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Niyi-Odumosu F, Ozoh OB, Ope VO, Ale BM, Akinnola O, Iseolorunkanmi A, Adeloye D. Exploring the impact of climate change on respiratory health in Nigeria: a scoping review of current research, government policies and programs. CLIMATIC CHANGE 2025; 178:35. [PMID: 39974337 PMCID: PMC11832684 DOI: 10.1007/s10584-025-03880-0] [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: 07/17/2024] [Accepted: 02/08/2025] [Indexed: 02/21/2025]
Abstract
Climate change significantly impacts health globally, especially in densely populated, rapidly industrialising and ecologically diverse countries like Nigeria. We analysed climate change policies, studies, programs, and events at the national and subnational levels in Nigeria and explored their effects on public and respiratory health. Using the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMAScR) checklist, we searched PubMed, African Journals Online (AJoL), Google Scholar and government data repositories on January 10, 2024. We synthesised results using an adapted sector-level framework based on the World Health Organization (WHO) guidelines. Our searches returned 262 items, of which 32, including research studies, reports and grey documents, were retained for synthesis. Although some policies and programmes, like the Climate Change Act and Nigerian Climate and Health Observatory, exist, implementation is limited across many settings. Key reported respiratory pollutants in Nigeria include particulate matter (PM2.5, PM10), gaseous emissions (CO, SO₂, NOx), agricultural by-products (NH₃, H₂S), greenhouse gases (CH₄, CO₂), and microbial contaminants, which collectively increase the risk of respiratory inflammation, infections, and exacerbations of chronic respiratory symptoms and diseases. Our findings underscore a clear link between climate change and worsening respiratory health in many Nigerian settings. The current policies and programmes' have limited impact, calling for comprehensive reforms, including improved enforcement and targeted action against major pollution sources, recognition of environmental rights, and stronger public health initiatives and community action. Supplementary Information The online version contains supplementary material available at 10.1007/s10584-025-03880-0.
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Affiliation(s)
| | - Obianuju B. Ozoh
- Department of Medicine, Faculty of Clinical Sciences, College of Medicine, University of Lagos, Lagos, Nigeria
| | | | - Boni M. Ale
- Cardiovascular Research Unit, University of Abuja and University of Abuja Teaching Hospital, Gwagwalada Abuja, Nigeria
- Institute of Tropical and Infectious Diseases, University of Nairobi, Nairobi, Kenya
- Holo Global Health Research Institute, Nairobi, Kenya
- Health Data Acumen, Nairobi, Kenya
| | - Olayemi Akinnola
- Department of Biological Sciences, Covenant University, Ota, Nigeria
| | | | - Davies Adeloye
- School of Health & Life Sciences, Teesside University, Middlesbrough, TS1 3BX UK
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Yirdaw AA, Ejeso A, Mokie Belayneh S, Yohannes L, Bezie AE, Beyene EM. Concentration of traffic air pollutants and influencing metrological factors in Hawassa City roadways, Ethiopia. Front Public Health 2025; 12:1510194. [PMID: 39944566 PMCID: PMC11814162 DOI: 10.3389/fpubh.2024.1510194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2024] [Accepted: 12/26/2024] [Indexed: 05/09/2025] Open
Abstract
Introduction The traffic air pollution caused by transportation is a growing global problem that contributes to millions of deaths each year. Despite its importance, information on pollutant concentration is limited in many developing cities, especially in Ethiopia. This study aimed to determine the concentration levels and spatial and temporal variations of traffic air pollutants in Hawassa and to investigate the influence of metrological parameters on the concentration of traffic air pollutants. Methods A real-time monitoring system of Aero-Qual Series 300/500 was used to monitor pollutants, and 24 monitoring sites were included on both heavy and low-traffic volume roads. The study monitored morning and afternoon times over 24 days to comprehensively characterize the temporal variations. Results The results showed that the mean PM2.5 concentration on heavy- and low-traffic volume roads was 161.6 ± 26.1 μg/m3 and 95 ± 14.2 μg/m3, respectively, whereas the PM10 concentration was 178.7 ± 20.3 μg/ m3 and 102.3 ± 17.6 μg/m3, respectively. Similarly, the mean NO2 concentrations on roads with heavy and low traffic volumes were 86.4 ± 14.4 μg/m3 and 61.7 ± 14.2 μg/m3, respectively. Significantly higher, concentrations were recorded on traffic light roads, followed by main asphalt roads, for both types of traffic air pollutants. The ratio of PM2.5/PM10 was higher (0.924), in which the pollution sources attributed to anthropogenic sources. Kendall's tau-b correlation analysis suggested that Meteorological parameters (temperature and relative humidity) were positively correlated with traffic air pollutants. Likewise, stepwise multiple linear regression analysis confirms that the concentrations of traffic air pollutants had a positive relationship with metrological parameters. Implications The findings of this study therefore showed the need for regular air quality monitoring of the urban areas to copping out the adverse public health impacts. And, it highlighted an urgent need for long-term monitoring of traffic air pollution and the development of emission control programs that can be readily implemented to decrease the emissions from anthropogenic sources. Also, it brings a sense of collaboration among stakeholders to tackle the effects of air pollution by providing an inclusive and sustainable development agenda for Hawassa.
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Affiliation(s)
- Asmare Asrat Yirdaw
- Departments of Environmental Health, School of Public Health, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
| | - Amanuel Ejeso
- Department of Environmental Health, College of Medicine and Health Science, Hawassa University, Hawassa, Ethiopia
| | - Samrawit Mokie Belayneh
- Departments of Environmental Health, School of Public Health, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
| | - Lamrot Yohannes
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Anmut Endalkachew Bezie
- Department of Occupational Health and Safety, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Embialle Mengistie Beyene
- Department of Environmental Health, College of Medicine and Health Science, Hawassa University, Hawassa, Ethiopia
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Boutros P, Kassem N, Boudo V, Sié A, Munga S, Maggioni MA, Golec M, Simion R, Bärnighausen T, Winkler V, Barteit S. Understanding the Risk Factors, Burden, and Interventions for Chronic Respiratory Diseases in Low- and Middle-Income Countries: A Scoping Review. Public Health Rev 2024; 45:1607339. [PMID: 39544625 PMCID: PMC11560431 DOI: 10.3389/phrs.2024.1607339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Accepted: 10/22/2024] [Indexed: 11/17/2024] Open
Abstract
Objective This scoping review aims to identify risk factors for COPD and asthma, examine the burden and intervention measures, and clarify the findings in the context of climate change, with a particular focus on LMICs. Methods Following the PRISMA-ScR guidelines, we conducted a scoping review using PubMed, Embase, and Scopus, focusing on studies published from 2011 to 2024. Results Our review included 52 studies that encompassed 244,004 participants. Predominantly conducted in SSA (n = 43, 83%) and Asia (n = 16, 31%), they address indoor and ambient air pollution, occupational hazards, and environmental conditions. Climate change exacerbates risks, varying regionally. SSA faces severe household and occupational exposures, while other LMICs deal with industrial and urban pollution. Stigma, social exclusion and economic burden underscore the necessity for intervention strategies (e.g., educational programs, pulmonary rehabilitation, low-emission cookstoves). Conclusion Our research shows a strong link between air pollution, occupational and environmental exposures, and the prevalence of COPD and asthma in LMICs. It suggests that targeted interventions are effective ways to mitigate these diseases and also highlights the significant impact of climate change on respiratory health.
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Affiliation(s)
- Perla Boutros
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg, Germany
| | - Nour Kassem
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg, Germany
| | - Valentin Boudo
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg, Germany
- Centre de Recherche en Santé de Nouna, Nouna, Burkina Faso
| | - Ali Sié
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg, Germany
- Centre de Recherche en Santé de Nouna, Nouna, Burkina Faso
| | - Stephen Munga
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg, Germany
- Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
| | - Martina A. Maggioni
- Institute of Physiology, Center for Space Medicine and Extreme Environment, Charité Universitätsmedizin Berlin, Berlin, Germany
- Department of Biomedical Sciences for Health, Faculty of Medicine and Surgery, University of Milan, Milan, Italy
- Charité Center for Global Health, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Marcin Golec
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg, Germany
| | - Robin Simion
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg, Germany
| | - Till Bärnighausen
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg, Germany
- Africa Health Research Institute (AHRI), Durban, South Africa
- Department of Global Health and Population, School of Public Health, Harvard University, Boston, MA, United States
| | - Volker Winkler
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg, Germany
| | - Sandra Barteit
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg, Germany
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Xu J, Shi Y, He G, Guo Y, Ruan Y, Hu J, Zhu Q, Chen Z, Liang S, Zheng Y, Huang Z, Yu S, Zhu R, Dong X, Wu F, Ma W, Liu T. Effects of Long-Term Exposure to Ambient Formaldehyde on Hypertension and Angina Pectoris Symptoms: Evidence From the WHO SAGE Cohort Study. J Am Heart Assoc 2024; 13:e035341. [PMID: 39291508 DOI: 10.1161/jaha.124.035341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Accepted: 08/13/2024] [Indexed: 09/19/2024]
Abstract
BACKGROUND We aimed to investigate the associations of long-term exposure to ambient formaldehyde with hypertension and angina pectoris symptoms in Chinese adults. METHODS AND RESULTS Participants' information was obtained from the WHO SAGE (World Health Organization Study on Global Aging and Adult Health) study. The Cox proportional hazards regression model was applied to estimate the associations of formaldehyde with hypertension and angina pectoris symptoms. Mediating effect analysis was used to investigate the mediating effect of hypertension between formaldehyde exposure and angina pectoris symptoms. Long-term exposure to formaldehyde was positively associated with the risk of angina pectoris symptoms (hazard ratio [HR], 1.66 [95% CI, 1.29-2.13], per interquartile range [IQR], 3.33, 1015 molecules/cm2) and hypertension (HR, 1.17 [95% CI, 1.02-1.34], per IQR, 3.34, 1015 molecules/cm2). The associations between formaldehyde and angina pectoris symptoms were greater in participants aged ≥65 years (HR, 1.90 [95% CI, 1.29-2.80]) and in rural areas (HR, 2.71 [95% CI, 1.54-4.77]), whereas the associations of formaldehyde with hypertension were stronger in men (HR, 1.27 [95% CI, 1.02-1.58]), rural areas (HR, 1.22 [95% CI, 0.94-1.59]), and in ever smokers (HR, 1.33 [95% CI, 1.02-1.72]). The mediation effect analysis indicated that 18.44% (95% CI, 2.17-37.65) of the association between formaldehyde exposure and angina pectoris symptoms was mediated by hypertension. CONCLUSIONS Long-term exposure to ambient formaldehyde was positively associated with hypertension and angina pectoris symptoms. The effects of formaldehyde may be modified by age, sex, urbanicity, and smoking status. Hypertension might play a mediating effect in formaldehyde-induced angina pectoris symptoms.
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Affiliation(s)
- Jiahong Xu
- Department of Public Health and Preventive Medicine, School of Medicine Jinan University Guangzhou China
- China Greater Bay Area Research Center of Environmental Health, School of Medicine Jinan University Guangzhou China
| | - Yan Shi
- Shanghai Municipal Centre for Disease Control and Prevention Shanghai China
| | - Guanhao He
- Department of Public Health and Preventive Medicine, School of Medicine Jinan University Guangzhou China
- China Greater Bay Area Research Center of Environmental Health, School of Medicine Jinan University Guangzhou China
| | - Yanfei Guo
- Shanghai Municipal Centre for Disease Control and Prevention Shanghai China
| | - Ye Ruan
- Shanghai Municipal Centre for Disease Control and Prevention Shanghai China
| | - Jianxiong Hu
- Department of Public Health and Preventive Medicine, School of Medicine Jinan University Guangzhou China
- China Greater Bay Area Research Center of Environmental Health, School of Medicine Jinan University Guangzhou China
| | - Qijiong Zhu
- Department of Public Health and Preventive Medicine, School of Medicine Jinan University Guangzhou China
- China Greater Bay Area Research Center of Environmental Health, School of Medicine Jinan University Guangzhou China
| | - Zhiqing Chen
- Department of Public Health and Preventive Medicine, School of Medicine Jinan University Guangzhou China
- China Greater Bay Area Research Center of Environmental Health, School of Medicine Jinan University Guangzhou China
| | - Shuru Liang
- Department of Public Health and Preventive Medicine, School of Medicine Jinan University Guangzhou China
- China Greater Bay Area Research Center of Environmental Health, School of Medicine Jinan University Guangzhou China
| | - Yuan Zheng
- Department of Public Health and Preventive Medicine, School of Medicine Jinan University Guangzhou China
- China Greater Bay Area Research Center of Environmental Health, School of Medicine Jinan University Guangzhou China
| | - Zhongguo Huang
- Department of Public Health and Preventive Medicine, School of Medicine Jinan University Guangzhou China
- China Greater Bay Area Research Center of Environmental Health, School of Medicine Jinan University Guangzhou China
| | - Siwen Yu
- Department of Public Health and Preventive Medicine, School of Medicine Jinan University Guangzhou China
- China Greater Bay Area Research Center of Environmental Health, School of Medicine Jinan University Guangzhou China
| | - Ruotong Zhu
- Department of Public Health and Preventive Medicine, School of Medicine Jinan University Guangzhou China
| | - Xiaomei Dong
- Department of Public Health and Preventive Medicine, School of Medicine Jinan University Guangzhou China
| | - Fan Wu
- Department of Epidemiology, School of Public Health Fudan University Shanghai China
- Shanghai Institute of Infectious Disease and Biosecurity Fudan University Shanghai China
| | - Wenjun Ma
- Department of Public Health and Preventive Medicine, School of Medicine Jinan University Guangzhou China
- China Greater Bay Area Research Center of Environmental Health, School of Medicine Jinan University Guangzhou China
- Key Laboratory of Viral Pathogenesis & Infection Prevention and Control（Jinan University） Ministry of Education Guangzhou China
| | - Tao Liu
- Department of Public Health and Preventive Medicine, School of Medicine Jinan University Guangzhou China
- China Greater Bay Area Research Center of Environmental Health, School of Medicine Jinan University Guangzhou China
- Key Laboratory of Viral Pathogenesis & Infection Prevention and Control（Jinan University） Ministry of Education Guangzhou China
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Debelu D, Mengistu DA, Aschalew A, Mengistie B, Deriba W. Global Public Health Implications of Traffic Related Air Pollution: Systematic Review. ENVIRONMENTAL HEALTH INSIGHTS 2024; 18:11786302241272403. [PMID: 39192968 PMCID: PMC11348364 DOI: 10.1177/11786302241272403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2024] [Accepted: 07/16/2024] [Indexed: 08/29/2024]
Abstract
Background Traffic-related air pollution (TRAP) has significant public health implications and a wide range of adverse health effects, including cardiovascular, respiratory, pulmonary, and other health problems. This study aimed to determine the public health impacts of traffic-related air pollution across the world that can be used as an input for protecting human health. Methods This study considered studies conducted across the world and full-text articles written in English. The articles were searched using a combination of Boolean logic operators (AND, OR, and NOT), MeSH, and keywords from the included electronic databases (SCOPUS, PubMed, EMBASE, Web of Science, CINAHL, and Google Scholars). The quality assessment of the articles was done using JBI tools to determine the relevance of each included article to the study. Results In this study, 1 282 032 participants ranging from 19 to 452 735 were included in 30 articles published from 2010 to 2022. About 4 (13.3%), 9 (30.0%), 12 (40.0%), 8 (26.7%), 2 (6.7%), 15 (50.0%), 3 (10.0%), 3 (10.0%) 1 (3.3%), and 3 (10.0%) of articles reported the association between human health and exposure to CO, PM10, PM2.5, NOx, NO, NO2, black carbon, O3, PAH, and SO2, respectively. Respiratory diseases, cancer, cognitive function problems, preterm birth, blood pressure and hypertension, diabetes, allergies and sensitization, coronary heart disease, dementia incidence, and hemorrhagic stroke were associated with exposure to TRAP. Conclusions Exposure to nitrogen dioxide, nitrogen oxide, sulfur dioxide, and fine particulate matter was associated with various health effects. This revealed that there is a need for the concerned organizations to respond appropriately.
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Affiliation(s)
- Desi Debelu
- School of Environmental Health, College of Health and Science, Haramaya University, Harar, Ethiopia
| | - Dechasa Adare Mengistu
- School of Environmental Health, College of Health and Science, Haramaya University, Harar, Ethiopia
| | - Alemayehu Aschalew
- Institutional Development and Facility Management, College of Health and Medical Science, Haramaya University, Harar, Ethiopia
| | - Bizatu Mengistie
- Saint Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Wegene Deriba
- School of Environmental Health, College of Health and Science, Haramaya University, Harar, Ethiopia
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Ogunro T. Environmental Justice and Health in Nigeria. Curr Environ Health Rep 2024; 11:158-167. [PMID: 38652205 DOI: 10.1007/s40572-024-00439-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2024] [Indexed: 04/25/2024]
Abstract
PURPOSE OF REVIEW The United Nations Sustainable Development Goals (SDGs) identified 17 goals to achieve by the year 2030, with many of these goals directly or indirectly linked to environmental justice. Health outcomes remain poor in Nigeria; the country ranks low in environmental quality despite supporting environmental treaties and laws. The burden of diseases in the country is in part related to poor environmental quality and is linked to environmental justice issues, such as mining, energy exploration, transport emission, poor waste management, and proliferation of slum settlement. RECENT FINDINGS Previous studies found that living in proximity to mines and environmental degradation of land and water disrupts means of livelihood and causes poor health outcomes among children and adults. Specifically, health issues like respiratory illness, malaria, kidney disease, and high blood pressure are likely consequences of proximity to mine waste. Few published studies are available for a developing country like Nigeria, although the link between environmental justice and health in Nigeria is clear enough to require action on the part of the government and polluting industries. This paper reviewed the concept and coverage of environmental justice in the Nigerian context and its impact on health. Addressing environmental injustices related to mining and other environmental issues can accelerate health gains through conscious and concerted efforts towards preserving the environment. Also, the right of everyone to a sustainable city regardless of socioeconomic class and geographical location can only be secured through environmental justice.
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Ezeigwe NM, Adinma ED, Okobia EL, Schwander S. Characterization and Quantification of Vehicular Emissions in Abuja Municipality-Implications for Public Health. Niger Med J 2024; 65:276-291. [PMID: 39022566 PMCID: PMC11249476 DOI: 10.60787/nmj-v65i3-383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2024] Open
Abstract
Background Air pollution from vehicular emission and other sources accounts for over seven million global deaths annually and contributes significantly to environmental degradation, including climate change. Vehicular emission is not prioritized for control in Nigeria, thus undermining public health and the Sustainable Development Goals 3, 11 and 13. This study aims to characterize vehicular emissions in Abuja municipality and quantify exhaust air pollutants of commonly used vehicles. Methodology Cross-sectional exhaust emissions study of vehicles in Abuja Municipal Area Council. Information on the type and age, fuel type, purchase and use category of 543 vehicles on routine Annual Road Worthiness Test at the Computerized Test Center, Abuja. Exhaust levels of CO, CO2 HCHO and PM10 were measured using hand-held devices. IBM SPSS version 26.0.0.0 (2019) statistical software. Results Toyota brand comprised 52.5% of the vehicles. Over 80% were older than 10 years; 85.5% preowned and 87.3% used for private purposes. PMS was the dominant fuel used (91.1%). Except PM10, older vehicles emitted higher levels of the measured pollutants than newer ones. The differences were significant for CO and HCHO. Diesel-fueled and commercial vehicles also emitted higher levels of CO, HCHO and PM10 compared to PMS-fueled and private vehicles respectively. Conclusions Strong regulatory policies that discourage over-aged vehicles; speedy adoption of the ECOWAS guidelines on cleaner fuels and emission limits; and coordinated implementation of effective Inspection & Monitoring programme by relevant government agencies are required to safeguard public health and the environment. We also recommend the introduction of vehicles powered by alternative energy, use of bicycles, designation of one-way traffic and pedestrian zones. Key Message Reducing the threats to the public's health from vehicular air pollution in Abuja municipality requires strong policy and coordinated monitoring programs for effective control.
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Affiliation(s)
- Nnenna M Ezeigwe
- Environment for Health Development Initiative (E4HDI), Abuja, Nigeria
| | - Echendu D Adinma
- Department of Community Medicine, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria
- Department of Community Medicine and Primary Health Care, Nnamdi Azikiwe University, Awka, Nigeria
- Center for Sustainable Development, Nnamdi Azikiwe University, Awka, Nigeria
| | - Efegbidiki L Okobia
- Nigerian Environmental Society, Abuja, FCT-Nigeria
- Lympson Leosentino Ireland, Republic of Ireland
| | - Stephan Schwander
- Departments of Environmental and Occupational Health and Justice and Urban-Global Public Health, School of Public Health, Piscataway, NJ 08854, USA
- Division of Global Environmental Health, Environmental and Occupational Health Sciences Institute, Rutgers University, Piscataway, NJ 08854, USA
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Mphahlele R, Lesosky M, Masekela R. Prevalence, severity and risk factors for asthma in school-going adolescents in KwaZulu Natal, South Africa. BMJ Open Respir Res 2023; 10:10/1/e001498. [PMID: 37192778 DOI: 10.1136/bmjresp-2022-001498] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Accepted: 05/02/2023] [Indexed: 05/18/2023] Open
Abstract
BACKGROUND Asthma remains highly prevalent, with more severe symptoms in low-income to middle-income countries (LMICs) compared with high-income countries. Identifying risk factors for severe asthma symptoms can assist with improving outcomes. We aimed to determine the prevalence, severity and risk factors for asthma in adolescents in an LMIC. METHODS A cross-sectional survey using the Global Asthma Network written and video questionnaires was conducted in adolescents aged 13 and 14 from randomly selected schools in Durban, South Africa, between May 2019 and June 2021. RESULTS A total of 3957 adolescents (51.9% female) were included. The prevalence of lifetime, current and severe asthma was 24.6%, 13.7% and 9.1%, respectively. Of those with current and severe asthma symptoms; 38.9% (n=211/543) and 40.7% (n=147/361) had doctor-diagnosed asthma; of these, 72.0% (n=152/211) and 70.7% (n=104/147), respectively, reported using inhaled medication in the last 12 months. Short-acting beta agonists (80.4%) were more commonly used than inhaled corticosteroids (13.7%). Severe asthma was associated with: fee-paying school quintile (adjusted OR (CI)): 1.78 (1.27 to 2.48), overweight (1.60 (1.15 to 2.22)), exposure to traffic pollution (1.42 (1.11 to 1.82)), tobacco smoking (2.06 (1.15 to 3.68)), rhinoconjunctivitis (3.62 (2.80 to 4.67)) and eczema (2.24 (1.59 to 3.14)), all p<0.01. CONCLUSION Asthma prevalence in this population (13.7%) is higher than the global average (10.4%). Although common, severe asthma symptoms are underdiagnosed and associated with atopy, environmental and lifestyle factors. Equitable access to affordable essential controller inhaled medicines addressing the disproportionate burden of asthma is needed in this setting.
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Affiliation(s)
- Reratilwe Mphahlele
- Paediatrics and Child Health, University of KwaZulu Natal, Durban, KwaZulu Natal, South Africa
| | - Maia Lesosky
- Division of Epidemiology and Biostatistics, University of Cape Town, Rondebosch, South Africa
- Global Health Trials Unit, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Refiloe Masekela
- Paediatrics and Child Health, University of KwaZulu Natal, Durban, KwaZulu Natal, South Africa
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Mustapha A, Amegah AK, Coker ES. Harmonization of Epidemiologic Research Methods to Address the Environmental and Social Determinants of Urban Slum Health Challenges in Sub-Saharan Africa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11273. [PMID: 36141546 PMCID: PMC9517459 DOI: 10.3390/ijerph191811273] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 08/21/2022] [Accepted: 09/02/2022] [Indexed: 06/16/2023]
Abstract
Sub-Saharan Africa (SSA) has a significant proportion of populations living in urban slum conditions, where exposure to multiple environmental stressors and social inequalities is ubiquitous. This commentary synthesizes commonalities in recent environmental health studies from urban cities in East and West Africa, presented during a symposium sponsored by the Africa Chapter of the International Society of Environmental Epidemiology (ISEE) in August 2020. A key takeaway from this symposium is the need for harmonization of epidemiologic and exposure data collection in three domains tailored to the SSA context: (1) improvements in socioeconomic status (SES) measurement through harmonization in the conceptualization and operationalization of SES indicators; (2) improvements in air pollution exposure assessment in resource-constrained contexts by better integration, validation, and harmonization of exposure data of air pollution and mitigating factors; and (3) harmonization in the assessment of health outcomes and biomonitoring of contaminants. Focusing on these three domains would galvanize environmental epidemiologists in SSA around shared data collection instruments and shared data platforms and facilitate the pooling of data across the continent. Fostering this collaborative research will enable researchers and decision-makers to glean new insights and develop robust environmental health interventions and policies for SSA urban slums and for improved population health.
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Affiliation(s)
- Adetoun Mustapha
- Nigeria Institute of Medical Research, 6 Edmund Crescent, Lagos 101245, Nigeria
| | - A. Kofi Amegah
- Department of Biomedical Sciences, School of Allied Health Sciences, University of Cape Coast, Cape Coast PMB TF0494, Ghana
| | - Eric Stephen Coker
- Department of Environmental & Public Health, College of Public Health & Health Professions, University of Florida, Gainesville, FL 32610, USA
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Truong N, Tesfamariam K, Visintin L, Goessens T, De Saeger S, Lachat C, De Boevre M. Associating multiple mycotoxin exposure and health outcomes: current statistical approaches and challenges. WORLD MYCOTOXIN J 2022. [DOI: 10.3920/wmj2022.2784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Mycotoxin contamination is a global challenge to food safety and population health. A diversity of adverse effects in human health such as organ damage, immunity disorders and carcinogenesis are attributed to acute and chronic exposure to mycotoxins. While there is a high likelihood of mycotoxin co-occurrence in the daily diet, multiple mycotoxin exposures represent a considerable challenge in understanding the accumulative effects of groups of exposures on health outcomes. Nevertheless, previous studies on mycotoxin exposure-health outcome associations have focused on a single or a limited number of exposures. To guide multi-exposure assessment, careful considerations of statistical approaches available are required. In addition, the issue of multicollinearity in high-dimensional settings of multiple exposure analysis underlies the controversy surrounding the reliability and consistency of statistical conclusions about the exposure-health outcome associations. Conventional approaches such as generalised linear regressions (GLR) in conjunction with regularisation methods, including ridge regression, lasso and elastic net, offer some clear advantages in terms of results’ interpretation and model selection. However, when highly-correlated variables are observed, these methods have shown a low specificity in variable selection. Principal component analysis (PCA) that has been widely used as a dimensionality reduction technique also has the limitation to identify important predictor variables as this approach may overlook the associations between certain components and health outcomes. Recently, some alternative approaches have been introduced to address the issues of high dimensionality and highly-correlated data in the context of epidemiological and environmental research. Two of the noticeable approaches are weighted quantile sum regression (WQSR) and Bayesian kernel machine regression (BKMR). Combining different methods of inference allows us to interpret the role of certain exposures, their interactions and the combined effects on human health under diverse statistical perspectives, which ultimately facilitate the construction of the toxicological profile of multiple mycotoxins’ exposure.
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Affiliation(s)
- N.N. Truong
- Center of Excellence in Mycotoxicology and Public Health, Faculty of Pharmaceutical Sciences, Ghent University, Ottergemsesteenweg 460, 9000 Ghent, Belgium
| | - K. Tesfamariam
- Center of Excellence in Mycotoxicology and Public Health, Faculty of Pharmaceutical Sciences, Ghent University, Ottergemsesteenweg 460, 9000 Ghent, Belgium
- Department of Food Technology, Safety and Health, Faculty of Bioscience Engineering, Ghent University, Coupure Links 653, 9000 Ghent, Belgium
- Department of Public Health, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia
- Department of Population and Family Health, Institute of Health, Jimma University, Jimma, Ethiopia
| | - L. Visintin
- Center of Excellence in Mycotoxicology and Public Health, Faculty of Pharmaceutical Sciences, Ghent University, Ottergemsesteenweg 460, 9000 Ghent, Belgium
| | - T. Goessens
- Center of Excellence in Mycotoxicology and Public Health, Faculty of Pharmaceutical Sciences, Ghent University, Ottergemsesteenweg 460, 9000 Ghent, Belgium
| | - S. De Saeger
- Center of Excellence in Mycotoxicology and Public Health, Faculty of Pharmaceutical Sciences, Ghent University, Ottergemsesteenweg 460, 9000 Ghent, Belgium
- Department of Biotechnology and Food Technology, Faculty of Science, University of Johannesburg, P.O. Box 17011, Doornfontein Campus 2028, Gauteng, South Africa
| | - C. Lachat
- Department of Food Technology, Safety and Health, Faculty of Bioscience Engineering, Ghent University, Coupure Links 653, 9000 Ghent, Belgium
| | - M. De Boevre
- Center of Excellence in Mycotoxicology and Public Health, Faculty of Pharmaceutical Sciences, Ghent University, Ottergemsesteenweg 460, 9000 Ghent, Belgium
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Glenn BE, Espira LM, Larson MC, Larson PS. Ambient air pollution and non-communicable respiratory illness in sub-Saharan Africa: a systematic review of the literature. Environ Health 2022; 21:40. [PMID: 35422005 PMCID: PMC9009030 DOI: 10.1186/s12940-022-00852-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 04/04/2022] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Aerosol pollutants are known to raise the risk of development of non-communicable respiratory diseases (NCRDs) such as asthma, chronic bronchitis, chronic obstructive pulmonary disease, and allergic rhinitis. Sub-Saharan Africa's rapid pace of urbanization, economic expansion, and population growth raise concerns of increasing incidence of NCRDs. This research characterizes the state of research on pollution and NCRDs in the 46 countries of Sub-Saharan Africa (SSA). This research systematically reviewed the literature on studies of asthma; chronic bronchitis; allergic rhinitis; and air pollutants such as particulate matter, ozone, NOx, and sulfuric oxide. METHODS We searched three major databases (PubMed, Web of Science, and Scopus) using the key words "asthma", "chronic bronchitis", "allergic rhinitis", and "COPD" with "carbon monoxide (CO)", "sulfuric oxide (SO)", "ozone (O3)", "nitrogen dioxide (NO2)", and "particulate matter (PM)", restricting the search to the 46 countries that comprise SSA. Only papers published in scholarly journals with a defined health outcome in individuals and which tested associations with explicitly measured or modelled air exposures were considered for inclusion. All candidate papers were entered into a database for review. RESULTS We found a total of 362 unique research papers in the initial search of the three databases. Among these, 14 met the inclusion criteria. These papers comprised studies from just five countries. Nine papers were from South Africa; two from Malawi; and one each from Ghana, Namibia, and Nigeria. Most studies were cross-sectional. Exposures to ambient air pollutants were measured using spectrometry and chromatography. Some studies created composite measures of air pollution using a range of data layers. NCRD outcomes were measured by self-reported health status and measures of lung function (spirometry). Populations of interest were primarily schoolchildren, though a few studies focused on secondary school students and adults. CONCLUSIONS The paucity of research on NCRDs and ambient air pollutant exposures is pronounced within the African continent. While capacity to measure air quality in SSA is high, studies targeting NCRDs should work to draw attention to questions of outdoor air pollution and health. As the climate changes and SSA economies expand and countries urbanize, these questions will become increasingly important.
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Affiliation(s)
- Bailey E. Glenn
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA USA
| | - Leon M. Espira
- Center for Global Health Equity, University of Michigan, Ann Arbor, USA
| | | | - Peter S. Larson
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA USA
- Social Environment and Health Program, Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI USA
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI USA
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12
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Liu X, Jin Z. On detecting the effect of exposure mixture. J Appl Stat 2022; 50:1980-1991. [PMID: 37378272 PMCID: PMC10291926 DOI: 10.1080/02664763.2022.2061430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 03/29/2022] [Indexed: 10/18/2022]
Abstract
To study the effect of exposure mixture on the continuous health outcomes, one can use the linear model with a weighted sum of multiple standardized exposure variables as an index predictor and its coefficient for the overall effect. The unknown weights typically range between zero and one, indicating contributions of individual exposures to the overall effect. Because the weight parameters present only when the parameter for overall effect is non-zero, testing hypotheses on the overall effect can be challenging, especially when the number of exposure variables is above two. This paper presents a working model based approach to estimate the parameter for overall effect and to test specific hypotheses, including two tests for detecting the overall effect and one test for detecting unequal weights when the overall effect is evident. The statistics are computationally easy and one can apply existing statistical software to perform the analysis. A simulation study shows that the proposed estimators for the parameters of interest may have better finite sample performance than some other estimators.
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Affiliation(s)
- Xinhua Liu
- Department of Biostatistics, Columbia University, New York, USA
| | - Zhezhen Jin
- Department of Biostatistics, Columbia University, New York, USA
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13
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Malhotra SK, White H, Dela Cruz NAO, Saran A, Eyers J, John D, Beveridge E, Blöndal N. Studies of the effectiveness of transport sector interventions in low- and middle-income countries: An evidence and gap map. CAMPBELL SYSTEMATIC REVIEWS 2021; 17:e1203. [PMID: 36951810 PMCID: PMC8724647 DOI: 10.1002/cl2.1203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Background There are great disparities in the quantity and quality of infrastructure. European countries such as Denmark, Germany, Switzerland, and the UK have close to 200 km of road per 100 km2, and the Netherlands over 300 km per 100 km2. By contrast, Kenya and Indonesia have <30, Laos and Morocco <20, Tanzania and Bolivia <10, and Mauritania only 1 km per 100 km2. As these figures show, there is a significant backlog of transport infrastructure investment in both rural and urban areas, especially in sub-Saharan Africa. This situation is often exacerbated by weak governance and an inadequate regulatory framework with poor enforcement which lead to high costs and defective construction.The wellbeing of many poor people is constrained by lack of transport, which is called "transport poverty". Lucas et al. suggest that up to 90% of the world's population are transport poor when defined as meeting at least one of the following criteria: (1) lack of available suitable transport, (2) lack of transport to necessary destinations, (3) cost of necessary transport puts household below the income poverty line, (4) excessive travel time, or (5) unsafe or unhealthy travel conditions. Objectives The aim of this evidence and gap map (EGM) is to identify, map, and describe existing evidence from studies reporting the quantitative effects of transport sector interventions related to all means of transport (roads, rail, trams and monorail, ports, shipping, and inland waterways, and air transport). Methods The intervention framework of this EGM reframes Berg et al's three categories (infrastructure, prices, and regulations) broadly as infrastructure, incentives, and institutions as subcategories for each intervention category which are each mode of transport (road, rail trams and monorail, ports, shipping, and inlands waterways, and air transport). This EGM identifies the area where intervention studies have been conducted as well as the current gaps in the evidence base.This EGM includes ongoing and completed impact evaluations and systematic reviews (SRs) of the effectiveness of transport sector interventions. This is a map of effectiveness studies (impact evaluations). The impact evaluations include experimental designs, nonexperimental designs, and regression designs. We have not included the before versus after studies and qualitative studies in this map. The search strategies included both academic and grey literature search on organisational websites, bibliographic searches and hand search of journals.An EGM is a table or matrix which provides a visual presentation of the evidence in a particular sector or a subsector. The map is presented as a matrix in which rows are intervention categories (e.g., roads) and subcategories (e.g., infrastructure) and the column outcome domains (e.g., environment) and subcategories as (e.g., air quality). Each cell contains studies of the corresponding intervention for the relevant outcome, with links to the available studies. Included studies were coded according to the intervention and outcomes assessed and additional filters as region, population, and study design. Critical appraisal of included SR was done using A Measurement Tool to Assess Systematic Reviews (AMSTAR -2) rating scale. Selection Criteria The search included both academic and grey literature available online. We included impact evaluations and SRs that assessed the effectiveness of transport sector interventions in low- and middle-income countries. Results This EGM on the transport sector includes 466 studies from low- and middle-income countries, of which 34 are SRs and 432 impact evaluations. There are many studies of the effects of roads intervention in all three subcategories-infrastructure, incentives, and institutions, with the most studies in the infrastructure subcategories. There are no or fewer studies on the interventions category ports, shipping, and waterways and for civil aviation (Air Transport).In the outcomes, the evidence is most concentrated on transport infrastructure, services, and use, with the greatest concentration of evidence on transport time and cost (193 studies) and transport modality (160 studies). There is also a concentration of evidence on economic development and health and education outcomes. There are 139 studies on economic development, 90 studies on household income and poverty, and 101 studies on health outcomes.The major gaps in evidence are from all sectors except roads in the intervention. And there is a lack of evidence on outcome categories such as cultural heritage and cultural diversity and very little evidence on displacement (three studies), noise pollution (four studies), and transport equity (2). There is a moderate amount of evidence on infrastructure quantity (32 studies), location, land use and prices (49 studies), market access (29 studies), access to education facilities (23 studies), air quality (50 studies), and cost analysis including ex post CBA (21 studies).The evidence is mostly from East Asia and the Pacific Region (223 studies (40%), then the evidence is from the sub-Saharan Africa (108 studies), South Asia (96 studies), Latin America & Caribbean (79 studies). The least evidence is from Middle East & North Africa (30 studies) and Europe & Central Asia (20 studies). The most used study design is other regression design in all regions, with largest number from East Asia and Pacific (274). There is total 33 completed SRs identified and one ongoing, around 85% of the SR are rated low confidence, and 12% rated as medium confidence. Only one review was rated as high confidence. This EGM contains the available evidence in English. Conclusion This map shows the available evidence and gaps on the effectiveness of transport sector intervention in low- and middle-income countries. The evidence is highly concentrated on the outcome of transport infrastructure (especially roads), service, and use (351 studies). It is also concentrated in a specific region-East Asia and Pacific (223 studies)-and more urban populations (261 studies). Sectors with great development potential, such as waterways, are under-examined reflecting also under-investment.The available evidence can guide the policymakers, and government-related to transport sector intervention and its effects on many outcomes across sectors. There is a need to conduct experimental studies and quality SRs in this area. Environment, gender equity, culture, and education in low- and middle-income countries are under-researched areas in the transport sector.
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Cai YS, Gibson H, Ramakrishnan R, Mamouei M, Rahimi K. Ambient Air Pollution and Respiratory Health in Sub-Saharan African Children: A Cross-Sectional Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18189729. [PMID: 34574653 PMCID: PMC8467583 DOI: 10.3390/ijerph18189729] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 09/11/2021] [Accepted: 09/13/2021] [Indexed: 02/03/2023]
Abstract
Ambient air pollution is projected to become a major environmental risk in sub-Saharan Africa (SSA). Research into its health impacts is hindered by limited data. We aimed to investigate the cross-sectional relationship between particulate matter with a diameter ≤ 2.5 μm (PM2.5) and prevalence of cough or acute lower respiratory infection (ALRI) among children under five in SSA. Data were collected from 31 Demographic and Health Surveys (DHS) in 21 SSA countries between 2005–2018. Prior-month average PM2.5 preceding the survey date was assessed based on satellite measurements and a chemical transport model. Cough and ALRI in the past two weeks were derived from questionnaires. Associations were analysed using conditional logistic regression within each survey cluster, adjusting for child’s age, sex, birth size, household wealth, maternal education, maternal age and month of the interview. Survey-specific odds ratios (ORs) were pooled using random-effect meta-analysis. Included were 368,366 and 109,664 children for the analysis of cough and ALRI, respectively. On average, 20.5% children had reported a cough, 6.4% reported ALRI, and 32% of children lived in urban areas. Prior-month average PM2.5 ranged from 8.9 to 64.6 μg/m3. Pooling all surveys, no associations were observed with either outcome in the overall populations. Among countries with medium-to-high Human Development Index, positive associations were observed with both cough (pooled OR: 1.022, 95%CI: 0.982–1.064) and ALRI (pooled OR: 1.018, 95%CI: 0.975–1.064) for 1 μg/m3 higher of PM2.5. This explorative study found no associations between short-term ambient PM2.5 and respiratory health among young SSA children, necessitating future analyses using better-defined exposure and health metrics to study this important link.
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Affiliation(s)
- Yutong Samuel Cai
- Nuffield Department of Women’s & Reproductive Health, University of Oxford, Oxford OX3 9DU, UK; (H.G.); (M.M.); (K.R.)
- Deep Medicine Programme, Oxford Martin School, University of Oxford, Oxford OX1 3BD, UK
- Informal Cities Programme, Oxford Martin School, University of Oxford, Oxford OX1 3BD, UK
- Correspondence:
| | - Harry Gibson
- Nuffield Department of Women’s & Reproductive Health, University of Oxford, Oxford OX3 9DU, UK; (H.G.); (M.M.); (K.R.)
- Deep Medicine Programme, Oxford Martin School, University of Oxford, Oxford OX1 3BD, UK
- Informal Cities Programme, Oxford Martin School, University of Oxford, Oxford OX1 3BD, UK
| | - Rema Ramakrishnan
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK;
| | - Mohammad Mamouei
- Nuffield Department of Women’s & Reproductive Health, University of Oxford, Oxford OX3 9DU, UK; (H.G.); (M.M.); (K.R.)
- Deep Medicine Programme, Oxford Martin School, University of Oxford, Oxford OX1 3BD, UK
- Informal Cities Programme, Oxford Martin School, University of Oxford, Oxford OX1 3BD, UK
| | - Kazem Rahimi
- Nuffield Department of Women’s & Reproductive Health, University of Oxford, Oxford OX3 9DU, UK; (H.G.); (M.M.); (K.R.)
- Deep Medicine Programme, Oxford Martin School, University of Oxford, Oxford OX1 3BD, UK
- Informal Cities Programme, Oxford Martin School, University of Oxford, Oxford OX1 3BD, UK
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15
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Cortes-Ramirez J, Wilches-Vega JD, Paris-Pineda OM, Rod JE, Ayurzana L, Sly PD. Environmental risk factors associated with respiratory diseases in children with socioeconomic disadvantage. Heliyon 2021; 7:e06820. [PMID: 33997379 PMCID: PMC8093469 DOI: 10.1016/j.heliyon.2021.e06820] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 03/05/2021] [Accepted: 04/12/2021] [Indexed: 11/17/2022] Open
Abstract
Children are more vulnerable to environmental exposures determinant of respiratory diseases due to their dynamic developmental physiology. Whereas social determinants of health are also associated with a higher risk of these diseases in children exposed to environmental risk factors, most studies incorporate them as covariates in the statistical analysis rather than focusing on specific vulnerable populations. In this study a systematic review searched and selected studies of respiratory diseases in children with socioeconomic disadvantage to identify the environmental risk factors associated with these diseases. The review followed the PRISMA protocol to identify eleven eligible studies of children with socioeconomic conditions that included low income and low socioeconomic status, overcrowding, adults with low education level and Indigenous status. Infectious respiratory diseases, asthma, rhinitis and mortality due to respiratory diseases were associated with risk factors such as biomass fuel use, tobacco smoking, particulate matter, coal dust and other pollutants including ozone, nitrogen dioxide and sulphur dioxide. The most common associations were between respiratory infections and household air pollution and asthma with indoor and outdoor air pollution. The findings support previous reports on these associations and suggest that specific vulnerabilities such as indigenous children and living with adults with low socioeconomic status and education level increase the risk of respiratory diseases. These populations can be given special attention to prioritize public health interventions to lower the burden of disease of respiratory diseases in children.
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Affiliation(s)
- Javier Cortes-Ramirez
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia.,Children's Health and Environment Program, University of Queensland, Brisbane, Australia.,Faculty of Health, University of Santander, Cúcuta, Colombia
| | | | | | - J E Rod
- Centre for Accident Research and Road Safety Queensland (CARRS-Q), Queensland University of Technology (QUT), Brisbane, Queensland, Australia.,Institute of Health and Biomedical Innovation Queensland University of Technology (QUT), Brisbane, Queensland, Australia
| | | | - Peter D Sly
- Children's Health and Environment Program, University of Queensland, Brisbane, Australia
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16
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Okedere OO, Elehinafe FB, Oyelami S, Ayeni AO. Drivers of anthropogenic air emissions in Nigeria - A review. Heliyon 2021; 7:e06398. [PMID: 33732932 PMCID: PMC7938250 DOI: 10.1016/j.heliyon.2021.e06398] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 01/21/2021] [Accepted: 02/25/2021] [Indexed: 11/25/2022] Open
Abstract
This study presents a review of sources and atmospheric levels of anthropogenic air emissions in Nigeria with a view to reviewing the existence or otherwise of national coordination aimed at mitigating the continued increase. According to individual researcher's reports, the atmospheric loading of anthropogenic air pollutants is currently on an alarming increase in Nigeria. Greater concerns are premised on the inadequacy existing emission inventories, continuous assessment, political will and development of policy plans for effective mitigation of these pollutants. The identified key drivers of these emissions include gas flaring, petroleum product refining, thermal plants for electricity generation, transportation, manufacturing sector, land use changes, proliferation of small and medium enterprises, medical wastes incineration, municipal waste disposal, domestic cooking, bush burning and agricultural activities such as land cultivation and animal rearing. Having identified the key sources of anthropogenic air emissions and established the rise in their atmospheric levels through aggregation of literature reports, this study calls for a review of energy policy, adoption of best practices in the management air emissions and solid wastes as well as agriculture and land use pattern which appear to be the rallying points of all identified sources of emission. The study concluded that the adoption of cleaner energy policies and initiatives in energy generation and usage as against pursuit of thermal plants and heavy dependence on fossil fuels will assist to ameliorate the atmospheric loadings of these pollutants.
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Affiliation(s)
- Oyetunji O Okedere
- Department of Chemical Engineering, Faculty of Engineering and Environmental Sciences, Osun State University, Nigeria
| | - Francis B Elehinafe
- Department of Chemical Engineering, School of Chemical and Petroleum Engineering, College of Engineering, Covenant University, Ota, Ogun State, Nigeria
| | - Seun Oyelami
- Department of Mechanical Engineering, Faculty of Engineering and Environmental Sciences, Osun State University, Nigeria
| | - Augustine O Ayeni
- Department of Chemical Engineering, School of Chemical and Petroleum Engineering, College of Engineering, Covenant University, Ota, Ogun State, Nigeria
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17
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Chemical Composition and Source Apportionment of PM10 in a Green-Roof Primary School Building. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10238464] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Research on air quality issues in recently refurbished educational buildings is relatively limited. However, it is an important topic as students are often exposed to high concentrations of air pollutants, especially in urban environments. This study presents the results of a 25-day experimental campaign that took place in a primary school located in a densely built-up area, which retains a green roof system (GRS). All measurements refer to mass concentrations and chemical analysis of PM10 (particulate matter less than 10 micrometers), and they were implemented simultaneously on the GRS and within the classroom (C3) below during different periods of the year. The results demonstrated relatively low levels of PM10 in both experimental points, with the highest mean value of 72.02 μg m−3 observed outdoors during the cold period. Elemental carbon (EC) was also found be higher in the ambient environment (with a mean value of 2.78 μg m−3), while organic carbon (OC) was relatively balanced between the two monitoring sites. Moreover, sulfate was found to be the most abundant water soluble anion (2.57 μg m−3), mainly originating from ambient primary SO2 and penetrating into the classroom from windows. Additionally, the crustal origin of particles was shown in trace metals, where Al and Fe prevailed (9.55% and 8.68%, respectively, of the total PM10). Nevertheless, infiltration of outdoor particles within the classroom was found to affect indoor sources of metals. Finally, source apportionment using a positive matrix factorization (PMF) receptor model demonstrated six main factors of emissions, the most important of which were vehicles and biomass burning (30.30% contribution), along with resuspension of PM10 within the classroom from human activities (29.89% contribution). Seasonal variations seem to play a key role in the results.
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18
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Masekela R, Vanker A. Lung Health in Children in Sub-Saharan Africa: Addressing the Need for Cleaner Air. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E6178. [PMID: 32858786 PMCID: PMC7504680 DOI: 10.3390/ijerph17176178] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 07/20/2020] [Accepted: 07/21/2020] [Indexed: 11/17/2022]
Abstract
Air pollution is increasingly recognized as a global health emergency with its impacts being wide ranging, more so for low- and middle-income countries where both indoor and outdoor pollution levels are high. In Africa, more than 80% of children live in households which use unclean sources of energy. The effects of both indoor and outdoor pollution on lung health on children who are the most vulnerable to their effects range from acute lower respiratory tract infections to long-term chronic health effects. We reviewed the literature on the effects of air pollution in children in Sub-Saharan Africa from prenatal exposure, infancy and school-going children. Data from Sub-Saharan Africa on quantification of exposures both indoor and outdoor mainly utilizes modelling or self-reporting. Exposures to biomass not only increases the risk of acute respiratory tract infections in young children but also increases the risk of carriage of pathogenic bacteria in the upper respiratory tract. Although there is limited evidence of association between asthma and pollution in African children, airway hyper-responsiveness and lower lung function has been demonstrated in children with higher risk of exposure. Interventions at a policy level to both quantify the exposure levels at a population level are urgently needed to address the possible interventions to limit exposure and improve lung health in children in Sub-Saharan Africa.
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Affiliation(s)
- Refiloe Masekela
- Department of Paediatrics and Child Health, Nelson R Mandela School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban 4013, South Africa
| | - Aneesa Vanker
- Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital and MRC Unit on Child and Adolescent Health, University of Cape Town, Cape Town 7700, South Africa;
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19
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P Ojukwu C, J Okemuo A, V Madu C, N Ativie R, Sylvester Caesar C, Emelie Moris A. Pulmonary functions of commercial tricyclists (Keke Napep riders) in Enugu State, Nigeria. Afr Health Sci 2020; 20:798-805. [PMID: 33163046 PMCID: PMC7609122 DOI: 10.4314/ahs.v20i2.33] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Tricyclists are continuously exposed to vehicle emissions and other environmental pollutants, due to the nature of their job and vehicle design, which may be hazardous to health. However, there is paucity of data on the pulmonary functions of commercial tricyclists in Nigeria, which should have provided insight into any relevant health concerns in this population, hence this study. Objectives This study evaluated the pulmonary functions of tricyclists, in comparison with those of age-matched non-tricyclists. Methods Two hundred and ten (210) [150 commercial tricyclists; 60 non-tricyclists] males (aged 20–65 years) participated in this unmatched case-control study in Enugu, Enugu state, Nigeria. Their pulmonary functions [Forced Vital Capacity (FVC), Forced Expiratory Volume in one second (FEV1), Peak Expiratory Flow Rate (PEFR)] were assessed using a computerized spirometer. Independent T-test and Pearson Chi-square were used to analyze data at a significant level of P<0.05. Results Cough (46.0%) and dust allergies (40.7%) were the commonest reported respiratory symptoms among tricyclists. There were significant differences in the FVC (P<0.001), FEV1 (P<0.001) and PEFR (P<0.001) between the two groups, with tricyclists showing lower pulmonary function values. FEV1/FVC was <70% with increased FVC in 83.3% of the tricyclists, suggesting restrictive pulmonary abnormalities. Conclusion Decreased pulmonary function values of commercial tricyclists in this study is suggestive of their predisposition to occupation-related pulmonary disorders, particularly the restrictive patterns.
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20
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Coker E, Katamba A, Kizito S, Eskenazi B, Davis JL. Household air pollution profiles associated with persistent childhood cough in urban Uganda. ENVIRONMENT INTERNATIONAL 2020; 136:105471. [PMID: 32044526 PMCID: PMC8772432 DOI: 10.1016/j.envint.2020.105471] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 01/03/2020] [Accepted: 01/06/2020] [Indexed: 06/02/2023]
Abstract
BACKGROUND Most household air pollution (HAP) interventions in developing countries of sub-Saharan Africa have focused on a single source, such as replacing polluting cooking sources with cleaner burning cooking stoves. Such interventions, however, have resulted in insufficient reductions in HAP levels and respiratory health risks in children. In this study we determined how multiple HAP combustion sources and exposure-mitigation factors in the home environment influence child respiratory health alone and in combination. METHODS We carried out a case-control study to determine associations between multiple indicators of HAP and persistent cough among children (<15 years of age) seeking care at three primary-care clinics in Kampala, Uganda. HAP indicators included self-report of combustion sources inside the home (e.g., stove type, fuel type, and smoking); housing characteristics and cooking practices that mitigate HAP exposure (e.g., use of windows, location of cooking, location of children during cooking) and perceptions of neighborhood air quality. To explore joint associations between indicators of HAP, we applied a Bayesian clustering technique (Bayesian profile regression) to identify HAP indicator profiles most strongly associated with persistent cough in children. RESULTS Most HAP indicators demonstrated significant positive bivariate associations with persistent cough among children, including fuel-type (kerosene), the number of hours burning solid fuels, use of polluting fuels (kerosene or candles) for lighting the home, tobacco smoking indoors, cooking indoors, cooking with children indoors, lack of windows in the cooking area, and not opening windows while cooking. Bayesian cluster analysis revealed 11 clusters of HAP indicator profiles. Compared to a reference cluster that was representative of the underlying study population cough prevalence, three clusters with profiles characterized by highly adverse HAP indicators resulted in ORs of 1.72 (95% credible interval: 1.15, 2.60), 4.74 (2.88, 8.0), and 8.6 (3.9, 23.9). Conversely, at least two clusters of HAP indicator-profiles were protective compared to the reference cluster, despite the fact that these protective HAP indicator profiles used solid fuels for cooking in combination with an unimproved stove (cooking was performed predominantly outdoors in these protective clusters). CONCLUSIONS In addition to cooking fuel and type of cook stove, multiple HAP indicators were strongly associated with persistent cough in children. Bayesian profile regression revealed that the combination of HAP sources and HAP exposure-mitigating factors was driving risk of adverse cough associations in children, rather than any single HAP source at the home.
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Affiliation(s)
- Eric Coker
- University of Florida, Department of Environmental and Global Health, 1225 Center Dr., Rm 4160, Gainesville, FL 32610, United States; Center for Environmental Research and Children's Health (CERCH), University of California, Berkeley, School of Public Health, 1995 University Avenue, Suite 265, Berkeley, CA 94720-7392, United States.
| | - Achilles Katamba
- Clinical Epidemiology & Biostatistics Unit, Department of Medicine, Makerere University College of Health Sciences, New Mulago Hill Rd, Kampala, Uganda.
| | - Samuel Kizito
- Clinical Epidemiology & Biostatistics Unit, Department of Medicine, Makerere University College of Health Sciences, New Mulago Hill Rd, Kampala, Uganda.
| | - Brenda Eskenazi
- Center for Environmental Research and Children's Health (CERCH), University of California, Berkeley, School of Public Health, 1995 University Avenue, Suite 265, Berkeley, CA 94720-7392, United States.
| | - J Lucian Davis
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, 60 College Street, New Haven, CT 06510, United States; Pulmonary Critical Care and Sleep Medicine Section, Department of Internal Medicine, Yale School of Medicine, 300 Cedar Street TAC - 441 South, New Haven, CT 06520-8057, United States.
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Toyinbo O, Phipatanakul W, Shaughnessy R, Haverinen-Shaughnessy U. Building and indoor environmental quality assessment of Nigerian primary schools: A pilot study. INDOOR AIR 2019; 29:510-520. [PMID: 30807666 PMCID: PMC6486416 DOI: 10.1111/ina.12547] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 01/12/2019] [Accepted: 02/25/2019] [Indexed: 06/09/2023]
Abstract
A total of 15 classrooms went through on-site assessments/inspections, including measurements of temperature (T), and concentrations of carbon monoxide (CO) and carbon dioxide (CO2 ). In addition, the level of surface biocontamination/cleaning effectiveness was assessed by measuring adenosine triphosphate (ATP) levels on students' desks. Based on the data, the quality of facilities in the buildings was low. Classroom occupancy exceeded ASHRAE 50 person/100 m2 standard in all cases indicating overcrowding. However, concentrations of CO2 remained below 1000 ppm in most classrooms. On the other hand, indoor T was above the recommended levels for thermal comfort in all classrooms. Maximum indoor CO was 6 ppm. Median ATP concentrations on the desk tops were moderately high in all schools. The use of open incinerators and power generator sets near classrooms, which was suspected to be the main source of CO, should be discouraged. Improved hygiene could be achieved by providing the students access to functioning bathroom facilities and cafeteria, and by effective cleaning of high contact surfaces such as desks. Although ventilation seems adequate based on CO2 concentrations, thermal comfort was not attained especially in the afternoon during extreme sunlight. Therefore, installing passive and/or mechanical cooling systems should be considered in this regard.
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Affiliation(s)
- Oluyemi Toyinbo
- National Institute for Health and Welfare, Kuopio FI-70701, Finland
- University of Eastern Finland, P.O. Box 1627, Kuopio 70211, Finland
| | - Wanda Phipatanakul
- Division of Allergy and Immunology, Boston Children’s Hospital, Harvard Medical School
| | | | - Ulla Haverinen-Shaughnessy
- National Institute for Health and Welfare, Kuopio FI-70701, Finland
- Indoor Air Program, the University of Tulsa, Tulsa, OK 74104, USA
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22
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Oguntunde PE, Okagbue HI, Oguntunde OA, Odetunmibi OO. A Study of Noise Pollution Measurements and Possible Effects on Public Health in Ota Metropolis, Nigeria. Open Access Maced J Med Sci 2019; 7:1391-1395. [PMID: 31110591 PMCID: PMC6514342 DOI: 10.3889/oamjms.2019.234] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 03/21/2019] [Accepted: 03/22/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND: Noise pollution has become a major environmental problem leading to nuisances and health issues. AIM: This paper aims to study and analyse the noise pollution levels in major areas in Ota metropolis. A probability model which is capable of predicting the noise pollution level is also determined. METHODS: Datasets on the noise pollution level in 41 locations across Ota metropolis were used in this research. The datasets were collected thrice per day; morning, afternoon and evening. Descriptive statistics were performed, and analysis of variance was also conducted using Minitab version 17.0 software. Easy fit software was however used to select the appropriate probability model that would best describe the dataset. RESULTS: The noise levels are way far from the WHO recommendations. Also, there is no significant difference in the effects of the noise pollution level for all the times of the day considered. The log-logistic distribution provides the best fit to the dataset based on the Kolmogorov Smirnov goodness of fit test. CONCLUSION: The fitted probability model can help in the prediction of noise pollution and act as a yardstick in the reduction of noise pollution, thereby improving the public health of the populace.
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Affiliation(s)
- Pelumi E Oguntunde
- Department of Mathematics, Covenant University, Ogun State, Ota, Nigeria
| | - Hilary I Okagbue
- Department of Mathematics, Covenant University, Ogun State, Ota, Nigeria
| | - Omoleye A Oguntunde
- Department of Business Management, Covenant University, Ogun State, Ota, Nigeria
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Kalisa E, Archer S, Nagato E, Bizuru E, Lee K, Tang N, Pointing S, Hayakawa K, Lacap-Bugler D. Chemical and Biological Components of Urban Aerosols in Africa: Current Status and Knowledge Gaps. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E941. [PMID: 30875989 PMCID: PMC6466367 DOI: 10.3390/ijerph16060941] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 03/08/2019] [Accepted: 03/09/2019] [Indexed: 12/22/2022]
Abstract
Aerosolized particulate matter (PM) is a complex mixture that has been recognized as the greatest cause of premature human mortality in low- and middle-income countries. Its toxicity arises largely from its chemical and biological components. These include polycyclic aromatic hydrocarbons (PAHs) and their nitro-derivatives (NPAHs) as well as microorganisms. In Africa, fossil fuel combustion and biomass burning in urban settings are the major sources of human exposure to PM, yet data on the role of aerosols in disease association in Africa remains scarce. This review is the first to examine studies conducted in Africa on both PAHs/NPAHs and airborne microorganisms associated with PM. These studies demonstrate that PM exposure in Africa exceeds World Health Organization (WHO) safety limits and carcinogenic PAHs/NPAHs and pathogenic microorganisms are the major components of PM aerosols. The health impacts of PAHs/NPAHs and airborne microbial loadings in PM are reviewed. This will be important for future epidemiological evaluations and may contribute to the development of effective management strategies to improve ambient air quality in the African continent.
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Affiliation(s)
- Egide Kalisa
- Institute for Applied Ecology New Zealand, School of Science, Auckland University of Technology, Auckland 1142, New Zealand.
- School of Sciences, College of Science and Technology, University of Rwanda, P.O. Box 4285, Kigali, Rwanda.
| | - Stephen Archer
- Institute for Applied Ecology New Zealand, School of Science, Auckland University of Technology, Auckland 1142, New Zealand.
| | - Edward Nagato
- Institute of Natural and Environmental Technology, Kanazawa University, Kakuma-machi, Kanazawa, Ishikawa 920-1192, Japan.
| | - Elias Bizuru
- School of Sciences, College of Science and Technology, University of Rwanda, P.O. Box 4285, Kigali, Rwanda.
| | - Kevin Lee
- Institute for Applied Ecology New Zealand, School of Science, Auckland University of Technology, Auckland 1142, New Zealand.
| | - Ning Tang
- Institute of Natural and Environmental Technology, Kanazawa University, Kakuma-machi, Kanazawa, Ishikawa 920-1192, Japan.
| | - Stephen Pointing
- Yale NUS-College and Department of Biological Sciences, National University of Singapore, Singapore 138527, Singapore.
| | - Kazuichi Hayakawa
- Institute of Natural and Environmental Technology, Kanazawa University, Kakuma-machi, Kanazawa, Ishikawa 920-1192, Japan.
| | - Donnabella Lacap-Bugler
- Institute for Applied Ecology New Zealand, School of Science, Auckland University of Technology, Auckland 1142, New Zealand.
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24
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Oliveira M, Slezakova K, Delerue-Matos C, Pereira MC, Morais S. Children environmental exposure to particulate matter and polycyclic aromatic hydrocarbons and biomonitoring in school environments: A review on indoor and outdoor exposure levels, major sources and health impacts. ENVIRONMENT INTERNATIONAL 2019; 124:180-204. [PMID: 30654326 DOI: 10.1016/j.envint.2018.12.052] [Citation(s) in RCA: 172] [Impact Index Per Article: 28.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 12/20/2018] [Accepted: 12/21/2018] [Indexed: 06/09/2023]
Abstract
Children, an important vulnerable group, spend most of their time at schools (up to 10 h per day, mostly indoors) and the respective air quality may significantly impact on children health. Thus, this work reviews the published studies on children biomonitoring and environmental exposure to particulate matter (PM) and polycyclic aromatic hydrocarbons (PAHs) at school microenvironments (indoors and outdoors), major sources and potential health risks. A total of 28, 35, and 31% of the studies reported levels that exceeded the international outdoor ambient air guidelines for PM10, PM2.5, and benzo(a)pyrene, respectively. Indoor and outdoor concentrations of PM10 at European schools, the most characterized continent, ranged between 7.5 and 229 μg/m3 and 21-166 μg/m3, respectively; levels of PM2.5 varied between 4 and 100 μg/m3 indoors and 6.1-115 μg/m3 outdoors. Despite scarce information in some geographical regions (America, Oceania and Africa), the collected data clearly show that Asian children are exposed to the highest concentrations of PM and PAHs at school environments, which were associated with increased carcinogenic risks and with the highest values of urinary total monohydroxyl PAH metabolites (PAH biomarkers of exposure). Additionally, children attending schools in polluted urban and industrial areas are exposed to higher levels of PM and PAHs with increased concentrations of urinary PAH metabolites in comparison with children from rural areas. Strong evidences demonstrated associations between environmental exposure to PM and PAHs with several health outcomes, including increased risk of asthma, pulmonary infections, skin diseases, and allergies. Nevertheless, there is a scientific gap on studies that include the characterization of PM fine fraction and the levels of PAHs in the total air (particulate and gas phases) of indoor and outdoor air of school environments and the associated risks for the health of children. There is a clear need to improve indoor air quality in schools and to establish international guidelines for exposure limits in these environments.
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Affiliation(s)
- Marta Oliveira
- REQUIMTE/LAQV, Instituto Superior de Engenharia do Instituto Politécnico do Porto, Porto, Portugal; LEPABE, Departamento de Engenharia Química, Faculdade de Engenharia, Universidade do Porto, Porto, Portugal
| | - Klara Slezakova
- REQUIMTE/LAQV, Instituto Superior de Engenharia do Instituto Politécnico do Porto, Porto, Portugal; LEPABE, Departamento de Engenharia Química, Faculdade de Engenharia, Universidade do Porto, Porto, Portugal
| | - Cristina Delerue-Matos
- REQUIMTE/LAQV, Instituto Superior de Engenharia do Instituto Politécnico do Porto, Porto, Portugal
| | - Maria Carmo Pereira
- LEPABE, Departamento de Engenharia Química, Faculdade de Engenharia, Universidade do Porto, Porto, Portugal
| | - Simone Morais
- REQUIMTE/LAQV, Instituto Superior de Engenharia do Instituto Politécnico do Porto, Porto, Portugal.
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Adaji EE, Ekezie W, Clifford M, Phalkey R. Understanding the effect of indoor air pollution on pneumonia in children under 5 in low- and middle-income countries: a systematic review of evidence. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2019; 26:3208-3225. [PMID: 30569352 PMCID: PMC6513791 DOI: 10.1007/s11356-018-3769-1] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Accepted: 11/15/2018] [Indexed: 04/12/2023]
Abstract
Exposure to indoor air pollution increases the risk of pneumonia in children, accounting for about a million deaths globally. This study investigates the individual effect of solid fuel, carbon monoxide (CO), black carbon (BC) and particulate matter (PM)2.5 on pneumonia in children under 5 in low- and middle-income countries. A systematic review was conducted to identify peer-reviewed and grey full-text documents without restrictions to study design, language or year of publication using nine databases (Embase, PubMed, EBSCO/CINAHL, Scopus, Web of Knowledge, WHO Library Database (WHOLIS), Integrated Regional Information Networks (IRIN), the World Meteorological Organization (WMO)-WHO and Intergovernmental Panel on Climate Change (IPCC). Exposure to solid fuel use showed a significant association to childhood pneumonia. Exposure to CO showed no association to childhood pneumonia. PM2.5 did not show any association when physically measured, whilst eight studies that used solid fuel as a proxy for PM2.5 all reported significant associations. This review highlights the need to standardise measurement of exposure and outcome variables when investigating the effect of air pollution on pneumonia in children under 5. Future studies should account for BC, PM1 and the interaction between indoor and outdoor pollution and its cumulative impact on childhood pneumonia.
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Affiliation(s)
- Enemona Emmanuel Adaji
- Division of Epidemiology and Public Health, University of Nottingham, Nottingham City Hospital, Clinical Sciences Building, Hucknall Road, Nottingham, NG5 1PB, UK.
| | - Winifred Ekezie
- Division of Epidemiology and Public Health, University of Nottingham, Nottingham City Hospital, Clinical Sciences Building, Hucknall Road, Nottingham, NG5 1PB, UK
| | - Michael Clifford
- Faculty of Engineering, University of Nottingham, Nottingham, UK
| | - Revati Phalkey
- Division of Epidemiology and Public Health, University of Nottingham, Nottingham City Hospital, Clinical Sciences Building, Hucknall Road, Nottingham, NG5 1PB, UK
- Climate Change and Human Health Group, Institute for Public Health, University of Heidelberg, Heidelberg, Germany
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Elevated Indoor Volatile Organic Compound Exposure in the Niger Delta Region of Nigeria. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15091939. [PMID: 30200602 PMCID: PMC6164300 DOI: 10.3390/ijerph15091939] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 08/29/2018] [Accepted: 09/04/2018] [Indexed: 11/17/2022]
Abstract
The implications of environmental contamination on human health in the Niger Delta region of Nigeria remain a topic of growing international public health interest. To better understand ongoing air pollution and initiate remediation efforts, the United Nations Environmental Programme (UNEP) report recommended the monitoring of volatile organic compounds (VOCs) across different media (water, soil, and air) in Ogoniland, an at-risk population in the Niger Delta region of Nigeria. In this pilot study, we measured indoor VOC concentrations in the indoor air of 20 households in Ogale, an Ogoniland community whose groundwater system is contaminated with benzene at levels 900 times the World Health Organization guidelines and evaluated self-reported health conditions and predicted cancer risks and hazards from inhalation exposure to VOCs. We detected higher concentrations of benzene (mean = 25.7 μg/m3, SD = 23.2 μg/m3) and naphthalene (mean = 7.6 μg/m3, SD = 13.8 μg/m3) than has been reported in other regions. Although study participants reported health symptoms consistent with VOC exposure, we were underpowered to detect a significant association between select indoor VOCs and these self-reported health symptoms using univariate logistic regression models. These findings suggest that that the health symptoms reported by participants may be poor proxies for the underlying disease processes associated with adverse health outcomes due to VOC exposure in this community and that the burden of adverse health effects due to VOC exposure may stem from the contaminated groundwater system. We estimated a non-cancer hazard quotient of 3 from exposure to naphthalene and lifetime excess cancer risks from exposure to naphthalene, benzene, p-dichlorobenzene, carbon tetrachloride, and ethylbenzene of 3 × 10−4, 2 × 10−4, 6 × 10−5, 6 × 10−6, and 1 × 10−5, respectively. These results exceed common risk benchmarks in the United States, suggesting a need for further studies to characterize VOC exposures, sources, and associated health risks in the Niger Delta.
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Coker E, Kizito S. A Narrative Review on the Human Health Effects of Ambient Air Pollution in Sub-Saharan Africa: An Urgent Need for Health Effects Studies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:427. [PMID: 29494501 PMCID: PMC5876972 DOI: 10.3390/ijerph15030427] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Revised: 02/21/2018] [Accepted: 02/27/2018] [Indexed: 11/16/2022]
Abstract
An important aspect of the new sustainable development goals (SDGs) is a greater emphasis on reducing the health impacts from ambient air pollution in developing countries. Meanwhile, the burden of human disease attributable to ambient air pollution in sub-Saharan Africa is growing, yet estimates of its impact on the region are possibly underestimated due to a lack of air quality monitoring, a paucity of air pollution epidemiological studies, and important population vulnerabilities in the region. The lack of ambient air pollution epidemiologic data in sub-Saharan Africa is also an important global health disparity. Thousands of air pollution health effects studies have been conducted in Europe and North America, rather than in urban areas that have some of the highest measured air pollution levels in world, including urban areas in sub-Saharan Africa. In this paper, we provide a systematic and narrative review of the literature on ambient air pollution epidemiological studies that have been conducted in the region to date. Our review of the literature focuses on epidemiologic studies that measure air pollutants and relate air pollution measurements with various health outcomes. We highlight the gaps in ambient air pollution epidemiological studies conducted in different sub-regions of sub-Saharan Africa and provide methodological recommendations for future environmental epidemiology studies addressing ambient air pollution in the region.
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Affiliation(s)
- Eric Coker
- School of Public Health, University of California-Berkeley, Berkeley, CA 94704, USA.
| | - Samuel Kizito
- College of Health Sciences, Makerere University, Kampala, Uganda.
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Oluwole O, Arinola GO, Huo D, Olopade CO. Household biomass fuel use, asthma symptoms severity, and asthma underdiagnosis in rural schoolchildren in Nigeria: a cross-sectional observational study. BMC Pulm Med 2017; 17:3. [PMID: 28056916 PMCID: PMC5216579 DOI: 10.1186/s12890-016-0352-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Accepted: 12/14/2016] [Indexed: 11/26/2022] Open
Abstract
Background In 2014, the International Study of Asthma and Allergies in Childhood (ISAAC) reported that the highest prevalence of symptoms of severe asthma was found in the low- and middle-income countries (LMICs), including Nigeria. While exposure to biomass fuel use may be an important risk factor in the development of asthma, its association with asthma symptoms severity has not been well-established. The aim of this study is to extend the spectrum of environmental risk factors that may be contributing towards increasing asthma morbidity, especially asthma symptoms severity in rural schoolchildren in Nigeria and to examine possible asthma underdiagnosis among this population. Methods Authors conducted a cross-sectional survey in three rural communities in Nigeria. Asthma symptoms were defined according to the ISAAC criteria. Information on the types of household fuel used for cooking was used to determine household cooking fuel status. Asthma symptoms severity was defined based on frequencies of wheeze, day- and night-time symptoms, and speech limitations. Logistic regression analyses were used to explore associations. Results A total of 1,690 Nigerian schoolchildren participated in the study. Overall, 37 (2.2%) had diagnosed asthma and 413 (24.4%) had possible asthma (asthma-related symptoms but not diagnosed asthma). Children from biomass fuel households had higher proportion of possible asthma (27.7 vs. 22.2%; p < 0.05) and symptoms of severe asthma (18.2 vs. 7.6%; p = 0.048). In adjusted analyses, biomass fuel use was associated with increased odds of severe symptoms of asthma [odds ratios (OR) = 2.37; 95% CI: 1.16–4.84], but not with possible asthma (OR = 1.22; 95% CI: 0.95–1.56). Conclusion In rural Nigerian children with asthma symptoms, the use of biomass fuel for cooking is associated with an increased risk of severe asthma symptoms. There is additional evidence that rural children might be underdiagnosed for asthma.
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Affiliation(s)
- Oluwafemi Oluwole
- Department of Community Health and Epidemiology and the Canadian Centre for Health and Safety in Agriculture, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada.,Department of Medicine and The Center for Global Health, University of Chicago, 5841 S Maryland Avenue, MC 6076, Chicago, IL, 60637, USA
| | - Ganiyu O Arinola
- College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - Dezheng Huo
- Department of Public Health Science, University of Chicago, Chicago, IL, USA
| | - Christopher O Olopade
- Department of Medicine and The Center for Global Health, University of Chicago, 5841 S Maryland Avenue, MC 6076, Chicago, IL, 60637, USA.
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Sylla FK, Faye A, Fall M, TAL-DIA A. Air Pollution Related to Traffic and Chronic Respiratory Diseases (Asthma and COPD) in Africa. Health (London) 2017. [DOI: 10.4236/health.2017.910101] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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30
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Oluwole O, Arinola GO, Huo D, Olopade CO. Biomass fuel exposure and asthma symptoms among rural school children in Nigeria. J Asthma 2016; 54:347-356. [PMID: 27589676 DOI: 10.1080/02770903.2016.1227334] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Approximately 70% of rural Nigerian households rely on biomass fuels for cooking. The International Study of Asthma and Allergies in Childhood (ISAAC) estimates the prevalence of current wheeze among children in Nigeria to have risen from 10.7% in 1999 to approximately 20% in 2014. OBJECTIVE To examine the effects of biomass smoke exposure on asthma symptom prevalence in rural children in Nigeria. METHODS We conducted a cross-sectional survey in rural communities in Nigeria. Asthma symptoms were defined according to ISAAC definitions. Biomass smoke exposure was determined by the types of fuel used for cooking. Logistic regression was used to explore associations between biomass smoke and asthma symptoms. RESULTS The study population comprised 1,690 school children, of which 865 lived in households cooking with biomass and 825 lived in households not using biomass. Asthma symptoms were reported in 481 (28.5%) children. Biomass fuel was associated with increased odds of asthma symptoms. Adjusted odds ratios (aORs) were 1.38 (95% CI: 1.05-1.80) for nocturnal cough, 1.26 (95% CI: 1.00-1.61) for current wheeze, and 1.33 (95% CI: 1.05-1.69) for report of any asthma-related symptoms. Sex modified the associations between asthma symptoms with biomass fuel: aORs were stronger and significant for males (nocturnal cough = 1.85, 95% CI: 1.24-2.76; current wheeze = 1.48, 95% CI: 1.03-2.13; report of any asthma-related symptoms = 1.60, 95% CI: 1.12-2.28), but weaker and non-significant for females. CONCLUSION The risk of asthma symptoms related to biomass smoke exposure appears to differ by sex.
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Affiliation(s)
- Oluwafemi Oluwole
- a Community Health and Epidemiology and the Canadian Centre for Health and Safety in Agriculture, College of Medicine, University of Saskatchewan , Saskatoon , SK , Canada.,d Department of Medicine and The Center for Global Health , University of Chicago , IL , USA
| | - Ganiyu O Arinola
- b College of Medicine, University of Ibadan , Ibadan , Oyo State , Nigeria
| | - Dezheng Huo
- c Department of Public Health Science , University of Chicago , Chicago , IL , USA
| | - Christopher O Olopade
- d Department of Medicine and The Center for Global Health , University of Chicago , IL , USA
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Liu W, Huang C, Hu Y, Fu Q, Zou Z, Sun C, Shen L, Wang X, Cai J, Pan J, Huang Y, Chang J, Sun Y, Sundell J. Associations of gestational and early life exposures to ambient air pollution with childhood respiratory diseases in Shanghai, China: A retrospective cohort study. ENVIRONMENT INTERNATIONAL 2016; 92-93:284-293. [PMID: 27128713 DOI: 10.1016/j.envint.2016.04.019] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Revised: 04/12/2016] [Accepted: 04/13/2016] [Indexed: 06/05/2023]
Abstract
BACKGROUND Associations of ambient air pollutants with respiratory health are inconsistent. OBJECTIVES We analyzed the associations of gestational and early life exposures to air pollutants with doctor-diagnosed asthma, allergic rhinitis, and pneumonia in children. METHODS We selected 3358 preschool children who did not alter residences after birth from a cross-sectional study in 2011-2012 in Shanghai, China. Parents reported children's respiratory health history, home environment, and family lifestyle behaviors. We collected daily concentrations of sulphur dioxide (SO2), nitrogen dioxide (NO2), and particulate matter with an aerodynamic diameter ≤10μm (PM10) during the child's total lifetime (2006-2012) for each district where the children lived. We analyzed the associations using logistic regression models. RESULTS After adjusting for covariates and the other studied pollutants, we found that exposure to NO2 (increment of 20μg/m(3)) during the first year of life was significantly associated with asthma [odds ratio (OR)=1.77; 95% confidence interval (CI): 1.29-2.43] and allergic rhinitis (OR=1.67; 95% CI: 1.07-2.61). Exposure to NO2 during gestation, the first two and three years, and over total lifetimewas all consistently associated with increased odds of allergic rhinitis. Quartiles of NO2 concentration during different exposure periods showed a slight dose-response relationship with the studied diseases. These diseases had significant associations with pollutant mixtures that included NO2, but had no significant association with exposures to SO2 and PM10 individually or in mixtures. CONCLUSIONS Gestational and early life exposures to ambient NO2 are risk factors for childhood respiratory diseases.
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Affiliation(s)
- Wei Liu
- Department of Building Environment and Energy Engineering, School of Environment and Architecture, University of Shanghai for Science and Technology (USST), Shanghai, China
| | - Chen Huang
- Department of Building Environment and Energy Engineering, School of Environment and Architecture, University of Shanghai for Science and Technology (USST), Shanghai, China.
| | - Yu Hu
- Tongji Architectural Design (Group) Company Limited (TJAD), Shanghai, China
| | - Qingyan Fu
- Shanghai Environmental Monitoring Center (SEMC), Shanghai, China
| | - Zhijun Zou
- Department of Building Environment and Energy Engineering, School of Environment and Architecture, University of Shanghai for Science and Technology (USST), Shanghai, China
| | - Chanjuan Sun
- Department of Building Environment and Energy Engineering, School of Environment and Architecture, University of Shanghai for Science and Technology (USST), Shanghai, China
| | - Li Shen
- R&B Technology (Shanghai) Company Limited, Shanghai, China
| | - Xueying Wang
- Department of Building Environment and Energy Engineering, School of Environment and Architecture, University of Shanghai for Science and Technology (USST), Shanghai, China
| | - Jiao Cai
- Department of Building Environment and Energy Engineering, School of Environment and Architecture, University of Shanghai for Science and Technology (USST), Shanghai, China
| | - Jun Pan
- Shanghai Environmental Monitoring Center (SEMC), Shanghai, China
| | - Yanmin Huang
- Shanghai Environmental Monitoring Center (SEMC), Shanghai, China
| | - Jing Chang
- Department of Building Environment and Energy Engineering, School of Environment and Architecture, University of Shanghai for Science and Technology (USST), Shanghai, China; Department of Thermal Energy and Power Engineering, Shandong Jiaotong University, Jinan, China
| | - Yuexia Sun
- School of Environmental Science and Engineering, Tianjin University, Tianjin, China
| | - Jan Sundell
- Department of Building Environment and Energy Engineering, School of Environment and Architecture, University of Shanghai for Science and Technology (USST), Shanghai, China; Department of Building Science, Tsinghua University, Beijing, China
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Deary ME, Bainbridge SJ, Kerr A, McAllister A, Shrimpton T. Practicalities of mapping PM 10 and PM 2.5 concentrations on city-wide scales using a portable particulate monitor. AIR QUALITY, ATMOSPHERE, & HEALTH 2016; 9:923-930. [PMID: 27867427 PMCID: PMC5093208 DOI: 10.1007/s11869-016-0394-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Accepted: 01/29/2016] [Indexed: 05/13/2023]
Abstract
Fine particulate matter is considered to be the most significant ambient air pollutant in terms of potential health impacts. Therefore, it is important that regulators are able to accurately assess the exposure of populations to PM10 and PM2.5 across municipal areas. We report on the practicalities of using a laser light scattering portable particulate monitor (Turnkey Instruments DustMate), in combination with a GPS, to map PM10 and PM2.5 concentrations on city-wide scales in Newcastle upon Tyne/Gateshead (UK), during a series of walking surveys. A heated inlet is necessary to remove moisture droplets from the sampled air prior to analysis by the instrument, though this also results in the loss of volatile particulate components, particularly from the PM2.5 fraction. A co-location calibration study was carried out with a reference urban background Tapered Element Oscillating Micro-Balance/Filter Dynamics Measuring System (TEOM-FDMS) system in Newcastle that is part of the UK's Automatic Urban and Rural Network (AURN) of air quality monitoring stations. For PM10, orthogonal regression of the DustMate against TEOM-FDMS data gave a slope and intercept of 1.02 ± 0.06 and -3.7 ± 1.2, respectively (R2 = 0.73), whereas for PM2.5, the respective values were 0.78 ± 0.06 and -0.63 ± 0.55 (R2 = 0.79). These parameters are comparable to literature calibration studies using this technology. There was good agreement between simultaneous samples taken using two DustMate instruments: for PM10, a slope and intercept of 1.05 ± 0.03 and 0.36 ± 0.5, respectively (R2 = 0.73), were obtained, whereas for the PM2.5, the respective values were 0.79 ± 0.01 and 0.19 ± 0.06 (R2 = 0.86). Correction factors based on the slope and intercepts obtained from the calibration exercise were applied to raw data collected from the DustMate. An annually-normalised correction procedure was then used to account for different background particulate concentrations on different sampling days. These corrected PM10 and PM2.5 concentrations and corresponding GPS coordinates were displayed on a base map using Google Fusion Tables and Google Earth Professional. Almost all areas surveyed in Newcastle/Gateshead were well below the EU Air Quality Standards for PM10 and PM2.5.
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Affiliation(s)
- Michael E. Deary
- Department of Geography, Faculty of Engineering and Environment, Northumbria University, Ellison Building, Newcastle upon Tyne, NE1 8ST UK
| | - Samantha J. Bainbridge
- Department of Geography, Faculty of Engineering and Environment, Northumbria University, Ellison Building, Newcastle upon Tyne, NE1 8ST UK
| | - Amy Kerr
- Department of Geography, Faculty of Engineering and Environment, Northumbria University, Ellison Building, Newcastle upon Tyne, NE1 8ST UK
| | - Adam McAllister
- Department of Geography, Faculty of Engineering and Environment, Northumbria University, Ellison Building, Newcastle upon Tyne, NE1 8ST UK
| | - Thomas Shrimpton
- Department of Geography, Faculty of Engineering and Environment, Northumbria University, Ellison Building, Newcastle upon Tyne, NE1 8ST UK
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Underhill LJ, Bose S, Williams DL, Romero KM, Malpartida G, Breysse PN, Klasen EM, Combe JM, Checkley W, Hansel NN. Association of Roadway Proximity with Indoor Air Pollution in a Peri-Urban Community in Lima, Peru. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:13466-81. [PMID: 26516875 PMCID: PMC4627043 DOI: 10.3390/ijerph121013466] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Revised: 09/26/2015] [Accepted: 10/09/2015] [Indexed: 12/19/2022]
Abstract
The influence of traffic-related air pollution on indoor residential exposure is not well characterized in homes with high natural ventilation in low-income countries. Additionally, domestic allergen exposure is unknown in such populations. We conducted a pilot study of 25 homes in peri-urban Lima, Peru to estimate the effects of roadway proximity and season on residential concentrations. Indoor and outdoor concentrations of particulate matter (PM2.5), nitrogen dioxide (NO2), and black carbon (BC) were measured during two seasons, and allergens were measured in bedroom dust. Allergen levels were highest for dust mite and mouse allergens, with concentrations above clinically relevant thresholds in over a quarter and half of all homes, respectively. Mean indoor and outdoor pollutant concentrations were similar (PM2.5: 20.0 vs. 16.9 μg/m3, BC: 7.6 vs. 8.1 μg/m3, NO2: 7.3 vs. 7.5 ppb), and tended to be higher in the summer compared to the winter. Road proximity was significantly correlated with overall concentrations of outdoor PM2.5 (rs = −0.42, p = 0.01) and NO2 (rs = −0.36, p = 0.03), and outdoor BC concentrations in the winter (rs = −0.51, p = 0.03). Our results suggest that outdoor-sourced pollutants significantly influence indoor air quality in peri-urban Peruvian communities, and homes closer to roadways are particularly vulnerable.
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Affiliation(s)
- Lindsay J Underhill
- Department of Environmental Health, Boston University School of Public Health, Boston, MA 02118, USA.
| | - Sonali Bose
- Division of Pulmonary and Critical Care, School of Medicine, John Hopkins University, Baltimore, MD 21224, USA.
| | - D'Ann L Williams
- Department of Environmental Health Sciences, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA.
| | | | - Gary Malpartida
- Laboratorio de Investigacion y Desarrollo, Universidad Peruana Cayetano Heredia, Lima 31, Peru.
| | - Patrick N Breysse
- Department of Environmental Health Sciences, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA.
| | - Elizabeth M Klasen
- Division of Pulmonary and Critical Care, School of Medicine, John Hopkins University, Baltimore, MD 21224, USA.
| | - Juan M Combe
- Center for Asthma Research, A.B. PRISMA, Lima 32, Peru.
| | - William Checkley
- Division of Pulmonary and Critical Care, School of Medicine, John Hopkins University, Baltimore, MD 21224, USA.
- Program in Global Disease Epidemiology and Control, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA.
| | - Nadia N Hansel
- Division of Pulmonary and Critical Care, School of Medicine, John Hopkins University, Baltimore, MD 21224, USA.
- Department of Environmental Health Sciences, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA.
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Fogarty AW. What have studies of non-industrialized countries told us about the cause of allergic disease? Clin Exp Allergy 2015; 45:87-93. [PMID: 24807225 DOI: 10.1111/cea.12339] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The increase in allergic diseases that was observed in countries that had experienced rapid economic growth since the mid-20th century initiated a search for environmental exposures that may explain these phenomena that continues to the present day. Societies that are in the earlier stages of the process of industrialization provide an opportunity to compare the initial stages of economic development and the lifestyle changes that may accompany this, with other communities whose way of life may not have changed appreciably for centuries. These studies have consistently demonstrated higher levels of allergic disease in the relatively affluent populations compared with those who maintain a more traditional lifestyle. Environmental changes that have emerged from these studies that may modify the risk of allergic disease include microbial exposures including parasite infection, pollution, diet and obesity. In addition, food and drug allergies represent a neglected area of research in these countries that may be causing a relatively high burden of disease.
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Affiliation(s)
- A W Fogarty
- Division of Epidemiology and Public Health, Clinical Science Building, Nottingham City Hospital, University of Nottingham, Nottingham, UK
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Carrico C, Gennings C, Wheeler DC, Factor-Litvak P. Characterization of Weighted Quantile Sum Regression for Highly Correlated Data in a Risk Analysis Setting. JOURNAL OF AGRICULTURAL, BIOLOGICAL, AND ENVIRONMENTAL STATISTICS 2015; 20:100-120. [PMID: 30505142 PMCID: PMC6261506 DOI: 10.1007/s13253-014-0180-3] [Citation(s) in RCA: 856] [Impact Index Per Article: 85.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
In risk evaluation, the effect of mixtures of environmental chemicals on a common adverse outcome is of interest. However, due to the high dimensionality and inherent correlations among chemicals that occur together, the traditional methods (e.g. ordinary or logistic regression) suffer from collinearity and variance inflation, and shrinkage methods have limitations in selecting among correlated components. We propose a weighted quantile sum (WQS) approach to estimating a body burden index, which identifies "bad actors" in a set of highly correlated environmental chemicals. We evaluate and characterize the accuracy of WQS regression in variable selection through extensive simulation studies through sensitivity and specificity (i.e., ability of the WQS method to select the bad actors correctly and not incorrect ones). We demonstrate the improvement in accuracy this method provides over traditional ordinary regression and shrinkage methods (lasso, adaptive lasso, and elastic net). Results from simulations demonstrate that WQS regression is accurate under some environmentally relevant conditions, but its accuracy decreases for a fixed correlation pattern as the association with a response variable diminishes. Nonzero weights (i.e., weights exceeding a selection threshold parameter) may be used to identify bad actors; however, components within a cluster of highly correlated active components tend to have lower weights, with the sum of their weights representative of the set.
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Affiliation(s)
- Caroline Carrico
- Department of Biostatistics, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | - Chris Gennings
- Department of Biostatistics, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | - David C Wheeler
- Department of Biostatistics, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | - Pam Factor-Litvak
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
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Carrico C, Gennings C, Wheeler DC, Factor-Litvak P. Characterization of Weighted Quantile Sum Regression for Highly Correlated Data in a Risk Analysis Setting. JOURNAL OF AGRICULTURAL, BIOLOGICAL, AND ENVIRONMENTAL STATISTICS 2015. [PMID: 30505142 DOI: 10.1007/sl3253-014-0180-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
In risk evaluation, the effect of mixtures of environmental chemicals on a common adverse outcome is of interest. However, due to the high dimensionality and inherent correlations among chemicals that occur together, the traditional methods (e.g. ordinary or logistic regression) suffer from collinearity and variance inflation, and shrinkage methods have limitations in selecting among correlated components. We propose a weighted quantile sum (WQS) approach to estimating a body burden index, which identifies "bad actors" in a set of highly correlated environmental chemicals. We evaluate and characterize the accuracy of WQS regression in variable selection through extensive simulation studies through sensitivity and specificity (i.e., ability of the WQS method to select the bad actors correctly and not incorrect ones). We demonstrate the improvement in accuracy this method provides over traditional ordinary regression and shrinkage methods (lasso, adaptive lasso, and elastic net). Results from simulations demonstrate that WQS regression is accurate under some environmentally relevant conditions, but its accuracy decreases for a fixed correlation pattern as the association with a response variable diminishes. Nonzero weights (i.e., weights exceeding a selection threshold parameter) may be used to identify bad actors; however, components within a cluster of highly correlated active components tend to have lower weights, with the sum of their weights representative of the set.
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Affiliation(s)
- Caroline Carrico
- Department of Biostatistics, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | - Chris Gennings
- Department of Biostatistics, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | - David C Wheeler
- Department of Biostatistics, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | - Pam Factor-Litvak
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
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Abstract
As described in a recently released report of the Forum of International Respiratory Societies, four of the leading causes of death in the world are chronic obstructive pulmonary disease, acute respiratory tract infections, lung cancer, and tuberculosis. A fifth, asthma, causes enormous global morbidity. Not enough progress has been made in introducing new therapies and reducing disease burden for these illnesses in the last few decades, despite generous investments and some notable progress in biomedical research. Four external and modifiable drivers are responsible for a substantial percentage of the disease burden represented by the major lung diseases: tobacco, outdoor air pollution, household air pollution, and occupational exposures to lung toxins. Especially in low- and middle-income countries, but in highly developed economies as well, pressures for economic development and lax regulation are contributing to the continued proliferation of these drivers. Public health approaches to the most common lung diseases could have enormous effects on reducing morbidity and mortality. There must be increased advocacy from and mobilization of civil society to bring attention to the drivers of lung diseases in the world. The World Health Organization should negotiate accords similar to the Framework Convention on Tobacco Control to address air pollution and occupational exposures. Large increases in funding by government agencies and nongovernmental organizations around the world are needed to identify technologies that will reduce health risks while allowing populations to enjoy the benefits of economic development. This paradigm, focused more on public health than on individual medical treatment, has the best chance of substantial reduction in the burden of lung disease around the world in the next several years.
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Choi JY, Baumgartner J, Harnden S, Alexander BH, Town RJ, D'Souza G, Ramachandran G. Increased risk of respiratory illness associated with kerosene fuel use among women and children in urban Bangalore, India. Occup Environ Med 2014; 72:114-22. [PMID: 25341423 DOI: 10.1136/oemed-2014-102472] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Kerosene is a widely used cooking and lighting fuel in developing countries. The potential respiratory health effects of cooking with kerosene relative to cooking with cleaner fuels such as liquefied petroleum gas (LPG) have not been well characterised. METHODS We sampled 600 households from six urban neighbourhoods in Bangalore, India. Each household's primary cook, usually the woman of the house, was interviewed to collect information on current domestic fuel use and whether there was any presence of respiratory symptoms or illness in her or in the children in the household. Our analysis was limited to 547 adult females (ages 18-85) and 845 children (ages 0-17) in households exclusively cooking with either kerosene or LPG. We investigated the associations between kerosene use and the likelihood of having respiratory symptoms or illness using multivariate logistic regression models. RESULTS Among adult women, cooking with kerosene was associated with cough (OR=1.88; 95% CI 1.19 to 2.99), bronchitis (OR=1.54; 95% CI 1.00 to 2.37), phlegm (OR=1.51; 95% CI 0.98 to 2.33) and chest illness (OR=1.61; 95% CI 1.02 to 2.53), relative to cooking with LPG in the multivariate models. Among children, living in a household cooking with kerosene was associated with bronchitis (OR=1.91; 95% CI 1.17 to 3.13), phlegm (OR=2.020; 95% CI 1.29 to 3.74) and chest illness (OR=1.70; 95% CI 0.99 to 2.90) after adjusting for other covariates. We also found associations between kerosene use and wheezing, difficulty breathing and asthma in adults and cough and wheezing in children, though these associations were not statistically significant. CONCLUSIONS Women and children in households cooking with kerosene were more likely to have respiratory symptoms and illnesses compared with those in households cooking with LPG. Transitioning from kerosene to LPG for cooking may improve respiratory health among adult women and children in this population.
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Affiliation(s)
- Jae-Young Choi
- Division of Business, Hallym University, Chuncheon, Gangwon-do, South Korea
| | - Jill Baumgartner
- Institute on the Environment, University of Minnesota, St. Paul, Minnesota, USA Department of Epidemiology, Biostatistics and Occupational Health, Institute for Health and Social Policy, McGill University, Montréal, Quebec, Canada
| | - Sarah Harnden
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Bruce H Alexander
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Robert J Town
- Department of Health Care Management, The Wharton School, University of Pennsylvania, Philadelphia, Pennsylvania, USA National Bureau of Economic Research, Cambridge, Massachusetts, USA
| | - George D'Souza
- Department of Chest Diseases, St John's Medical College Hospital, Bangalore, Karnataka, India
| | - Gurumurthy Ramachandran
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
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Shirinde J, Wichmann J, Voyi K. Association between wheeze and selected air pollution sources in an air pollution priority area in South Africa: a cross-sectional study. Environ Health 2014; 13:32. [PMID: 24885606 PMCID: PMC4018977 DOI: 10.1186/1476-069x-13-32] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Accepted: 04/28/2014] [Indexed: 05/16/2023]
Abstract
BACKGROUND An association between wheeze (a symptom of asthma) and environmental tobacco smoke (ETS), types of fuel used for residential heating or cooking and the frequency of trucks passing near homes, has been reported mainly in developed countries. Little is known about the strength of such associations in developing countries. This study was conducted in residential areas situated in Ekurhuleni Metropolitan Municipality, namely Tembisa and Kempton Park, which form part of the Highveld region, a priority area in terms of air pollution in South Africa. METHODS From 3764 eligible school children, aged between 13 and 14 years, from 16 selected high schools in the study area, 3468 completed a modified questionnaire based on the International Study of Asthma and Allergies in Childhood (ISAAC). Data were analysed using multiple logistic regression models. RESULTS The results are based on data from 3424 children. In the adjusted models, exposure to ETS at school was associated with wheeze ever (OR 1.22 95% CI: 1.03 - 1.45) and current wheeze (OR 1.33 95% CI: 1.08 - 1.64). When gas was most frequently used for residential heating the likelihood of wheeze ever increased by 47% (OR 1.47 95% CI: 1.15 - 1.88). Trucks passing near homes for almost the whole day during weekdays, increased the likelihood of wheeze ever (OR 1.32 95% CI: 1.01 - 1.73), current wheeze (OR 1.61 95% CI: 1.15 - 2.24) and current severe wheeze (OR 2.22 95% CI: 1.28 - 3.77). When data were stratified according to residential area, for children living in Tembisa, ETS exposure at home was associated with current wheeze (OR 1.36 95% CI: 1.06 - 1.77); gas most frequently used for residential heating was associated with wheeze ever (OR 1.68 95% CI: 1.23 - 2.28) and current wheeze (OR 1.61 95% CI: 1.08 - 2.39); paraffin most frequently used for residential heating was associated with current severe wheeze (OR 1.85 95% CI: 1.04 - 3.28). CONCLUSION It was concluded that children living in one of the air pollution priority areas of South Africa, have an increased risk of wheezing due to exposure to both indoor and outdoor air pollution sources.
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Affiliation(s)
- Joyce Shirinde
- Department of Environmental Health, Tshwane University of Technology, Private Bag X680, Pretoria 0001, South Africa
- School of Health Systems and Public Health, Health Sciences Faculty, University of Pretoria, P.O. Box 667, Pretoria 0001, South Africa
| | - Janine Wichmann
- School of Health Systems and Public Health, Health Sciences Faculty, University of Pretoria, P.O. Box 667, Pretoria 0001, South Africa
| | - Kuku Voyi
- School of Health Systems and Public Health, Health Sciences Faculty, University of Pretoria, P.O. Box 667, Pretoria 0001, South Africa
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Adeloye D, Chan KY, Rudan I, Campbell H. An estimate of asthma prevalence in Africa: a systematic analysis. Croat Med J 2014; 54:519-31. [PMID: 24382846 PMCID: PMC3893990 DOI: 10.3325/cmj.2013.54.519] [Citation(s) in RCA: 120] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Aim To estimate and compare asthma prevalence in Africa in 1990, 2000, and 2010 in order to provide information that will help inform the planning of the public health response to the disease. Methods We conducted a systematic search of Medline, EMBASE, and Global Health for studies on asthma published between 1990 and 2012. We included cross-sectional population based studies providing numerical estimates on the prevalence of asthma. We calculated weighted mean prevalence and applied an epidemiological model linking age with the prevalence of asthma. The UN population figures for Africa for 1990, 2000, and 2010 were used to estimate the cases of asthma, each for the respective year. Results Our search returned 790 studies. We retained 45 studies that met our selection criteria. In Africa in 1990, we estimated 34.1 million asthma cases (12.1%; 95% confidence interval [CI] 7.2-16.9) among children <15 years, 64.9 million (11.8%; 95% CI 7.9-15.8) among people aged <45 years, and 74.4 million (11.7%; 95% CI 8.2-15.3) in the total population. In 2000, we estimated 41.3 million cases (12.9%; 95% CI 8.7-17.0) among children <15 years, 82.4 million (12.5%; 95% CI 5.9-19.1) among people aged <45 years, and 94.8 million (12.0%; 95% CI 5.0-18.8) in the total population. This increased to 49.7 million (13.9%; 95% CI 9.6-18.3) among children <15 years, 102.9 million (13.8%; 95% CI 6.2-21.4) among people aged <45 years, and 119.3 million (12.8%; 95% CI 8.2-17.1) in the total population in 2010. There were no significant differences between asthma prevalence in studies which ascertained cases by written and video questionnaires. Crude prevalences of asthma were, however, consistently higher among urban than rural dwellers. Conclusion Our findings suggest an increasing prevalence of asthma in Africa over the past two decades. Due to the paucity of data, we believe that the true prevalence of asthma may still be under-estimated. There is a need for national governments in Africa to consider the implications of this increasing disease burden and to investigate the relative importance of underlying risk factors such as rising urbanization and population aging in their policy and health planning responses to this challenge.
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Affiliation(s)
- Davies Adeloye
- Davies Adeloye, WHO Collaborative Centre for Population Health Research and Training, Centre for Population Health Sciences, University of Edinburgh Medical School, Edinburgh, EH8 9AG, UK,
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Kraai S, Verhagen LM, Valladares E, Goecke J, Rasquin L, Colmenares P, Del Nogal B, Hermans PW, de Waard JH. High prevalence of asthma symptoms in Warao Amerindian children in Venezuela is significantly associated with open-fire cooking: a cross-sectional observational study. Respir Res 2013; 14:76. [PMID: 23870058 PMCID: PMC3723947 DOI: 10.1186/1465-9921-14-76] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2013] [Accepted: 07/15/2013] [Indexed: 11/16/2022] Open
Abstract
Background The International Study on Asthma and Allergies in Childhood (ISAAC) reported a prevalence of asthma symptoms in 17 centers in nine Latin American countries that was similar to prevalence rates reported in non-tropical countries. It has been proposed that the continuous exposure to infectious diseases in rural populations residing in tropical areas leads to a relatively low prevalence of asthma symptoms. As almost a quarter of Latin American people live in rural tropical areas, the encountered high prevalence of asthma symptoms is remarkable. Wood smoke exposure and environmental tobacco smoke have been identified as possible risk factors for having asthma symptoms. Methods We performed a cross-sectional observational study from June 1, 2012 to September 30, 2012 in which we interviewed parents and guardians of Warao Amerindian children from Venezuela. Asthma symptoms were defined according to the ISAAC definition as self-reported wheezing in the last 12 months. The associations between wood smoke exposure and environmental tobacco smoke and the prevalence of asthma symptoms were calculated by means of univariate and multivariable logistic regression analyses. Results We included 630 children between two and ten years of age. Asthma symptoms were recorded in 164 of these children (26%). The prevalence of asthma symptoms was associated with the cooking method. Children exposed to the smoke produced by cooking on open wood fires were at higher risk of having asthma symptoms compared to children exposed to cooking with gas (AOR 2.12, 95% CI 1.18 - 3.84). Four percent of the children lived in a household where more than ten cigarettes were smoked per day and they had a higher risk of having asthma symptoms compared to children who were not exposed to cigarette smoke (AOR 2.69, 95% CI 1.11 - 6.48). Conclusion Our findings suggest that children living in rural settings in a household where wood is used for cooking or where more than ten cigarettes are smoked daily have a higher risk of having asthma symptoms.
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Nandasena S, Wickremasinghe AR, Sathiakumar N. Indoor air pollution and respiratory health of children in the developing world. World J Clin Pediatr 2013; 2:6-15. [PMID: 25254169 PMCID: PMC4145638 DOI: 10.5409/wjcp.v2.i2.6] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2013] [Accepted: 04/17/2013] [Indexed: 02/06/2023] Open
Abstract
Indoor air pollution (IAP) is a key contributor to the global burden of disease mainly in developing countries. The use of solid fuel for cooking and heating is the main source of IAP in developing countries, accounting for an estimated 3.5 million deaths and 4.5% of Disability-Adjusted Life Years in 2010. Other sources of IAP include indoor smoking, infiltration of pollutants from outdoor sources and substances emitted from an array of human utilities and biological materials. Children are among the most vulnerable groups for adverse effects of IAP. The respiratory system is a primary target of air pollutants resulting in a wide range of acute and chronic effects. The spectrum of respiratory adverse effects ranges from mild subclinical changes and mild symptoms to life threatening conditions and even death. However, IAP is a modifiable risk factor having potential mitigating interventions. Possible interventions range from simple behavior change to structural changes and from shifting of unclean cooking fuel to clean cooking fuel. Shifting from use of solid fuel to clean fuel invariably reduces household air pollution in developing countries, but such a change is challenging. This review aims to summarize the available information on IAP exposure during childhood and its effects on respiratory health in developing countries. It specifically discusses the common sources of IAP, susceptibility of children to air pollution, mechanisms of action, common respiratory conditions, preventive and mitigating strategies.
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Nandasena S, Wickremasinghe AR, Sathiakumar N. Respiratory health status of children from two different air pollution exposure settings of Sri Lanka: a cross-sectional study. Am J Ind Med 2012; 55:1137-45. [PMID: 22298308 PMCID: PMC3432736 DOI: 10.1002/ajim.22020] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/12/2012] [Indexed: 12/30/2022]
Abstract
BACKGROUND Health effects due to air pollution is becoming a major public health problem with growing traffic congestion and establishment of small- to medium-scale industries with poor emission controls in urban cities of Sri Lanka. METHODS Respiratory health status of 7- to 10-year-old children in two settings (urban and semi-urban) was assessed using standard questionnaires. Information on socio-demographic characteristics and potential determinants of both outdoor and indoor air pollutants exposure levels were also obtained. The respiratory health status of children in the two settings was compared. RESULTS We found that children from the urban setting had a significantly higher prevalence of wheezing within the last 12 months as compared to children from the semi-urban setting (adjusted OR = 2.02; 95% CI = 1.13-3.59). Indoor cooking with unclean fuels was a risk factor for wheezing independent of the area of residence (adjusted OR = 1.57; 95% CI = 1.01-2.46). CONCLUSIONS Poor indoor air quality was a major determinant of wheezing for the overall study group. Children from urban areas of Sri Lanka have poorer respiratory health status as compared to children from semi-urban areas. Besides poor outdoor air quality, this difference may also be due to other unexplored factors which may differ between urban and semi-urban areas in Sri Lanka.
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Affiliation(s)
- Sumal Nandasena
- Evaluation and Research Unit, National Institute of Health Sciences, Ministry of Health, Sri Lanka
| | | | - Nalini Sathiakumar
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham
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Lindén J, Boman J, Holmer B, Thorsson S, Eliasson I. Intra-urban air pollution in a rapidly growing Sahelian city. ENVIRONMENT INTERNATIONAL 2012; 40:51-62. [PMID: 22280928 DOI: 10.1016/j.envint.2011.11.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2011] [Revised: 11/11/2011] [Accepted: 11/13/2011] [Indexed: 05/31/2023]
Abstract
In this paper we analyze spatial and temporal variations of air pollution (PM(1), PM(2.5), PM(10), CO, NO(x), O(3), Toluene and Benzene) and climate in areas of different development typology in Ouagadougou, Burkina Faso. Analyses are based on measurements from fixed sites and car traverse measurements during field studies in 2007 and 2010. Large spatial and temporal variations were found, showing a generally poor air quality situation, with extreme levels of PM(10), commonly exceeding air quality guidelines of WHO. Pollution levels increase considerably with increased atmospheric stability. Important sources were transported dust and re-suspension of dust from unpaved roads, but also traffic emissions and biomass burning. The spatial variations are examined with focus on effects for variations in potential exposure depending on for example area of residence and daily activity pattern, showing that great differences are likely to exist. Ouagadougou, like most developing countries worldwide, currently experiences an extremely rapid population growth in combination with limited financial means. This is likely to create increasingly harmful air pollution situations for the rapidly growing populations of these areas, and shows an urgent need for increased understanding of the pollution situation as well as development of mitigation strategies.
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Affiliation(s)
- J Lindén
- Department of Earth Science, Urban Climate Group, University of Gothenburg, Box 460, SE-405 30, Gothenburg, Sweden.
| | - J Boman
- Department of Chemistry, Atmospheric Science, University of Gothenburg, SE-412 96, Gothenburg, Sweden
| | - B Holmer
- Department of Earth Science, Urban Climate Group, University of Gothenburg, Box 460, SE-405 30, Gothenburg, Sweden
| | - S Thorsson
- Department of Earth Science, Urban Climate Group, University of Gothenburg, Box 460, SE-405 30, Gothenburg, Sweden
| | - I Eliasson
- Department of Conservation, Box 130, University of Gothenburg, SE-405 30, Gothenburg, Sweden
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Lam NL, Smith KR, Gauthier A, Bates MN. Kerosene: a review of household uses and their hazards in low- and middle-income countries. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART B, CRITICAL REVIEWS 2012; 15:396-432. [PMID: 22934567 PMCID: PMC3664014 DOI: 10.1080/10937404.2012.710134] [Citation(s) in RCA: 141] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Kerosene has been an important household fuel since the mid-19th century. In developed countries its use has greatly declined because of electrification. However, in developing countries, kerosene use for cooking and lighting remains widespread. This review focuses on household kerosene uses, mainly in developing countries, their associated emissions, and their hazards. Kerosene is often advocated as a cleaner alternative to solid fuels, biomass and coal, for cooking, and kerosene lamps are frequently used when electricity is unavailable. Globally, an estimated 500 million households still use fuels, particularly kerosene, for lighting. However, there are few studies, study designs and quality are varied, and results are inconsistent. Well-documented kerosene hazards are poisonings, fires, and explosions. Less investigated are exposures to and risks from kerosene's combustion products. Some kerosene-using devices emit substantial amounts of fine particulates, carbon monoxide (CO), nitric oxides (NO(x)), and sulfur dioxide (SO(2)). Studies of kerosene used for cooking or lighting provide some evidence that emissions may impair lung function and increase infectious illness (including tuberculosis), asthma, and cancer risks. However, there are few study designs, quality is varied, and results are inconsistent. Considering the widespread use in the developing world of kerosene, the scarcity of adequate epidemiologic investigations, the potential for harm, and the implications for national energy policies, researchers are strongly encouraged to consider collecting data on household kerosene uses in studies of health in developing countries. Given the potential risks of kerosene, policymakers may consider alternatives to kerosene subsidies, such as shifting support to cleaner technologies for lighting and cooking.
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Affiliation(s)
- Nicholas L Lam
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, California 94720-7367, USA
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