Environmental risks to public health in the United Arab Emirates: a quantitative assessment and strategic plan.

BACKGROUND: Environmental risks to health in the United Arab Emirates (UAE) have shifted rapidly from infectious to noninfectious diseases as the nation has developed at an unprecedented rate. In response to public concerns over newly emerging environmental risks, the Environment Agency-Abu Dhabi commissioned a multidisciplinary environmental health strategic planning project. OBJECTIVES: In order to develop the environmental health strategic plan, we sought to quantify the illnesses and premature deaths in the UAE attributable to 14 environmental pollutant categories, prioritize these 14 risk factors, and identify interventions. METHODS: We estimated the disease burden imposed by each risk factor using an attributable fraction approach, and we prioritized the risks using an empirically tested stakeholder engagement process. We then engaged government personnel, scientists, and other stakeholders to identify interventions. RESULTS: The UAE's environmental disease burden is low by global standards. Ambient air pollution is the leading contributor to premature mortality [~ 650 annual deaths; 95% confidence interval (CI): 140, 1,400]. Risk factors leading to > 10,000 annual health care facility visits included occupational exposures, indoor air pollution, drinking water contamination, seafood contamination, and ambient air pollution. Among the 14 risks considered, on average, outdoor air pollution was ranked by the stakeholders as the highest priority (mean rank, 1.4; interquartile range, 1-2) and indoor air pollution as the second-highest priority (mean rank 3.3; interquartile range, 2-4). The resulting strategic plan identified 216 potential interventions for reducing environmental risks to health. CONCLUSIONS: The strategic planning exercise described here provides a framework for systematically deciding how to invest public funds to maximize expected returns in environmental health, where returns are measured in terms of reductions in a population's environmental burden of disease.

Sero-epidemiology of hepatitis B infection in pregnant women in Oman, Qatar and the United Arab Emirates.

OBJECTIVE: The aim of this cross-sectional study was to evaluate the prevalence of hepatitis B 'e' antigen (HBeAg) and hepatitis B surface antigen (HBsAg) in pregnant women in the Gulf States. METHODS: A total of 1710 pregnant women aged 15-45 years were enrolled in June-July 2000 in nine centres across Oman, Qatar and Unite Arab Emirates. The percentage of HBsAg-positive and HBeAg-positive individuals was determined. RESULTS: Serology results were available for 1694 women. A total of 7.1% of the women in Oman, 1% in Qatar and 1.5% in UAE were HBsAg-positive. Three (0.5%) women in Oman were HBeAg-positive. Risk factors identified for being HBsAg-positive were younger age, being a national (i.e. not an expatriate) and residing outside the city. CONCLUSIONS: Results from this study have shown that hepatitis B virus (HBV) prevalence in pregnant women is of intermediate endemicity in Oman and of low endemicity in Qatar and UAE. Thus, universal vaccination of all female adolescents before potential pregnancy is recommended in Oman in order to prevent perinatal infection, as well as to minimize horizontal transmission of the HBV in the community.