Evaluation of the effect of air pollution on human health in Kuwait
Even before the 1990 war the populations of some areas of Kuwait was subject to severe atmospheric pollution. However, little was known about the effect of this pollution on health and on the use of health care. Three areas in Kuwait were chosen for study which were demographically similar and lay at a different distances to the north (i.e. usually downwind) of the industrial area. Plant in this area emits hydrogen sulphide, sulphur dioxide, hydrocarbons, nitrogen oxides, ammonia and carbon monoxide among other pollutants. A special survey was carried out to gather information on demographic, health and lifestyle factors including age, sex, place of residence, smoking, physical symptoms, psychological effects, life satisfaction, environmental problems, experience of air pollution and use of health care. A random sample of 136 households (1140 persons) was chosen from the three areas and studied over the period from lst February 1988 to 31st January 1989. Data on levels of pollution concentrations and meteorological conditions were also collected over the same period for each area studied. Data on use of health care were available from the health centres in the three areas studied and also from the population survey. The demographic similarity of the three areas studied was generally confirmed by the data from population survey. The relationships involved were examined for different age groups using cross tabulation, time series analysis and regression analysis. There were clear gradients with increased distance from the industrial area in levels of pollution, levels of selfreported physical and psychological symptoms and in the use of health care. Of the individual pollutants it appeared that carbon monoxide levels were most closely correlated with levels of symptoms. For those aged less than 18, the link to CO was closest for respiratory symptoms, while for those aged 18 to 64 the link was with headache. The use of primary care is more closely linked to H2S although this relationship is relatively weak. Consider the relationship between levels of pollution in the three areas studied and Kuwait City and the levels of pollution in Shuaiba area taking meteorological conditions into account. The purpose of this was to allow for estimates of the effect of pollution reduction in Shuaiba on the health of population elsewhere in the country. However, no way was and of making such estimates with sufficient prison. This analysis confirmed a number of recommendations that have been made by others.