Erratum: Hussein et al. Indoor Particle Concentrations, Size Distributions, and Exposures in Middle Eastern Microenvironments. Atmosphere 2020, 11, 41

The authors would like to correct the published article [...

Indoor Particle Concentrations, Size Distributions, and Exposures in Middle Eastern Microenvironments

There is limited research on indoor air quality in the Middle East. In this study, concentrations and size distributions of indoor particles were measured in eight Jordanian dwellings during the winter and summer. Supplemental measurements of selected gaseous pollutants were also conducted. Indoor cooking, heating via the combustion of natural gas and kerosene, and tobacco/shisha smoking were associated with significant increases in the concentrations of ultrafine, fine, and coarse particles. Particle number (PN) and particle mass (PM) size distributions varied with the different indoor emission sources and among the eight dwellings. Natural gas cooking and natural gas or kerosene heaters were associated with PN concentrations on the order of 100,000 to 400,000 cm−3 and PM2.5 concentrations often in the range of 10 to 150 µg/m3. Tobacco and shisha (waterpipe or hookah) smoking, the latter of which is common in Jordan, were found to be strong emitters of indoor ultrafine and fine particles in the dwellings. Non-combustion cooking activities emitted comparably less PN and PM2.5. Indoor cooking and combustion processes were also found to increase concentrations of carbon monoxide, nitrogen dioxide, and volatile organic compounds. In general, concentrations of indoor particles were lower during the summer compared to the winter. In the absence of indoor activities, indoor PN and PM2.5 concentrations were generally below 10,000 cm−3 and 30 µg/m3, respectively. Collectively, the results suggest that Jordanian indoor environments can be heavily polluted when compared to the surrounding outdoor atmosphere primarily due to the ubiquity of indoor combustion associated with cooking, heating, and smoking

Systematic Literature Review

Abstract This study was conducted to assess the risk of cancer associated with air pollution in Eastern Mediterranean Region (EMR) by summarizing the existing knowledge from previous studies in the region and to identify knowledge and research gaps to support further research efforts. Combinations of search terms from three categories ("country" keywords AND 'air pollution" keywords AND "cancer" keywords) were used to search for the relevant literature published between January 2000 and June 2016 using MEDLINE and other databases. Six case-control studies and three studies of other designs had assessed the association between air pollution and cancer in the EMR and met the inclusion criteria. These studies have assessed the effect of various indoor and outdoor air pollutants on the risk of different types of cancer. In this review, cancers were classified into: lung cancer; nasopharyngeal cancer; urinary bladder cancer; overall incidence of cancer in adults; and childhood cancer incidence. Limited epidemiological studies were found in the literature that properly address cancer incidence and air pollution in the EMR countries. Outdoor air pollution was not properly addressed in the included studies. Studies showed that using fuel for heating and living near an electricity generator and diesel exhaust exposure were significant contributors to lung cancer. NO 2 has been shown to increase the risk of lung and breast cancer incidence. PAHs exposure did not increase the risk of cancer incidence. In conclusion, studies on the link between air pollution and cancer in EMR are limited to few studies in few countries. The reviewed studies have many limitations that make the evidence about the link between air pollution and cancer weak

Exposure to Air Pollution and Pregnancy Outcomes in the East Mediterranean Region: a Systematic Review

The East Mediterranean region suffers from high levels of air pollution which has a negative impact on pregnancy outcomes. This work systematically reviews the epidemiological evidence on maternal exposure to air pollution and adverse pregnancy outcomes in the region. Relevant papers and reports published between 2000 and 2014 were searched. Combinations of search terms including countries, exposures, and pregnancy outcomes were used to search for the relevant literature. Twelve articles from 6 countries met the inclusion criteria. There was a pattern of an association between outdoor air pollution and preterm birth and spontaneous abortion; indoor wood fuel smoke and birth weight; and second-hand smoke and birth weight, preterm birth, and spontaneous abortion.The quality of evidence on the impact of air pollution on pregnancy outcomes in the EMR is inadequate to form a base for future adaptation strategies and action plans. Therefore, more quality research is needed to portrait the actual situation in the regio

Long-term trends and health impact of PM_2.5 and O₃ in Tehran, Iran, 2006-2015

The main objectives of this study were (1) investigation of the temporal variations of ambient fine particulate matter (PM; 2.5; ) and ground level ozone (O; 3; ) concentrations in Tehran megacity, the capital and most populous city in Iran, over a 10-year period from 2006 to 2015, and (2) estimation of their long-term health effects including all-cause and cause-specific mortality. For the first goal, the data of PM; 2.5; and O; 3; concentrations, measured at 21 regulatory monitoring network stations in Tehran, were obtained and the temporal trends were investigated. The health impact assessment of PM; 2.5; and O; 3; was performed using the World Health Organization (WHO) AirQ+ software updated in 2016 by WHO European Centre for Environment and Health. Local baseline incidences in Tehran level were used to better reveal the health effects associated with PM; 2.5; and O; 3; . Our study showed that over 2006-2015, annual mean concentrations of PM; 2.5; and O; 3; varied from 24.7 to 38.8 μg m; -3; and 35.4 to 76.0 μg m; -3; , respectively, and were significantly declining in the recent 6 years (2010-2015) for PM; 2.5; and 8 years (2008-2015) for O; 3; . However, Tehran citizens were exposed to concentrations of annual PM; 2.5; exceeding the WHO air quality guideline (WHO AQG) (10 μg m; -3; ), U.S. EPA and Iranian standard levels (12 μg m; -3; ) during entire study period. We estimated that long-term exposure to ambient PM; 2.5; contributed to between 24.5% and 36.2% of mortality from cerebrovascular disease (stroke), 19.8% and 24.1% from ischemic heart disease (IHD), 13.6% and 19.2% from lung cancer (LC), 10.7% and 15.3% from chronic obstructive pulmonary disease (COPD), 15.0% and 25.2% from acute lower respiratory infection (ALRI), and 7.6% and 11.3% from all-cause annual mortality in the time period. We further estimated that deaths from IHD accounted for most of mortality attributable to long-term exposure to PM; 2.5; . The years of life lost (YLL) attributable to PM; 2.5; was estimated to vary from 67,970 to 106,706 during the study period. In addition, long-term exposure to O; 3; was estimated to be responsible for 0.9% to 2.3% of mortality from respiratory diseases. Overall, long-term exposure to ambient PM; 2.5; and O; 3; contributed substantially to mortality in Tehran megacity. Air pollution is a modifiable risk factor. Appropriate sustainable control policies are recommended to protect public health

Assessing capabilities of conducted ambient air pollution health effects studies in 22 Eastern Mediterranean countries to adopt air quality standards: a review

Purpose: The Eastern Mediterranean Region (EMR) countries suffer from exposure to high levels of ambient air pollutants due to dust storms and have unique climatic as well as topographic and socio-economic conditions which lead to adverse health effects on humans. The purpose of the review was to evaluate the quantity and quality of published articles on air pollution and health-based studies in 22 EMR countries to determine if they can be applied to adopting air quality standards. Methods: We designed a review based on a broad search of the literature in the Scopus, PubMed, and web of science (WOS) databases published from January 1, 2000, to January 2, 2022, using combinations of the following relevant terms: air pollution, health, and EMR countries. The generic eligibility criteria for this review were based on the population, exposure, comparator, outcome, and study design (PECOS) statement. Results: The search results showed that following the PRISMA approach, of 2947 identified articles, 353 studies were included in this review. The analysis of the types of studies showed that about 70% of the studies conducted in EMR countries were Health Burden Estimation studies (31%), Ecological and time trend ecological studies (23%), and cross-sectional studies (16%). Also, researchers from Iran participated in the most published relevant studies in the region 255 (~ 63%) and just 10 published documents met all the PECOS criteria. Conclusion: The lack of sufficient studies which can meet the PECOS appraising criteria and the lack of professionals in this field are some of the issues that make it impossible to use as potential documents in the WHO future studies and adopt air quality standards.</p

Source apportionment, identification and characterization, and emission inventory of ambient particulate matter in 22 Eastern Mediterranean Region countries: A systematic review and recommendations for good practice

Little is known about the main sources of ambient particulate matter (PM) in the 22 Eastern Mediterranean Region (EMR) countries. We designed this study to systematically review all published and unpublished source apportionment (SA), identification and characterization studies as well as emission inventories in the EMR. Of 440 articles identified, 82 (11 emission inventory ones) met our inclusion criteria for final analyses. Of 22 EMR countries, Iran with 30 articles had the highest number of studies on source specific PM followed by Pakistan (n = 15 articles) and Saudi Arabia (n = 8 papers). By contrast, there were no studies in Afghanistan, Bahrain, Djibouti, Libya, Somalia, Sudan, Syria, Tunisia, United Arab Emirates and Yemen. Approximately 72% of studies (51) were published within a span of 2015–2021.48 studies identified the sources of PM2.5 and its constituents. Positive matrix factorization (PMF), principal component analysis (PCA) and chemical mass balance (CMB) were the most common approaches to identify the source contributions of ambient PM. Both secondary aerosols and dust, with 12–51% and 8–80% (33% and 30% for all EMR countries, on average) had the greatest contributions in ambient PM2.5. The remaining sources for ambient PM2.5, including mixed sources (traffic, industry and residential (TIR)), traffic, industries, biomass burning, and sea salt were in the range of approximately 4–69%, 4–49%, 1–53%, 7–25% and 3–29%, respectively. For PM10, the most dominant source was dust with 7–95% (49% for all EMR countries, on average). The limited number of SA studies in the EMR countries (one study per approximately 9.6 million people) in comparison to Europe and North America (1 study per 4.3 and 2.1 million people respectively) can be augmented by future studies that will provide a better understanding of emission sources in the urban environment.</p