Meta analysis of health effects of ambient air pollution exposure in low- and middle-income countries.

It is well established that exposure to ambient air pollution affects human health. A majority of literature concentrated on health effects of air pollution in high income countries. Only fewer studies analyzing health effects of air pollution in Low- and Middle-Income Countries (LMICs) are available. To bridge this gap in literature, this study investigated short term and long-term health impacts of ambient air pollutants focussed in LMICs. We evaluated Total Non-accidental mortality, Respiratory Mortality, Stroke Mortality, Cardio-vascular Mortality, Chronic Obstructive Pulmonary Disease (COPD), Ischemic Heart Disease (IHD) and Lung Cancer Mortality in LMICs particularly. Random Effects Model was utilised to derive overall risk estimate. Relative Risk (RR) estimates per 10 µg/m3 was used as input for model. Subgroup and Sensitivity Analysis by Design and Country was conducted. A total of 152 studies were included for quantitative analysis. We found positive associations between pollutants and Total Non-accidental mortality for PM10 ((RR:1.0043-1.0036), p < 0.0001), NO2 (RR:1.0222 (1.0111-1.0336), p < 0.0001), SO2 (RR:1.0107 - (1.0073-1.0140), p < 0.0001), O3 (RR: 1.0038 (1.0023-1.0053), p < 0.0001) and PM2.5 (RR: 1.0048 (1.0037-1.0059), p < 0.0001) for every 10 µg/m3 increase. We found positive association between Long-term exposure to PM10 and Total Non-accidental mortality (RR: 1.0430 (1.0278-1.0583), p < 0.0001) We also found statistically significant positive associations between pollutants and Cardiorespiratory and Cardiovascular morbidity. The positive associations persisted when analysed amongst sub-groups. However, the high heterogeneity amongst studies persisted even after performing sub-group analysis. The study has found statistically significant positive associations between short-term and long-term exposure to Ambient air pollution with various health-outcome combinations.

Occupational health and safety risk assessment using a fuzzy multi-criteria approach in a hospital in Chennai, India.

Objectives. Hospitals provide direct and indirect employment benefits to medical professionals. Accidents in hospitals often lead to disastrous consequences such as fatalities, property damage and economic losses. It is, therefore, imperative to have an occupational health and safety (OHS) policy that aims to reduce work-related accidents to acceptable levels. This study aims to investigate health risks to staff from various hazards and suggest control measures to prevent recurrence of accidents. Methods. A two-stage fuzzy multi-criteria decision-making (MCDM) approach incorporating the fuzzy analytical hierarchical process (FAHP) and fuzzy technique for order preference for similarity to ideal solution (TOPSIS) was applied to assess the hazards in a leading multi-speciality hospital in Chennai. Results. The top three hazards identified in the workplace were electrical hazards, faulty medical equipment, and ventilation and air conditioning hazards. Subsequently, control measures were suggested to reduce the recurrence of hazards. Finally, a survey of hospital accidents occurring in India between 2010 and 2020 was conducted and compared with the results of this study. Conclusions. The survey findings show similarity to the hazard rankings obtained in this work, thus validating the methodology used for the assessment of hazards in hospitals. Electrical hazards and faulty medical equipment should be monitored.