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.

Risky Roads in Kuwait: An Uneven Toll on Migrant Workers.

This descriptive study reveals trends in citations and traffic-related mortality in Kuwait. Secondary data were utilized, where data on road traffic citations were obtained from the traffic police in the Ministry of Interior for the years from 2011 to 2015, and road traffic mortality data for the study period were obtained from the Ministry of Health. OBJECTIVE: To describe recent trends in data related to road traffic safety in Kuwait over time, which could serve as an important indicator for the level of enforcement of existing traffic regulations. Descriptive summary statistics are presented. RESULTS: There was a total of 24.2 million traffic violations during the study period. The number rose dramatically from 4 million citations in 2011 to nearly 6.5 million in 2015. The indirect method of citation (issued indirectly via surveillance methods) constituted a higher percentage of citations, 70.4%, compared to the direct method of citation (issued directly by the police officer), 29.6%. Furthermore, the top reason for citation was speeding, followed by parking in no parking/handicapped zones, driving with an expired license, and crossing a red light. Road traffic fatalities (RTFs) in Kuwait from 2011 to 2015 totaled 2282. About 450 people die each year in Kuwait from road traffic injuries and a slightly decreasing trend was found. Non-Kuwaitis have RTF counts that are four times higher than Kuwaitis, with 1663 and 263 deaths, respectively. CONCLUSIONS: Road traffic safety continues to be a major problem in Kuwait. Increases in citation issuance show a rise in traffic regulation enforcement, yet risky driving behaviors continue to account for most violations issued. Harsher penalties, road safety education, and implementing graduated driving licensing may be warranted to increase the safety of the roads.

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.