Ambient exposure of O3 and NO2 and associated health risk in Kuwait.

Ozone (O3) and nitrogen dioxide (NO2), indissoluble air pollutants in the atmosphere, have been confirmed in various parts of the world to have detrimental health effects on humans. Currently, such information is lacking in Kuwait. The objectives of this study are to investigate the spatial and temporal variations of O3 and NO2 concentrations in Kuwait during a 4-year period (2014-2017) and to quantify the associated short- and long-term health effects, including all-cause, respiratory, and cardiovascular mortalities and morbidities during the same study period. Exposure assessment showed that the annual levels (22.5-26.4 ppb), SOMO35, and the 8-hour 4-year mean (38 ppb) of O3 were very low and below the World Health Organization (WHO) (50 ppb) and Kuwaiti (70 ppb) regulatory limits. The annual mean levels of NO2 ranged from 30.3 to 43.8 ppb and were significantly higher than both WHO and Kuwait limits (21 ppb). As expected, O3 and NO2 levels showed opposing trends, with higher concentrations of NO2 recorded in early morning and mid-evening, during autumn and winter, and during Saturdays (the so-called weekend effect). Health effects indicated high respiratory diseases due to short-term exposure to NO2. Contrary to the western countries' pollution levels, Kuwait showed lower O3 and higher NO2 levels. There is potential for substantial health improvements in Kuwait by reducing NO2 pollution through stringent control measures of stationary and mobile sources.

Exposure levels of air pollution (PM2.5) and associated health risk in Kuwait.

It is well established that respiratory and cardiovascular mortality and morbidity rates are associated with poor air quality as measured by high concentrations of fine particulate matter such as PM2.5 parameters. Since such information is lacking for the State of Kuwait, this study examined the exposure levels of PM2.5 and the associated health risk as evaluated by five mortality measures embodied in ischemic heart disease, stroke, lung cancer, chronic obstructive pulmonary disease and acute lower respiratory infection as well as two morbidity outcomes related to both cardiovascular and respiratory diseases. The measurement models utilized in this investigation followed the WHO guidelines. Over a span of a four-year period (2014-2017), the annual PM2.5 concentration levels ranged from 38.0 µg/m3 to 75.2 µg/m3. In general, exposure levels tended to fluctuate throughout the day with the higher levels recorded during rush hours (early morning and early evening), weekends (particularly Saturdays), and summer (i.e., August and September). The highest number of excess cases and attributable proportions of premature mortalities were related to ischemic heart disease and stroke at 352 (95% CI 275-426) and 70.8% (95% CI 39.7-85.2), respectively. In general, respiratory diseases showed a higher number of excess cases and attributable proportions than cardiovascular diseases. Relative to other findings on the global stage, the results emanating from Kuwait are emerging on the higher side. The study outcomes suggest that control strategies are in dire need to bend the pollution levels in Kuwait.

Disability Adjusted Life Years (DALYs) in Terms of Years of Life Lost (YLL) Due to Premature Adult Mortalities and Postneonatal Infant Mortalities Attributed to PM2.5 and PM10 Exposures in Kuwait.

Ambient air pollution in terms of fine and coarse particulate matter (PM2.5 and PM10) has been shown to increase adult and infant mortalities. Most studies have estimated the risk of mortalities through attributable proportions and number of excess cases with no reference to the time lost due to premature mortalities. Disability adjusted life years (DALYs) are necessary to measure the health impact of Ambient particulate matter (PM) over time. In this study, we used life-tables for three years (2014⁻2016) to estimate the years of life lost (YLL), a main component of DALYs, for adult mortalities (age 30+ years) and postneonatal infant mortalities (age 28+ days⁻1 year) associated with PM2.5 exposure and PM10 exposure, respectively. The annual average of PM2.5 and PM10 concentrations were recorded as 87.9 µg/m³ and 167.5 µg/m³, which are 8 times greater than the World Health Organization (WHO) air quality guidelines of 10 µg/m³ and 20 µg/m³, respectively. Results indicated a total of 252.18 (95% CI: 170.69⁻322.92) YLL for all ages with an increase of 27,474.61 (95% CI: 18,483.02⁻35,370.58) YLL over 10 years. The expected life remaining (ELR) calculations showed that 30- and 65-year-old persons would gain 2.34 years and 1.93 years, respectively if the current PM2.5 exposure levels were reduced to the WHO interim targets (IT-1 = 35 µg/m³). Newborns and 1-year old children may live 79.81 and 78.94 years, respectively with an increase in average life expectancy of 2.65 years if the WHO PM10 interim targets were met (IT-1 = 70 µg/m³). Sensitivity analyses for YLL were carried out for the years 2015, 2025, and 2045 and showed that the years of life would increase significantly for age groups between 30 and 85. Life expectancy, especially for the elderly (≥60 years), would increase at higher rates if PM2.5 levels were reduced further. This study can be helpful for the assessment of poor air quality represented by PM2.5 and PM10 exposures in causing premature adult mortalities and postneonatal infant mortalities in developing countries with high ambient air pollution. Information in this article adds insights to the sustainable development goals (SDG 3.9.1 and 11.6.2) related to the reduction of mortality rates attributed to ambient air levels of coarse and fine particulate matter.

Violence against nurses in healthcare facilities in Kuwait.

A national cross-sectional survey was conducted to document the prevalence and determinants of violence against nurses in healthcare facilities in Kuwait. It involved all nurses employed in all types of health-related facilities and available in the country in May 1999. The questionnaire was completed by 5876 nurses (85% females, 88% non-Kuwaitis). Verbal violence had been experienced in the 6 previous months by 48% of the group, and physical violence by 7%. There was no physical harm reported in 63% of cases of physical violence. Physical abusers were mostly patients (51%). Compared to nurses who had never experienced physical violence, those who had experienced some were more likely to be male, non-Kuwaiti, to have had a shorter professional experience, and to be working in a hospital rather than in a primary healthcare center. The experience of nurses with violence is still relatively rare in Kuwait. Communication with patients and their entourage of family members and/or close friends is needed to clarify expectations and to avoid frustration and angry verbal outbursts.