Extreme heat and work injuries in Kuwait's hot summers.

BACKGROUND: Hot, desert Gulf countries are host to millions of migrant workers doing outdoor jobs such as construction and hospitality. The Gulf countries apply a summertime ban on midday work to protect workers from extreme heat, although without clear evidence of effectiveness. We assessed the risk of occupational injuries associated with extreme hot temperatures during the summertime ban on midday work in Kuwait. METHODS: We collected daily occupational injuries in the summer months that are reported to the Ministry of Health's Occupational Health Department for 5 years from 2015 to 2019. We fitted generalised additive models with a quasi-Poisson distribution in a time series design. A 7-day moving average of daily temperature was modelled with penalised splines adjusted for relative humidity, time trend and day of the week. RESULTS: During the summertime ban, the daily average temperature was 39.4°C (±1.8°C). There were 7.2, 7.6 and 9.4 reported injuries per day in the summer months of June, July and August, respectively. Compared with the 10th percentile of summer temperatures in Kuwait (37.0°C), the average day with a temperature of 39.4°C increased the relative risk of injury to 1.44 (95% CI 1.34 to 1.53). Similarly, temperatures of 40°C and 41°C were associated with relative risks of 1.48 (95% CI 1.39 to 1.59) and 1.44 (95% CI 1.27 to 1.63), respectively. At the 90th percentile (42°C), the risks levelled off (relative risk 1.21; 95% CI 0.93 to 1.57). CONCLUSION: We found substantial increases in the risk of occupational injury from extremely hot temperatures despite the ban on midday work policy in Kuwait. 'Calendar-based' regulations may be inadequate to provide occupational heat protections, especially for migrant workers.

Acute exposure to total and source-specific ambient fine particulate matter and risk of respiratory disease hospitalization in Kuwait.

Many epidemiologic studies concerned with acute exposure to ambient PM2.5 have reported positive associations for respiratory disease hospitalization. However, few studies have investigated this relationship in Kuwait and extrapolating results from other regions may involve considerable uncertainty due to variations in concentration levels, particle sources and composition, and population characteristics. Local studies can provide evidence for strategies to reduce risks from episodic exposures to high levels of ambient PM2.5 and generating hypotheses for evaluating health risks from chronic exposures. Therefore, using speciated PM2.5 data from local samplers, we analyzed the impact of daily total and source-specific PM2.5 exposure on respiratory hospitalizations in Kuwait using a case-crossover design with conditional quasi-Poisson regression. Total and source-specific ambient PM2.5 were modeled using 0-5-day cumulative distributed lags. For total PM2.5, we observed a 0.16% (95% confidence interval [CI] = 0.05, 0.27%) increase in risk for respiratory hospitalization per 1 µg/m3 increase in concentration. Of the source factors assessed, dust demonstrated a statistically significant increase in risk (0.16%, 95% CI = 0.04, 0.29%), and the central estimate for regional PM2.5 was positive (0.11%) but not statistically significant (95% CI = -0.11, 0.33%). No effect was observed from traffic emissions and 'other' source factors. When hospitalizations were stratified by sex, nationality, and age, we found that female, Kuwaiti national, and adult groups had higher effect estimates. These results suggest that exposure to ambient PM2.5 is harmful in Kuwait and provide some evidence of differential toxicity and effect modification depending on the PM2.5 source and population affected.

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

It is well established that respiratory and cardiovascular mortality and morbidity rates are associated with poor air quality as measured by high concentrations of fine particulate matter such as PM2.5 parameters. Since such information is lacking for the State of Kuwait, this study examined the exposure levels of PM2.5 and the associated health risk as evaluated by five mortality measures embodied in ischemic heart disease, stroke, lung cancer, chronic obstructive pulmonary disease and acute lower respiratory infection as well as two morbidity outcomes related to both cardiovascular and respiratory diseases. The measurement models utilized in this investigation followed the WHO guidelines. Over a span of a four-year period (2014-2017), the annual PM2.5 concentration levels ranged from 38.0 µg/m3 to 75.2 µg/m3. In general, exposure levels tended to fluctuate throughout the day with the higher levels recorded during rush hours (early morning and early evening), weekends (particularly Saturdays), and summer (i.e., August and September). The highest number of excess cases and attributable proportions of premature mortalities were related to ischemic heart disease and stroke at 352 (95% CI 275-426) and 70.8% (95% CI 39.7-85.2), respectively. In general, respiratory diseases showed a higher number of excess cases and attributable proportions than cardiovascular diseases. Relative to other findings on the global stage, the results emanating from Kuwait are emerging on the higher side. The study outcomes suggest that control strategies are in dire need to bend the pollution levels in Kuwait.

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

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

Assessing the role of drought in dust storm formation in the Tigris and Euphrates basin.

Drought is a common meteorological phenomenon and one of the world's most costly natural hazards. A large part of the Tigris and Euphrates basin (TEB) is located in the arid and semi-arid regions of western Asia and suffers from drought. Drought has many destructive effects on the environment and human societies, among which the formation of dust storms, is a major global challenge. This study aims to figure out the role of different types of drought on dust storm formation in the TEB. Standardized precipitation index (SPI), Tasseled Cap greenness index, and surface water area changes based on time series of satellite remote sensing data were considered as proxies to investigate meteorological, agricultural, and hydrological droughts, respectively. Our results show that the continuation of the 5-month and 27-month meteorological droughts are followed by agricultural and hydrological droughts, respectively. In recent decades, the TEB has experienced two prominent drought periods in 2008-2012 and 2021-2022, resulting in a 214 % and 200 % increase in dust events, respectively, compared to the 23-year (2000-2022) average. Overall, 84 %, 10 %, and 6 % of the TEB dust events can be attributed to meteorological, agricultural, and hydrological droughts, respectively.

Burden of fine air pollution on mortality in the desert climate of Kuwait.

BACKGROUND: Middle Eastern desert countries like Kuwait are known for intense dust storms and enormous petrochemical industries affecting ambient air pollution. However, local health authorities have not been able to assess the health impacts of air pollution due to limited monitoring networks and a lack of historical exposure data. OBJECTIVE: To assess the burden of PM2.5 on mortality in the understudied dusty environment of Kuwait. METHODS: We analyzed the acute impact of fine particulate matter (PM2.5) on daily mortality in Kuwait between 2001 and 2016. To do so, we used spatiotemporally resolved estimates of PM2.5 in the region. Our analysis explored factors such as cause of death, sex, age, and nationality. We fitted quasi-Poisson time-series regression for lagged PM2.5 adjusted for time trend, seasonality, day of the week, temperature, and relative humidity. RESULTS: There was a total of 70,321 deaths during the study period of 16 years. The average urban PM2.5 was estimated to be 46.2 ± 19.8 µg/m3. A 10 µg/m3 increase in a 3-day moving average of urban PM2.5 was associated with 1.19% (95% CI: 0.59, 1.80%) increase in all-cause mortality. For a 10 µg/m3 reduction in annual PM2.5 concentrations, a total of 52.3 (95% CI: 25.7, 79.1) deaths each year could be averted in Kuwait. That is, 28.6 (95% CI: 10.3, 47.0) Kuwaitis, 23.9 (95% CI: 6.4, 41.5) non-Kuwaitis, 9.4 (95% CI: 1.2, 17.8) children, and 20.9 (95% CI: 4.3, 37.6) elderly deaths each year. IMPACT STATEMENT: The overwhelming prevalence of devastating dust storms and enormous petrochemical industries in the Gulf and the Middle East has intensified the urgency to address air pollution and its detrimental health effects. Alarmingly, the region's epidemiological research lags behind, hindered by a paucity of ground monitoring networks and historical exposure data. In response, we are harnessing the power of big data to generate predictive models of air pollution across time and space, providing crucial insights into the mortality burden associated with air pollution in this under-researched yet critically impacted area.

Air Pollution and Respiratory Hospital Admissions in Kuwait: The Epidemiological Applicability of Predicted PM2.5 in Arid Regions.

Dust is a major component of fine particulate matter (PM2.5) in arid regions; therefore, concentrations of this pollutant in countries such as Kuwait exceed air quality standards. There is limited understanding on the impact and burden of high PM2.5 concentrations on morbidity in these countries. In this study, we explore the association of PM2.5 and the risk of respiratory hospital admissions in Kuwait. A time-series regression model was used to investigate daily variations in respiratory admissions and PM2.5 concentrations from 2010 to 2018. Due to the lack of historical air quality sampling in Kuwait, we used estimated daily PM2.5 levels from a hybrid PM2.5 prediction model. Individual and cumulative lag effects of PM2.5 over a 5-day period were estimated using distributed lag linear models. Associations were stratified by sex, age, and nationality. There were 218,749 total respiratory admissions in Kuwait during the study period. Results indicate that for every 10 µg/m3 increase in PM2.5, a 1.61% (95% CI = 0.87, 2.35%) increase in respiratory admissions followed over a 5-day cumulative lag. Our estimates show that a 10 µg/m3 reduction in average exposure will potentially avert 391 yearly respiratory admissions (95% CI = 211,571), with 265 fewer admissions among Kuwaitis (95% CI = 139,393) and 262 fewer admissions among children under 15 years of age (95% CI = 125,351). Different strata of the Kuwaiti population are vulnerable to respiratory hospitalization with short-term exposure to PM2.5, especially those under 15 years of age. The findings are informative for public health authorities in Kuwait and other dust-prone countries.

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

BACKGROUND: The absence of air pollution monitoring networks makes it difficult to assess historical fine particulate matter (PM2.5) exposures for countries in the areas, such as Kuwait, which are severe impacted by desert dust and anthropogenic pollution. OBJECTIVE: We constructed an ensemble machine learning model to predict daily PM2.5 concentrations for regions lack of PM2.5 observations. METHODS: The model was constructed based on daily PM2.5, visibility, and other meteorological data collected at two sites in Kuwait. Then, our model was applied to predict the daily level of PM2.5 concentrations for eight airports located in Kuwait and Iraq from 2013 to 2020. RESULTS: As compared to traditional statistic models, the proposed machine learning methods improved the accuracy in using visibility to predict daily PM2.5 concentrations with a cross-validation R2 of 0.68. The predicted level of daily PM2.5 concentrations were consistent with previous measurements. The predicted average yearly PM2.5 concentration for the eight stations is 50.65 µg/m3. For all stations, the monthly average PM2.5 concentrations reached their maximum in July and their minimum in November. SIGNIFICANCE: These findings make it possible to retrospectively estimate daily PM2.5 exposures using the large-scale databases of historical visibility in regions with few particulate matter monitoring stations. IMPACT STATEMENT: The scarcity of air pollution ground monitoring networks makes it difficult to assess historical fine particulate matter exposures for countries in arid areas such as Kuwait. Visibility is closely related to atmospheric particulate matter concentrations and historical airport visibility records are commonly available in most countries. Our model make it possible to retrospectively estimate daily PM2.5 exposures using the large-scale databases of historical visibility in arid regions with few particulate matter ground monitoring stations. The product of such models can be critical for environmental risk assessments and population health studies.

Carbon Monoxide Poisoning in Kuwait: A Five-Year, Retrospective, Epidemiological Study.

BACKGROUND: Carbon monoxide (CO) poisoning is a major public health concern and a common cause of death worldwide. However, to our knowledge, no studies have been conducted on CO poisoning exposure and mortality in Kuwait. OBJECTIVES: Using epidemiological and forensic data analysis, we investigated the prevalence and characteristics of CO poisoning-associated deaths in Kuwait over five years (2014-2018), using official police data. METHODS: The Forensic Toxicology Laboratory analyzed 203 blood specimens of deceased individuals for potential CO poisoning during the study period. We obtained demographic information of the deceased and other information regarding the source of the CO, the type of death and the seasonal and geographical distribution of fatalities. The percentage of carboxyhemoglobin (COHb%) was assessed using a CO-oximeter. RESULTS: CO poisoning was confirmed in ~29% (59 cases) of the analyzed specimens, of which CO poisoning was accidental in the majority of cases (~95%) and homicidal in the remaining of cases (~5%), with no reported suicides. The five-year cumulative mean of COHb% in the blood specimens of the 59 confirmed cases was ~63%. Most of the deceased were males (~68%). The mean age of male and female victims per year were similar (~23-38 years). Fatalities were more common (~44%) during the winter (December-February). Uncontrolled home fires and coal stoves contributed to the primary sources of CO poisoning at 61% and 22%, respectively. RECOMMENDATIONS: Based on our findings, we propose that the local government should mandate the installation of smoke alarms and CO detectors in residential settings and endorse health education, informing the local population about the causes of fire and potential for CO poisoning, with an emphasis on prevention. Practical measures that can be applied include proper installation and regular maintenance of home-heating appliances and appropriate ventilation. The present study could greatly benefit the government in directing efforts toward decreasing CO poisoning incidents in Kuwait in the future.

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

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

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

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

Analytical and Early Detection System of Infectious Diseases and Animal Health Status in Kuwait.

This study aimed at the development of an analytic web-based system for the assessment of animal health in Kuwait. The data sources were based on the World Organization for Animal Health (OIE) and the World Animal Health Information System (WAHIS) repository with data gathered for the period (2005-2020). An on-line web-based system using TABLEAU Creator was developed for monitoring and surveillance of animal disease outbreaks. Five animal diseases were identified in Kuwait; namely, HPAI, FMD, glanders, LSD and MERS-CoV. The highest numbers of outbreaks were recorded for HPAI, followed by FMD. Examples of spatio-temporal visualizations of the web based mappings are presented and include disease cases, number of outbreaks and farm locations, among other features. The web-based system can serve as a monitoring tool to easily display the status of animal health in Kuwait. It can also serve to quickly identify and track disease outbreaks and monitor the spread patterns of new or emerging animal diseases between neighboring countries.

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

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

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

BACKGROUND: Kuwait and the Gulf region have a desert, hyper-arid and hot climate that makes outdoor air sampling challenging. The region is also affected by intense dust storms. Monitoring challenges from the harsh climate have limited data needed to inform appropriate regulatory actions to address air pollution in the region. OBJECTIVES: To compare gravimetric measurements with existing networks that rely on beta-attenuation measurements in a desert climate; determine the annual levels of PM2.5 and PM10 over a two-year period in Kuwait; assess compliance with air quality standards; and identify and quantify PM2.5 sources. METHODS: We custom-designed particle samplers that can withstand large quantities of dust without their inlet becoming overloaded. The samplers were placed in two populated residential locations, one in Kuwait City and another near industrial and petrochemical facilities in Ali Sabah Al-Salem (ASAS) to collect PM2.5 and PM10 samples for mass and elemental analysis. We used positive matrix factorization to identify PM2.5 sources and apportion their contributions. RESULTS: We collected 2339 samples during the period October 2017 through October 2019. The beta-attenuation method in measuring PM2.5 consistently exceeded gravimetric measurements, especially during dust events. The annual levels for PM2.5 in Kuwait City and ASAS were 41.6 ± 29.0 and 47.5 ± 27.6 µg/m3, respectively. Annual PM2.5 levels in Kuwait were nearly four times higher than the U.S. National Ambient Air Quality Standard. Regional pollution was a major contributor to PM2.5 levels in both locations accounting for 44% in Kuwait City and 46% in ASAS. Dust storms and re-suspended road dust were the second and third largest contributors to PM2.5, respectively. CONCLUSIONS: The premise that frequent and extreme dust storms make air quality regulation futile is dubious. In this comprehensive particulate pollution analysis, we show that the sizeable regional anthropogenic particulate sources warrant national and regional mitigation strategies to ensure compliance with air quality standards.

Spatial Distribution of Land Surface Temperatures in Kuwait: Urban Heat and Cool Islands.

The global rise of urbanization has led to the formation of surface urban heat islands and surface urban cool islands. Urban heat islands have been shown to increase thermal discomfort, which increases heat stress and heat-related diseases. In Kuwait, a hyper-arid desert climate, most of the population lives in urban and suburban areas. In this study, we characterized the spatial distribution of land surface temperatures and investigated the presence of urban heat and cool effects in Kuwait. We used historical Moderate-Resolution Imaging Spectroradiometer (MODIS) Terra satellite 8-day composite land surface temperature (LST) from 2001 to 2017. We calculated the average LSTs of the urban/suburban governorates and compared them to the average LSTs of the rural and barren lands. We repeated the analysis for daytime and nighttime LST. During the day, the temperature difference (urban/suburban minus versus governorates) was -1.1 °C (95% CI; -1.2, -1.00, p < 0.001) indicating a daytime urban cool island. At night, the temperature difference (urban/suburban versus rural governorates) became 3.6 °C (95% CI; 3.5, 3.7, p < 0.001) indicating a nighttime urban heat island. In light of rising temperatures in Kuwait, this work can inform climate change adaptation efforts in the country including urban planning policies, but also has the potential to improve temperature exposure assessment for future population health studies.

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

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

Extreme temperatures and mortality in Kuwait: Who is vulnerable?

BACKGROUND: Previous climate change temperature-related health studies have been performed mostly in western countries with relatively cooler temperatures than the Gulf region. Regions that are inherently hot, like Kuwait, are witnessing soaring temperatures unlike ever before. Meanwhile, Kuwait and other Gulf countries are unique in their demographic profiles due to the large number of non-national migrant workers. OBJECTIVE: To examine the associations of hot and cold temperature extremes on the risk of mortality across gender, age groups and nationality in Kuwait. METHODS: We investigated daily variations of all-cause non-accidental and cardiovascular mortality death counts and ambient temperatures from 2010 to 2016 in a time-series design using a negative binomial distribution. The temperature lag was modeled with distributed lag non-linear models. RESULTS: A total of 33,472 all-cause non-accidental deaths happened during the study period. For the extreme hot temperatures and over the entire lag period, comparing the 99th percentile of temperature to the minimum mortality temperature, the risk of dying among males was 2.08 (95% CI: 1.23-3.52). Among non-Kuwaitis, males and working age group (15-64 year) had relative risks of death from extreme hot temperatures of 2.90 (1.42-5.93), and 2.59 (1.20-5.59), respectively. For extreme cold temperatures and over the entire lag period, comparing the 1st percentile of temperature to the minimum mortality temperature, the relative risk of death among Kuwaitis was 2.03 (1.05-3.93). Elderly Kuwaitis (65+ year) exposed to extreme cold temperatures had a relative risk of 2.75 (1.16-6.52). CONCLUSIONS: Certain subpopulations in Kuwait are vulnerable to extreme temperatures with doubling to tripling risk of mortality. Nationality is an important effect modifier in temperature-related mortality studies in Kuwait and possibly the Gulf region. To the best of our knowledge, we are the first study to examine specific subpopulation vulnerabilities to temperature in this region. Our findings could carry a potential for broader insight into similar hyper-arid and hot regions.

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

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

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

Ambient air pollution in terms of fine and coarse particulate matter (PM2.5 and PM10) has been shown to increase adult and infant mortalities. Most studies have estimated the risk of mortalities through attributable proportions and number of excess cases with no reference to the time lost due to premature mortalities. Disability adjusted life years (DALYs) are necessary to measure the health impact of Ambient particulate matter (PM) over time. In this study, we used life-tables for three years (2014⁻2016) to estimate the years of life lost (YLL), a main component of DALYs, for adult mortalities (age 30+ years) and postneonatal infant mortalities (age 28+ days⁻1 year) associated with PM2.5 exposure and PM10 exposure, respectively. The annual average of PM2.5 and PM10 concentrations were recorded as 87.9 µg/m³ and 167.5 µg/m³, which are 8 times greater than the World Health Organization (WHO) air quality guidelines of 10 µg/m³ and 20 µg/m³, respectively. Results indicated a total of 252.18 (95% CI: 170.69⁻322.92) YLL for all ages with an increase of 27,474.61 (95% CI: 18,483.02⁻35,370.58) YLL over 10 years. The expected life remaining (ELR) calculations showed that 30- and 65-year-old persons would gain 2.34 years and 1.93 years, respectively if the current PM2.5 exposure levels were reduced to the WHO interim targets (IT-1 = 35 µg/m³). Newborns and 1-year old children may live 79.81 and 78.94 years, respectively with an increase in average life expectancy of 2.65 years if the WHO PM10 interim targets were met (IT-1 = 70 µg/m³). Sensitivity analyses for YLL were carried out for the years 2015, 2025, and 2045 and showed that the years of life would increase significantly for age groups between 30 and 85. Life expectancy, especially for the elderly (≥60 years), would increase at higher rates if PM2.5 levels were reduced further. This study can be helpful for the assessment of poor air quality represented by PM2.5 and PM10 exposures in causing premature adult mortalities and postneonatal infant mortalities in developing countries with high ambient air pollution. Information in this article adds insights to the sustainable development goals (SDG 3.9.1 and 11.6.2) related to the reduction of mortality rates attributed to ambient air levels of coarse and fine particulate matter.

A behavior based safety approach at a Kuwait research institution.

INTRODUCTION: Behavior based safety (BBS) initiatives are the current trend toward improving safety performance. METHOD: This study outlines the framework of the BBS process and summarizes several behavioral safety approaches to accident prevention. RESULTS: Although most of the published research has focused on the improvement of safe behavior in industry, this study is the first to apply the current approach of behavior based safety in a research/educational setting. An experiment conducted at a research institution demonstrated the effectiveness of a well-designed behavior based safety process. A follow-up study indicated that the BBS produced a lasting effect for the experimental group. IMPACT ON INDUSTRY: Results from this study can be the driving force to implement behavior-based safety processes into educational, research, and training organizations.