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Air Pollution and Health Outcomes in the Eastern Mediterranean Region: Knowledge and Research Gaps and Need

  • Yousef Saleh KhaderEmail author
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Abstract

Although air pollution is recognized as an emerging public health problem in the EMR countries, it is difficult to construct evidence on the effect of air pollution on health in the EMR countries for several reasons, in part because the impact of air pollution on health is not recognized as a priority area by health researchers, health professionals, and policy makers in the EMR countries. Although the burden of diseases from air pollution is expected to be high in the EMR, a limited number of studies in a few areas of the EMR countries have assessed the association between various air pollution exposures and health outcomes. For the majority of reviewed studies, limitations do exist – even in well-conducted ones. The limitations and shortcomings arise from inappropriate study designs, poor assessment of exposure and outcomes, questionable sources of data, lack of standardized methods, poor adjustment of confounders, limited geographical area studies, small sample sizes, poor statistical modeling, and not testing for possible interactions between exposures.

Tobacco smoking increases the risk of some types of cancers. Nitrogen dioxide increases the risk of lung and breast cancer incidence. Outdoor and indoor pollution, using fuel for heating, and living near an electric generator are associated with an increased risk of lung cancer. Air pollution is associated with cardiovascular morbidity, especially in high-risk groups. Moreover, exposure to poor ambient air quality and particulate matter increases blood pressure in schoolchildren. The few studies in the EMR that have examined the effect of air pollution on pregnancy outcomes show that prenatal secondhand smoke, carbon monoxide, and exposure to wood fuel smoke have harmful effects on the weight of newborn babies and increase the risk of spontaneous abortion. Other ambient air pollutants have no significant association with the mean birth weight and do not affect preterm birth.

In conclusion, it is difficult to gauge the evidence on the effects of air pollution on health in the EMR countries based on the limited number of published material and the poor qualities of many of the studies. Policy makers should use the best available evidence to make recommendations. Standardized reliable assessments on national levels for various air pollutants in different countries should be implemented and made publicly available for research purposes. Advancing and utilizing epidemiological designs is of key importance. Best epidemiological designs should be used to yield information on rare chronic health outcomes. In addition, well-designed case-control studies should be used to study the health effects of airborne toxins and pollutants. Accurate exposure levels, detailed outcome assessments, and incorporating appropriate confounders should be considered in future studies, which should also consider exposures to pollutants that are emitted together, or as individual pollutants, to better understand the mechanisms of the health outcomes of environmental pollutants.

Keywords

Air pollution Health outcomes Research gaps Epidemiology 

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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Department of Community Medicine, Public Health and Family Medicine, Faculty of MedicineJordan University of Science & TechnologyIrbidJordan

Section editors and affiliations

  • Yousef Khader
    • 1
    • 2
  1. 1.Department of Community Medicine, Public Health and Family Medicine, Faculty of MedicineJordan University of Science and TechnologyIrbidJordan
  2. 2.Global Health Development (GHD)/The Eastern Mediterranean Public Health Network (EMPHNET)AmmanJordan

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