Temporal changes in temperature-related mortality in relation to the establishment of the heat-health alert system in Victoria, Australia.

Extreme heat alerts are the most common form of weather forecasting services used in Australia, yet very limited studies have documented their effectiveness in improving health outcomes. This study aimed to examine the temporal changes in temperature-related mortality in relation to the activation of the heat-health alert and response system (HARS) in the State of Victoria, Australia. We examined the relationship between temperatures and mortality using quasi-Poisson regression and the distributed lag non-linear model (dlnm) and compared the temperature-mortality association between the two periods: period 1- prior-HARS (1992-2009) and period 2- post-HARS (2010-2019). Since the HARS heavily weights heatwave effects, we also compared the main effects of heatwave events between the two periods. The heatwaves were defined for three levels, including 3 consecutive days at 97th, 98th, and 99th percentiles. We also controlled the potential confounding effect of seasonality by including a natural cubic B-spline of the day of the year with equally spaced knots and 8 degrees of freedom per year. The exposure-response curve reveals the temperature mortality was reduced in period 2 in comparison with period 1. The relative risk ratios (RRR) of Period 2 over Period 1 were all less than one and gradually decreased from 0.86 (95% CI, 0.72-1.03) to 0.64 (95% CI, 0.33-1.22), and the differences in attributable risk percent increased from 13.2 to 25.3%. The reduction in the risk of heatwave-related deaths decreased by 3.4% (RRp1 1.068, 95% CI, 1.024-1.112 versus RRp2 1.034, 95% CI, 0.986-1.082) and 10% (RRp1 1.16, 95% CI, 1.10-1.22 versus RRp2 1.06, 95% CI, 1.002-1.119) for all groups of people. The study indicated a decrease in heat-related mortality following the operation of HARS in Victoria under extreme heat and high-intensity heatwaves conditions. Further studies could investigate the extent of changes in mortality among populations of differing socio-economic groups during the operation of the heat-health alert system.

Contribution of outdoor noise-induced health risk in schools located in urbanized arid country.

Ambient noise pollution is deemed as one of the major growing public health issues, especially in developing countries. Therefore, it is crucial to assess the impact of noise pollution on public health. The aim of this study is to investigate the health risk of noise exposure levels in three schools: Kaab Bin Zeyd of Basic Education (school A), Hail Al-Awamour Girls school (school B), and Al-Fikr School (school C) in Muscat, Oman. The study employed a survey of 300 students, dose-response models, and regression models to quantify health risk and to determine the relationship between noise levels and perceived noise annoyance sources. The study found average noise levels (LAeq) of school A (70.03±8.21 dBA), school B (69.54±7.75 dBA), and school C (55.95± 5.67 dBA) to be higher than WHO's outdoor schools environment standard of 55 dBA and European (EN16798-1) classroom's critical limits of 30-34 dBA. Most of the students from schools A (30.9%), B (33.3%), and C (63%) have reported noise produced from traffic as extremely annoyed compared to aircraft of 15.4%, 11.5%, and 27.2%, respectively. Regression analysis shows that perceived traffic noise was strongly correlated with LAeq in school A (R2 =0.481), B (R2 =0.121), and C (R2 = 0.132) when compared with other subjective noise types. The health risk assessment results show that the percentage of highly annoyed (%HA) was higher in school A (15.2%) and school B (14.95%) than in school C (8.18%). The estimated highly sleep disturbed (%HSD) based on mean noise levels were almost the same in schools A (15.62%) and B (15.19%) but far higher compared to school C (6.01%). However, there was an association between the mean noise exposure levels and the risk of developing ischemic heart diseases (IHD) in school A (RR= 1.172, 95% CI: 1.020-1.334), school B (RR=1.167, 95% CI: 1.020-1.325), and school C (RR=1.051, 95% CI: 1.006-1.095). Moreover, attributable risk percentage (AR%) for school A (AR% =14.675, 95% CI: 2.028-25.037), school B (AR% =14.310, 95% CI: 1.960-24.528), and school C (AR% = 4.852, 95% CI:0.596-8.742) have shown that a substantial portion of the population could be prevented from developing IHD. It is expected that findings of the study can be applied in other arid regions with sprawl urbanized built environments.

Effect of ambient noise on indoor environments in a health care facility in Oman.

Hospital-noise levels can induce physiological responses and affect sleep quality, which could contribute to cardiovascular-related health problems. Till date, high-resolution hospital noise exposure assessment studies have not received much attention in Oman. This study aims at assessing sound pressure levels across hospital wards and intensive care unit (ICU) rooms to determine annoyance and potential health effects based on perception and risk estimates. An indoor exposure assessment using high precision noise sensors was conducted in a female medical ward (FMW), isolated ward (SLW), emergency ward (EMW), and intensive care unit (ICU) in a public hospital in Muscat city, Oman. Self-administered questionnaire was randomly distributed among respondents using both online and field survey approach to ascertain annoyance, health effects, and potential risks associated with exposure. The study found that 24-h noise levels (LAeq) ranged from 55.2 to 61.7 dB(A) in the hospital wards and ICU rooms, which exceeded WHO's hospital indoor rooms critical limit of 35 dB(A) by 58-76%. A total of 150 participants took part in the survey. Among the respondents, 53% reported moderate annoyance at the hospital wards, while 56% felt sensitivity to the noise levels. Noise annoyance was reported by the majority of the patients across the various wards and emergency rooms as causing slight annoyance (50%) and intermittent sleep disturbances (49%). The majority (73%) of the medical staff have complained that the current noise levels affect overall work performance (p = 0.004), while 70% of them have further complained of it as a cause of workplace distraction (p = 0.011). Logistic binary regression analysis has revealed that the complaint of noise sensitivity has a positive association with noise levels in VCW (OR: 1.54; 95% CI: 0.92-2.58), and reported loss of concentration by the medical staff also associated with noise levels at the EMW (OR: 1.61; 95% CI: 0.65-4.01). Quantitative risk estimates showed that both the percentages of highly annoyed (HA) persons (16%), and highly sleep-disturbed (HSD) persons (9%) were very high in FMW, while ICU was found to have the lowest risk. However, the greater number of the respondents (87%) believed that there are possibilities of mitigating (p < 0.001) the current noise levels.

Impact of COVID-19 pandemic on aircraft noise levels, annoyance, and health effects in an urban area in Oman.

This study aimed at investigating aircraft noise exposure levels, their annoyance, and potential health effects among communities living within airport catchment areas during the COVID-19 pandemic. Both field measurements and an online survey approach were used to investigate aircraft noise exposure levels, annoyance, and general health effects among residents living near Muscat International Airport (MCT) in Muscat, Oman, amid the COVID-19 period. The study found a drastic decline in aircraft noise levels due to the introduction of COVID-19 intervention measures such as lockdowns, social distancing, and closure of airports. In June 2020, during the COVID-19 pandemic, average daily aircraft noise levels of LAeq (39.9 dB(A)) and Lmax (49.7 dB(A)) was observed compared to the previous year (April-May 2019) of 58.5 and 76.8 dB(A), indicating aircraft noise reductions level of 32% and 35%, respectively. The results of the online social survey among 187 participants showed that most (58.8%) of the respondents did not feel that the level of noise produced by aircraft causes annoyance. During the day, the vast majority of the interviewees did not complain of any annoyance during the morning (45.5%), afternoon (39.6%), and evening (31%) with only < 4% of residents have reported a very high degree of annoyance of during COVID-19 pandemic period. Very few people (17%) did complain of experiencing general health problems while 29% did not know of any potential health effects that could be attributed to aircraft noise exposures. Aircraft noise annoyance complaints among the As-Seeb residents during the pre-COVID-19 pandemic periods were reported to be extremely high reaching about 84% compared to 41% during this current COVID-19 pandemic period. These findings support the need to develop future sustainable noise mitigation policies in order to help reduce noise exposures and improve human health during post-COVID-19 pandemic periods.

Characterization and exposure assessment to urban air toxics across Middle Eastern and North African countries: a review.

Middle East and North African (MENA) countries over the decades are experiencing rapid industrial and infrastructural growth combined with being the global hub of oil and gas industries. These economic transformations are associated with release of air pollutants including urban air toxics (UAT) through industrial, traffic, and constructional activities into ambient urban environments. UAT concentrations levels may exacerbate in most MENA countries considering high number of vehicular traffic populations and petrochemical industries which are one of the main sources of this pollutant. Therefore, the main objective of the study is to review major findings of UAT levels in urban areas across thirteen (13) MENA countries. The study characterizes various measured UAT, assesses their concentrations in ambient environment, and identifies their major sources of emissions by reviewing more than 100 relevant UAT papers across the selected MENA countries. It was found that benzene, heavy metals, formaldehyde, and dioxin-like compounds are the most reported UAT. The study concluded that road traffic, fuel stations, and petrochemical industries were identified as the main sources of ambient UAT levels. It was further reported that most of the studies were based on short-term ambient environment with limited studies in indoor environments. Therefore, it is highly recommended that future research should focus on innovative health impact assessment and epidemiological studies from exposure to UAT levels. Also embarking on sustainable mitigation approaches through urban greenery, eco-industrial estates infrastructural developments, and renewable energy shares will reduce UAT levels and improve human health.

A critical review of environmental and public health impacts from the activities of evaporation ponds.

Evaporation ponds (EVPs) are among the most cost-effective, and simple wastewater treatment technologies used in many regions/countries with high solar radiation levels. However, its operational limitations, which include the overflow of wastewater, leakages via liners, and large surface area of the EVP that is exposed to atmosphere, creates a negative feedback to the environment. Therefore, the main aim of this review study of more than a hundred works published a little all over the continents is to provide a summary of various contaminations that are associated with EVPs activities through different environmental compartments. In addition, the impacts of EVP on fauna, human health including the current on-site sustainable mitigation strategies were also reviewed. The first conclusion from this study shows that the most commonly contaminants released into surface waters, groundwater, soil and sediments were heavy metals, pesticides, herbicides, selenium, including several major anions and cations. Non-methane hydrocarbons (NMHCs), volatile organic compounds (VOCs), and particulate matters (PMs) were the main air pollutants emitted from the surfaces of an EVP. Limited data is available about the emissions of atmospheric greenhouse gas (GHGs) especially carbon dioxide (CO2) and methane (CH4) from EVP surfaces. Migratory birds and aquatic organisms are the most vulnerable fauna as EVP wastewaters can cause obstruction of movements, affect diversity, and causes mortalities following the exposure to the toxic wastewater. The study revealed limited data about the potential health risk associated with occupational and environmental exposure to radiological hazards and contaminated drinking water from EVP activities. On-site EVP treatment strategies using bioremediation and electrochemical treatment technologies have shown to be a promising sustainable mitigation approach. Knowledge gaps in areas of GHGs monitoring/modeling, pollution exposure estimation and health risk assessments are urgently required to gain deeper understanding about the impact of EVP activities, and incorporate them into future EVP designs.

Assessment of noise levels and induced annoyance in nearby residential areas of an airport region in Oman.

There is adequate evidence from epidemiological studies showing an association between noise exposures and incidence of cardiovascular diseases and cognitive impairment among exposed populations. This study aimed to investigate noise exposure levels in an airport region and their effects on the nearby two neighborhood communities (i.e., Al Seeb and Bawshar). To achieve this, noise levels were measured across 15 different points within the communities for more than 3 weeks at a median distance of 3.5 km from the airport runways using a sound level analyzer. In addition, we conducted an online social survey in a random sampling of a total of 913 residents who were living closer to the airport. A combination of a 5-point scale and 3-point Likert scale was used to assess the resident population's noise annoyance and the potential health impacts. The results revealed that the majority of the measured points have noise levels (55.71-65.24 LAeq dBA) exceeding both Oman and WHO critical limits. There was a general decrease in noise levels at points further away from the runways; thus, at points 2.5, 4.8, and 8.8 km, sound pressure levels were found to be 63.08, 57.41, and 52.31 dBA, respectively. However, steady noise levels were observed throughout most of the daily (24 h) measurements indicating continual exposures. Overall, 44.6% of residents reported noise annoyance level as very high, with Al Seeb inhabitants (46%) eliciting a greater percentage of annoyance levels compared to Bawshar (5%) due to their closer proximity to the airport. Also, the noise was significantly (p ˂ 0.001) associated with sleep disturbance, insomnia, irritation, and frightening. The majority of the residents complained of an increase in insomnia (41.5%), stress (34.3%), headache (47.3%), and cardiovascular diseases (16.2%). With the question of reducing noise exposures, about 41% of the respondents have plans of relocating to distant areas with low noise levels.

Evaluation of vehicular pollution levels using line source model for hot spots in Muscat, Oman.

A detailed investigation was carried out to assess the concentration of near-road traffic-related air pollution (TRAP) using a dispersion model in Muscat. Two ambient air quality monitoring (AQM) stations were utilized separately at six locations near major roadways (each location for 2 months) to monitor carbon monoxide (CO) and nitrogen oxides (NOx). The study aimed to measure the concentration of near-road TRAP in a city hot spots and develop a validated dispersion model via performance measures. The US Environmental Protection Agency (US EPA) Line Source Model was implemented in which the pollutant emission factors were obtained through Comprehensive Modal Emission Model (CMEM) and COmputer Programme to calculate Emissions from Road Transport (COPERT) model. Traffic data of all vehicle categories under normal driving conditions including average vehicle speed limits and local meteorological conditions were included in the modeling study. The analysis of monitoring data showed that hourly (00:00 to 23:00) concentrations of CO were within the US EPA limits, while NOx concentration was exceeded in most locations. Also, the measured pollutant levels were consistent with hourly peak and off-peak traffic volumes. The overall primary statistical performance measures showed that COPERT model was better than CMEM due to the high sensitivity of CMEM to the local meteorological factors. The best fractional bias (0.47 and 0.39), normalized mean square error (0.44 and 0.50), correlation coefficient (0.64 and 0.70), geometric mean bias (1.07 and 1.57), and geometric variance (2.00 and 2.32) were obtained for CO and NOx, respectively. However, the bootstrap 95% CI estimates over normalized mean square error, fractional bias, and correlation coefficient for COPERT and CMEM were found to be statistically significant from 0 in the case of combined model comparison across all the traffic locations for both CO and NOx. In overall, certain roads showed weak performance mainly due to the terrain features and the lack of reliable background concentrations, which need to be considered in the future study.

Exposure assessment to road traffic noise levels and health effects in an arid urban area.

Road traffic noise exposures have been recognized as serious environmental health concerns, especially in most developing countries with arid climate conditions, rapid increase in vehicle population, and limited traffic management systems. The excessive noise exposure level is associated with increase in the incidence of cardiovascular diseases and anxiety, including annoyance. This study aimed at determining traffic noise levels in residential areas, including the assessment of its annoyance and health effects based on the people's perception and reportage. To do so, field measurement and traffic noise modeling were carried out in six road points to estimate the current noise levels along various roads close to human inhabitants in Muscat Governorate, Sultanate of Oman. The detailed measured noise levels in urban residential areas across the selected roads showed that noise levels have exceeded the local and international threshold limits at all locations during the entire day. The high sound levels (48.0-56.3 dBA) were observed using the US Federal Highway Administration's Traffic Noise Model (TNM, version 2.5) results, which were in agreement with the observed (56.3-60.4 dBA) data. To assess health implication to residents through interviews (n = 208), annoyance at home was found to be little (32%), moderate (28%), and high (9%) in comparison with workplace settings of 42%, 43%, and 15%, respectively. Nineteen percent of the interviewees had difficulties in sleeping, while 19.8% experienced stress due to road traffic noise exposures. Moreover, a strong association (p < 0.05) was established between the use and objection of noise barriers. The study revealed high noise levels and the prevalence of annoyance and health effects among the exposed population. Therefore, immediate action is required to tackle the current noise levels.

Impact of building ventilation systems and habitual indoor incense burning on SARS-CoV-2 virus transmissions in Middle Eastern countries.

Majority of countries across the globe have employed improving building ventilation, quarantine, social distancing, and disinfections as a general measure of preventing SARS-CoV-2 virus transmissions. However, arid Middle Eastern countries with hot climate (elevated outdoor temperature and humidity levels) are experiencing a different situation. Unfortunately, these harsh ambient climatic conditions in Middle Eastern countries make it impossible for most buildings to utilize natural/mechanical ventilation systems. Besides, indoor air temperatures of most buildings are very low due to overconsumption of air conditioning, thereby, it can be a potential factor of virus spread in most residential homes and public buildings. Most importantly, habitual indoor burning of incense which is the major source of coarse (PM10; aerodynamic diameter <10 µm) and fine (PM2.5; aerodynamic diameter <2.5 µm) particulate matters (PM) could facilitate the transmission of SARS-CoV-2 virus droplets and particles in indoor environments. In fact, it increases the spread of the virus via inhalation in these countries, especially where the wearing of masks is not regulated in public, commercial and residential buildings. It is therefore highly recommended for the relevant public health agencies to critically assess the role of poor indoor environmental conditions including the burning of incense on virus transmissions, which may help to develop control measures for the future viral outbreak effectively.

Occupational exposure to pesticides and associated health effects among greenhouse farm workers.

The number and production capacities of greenhouse farms have been increased across the globe, driven by an effort for addressing food security problems related to the rapid population growth and the effects of climate change. As a result, there was a large increase in the number of greenhouse farm workers who are typically involved in chemical preparations and pesticide sprayings, crop harvesting, and greenhouse maintenance activities. Considering the enclosed architecture of the greenhouse farm design and the frequent application of pesticides, the objective of this review was to characterize pesticide exposure levels and resultant health effects among greenhouse farm workers. While most health assessment studies were mainly based on self-reported symptoms, this review showed limited epidemiological and clinical studies on the assessment of the health effects of pesticide exposure on greenhouse workers' health. Reproductive disorders, respiratory symptoms, neurological symptoms, and skin irritations were the most reported health effects among greenhouse farm workers. Additionally, there were limited studies on respirable pesticide-borne fine and ultrafine particulate matters in greenhouse farms. Ventilation systems and indoor environmental conditions of greenhouse farms were not designed according to specifications of the American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE). Among recommendations provided, long-term exposure assessments of pesticide effects on children born by greenhouse farm workers should be considered in future research. Also, compliance with ASHRAE indoor ventilation and environmental standards will be very important in reducing pesticide exposure and health effects among greenhouse farm workers.

Association between human health and indoor air pollution in the Gulf Cooperation Council (GCC) countries: a review.

Studies on the assessment of indoor air pollutants in terms of concentration and characterization in the Gulf Cooperation Council (GCC) countries have been recently carried out. This review assesses the health effects associated with indoor air pollution exposures in GCC, including other air pollutants (siloxanes, flame retardants, synthetic phenolic antioxidants) which were not explored in a previous study. In addition, the influence of ventilation conditions due to different indoor environments was also investigated. It was revealed that there is a lack of human health assessment studies on most indoor air pollutants in almost all GCC countries, except the United Arab Emirates, Kingdom of Saudi Arabia and Kuwait, where few attempts were made for some specific pollutants. Commonly reported plausible health effects potentially associated with indoor air pollution were related to respiratory symptoms and sick building syndrome (SBS). Many of the current health assessment studies in GCC countries were based on predictions and/or estimates of exposures rather than clinically based observational studies. Measured ventilation levels and indoor air velocities in most buildings failed to meet the American Society of Heating, Refrigerating and Air-conditioning Engineers (ASHRAE) threshold limits of 8 L/s/p and 0.18-0.25 m/s, respectively. Additionally, limited studies have investigated respiratory symptoms and SBS potentially attributable to poor ventilation in the region. It is highly recommended that future indoor air quality (IAQ) studies in GCC should focus more on epidemiologic and intervention studies.

Effects of pollution on freshwater aquatic organisms.

This paper presents the reviews of scientific papers published in 2018 issues on the effects of anthropogenic pollution on the aquatic organisms dwelling in freshwater ecosystem at global scale. The first part of the study provides the summary of relevant literature reviews followed by field and survey based studies. The second part is based on categories of different classes/sources of pollutants which affect freshwater organism. This is composed of several sections including metals and metalloids, wastewater and effluents, sediments, nutrients, pharmaceuticals, polycyclic aromatic hydrocarbons, flame retardants, persistent organic pollutants, pharmaceuticals and illicit drugs, emerging contaminants, pesticides, herbicides, and endocrine disruptors. The final part of the study highlights the reviews of published research work on new pollutants such as microplastics and engineered nanoparticles which affect the freshwater organisms. PRACTITIONER POINTS: Heavy metals concentrations should be assessed at nano-scale in aquatic environment. Air pollutants could have long-term effects on freshwater ecosystem. Future studies should focus on bioremediations of freshwater pollution.

Indoor air pollution and exposure assessment of the gulf cooperation council countries: A critical review.

Indoor air pollution is one of the human health threat problems in the Gulf Cooperation Council (GCC) countries. In these countries, due to unfavorable meteorological conditions, such as elevated ambient temperature, high relative humidity, and natural events such as dust storms, people spend a substantial amount of their time in indoor environments. In addition, production of physical and biological aerosols from air conditioners, cooking activities, burning of Arabian incense, and overcrowding due to pilgrimage programs are common causes of low quality indoor air in this region. Thus, due to infiltration of outdoor sources as well as various indoor sources, people living in the GCC countries are highly exposed to indoor air pollutants. Inhalation of indoor air pollutants causes mortalities and morbidities attributed to cardiorespiratory, pulmonary, and lung cancer diseases. Hence, the aim of this review study is to provide a summary of the major findings of indoor air pollution studies in different microenvironments in six GCC countries. These include characterization of detected indoor air pollutants, exposure concentration levels, source identifications, sustainable building designs and ventilation systems, and the mitigation strategies. To do so, >130 relevant indoor air pollution studies across the GCC countries were critically reviewed. Particulate matters (PM10 and PM2.5), total volatile organic compounds (TVOCs), carbon dioxide (CO2), sulfur dioxide (SO2), nitrogen dioxide (NO2), and heavy metals were identified as the reported indoor air pollutants. Apart from them, indoor Radon and bioaerosols were studied only in specific GCC countries. Thus, future studies should also focus on the investigation of emerging indoor air pollutants, such as ultrafine and nanoparticles and their associated health effects. Furthermore, studies on the mitigation of indoor air pollution through the development of advanced air purification and ventilation systems could improve the indoor air quality (IAQ) in the GCC region.

Mortality and morbidity for cardiopulmonary diseases attributed to PM2.5 exposure in the metropolis of Rome, Italy.

The aim of the study was to evaluate the health effects associated with the exposure to ground-level of particulate matters with aerodynamic diameter ≤ 2.5 µm (PM2.5) on citizens in Rome (Italy) in 2015 and 2016. Based on the new version of the World Health Organization's AirQ+ model, we have estimated the short- and long-term effects of PM2.5 on hospital admissions due to cardiovascular (HA-CVD) and respiratory diseases (HA-RD) as well as on mortality for ischemic heart disease (M-IHD) and chronic obstructive pulmonary disease (M-COPD). In this study, city-specific relative risk values and baseline incidence rates were used to calculate the association between PM2.5 and daily counts of emergency hospitalizations and mortality. The annual mean PM2.5 concentrations were 18 µg m-3 and 14 µg m-3 in 2015 and 2016, respectively. In Rome, the citizens are mostly exposed to daily mean PM2.5 concentrations of 10-20 µg m-3 during the study period. In 2015-2016, 0.4-0.6% for HA-CVD, 1.1-1.5% for HA-RD, 16.5-18.1% for M-IHD and 8.5-9.2% for M-COPD are attributed to PM2.5. In 2015-2016, 134-186 HA-CVD, 126-175 HA-RD, 947-1037 M-IHD and 244-279 M-COPD, caused by PM2.5 exposure, could be "avoided" if PM2.5 concentrations would not exceed 10 µg m-3, i.e. the threshold recommended by the World Health Organization. Thus, a consistent air quality management and sustainable city planning are needed, urgently, to mitigate the adverse effects of PM2.5 exposure in Rome.