expertise, promoting collaboration, and engaging the community are crucial for reliable HBM data in the GCC.

Estimation of fine particulate matter in an arid area from visibility based on machine learning

BACKGROUND

The absence of air pollution monitoring networks makes it difficult to assess historical fine particulate matter (PM_2.5) exposures for countries in the areas, such as Kuwait, which are severe impacted by desert dust and anthropogenic pollution.

OBJECTIVE

We constructed an ensemble machine learning model to predict daily PM_2.5 concentrations for regions lack of PM_2.5 observations.

METHODS

The model was constructed based on daily PM_2.5, visibility, and other meteorological data collected at two sites in Kuwait. Then, our model was applied to predict the daily level of PM_2.5 concentrations for eight airports located in Kuwait and Iraq from 2013 to 2020.

RESULTS

As compared to traditional statistic models, the proposed machine learning methods improved the accuracy in using visibility to predict daily PM_2.5 concentrations with a cross-validation R² of 0.68. The predicted level of daily PM_2.5 concentrations were consistent with previous measurements. The predicted average yearly PM_2.5 concentration for the eight stations is 50.65 µg/m³. For all stations, the monthly average PM_2.5 concentrations reached their maximum in July and their minimum in November.

SIGNIFICANCE

These findings make it possible to retrospectively estimate daily PM_2.5 exposures using the large-scale databases of historical visibility in regions with few particulate matter monitoring stations.

IMPACT STATEMENT

The scarcity of air pollution ground monitoring networks makes it difficult to assess historical fine particulate matter exposures for countries in arid areas such as Kuwait. Visibility is closely related to atmospheric particulate matter concentrations and historical airport visibility records are commonly available in most countries. Our model make it possible to retrospectively estimate daily PM_2.5 exposures using the large-scale databases of historical visibility in arid regions with few particulate matter ground monitoring stations. The product of such models can be critical for environmental risk assessments and population health studies.

Socio-Environmental Determinants and Human Health Exposures in Arid and Semi-Arid Zones of Iran-Narrative Review

Lifestyle is different in arid and semi-arid zones. However, where people are born and live have a lasting influence on their social and environmental exposure. This review focuses on the, various dimensions of environmental health imbalance inequality especially in significant environmental sources such as (ie, air, water, soil) among provinces that creates a big health gap in the center, East and the Southeast of Iran. Thus, the population of the arid and semi-arid zones of Iran is facing respiratory, cardiovascular, cancer and infection diseases linked to environmental problems such as chemical and microbial pollution due to air pollution and unsafe water sources, respectively. The prevalence of certain types of cancer such as skin, stomach, bladder, prostate and colorectal cancer together with some respiratory and cardiovascular diseases in arid and semiarid zones such as Kerman, Yazd, etc., has been reported in comparison with other provinces frequently. These impacts have effects on multiple levels of health security in those zones. Based on these concerns, we propose key questions that should guide research in the context of the socio environmental science to support science-based management actions in Iran and other similar semi-arid areas worldwide.

Evaluating the Presence of Hospitals on Social Media

Today, adults are use social media to seek health information. Evidence suggests that hospitals using Instagram reported better patient engagement and in turn increased profit and reputation. Yet, little is known about how public and private hospitals are leveraging Instagram. This study aims to analyze the presence of hospitals on Instagram using Kuwait as a case study. Hospitals were identified using the Ministry of Health’s website and Instagram. Posts collected from 7 odd months were analyzed using the Constant Comparison method. A total of 3,439 posts were distributed across six categories: Health advice & education, operations & services, current events, hospital community, seasonal occasions, and trivia. Public and private hospitals differed in their activity on Instagram in terms of health topics covered, post categories, and interactions. Hospitals should improve their presence on Instagram to promote healthy lifestyles, augment public health campaigns, and be a source of reliable and accessible health information online.

Air pollution tolerance, anticipated performance, and metal accumulation capacity of common plant species for green belt development

Green vegetation enrichment is a cost-effective technique for reducing atmospheric pollution. Fifteen common tropical plant species were assessed for identifying their air pollution tolerance, anticipated performance, and metal accumulation capacity at Jharia Coalfield and Reference (JCF) site using Air Pollution Tolerance Index (APTI), Anticipated Performance Index (API), and Metal Accumulation Index (MAI). Metal accumulation efficiencies were observed to be highest for Ficus benghalensis L. (12.67mg/kg) and Ficus religiosa L. (10.71 mg/kg). The values of APTI were found to be highest at JCF for F. benghalensis (APTI: 25.21 ± 0.95), F. religiosa (APTI: 23.02 ± 0.21), Alstonia scholaris (L.) R. Br. (APTI: 18.50 ± 0.43), Mangifera indica L. (APTI: 16.88 ± 0.65), Azadirachta indica A. Juss. (APTI: 15.87 ± 0.21), and Moringa oleifera Lam. (APTI: 16.32 ± 0.66). F. benghalensis and F. religiosa were found to be excellent performers to mitigate air pollution at JCF as per their API score. Values of MAI, APTI, and API were observed to be lowest at reference sites for all the studied plant species due to absence of any air polluting sources. The findings revealed that air pollution played a significant impact in influencing the biochemical and physiological parameters of plants in a contaminated coal mining area. The species with the maximum MAI and APTI values might be employed in developing a green belt to minimize the levels of pollutants into the atmosphere.

PM2.5 and PM10 during COVID-19 lockdown in Kuwait: Mixed effect of dust and meteorological covariates

This study investigated the impact of COVID-19 lockdown on particulate matter concentrations, specifically PM2.5 and PM10, in Kuwait. We studied the variations in PM2.5 and PM10 between the lockdown in 2020 with the corresponding periods of the years 2017-2019, and also investigated the differences in PM variations between the 'curfew' and 'non curfew' hours. We applied mixed-effect regression to investigate the factors that dictate PM variability (i.e., dust and meteorological covariates), and also processed satellite-based aerosol optical depths (AOD) to determine the spatial variability in aerosol loads. The results showed low PM2.5 concentration during the lockdown (33 μg/m3) compared to the corresponding previous three years (2017-2019); however, the PM10 concentration (122.5 μg/m3) increased relative to 2017 (116.6 μg/m3), and 2019 (92.8 μg/m3). After removing the 'dust effects', both PM2.5 and PM10 levels dropped by 18% and 31%, respectively. The mixed-effect regression model showed that high temperature and high wind speed were the main contributors to high PM2.5 and PM10, respectively, in addition to the dust haze and blowing dust. This study highlights that the reductions of anthropogenic source emissions are overwhelmed by dust events and adverse meteorology in arid regions, and that the lockdown did not reduce the high concentrations of PM in Kuwait.

Effect of Dust Storms on Non-Accidental, Cardiovascular, and Respiratory Mortality: A Case of Dezful City in Iran

BACKGROUND

Despite the fact that Iran has been exposed to severe dust storms during the past 2 decades, few studies have investigated the health effects of these events in Iran. This study was conducted to assess the association between dust storms and daily non-accidental, cardiovascular, and respiratory mortality in Dezful City (Khuzestan Province, Iran) during 2014 to 2019.

METHODS

In this study, mortality, meteorological, and climatological data were obtained from the Dezful University of Medical Sciences, Iranian Meteorological Organization, and Department of Environment in Khuzestan Province, respectively. Days of dust storm were identified based on the daily concentration threshold of particulate matter with an aerodynamic diameter of less than 10 μm (PM10) according to Hoffmanns҆ definition, and then an ecological time-series was used to estimate the short-term effects of dust storms on daily mortality. Statistical analysis was performed using a distributed lag linear model (DLM) and a distributed lag non-linear model (DLNM) packages by R software and the study results were reported as excess mortality.

RESULTS

During the study period, 15 223 deaths were recorded, and 139 dust storms occurred in Dezful city. In addition, there was statistically significant excess risk of mortality due to dust storms in Dezful City (mortality in the group under 15 years of age, lag4: 34.17% and 15-64 years of age groups, lag5: 32.19%, lag6: 3.28%), also dust storms had statistically significant effects on respiratory mortality (lag6: 5.49%).

CONCLUSION

The findings of the current study indicate that dust storms increase the risk of mortality with some lags. An evidence-based early warning system may be able to aware the people of the health effects of dust storms.

Associations between Dust Exposure and Hospitalizations in El Paso, Texas, USA

The Southwestern USA has been identified as one of the most persistent dust-producing regions of North America, where exposure to inhalable particulate matter (PM10) originating from desertic landscape during dust events/dust exposures (DEs) can reach hazardous levels. El Paso, Texas’s ambient air has reached hazardous levels of PM10 from dust with near zero visibility due to these natural events originating in the surrounding Chihuahuan Desert. The aim of this study was to investigate whether dust exposures in El Paso (generally acute, short-term exposures from nearby source areas) are associated with significant increases in hospitalizations on the day of the exposure and up to seven days afterwards. Using a Poisson regression, it was found that the relative risks of hospitalizations due to a variety of conditions were associated with dust exposures (through increases of 100 μg/m3 maximum hourly PM10 and/or increases of 4.5 m/s maximum hourly wind speed) in El Paso County, Texas between 2010 and 2014. Valley fever, coronary atherosclerosis, genitourinary diseases, neurodegenerative diseases, injury and poisoning, circulatory system conditions, respiratory system diseases, births, septicemia, Associated Diseases (the aggregation of hospital admissions for all causes, each associated with at least 5% of hospitalizations), and all ICD-9 admissions were significantly positively associated with dust exposures, indicated from higher to lower significant risk, at different lag periods after exposure. These findings, showing that an association does exist between dust exposures and hospitalizations, have important implications for residents of the world’s dryland cities.

A two-year assessment of particulate air pollution and sources in Kuwait

BACKGROUND

Kuwait and the Gulf region have a desert, hyper-arid and hot climate that makes outdoor air sampling challenging. The region is also affected by intense dust storms. Monitoring challenges from the harsh climate have limited data needed to inform appropriate regulatory actions to address air pollution in the region.

OBJECTIVES

To compare gravimetric measurements with existing networks that rely on beta-attenuation measurements in a desert climate; determine the annual levels of PM_2.5 and PM₁₀ over a two-year period in Kuwait; assess compliance with air quality standards; and identify and quantify PM_2.5 sources.

METHODS

We custom-designed particle samplers that can withstand large quantities of dust without their inlet becoming overloaded. The samplers were placed in two populated residential locations, one in Kuwait City and another near industrial and petrochemical facilities in Ali Sabah Al-Salem (ASAS) to collect PM_2.5 and PM₁₀ samples for mass and elemental analysis. We used positive matrix factorization to identify PM_2.5 sources and apportion their contributions.

RESULTS

We collected 2339 samples during the period October 2017 through October 2019. The beta-attenuation method in measuring PM_2.5 consistently exceeded gravimetric measurements, especially during dust events. The annual levels for PM_2.5 in Kuwait City and ASAS were 41.6 ± 29.0 and 47.5 ± 27.6 μg/m³, respectively. Annual PM_2.5 levels in Kuwait were nearly four times higher than the U.S. National Ambient Air Quality Standard. Regional pollution was a major contributor to PM_2.5 levels in both locations accounting for 44% in Kuwait City and 46% in ASAS. Dust storms and re-suspended road dust were the second and third largest contributors to PM_2.5, respectively.

CONCLUSIONS

The premise that frequent and extreme dust storms make air quality regulation futile is dubious. In this comprehensive particulate pollution analysis, we show that the sizeable regional anthropogenic particulate sources warrant national and regional mitigation strategies to ensure compliance with air quality standards.

Estimation of ambient PM2.5 in Iraq and Kuwait from 2001 to 2018 using machine learning and remote sensing

Iraq and Kuwait are in a region of the world known to be impacted by high levels of fine particulate matter (PM2.5) attributable to sources that include desert dust and ambient pollution, but historically have had limited pollution monitoring networks. The inability to assess PM2.5 concentrations have limited the assessment of the health impact of these exposures, both in the native populations and previously deployed military personnel. As part of a Department of Veterans Affairs Cooperative Studies Program health study of land-based U.S. military personnel who were previously deployed to these countries, we developed a novel approach to estimate spatially and temporarily resolved daily PM2.5 exposures 2001-2018. Since visibility is proportional to ground-level particulate matter concentrations, we were able to take advantage of extensive airport visibility data that became available as a result of regional military operations over this time period. First, we combined a random forest machine learning and a generalized additive mixed model to estimate daily high resolution (1 km × 1 km) visibility over the region using satellite-based aerosol optical depth (AOD) and airport visibility data. The spatially and temporarily resolved visibility data were then used to estimate PM2.5 concentrations from 2001 to 2018 by converting visibility to PM2.5 using empirical relationships derived from available regional PM2.5 monitoring stations. We adjusted for spatially resolved meteorological parameters, land use variables, including the Normalized Difference Vegetation Index, and satellite-derived estimates of surface dust as a measure of sandstorm activity. Cross validation indicated good model predictive ability (R2 = 0.71), and there were considerable spatial and temporal differences in PM2.5 across the region. Annual average PM2.5 predictions for Iraq and Kuwait were 37 and 41 μg/m3, respectively, which are greater than current U.S. and WHO standards. PM2.5 concentrations in many U.S. bases and large cities (e.g. Bagdad, Balad, Kuwait city, Karbala, Najaf, and Diwaniya) had annual average PM2.5 concentrations above 45 μg/m3 with weekly averages as high as 150 μg/m3 depending on calendar year. The highest annual PM2.5 concentration for both Kuwait and Iraq were observed in 2008, followed by 2009, which was associated with extreme drought in these years. The lowest PM2.5 values were observed in 2014. On average, July had the highest concentrations, and November had the lowest values, consistent with seasonal patterns of air pollution in this region. This is the first study that estimates long-term PM2.5 exposures in Iraq and Kuwait at a high resolution based on measurements data that will allow the study of health effects and contribute to the development of regional environmental policies. The novel approach demonstrated may be used in other parts of the world with limited monitoring networks.

Global Health Impacts of Dust Storms: A Systematic Review

BACKGROUND

Dust storms and their impacts on health are becoming a major public health issue. The current study examines the health impacts of dust storms around the world to provide an overview of this issue.

METHOD

In this systematic review, 140 relevant and authoritative English articles on the impacts of dust storms on health (up to September 2019) were identified and extracted from 28 968 articles using valid keywords from various databases (PubMed, WOS, EMBASE, and Scopus) and multiple screening steps. Selected papers were then qualitatively examined and evaluated. Evaluation results were summarized using an Extraction Table.

RESULTS

The results of the study are divided into two parts: short and long-term impacts of dust storms. Short-term impacts include mortality, visitation, emergency medical dispatch, hospitalization, increased symptoms, and decreased pulmonary function. Long-term impacts include pregnancy, cognitive difficulties, and birth problems. Additionally, this study shows that dust storms have devastating impacts on health, affecting cardiovascular and respiratory health in particular.

CONCLUSION

The findings of this study show that dust storms have significant public health impacts. More attention should be paid to these natural hazards to prepare for, respond to, and mitigate these hazardous events to reduce their negative health impacts.Registration: PROSPERO registration number CRD42018093325.

Solution Crystallization of Polycarbonate Surfaces for Hydrophobic State: Water Droplet Dynamics and Life Cycle Assessment towards Self-Cleaning Applications

Polycarbonate sheets are optically transparent and have the potential to be used as one of the cover materials for PV applications. Solution treatment of polycarbonate surfaces enables to create surface texture topology giving rise to a hydrophobic state, which is favorable for self-cleaning applications. In the present study, hydrophobization of polycarbonate surface is investigated via crystallization of surface by a one-step process. The influence of texture topology, which is created via crystallization, on water droplet mobility and optical transmittance is examined. Findings revealed that solution treatment, using acetone, results in crystallized polycarbonate surfaces with a hydrophobic state. Depending on the treatment duration, the texture characteristics of crystallized surface change while influencing the water contact angle hysteresis. This in turn affects the droplet mobility over the inclined crystallized surface and alters the UV visible transmittance. Moreover, the droplet mobility improves and dust mitigation rates from the treated surface increase as the solution treatment duration are reduced to 2 min. Oil impregnated samples result in improved UV visible transmittance; however, droplet motion changes from rolling to sliding over the surface. A sliding water droplet enables the removal of the dust particles from the oil-impregnated sample surface.

Ambient exposure of O3 and NO2 and associated health risk in Kuwait

Ozone (O₃) and nitrogen dioxide (NO₂), indissoluble air pollutants in the atmosphere, have been confirmed in various parts of the world to have detrimental health effects on humans. Currently, such information is lacking in Kuwait. The objectives of this study are to investigate the spatial and temporal variations of O₃ and NO₂ concentrations in Kuwait during a 4-year period (2014-2017) and to quantify the associated short- and long-term health effects, including all-cause, respiratory, and cardiovascular mortalities and morbidities during the same study period. Exposure assessment showed that the annual levels (22.5-26.4 ppb), SOMO35, and the 8-hour 4-year mean (38 ppb) of O₃ were very low and below the World Health Organization (WHO) (50 ppb) and Kuwaiti (70 ppb) regulatory limits. The annual mean levels of NO₂ ranged from 30.3 to 43.8 ppb and were significantly higher than both WHO and Kuwait limits (21 ppb). As expected, O₃ and NO₂ levels showed opposing trends, with higher concentrations of NO₂ recorded in early morning and mid-evening, during autumn and winter, and during Saturdays (the so-called weekend effect). Health effects indicated high respiratory diseases due to short-term exposure to NO₂. Contrary to the western countries' pollution levels, Kuwait showed lower O₃ and higher NO₂ levels. There is potential for substantial health improvements in Kuwait by reducing NO₂ pollution through stringent control measures of stationary and mobile sources.

Effect of Air Pollution on Glutathione S-Transferase Activity and Total Antioxidant Capacity: Cross Sectional Study in Kuwait

BACKGROUND

Air pollution poses a significant threat to human health worldwide. Investigating potential health impacts is essential to the development of regulations and legislation to minimize health risks.

OBJECTIVES

The aim of the present study was to investigate the potentially hazardous effect of air pollution on the Ali Sabah Al Salem residential area in Kuwait by comparing the pollution level to a control area (Al-Qirawan) by assessing two biomarkers: erythrocyte glutathione S-transferases (e-GST) and total blood antioxidant, and then correlating the activity to pollution-related oxidative stress.

METHODS

The average concentrations of several airborne gases were measured at Ali Sabah Al Salem and Al-Qirawan, including ozone, carbon monoxide, nitrogen dioxide, nitrogen oxides, particulate matter less than 10 μm (PM₁₀), sulfur dioxide, ammonia, carbon dioxide, hydrogen sulfide, methane, and non-methane hydrocarbon. A total of fifty-eight participants were sampled from two different areas and divided into two groups. The study group was composed of 40 residents exposed to polluted ambient air in the Ali Sabah Al Salem residential area. A reference group composed of 18 residents in the Al-Qairawan area living far from major pollution sources was also tested.

RESULTS

All measured gases were higher in concentration at Ali Sabah Al Salem compared to the Al-Qirawan area. Furthermore, PM₁₀ and sulfur dioxide were higher than World Health Organization (WHO) guidelines. The e-GST activity was lower among participants of the Ali Sabah Al Salem residential area compared to participants living in the Al-Qairawan area. The total antioxidant capacity in whole blood of Ali Sabah Al Salem residents was significantly (p<0.0001) higher than in control subjects.

CONCLUSIONS

Residents in Ali Sabah Al Salem are exposed to a high level of air pollution that has a serious impact on glutathione S-transferases levels. Subsequently, regulations on pollution sources are needed to lower current health risks. Furthermore, the present study provides evidence that finger-prick blood sampling is a quick, non-invasive method suitable for screening e-GST activity and total antioxidants which may be applied for surveillance purposes.

PARTICIPANT CONSENT

Obtained.

ETHICS APPROVAL

The study was approved by the Scientific Research Committee of the Public Authority for Applied Education and Training, Kuwait.

COMPETING INTERESTS

The authors declare no competing financial interests.

Saharan sand and dust storms and neonatal mortality: Evidence from Burkina Faso

West African populations are exposed to the longest and harshest dust storms on the planet, the Saharan sand and dust storms (SDS). Nonetheless, little is known about the effects of the severe storms on early-life health in West Africa. This study investigated the association of the risk of neonatal mortality, an indicator of the population's early-life health, with potential prenatal and neonatal exposure to the Saharan SDS. Data on 30,552 under-five children from Burkina Faso's 1993, 2003, and 2010 demographic and health surveys were matched to the particulate matters (PM) and terrestrial air temperature and precipitation forecasts. Exposure to dust events was measured by the number of days with average PM10 and PM2.5 concentrations above a series of threshold. Intensity-dependent patterns of associations between neonatal mortality and both prenatal and birth month exposure to dust events were identified. There was no association if average daily PM10 and PM2.5 levels were <60 and 30 μg/m³, respectively. However, strong associations, which increase almost linearly with the intensity of exposure, were identified when daily PM10 and PM2.5 levels ranged from 70 to 150 and from 40 to 70 μg/m³, respectively. At the higher PM levels, the association for the gestation period decreased, but that for the birth month remained mostly unresponsive to changes in the PM levels. Larger associations were identified when siblings were compared.

Investigation of the impacts of urban vegetation loss on the ecosystem service of air pollution mitigation in Karaj metropolis, Iran

The present study aims to investigate the relationship between reduced air pollution and ecosystem services in Karaj metropolis, Iran. To the end, the trends in the concentrations of O₃, NO₂, CO, SO₂, PM₁₀, and PM_2.5 as the main atmospheric pollutants of Karaj were studied. Five time series models of autoregressive (AR), moving average (MA), autoregressive moving average (ARMA), autoregressive integrated moving average (ARIMA), and seasonal autoregressive integrated moving average (SARIMA) were used to predict changes in air pollutant concentrations. Air pollution zoning is conducted via ArcGIS_10.3 by using spline tension interpolation method. Then, normalized difference vegetation index (NDVI) was obtained from Landsat Thematic Mapper (TM) and Operational Land Imager (OLI) images to analyze vegetation dynamics as an index of ecosystem functioning. NDVI thresholds were selected to present guidelines for qualitative and quantitative changes in green cover and were divided into five different categories. Based on the results, AR (1) and ARIMA (1,2,1) were recognized as appropriate models for predicting the concentration of air pollutants in the study area. A decrease in very dense vegetation coverage and increase in poor vegetation areas, followed by an increase in air pollution, revealed that the loss of urban green coverage and decreased ecosystem services were positively related. Furthermore, the expansion of urban lands toward the north and the west from the baseline to future condition led to great changes in the land cover and losses in vegetation along these axes, which finally resulted in increased air pollution in these areas. Thus, the results of this study can be directly used in decision-making in the area of air pollution.

Impacts of meteorology and vegetation on surface dust concentrations in Middle Eastern countries

Severe dust events have occurred frequently in arid regions, which greatly impacted air quality, climate, and public health. The Middle East is one of the areas in the world impacted by intense dust storms. We investigated the characteristics of airborne dust levels in five Middle Eastern countries (Kuwait, Iraq, Iran, Saudi Arabia, and Syria) from 2001 to 2017. Surface level dust concentrations were determined using the Modern-Era Retrospective analysis for Research and Applications version 2. Kuwait was selected as an example to assess sources and other factors influencing dust levels in arid regions. We performed backward trajectory analysis to identify the dust transport pathways. We quantitatively assessed the impacts of meteorological parameters along with the Normalized Difference Vegetation Index (NDVI). Dust levels in Kuwait were higher than the other four countries, and had a distinct seasonal pattern, with the highest in summer and the lowest in winter. Our results showed that dust levels in Kuwait in January were influenced largely by local emissions, whereas in June they were affected more by emissions attributable to long-distance transport. There were significant positive associations between wind speed in the five countries, particularly Iraq, with dust levels in Kuwait, indicating the impact of nearby desert areas. Significant negative associations were observed between NDVI in Kuwait, Iraq, and Saudi Arabia with dust levels in Kuwait. Our result highlights that climatic variations and vegetation conditions are associated with changes in dust levels in arid regions.

Sand and dust storm trajectories from Iraq Mesopotamian flood plain to Kuwait

Although Kuwait is greatly impacted by sand and dust storms (SDS) from Southern Iraq, to date little is known about the nature of these storms. Kuwait is vulnerable to SDS trajectories from the middle Euphrates region, specifically, from two "hot spot" areas (Al-Batha and Mamlahat Al-Samawah) of 4550 km² located 250 km from its northern border. This study explores the transboundary SDS jets originating from Southern Iraq using Moderate Resolution Imaging Spectroradiometer (MODIS) images obtained from Aqua and Terra satellites over a twelve-year period (2007-2018). Furthermore, an analysis of a 5-day diurnal variation (two days prior, the day of the SDS occurrence, and two days after) explored the hourly patterns of visibility and wind speed, as well as grain size distribution of soil samples to better understand grain size compositions and sediment transport mechanisms. Satellite images confirmed that dust storm jets originated from the "hot spot" in southern Iraq and spread over Kuwait and extended to neighboring Arab Gulf countries as far as Bahrain (900 km) and Qatar (1200 km). In general, the highest wind speed and lowest visibility values were recorded in Northern of Kuwait, with suspended dust sustained for two days following the dust storm. The largest silt and clay fractions (grains ≤63 μm) were identified at the center and west Sabkha region of the "hot spot" area. Very fine sand particles (63-250 μm) were identified within the crescent sand dunes (Barchans) and artificial sand dunes (Al-Fajr). It is recommended that sustainable rehabilitation and land restoration of the "hot spot" area will result in the elimination of the long-range transport of SDS jet streams affecting the downwind Gulf countries.

Exposure levels of air pollution (PM2.5) and associated health risk in Kuwait

It is well established that respiratory and cardiovascular mortality and morbidity rates are associated with poor air quality as measured by high concentrations of fine particulate matter such as PM_2.5 parameters. Since such information is lacking for the State of Kuwait, this study examined the exposure levels of PM_2.5 and the associated health risk as evaluated by five mortality measures embodied in ischemic heart disease, stroke, lung cancer, chronic obstructive pulmonary disease and acute lower respiratory infection as well as two morbidity outcomes related to both cardiovascular and respiratory diseases. The measurement models utilized in this investigation followed the WHO guidelines. Over a span of a four-year period (2014-2017), the annual PM_2.5 concentration levels ranged from 38.0 μg/m³ to 75.2 μg/m³. In general, exposure levels tended to fluctuate throughout the day with the higher levels recorded during rush hours (early morning and early evening), weekends (particularly Saturdays), and summer (i.e., August and September). The highest number of excess cases and attributable proportions of premature mortalities were related to ischemic heart disease and stroke at 352 (95% CI 275-426) and 70.8% (95% CI 39.7-85.2), respectively. In general, respiratory diseases showed a higher number of excess cases and attributable proportions than cardiovascular diseases. Relative to other findings on the global stage, the results emanating from Kuwait are emerging on the higher side. The study outcomes suggest that control strategies are in dire need to bend the pollution levels in Kuwait.

Impacts of air pollution on human and ecosystem health, and implications for the National Emission Ceilings Directive: Insights from Italy

Across the 28 EU member states there were nearly half a million premature deaths in 2015 as a result of exposure to PM_2.5, O₃ and NO₂. To set the target for air quality levels and avoid negative impacts for human and ecosystems health, the National Emission Ceilings Directive (NECD, 2016/2284/EU) sets objectives for emission reduction for SO₂, NOx, NMVOCs, NH₃ and PM_2.5 for each Member State as percentages of reduction to be reached in 2020 and 2030 compared to the emission levels into 2005. One of the innovations of NECD is Article 9, that mentions the issue of "monitoring air pollution impacts" on ecosystems. We provide a clear picture of what is available in term of monitoring network for air pollution impacts on Italian ecosystems, summarizing what has been done to control air pollution and its effects on different ecosystems in Italy. We provide an overview of the impacts of air pollution on health of the Italian population and evaluate opportunities and implementation of Article 9 in the Italian context, as a case study beneficial for all Member States. The results showed that SO₄^2- deposition strongly decreased in all monitoring sites in Italy over the period 1999-2017, while NO₃^- and NH₄⁺ decreased more slightly. As a consequence, most of the acid-sensitive sites which underwent acidification in the 1980s partially recovered. The O₃ concentration at forest sites showed a decreasing trend. Consequently, AOT40 (the metric identified to protect vegetation from ozone pollution) showed a decrease, even if values were still above the limit for forest protection (5000 ppb h^-1), while PODy (flux-based metric under discussion as new European legislative standard for forest protection) showed an increase. National scale studies pointed out that PM10 and NO2 induced about 58,000 premature deaths (year 2005), due to cardiovascular and respiratory diseases. The network identified for Italy contains a good number of monitoring sites (6 for terrestrial ecosystem monitoring, 4 for water bodies monitoring and 11 for ozone impact monitoring) distributed over the territory and will produce a high number of monitored parameters for the implementation of the NECD.

Disability Adjusted Life Years (DALYs) in Terms of Years of Life Lost (YLL) Due to Premature Adult Mortalities and Postneonatal Infant Mortalities Attributed to PM2.5 and PM10 Exposures in Kuwait

Ambient air pollution in terms of fine and coarse particulate matter (PM_2.5 and PM₁₀) has been shown to increase adult and infant mortalities. Most studies have estimated the risk of mortalities through attributable proportions and number of excess cases with no reference to the time lost due to premature mortalities. Disability adjusted life years (DALYs) are necessary to measure the health impact of Ambient particulate matter (PM) over time. In this study, we used life-tables for three years (2014⁻2016) to estimate the years of life lost (YLL), a main component of DALYs, for adult mortalities (age 30+ years) and postneonatal infant mortalities (age 28+ days⁻1 year) associated with PM_2.5 exposure and PM₁₀ exposure, respectively. The annual average of PM_2.5 and PM₁₀ concentrations were recorded as 87.9 μg/m³ and 167.5 μg/m³, which are 8 times greater than the World Health Organization (WHO) air quality guidelines of 10 μg/m³ and 20 μg/m³, respectively. Results indicated a total of 252.18 (95% CI: 170.69⁻322.92) YLL for all ages with an increase of 27,474.61 (95% CI: 18,483.02⁻35,370.58) YLL over 10 years. The expected life remaining (ELR) calculations showed that 30- and 65-year-old persons would gain 2.34 years and 1.93 years, respectively if the current PM_2.5 exposure levels were reduced to the WHO interim targets (IT-1 = 35 μg/m³). Newborns and 1-year old children may live 79.81 and 78.94 years, respectively with an increase in average life expectancy of 2.65 years if the WHO PM₁₀ interim targets were met (IT-1 = 70 μg/m³). Sensitivity analyses for YLL were carried out for the years 2015, 2025, and 2045 and showed that the years of life would increase significantly for age groups between 30 and 85. Life expectancy, especially for the elderly (≥60 years), would increase at higher rates if PM_2.5 levels were reduced further. This study can be helpful for the assessment of poor air quality represented by PM_2.5 and PM₁₀ exposures in causing premature adult mortalities and postneonatal infant mortalities in developing countries with high ambient air pollution. Information in this article adds insights to the sustainable development goals (SDG 3.9.1 and 11.6.2) related to the reduction of mortality rates attributed to ambient air levels of coarse and fine particulate matter.

Mortality and morbidity for cardiopulmonary diseases attributed to PM2.5 exposure in the metropolis of Rome, Italy

The aim of the study was to evaluate the health effects associated with the exposure to ground-level of particulate matters with aerodynamic diameter ≤ 2.5 μm (PM_2.5) on citizens in Rome (Italy) in 2015 and 2016. Based on the new version of the World Health Organization's AirQ+ model, we have estimated the short- and long-term effects of PM_2.5 on hospital admissions due to cardiovascular (HA-CVD) and respiratory diseases (HA-RD) as well as on mortality for ischemic heart disease (M-IHD) and chronic obstructive pulmonary disease (M-COPD). In this study, city-specific relative risk values and baseline incidence rates were used to calculate the association between PM_2.5 and daily counts of emergency hospitalizations and mortality. The annual mean PM_2.5 concentrations were 18 μg m^-3 and 14 μg m^-3 in 2015 and 2016, respectively. In Rome, the citizens are mostly exposed to daily mean PM_2.5 concentrations of 10-20 μg m^-3 during the study period. In 2015-2016, 0.4-0.6% for HA-CVD, 1.1-1.5% for HA-RD, 16.5-18.1% for M-IHD and 8.5-9.2% for M-COPD are attributed to PM_2.5. In 2015-2016, 134-186 HA-CVD, 126-175 HA-RD, 947-1037 M-IHD and 244-279 M-COPD, caused by PM_2.5 exposure, could be "avoided" if PM_2.5 concentrations would not exceed 10 μg m^-3, i.e. the threshold recommended by the World Health Organization. Thus, a consistent air quality management and sustainable city planning are needed, urgently, to mitigate the adverse effects of PM_2.5 exposure in Rome.

Effects of Dust Storms and Climatological Factors on Mortality and Morbidity of Cardiovascular Diseases Admitted to ED

Objective

This study was designed to investigate the effects of Desert Dust Storms and Climatological Factors on Mortality and Morbidity of Cardiovascular Diseases admitted to emergency department in Gaziantep.

Method

Hospital records, obtained between September 01, 2009 and January 31, 2014, from four state hospitals in Gaziantep, Turkey, were compared to meteorological and climatological data. Statistical analysis was performed by Statistical Package for the Social Science (SPSS) for windows version 24.0.

Results

168,467 patients were included in this study. 83% of the patients had chest pain and 17% of patients had cardiac failure (CF). An increase in inpatient hospitalization due to CF was observed and corresponded to the duration of dust storms measured by number of days. However, there was no significant increase in emergency department (ED) presentations. There was no significant association of cardiac related mortality and coinciding presence of a dust storm or higher recorded temperature. The association of increases in temperature levels and the presence of dust storms with “acute coronary syndrome- (ACS-) related emergency service presentations, inpatient hospitalization, and mortality” were statistically significant. The relationship between the increase in PM10 levels due to causes unrelated to dust storms and the outpatient application, admission, and mortality due to heart failure was not significant. The increase in particle matter 10 (PM) levels due to causes outside the dust storm caused a significant increase in outpatient application, hospitalization, and mortality originated from ACS.

Conclusion

Increased number of dust storms resulted in a higher prevalence of mortality due to ACS while mortality due to heart failure remained unchanged. Admission, hospitalization, and mortality due to chest pain both dependent and independent of ACS were increased by the presence of dust storms, PM10 elevation, and maximum temperature.

Chronic obstructive pulmonary diseases related to outdoor PM10, O3, SO2, and NO2 in a heavily polluted megacity of Iran

This study was conducted to quantify, by an approach proposed by the World Health Organization (WHO), the daily hospital admissions for chronic obstructive pulmonary disease (COPD) related to exposure to particulate matter (PM₁₀) and oxidants such as ozone (O₃), sulfur dioxide (SO₂), and nitrogen dioxide (NO₂) in a heavily polluted city in Iran. For the health impact assessment, in terms of COPD, the current published relative risk (RR) and baseline incidence (BI) values, suggested by the WHO, and the 1-h O₃ concentrations and daily PM₁₀, NO₂, and SO₂ concentrations were compiled. The results showed that 5.9, 4.1, 1.2, and 1.9% of the COPD daily hospitalizations in 2011 and 6.6, 1.9, 2.3, and 2.1% in 2012 were attributed to PM₁₀, O₃, SO₂, and NO₂ concentrations exceeding 10 μg/m³, respectively. This study indicates that air quality and the high air pollutant levels have an effect on COPD morbidity. Air pollution is associated with visits to emergency services and hospital admissions. A lower relative risk can be achieved if some stringent control strategies for reducing air pollutants or emission precursors are implemented.