Projecting non-communicable diseases attributable to air pollution in the climate change era: a systematic review.

OBJECTIVES: Climate change is a major global issue with significant consequences, including effects on air quality and human well-being. This review investigated the projection of non-communicable diseases (NCDs) attributable to air pollution under different climate change scenarios. DESIGN: This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 flow checklist. A population-exposure-outcome framework was established. Population referred to the general global population of all ages, the exposure of interest was air pollution and its projection, and the outcome was the occurrence of NCDs attributable to air pollution and burden of disease (BoD) based on the health indices of mortality, morbidity, disability-adjusted life years, years of life lost and years lived with disability. DATA SOURCES: The Web of Science, Ovid MEDLINE and EBSCOhost databases were searched for articles published from 2005 to 2023. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: The eligible articles were evaluated using the modified scale of a checklist for assessing the quality of ecological studies. DATA EXTRACTION AND SYNTHESIS: Two reviewers searched, screened and selected the included studies independently using standardised methods. The risk of bias was assessed using the modified scale of a checklist for ecological studies. The results were summarised based on the projection of the BoD of NCDs attributable to air pollution. RESULTS: This review included 11 studies from various countries. Most studies specifically investigated various air pollutants, specifically particulate matter <2.5 µm (PM2.5), nitrogen oxides and ozone. The studies used coupled-air quality and climate modelling approaches, and mainly projected health effects using the concentration-response function model. The NCDs attributable to air pollution included cardiovascular disease (CVD), respiratory disease, stroke, ischaemic heart disease, coronary heart disease and lower respiratory infections. Notably, the BoD of NCDs attributable to air pollution was projected to decrease in a scenario that promotes reduced air pollution, carbon emissions and land use and sustainable socioeconomics. Contrastingly, the BoD of NCDs was projected to increase in a scenario involving increasing population numbers, social deprivation and an ageing population. CONCLUSION: The included studies widely reported increased premature mortality, CVD and respiratory disease attributable to PM2.5. Future NCD projection studies should consider emission and population changes in projecting the BoD of NCDs attributable to air pollution in the climate change era. PROSPERO REGISTRATION NUMBER: CRD42023435288.

Impacts of climate change and environmental degradation on children in Malaysia.

The impacts of climate change and degradation are increasingly felt in Malaysia. While everyone is vulnerable to these impacts, the health and wellbeing of children are disproportionately affected. We carried out a study composed of two major components. The first component is an environmental epidemiology study comprised of three sub-studies: (i) a global climate model (GCM) simulating specific health-sector climate indices; (ii) a time-series study to estimate the risk of childhood respiratory disease attributable to ambient air pollution; and (iii) a case-crossover study to identify the association between haze and under-five mortality in Malaysia. The GCM found that Malaysia has been experiencing increasing rainfall intensity over the years, leading to increased incidences of other weather-related events. The time-series study revealed that air quality has worsened, while air pollution and haze have been linked to an increased risk of hospitalization for respiratory diseases among children. Although no clear association between haze and under-five mortality was found in the case-crossover study, the lag patterns suggested that health effects could be more acute if haze occurred over a longer duration and at a higher intensity. The second component consists of three community surveys on marginalized children conducted (i) among the island community of Pulau Gaya, Sabah; (ii) among the indigenous Temiar tribe in Pos Kuala Mu, Perak; and (iii) among an urban poor community (B40) in PPR Sg. Bonus, Kuala Lumpur. The community surveys are cross-sectional studies employing a socio-ecological approach using a standardized questionnaire. The community surveys revealed how children adapt to climate change and environmental degradation. An integrated model was established that consolidates our overall research processes and demonstrates the crucial interconnections between environmental challenges exacerbated by climate change. It is recommended that Malaysian schools adopt a climate-smart approach to education to instill awareness of the impending climate change and its cascading impact on children's health from early school age.

Seasonal variation and size distribution of inorganic and carbonaceous components, source identification of size-fractioned urban air particles in Kuala Lumpur, Malaysia.

This study aims to determine the inorganic and carbonaceous components depending on the seasonal variation and size distribution of urban air particles in Kuala Lumpur. Different fractions of particulate matter (PM) were measured using a Nanosampler from 17 February 2017 until 27 November 2017. The water-soluble inorganic ions (WSIIs) and carbonaceous components in all samples were analysed using ion chromatography and carbon analyser thermal/optical reflectance, respectively. Total PM concentration reached its peak during the southwest (SW) season (70.99 ± 6.04 µg/m3), and the greatest accumulation were observed at PM0.5-1.0 (22%-30%, 9.55 ± 1.03 µg/m3) and PM2.5-10 (22%-25%, 10.34 ± 0.81 µg/m3). SO42-, NO3- and NH4+ were major contributors of WSIIs, and their formation was favoured mainly during SW season (80.5% of total ions). PM0.5-1.0 and PM2.5-10 exhibited the highest percentage of WSII size distribution, accounted for 28.4% and 13.5% of the total mass, respectively. The average contribution of carbonaceous species (OC + EC) to total carbonaceous concentrations were higher in PM0.5-1.0 (35.2%) and PM2.5-10 (26.6%). Ultrafine particles (PM<0.1) consistently indicated that the sources were from vehicle emission while the SW season was constantly dominated by biomass burning sources. Using the positive matrix factorization (PMF) model, secondary inorganic aerosol and biomass burning (30.3%) was known as a significant source of overall PM. As a conclusion, ratio and source apportionment indicate the mixture of biomass burning, secondary inorganic aerosols and motor vehicle contributed to the size-segregated PM and seasonal variation of inorganic and carbonaceous components of urban air particles.

Ambient volatile organic compounds in tropical environments: Potential sources, composition and impacts - A review.

Volatile organic compounds (VOCs) are widely recognized to affect the environment and human health. This review provides a comprehensive presentation of the types and levels of VOCs, their sources and potential effects on human health and the environment based on past and current observations made at tropical sites. Isoprene was found to be the dominant biogenic VOC in the tropics. Tropical broad leaf evergreen trees are the main emitters of isoprene, making up more than 70% of the total emissions. The VOCs found in the tropical remote marine atmosphere included isoprene (>100 ppt), dimethyl sulfide (≤100 ppt) and halocarbons, i.e. bromoform (≤8.4 ppt), dibromomethane (≤2.7 ppt) and dibromochloromethane (≤1.6 ppt). VOCs such as benzene, toluene, ethylbenzene and xylene (BTEX) are the most monitored anthropogenic VOCs and are present mainly due to motor vehicles emissions. Additionally, biomass burning contributes to anthropogenic VOCs, especially high molecular weight VOCs, e.g. methanol and acetonitrile. The relative contributions of VOC species to ozone are determined through the level of the Ozone Formation Potential (OFP) of different species. Emissions of VOCs (e.g. very short-lived halogenated gases) in the tropics are capable of contributing to stratospheric ozone depletion. BTEX has been identified as the main types of VOCs that are associated with the cancer risk in urban areas in tropical regions. Finally, future studies related to VOCs in the tropics and their associated health risks are needed to address these concerns.

Characteristics and health effect of heavy metals on non-exhaust road dusts in Kuala Lumpur.

This study aimed to assess the concentrations and health effect of trace metals [cadmium (Cd), chromium (Cr), copper (Cu), lead (Pb), nickel (Ni), and zinc (Zn)] on the road dust of selected locations in the city of Kuala Lumpur. Sampling was conducted thrice at four locations, namely, Tun Razak Road, Raja Abdullah Road, Tunku Abdul Rahman (TAR) Road, and Ayer Molek Road. The concentrations of trace metals in road dust were analyzed by inductively coupled plasma mass spectrometry. TAR Road presented the highest Cd, Cu, Ni, and Pb contents compared with the other roads. The pollution level of trace metals in road dust was assessed by pollution index and pollution load index (PLI), showing that all studied locations were highly contaminated except Ayer Molek Road. Based on the PLI value, the sequence of pollution in descending order is as follows: TAR Road > Raja Abdullah Road > Tun Razak Road > Ayer Molek Road. Health risk assessment was performed to assess the health effects of carcinogenic and noncarcinogenic pollutants caused by the exposure to trace metals in road dust on adults and children. Based on the integrated hazard index values for children at all locations, >1 indicates a possible noncarcinogenic effect. All incremental lifetime cancer risk values for adult and children at all locations are within acceptable limits and are considered safe.

Airborne particles in the city center of Kuala Lumpur: Origin, potential driving factors, and deposition flux in human respiratory airways.

Equatorial warming conditions in urban areas can influence the particle number concentrations (PNCs), but studies assessing such factors are limited. The aim of this study was to evaluate the level of size-resolved PNCs, their potential deposition rate in the human respiratory system, and probable local and transboundary inputs of PNCs in Kuala Lumpur. Particle size distributions of a 0.34 to 9.02 µm optical-equivalent size range were monitored at a frequency of 60 s between December 2016 and January 2017 using an optical-based compact scanning mobility particle sizer (SMPS). Diurnal and correlation analysis showed that traffic emissions and meteorological confounding factors were potential driving factors for changes in the PNCs (Dp ≤1 µm) at the modeling site. Trajectory modeling showed that a PNC <100/cm3 was influenced mainly by Indo-China region air masses. On the other hand, a PNC >100/cm3 was influenced by air masses originating from the Indian Ocean and Indochina regions. Receptor models extracted five potential sources of PNCs: industrial emissions, transportation, aged traffic emissions, miscellaneous sources, and a source of secondary origin coupled with meteorological factors. A respiratory deposition model for male and female receptors predicted that the deposition flux of PM1 (particle mass ≤1 µm) into the alveolar (AL) region was higher (0.30 and 0.25 µg/h, respectively) than the upper airway (UA) (0.29 and 0.24 µg/h, respectively) and tracheobronchial (TB) regions (0.02 µg/h for each). However, the PM2.5 deposition flux was higher in the UA (2.02 and 1.68 µg/h, respectively) than in the TB (0.18 and 0.15 µg/h, respectively) and the AL regions (1.09 and 0.91 µg/h, respectively); a similar pattern was also observed for PM10.