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

ABSTRACT: 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.

SUBMITTER: Gibson JM

PROVIDER: S-EPMC3346776 | biostudies-literature | 2012 May

REPOSITORIES: biostudies-literature

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

Gibson Jacqueline MacDonald JM Farah Zeinab S ZS

Environmental health perspectives 20120222 5

<h4>Background</h4>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.<h4>Objectives</h4>In order to develop the environmental health strategic plan, we sought to quantify the illnesse ...[more]

PMID: 22357098

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Project description:BackgroundThis study estimates the potential health gains achievable in the United Arab Emirates (UAE) with improved controls on environmental pollution. The UAE is an emerging economy in which population health risks have shifted rapidly from infectious diseases to chronic conditions observed in developed nations. The UAE government commissioned this work as part of an environmental health strategic planning project intended to address this shift in the nature of the country's disease burden.Methods and findingsWe assessed the burden of disease attributable to six environmental exposure routes outdoor air, indoor air, drinking water, coastal water, occupational environments, and climate change. For every exposure route, we integrated UAE environmental monitoring and public health data in a spatially resolved Monte Carlo simulation model to estimate the annual disease burden attributable to selected pollutants. The assessment included the entire UAE population (4.5 million for the year of analysis). The study found that outdoor air pollution was the leading contributor to mortality, with 651 attributable deaths (95% confidence interval [CI] 143-1,440), or 7.3% of all deaths. Indoor air pollution and occupational exposures were the second and third leading contributors to mortality, with 153 (95% CI 85-216) and 46 attributable deaths (95% CI 26-72), respectively. The leading contributor to health-care facility visits was drinking water pollution, to which 46,600 (95% CI 15,300-61,400) health-care facility visits were attributed (about 15% of the visits for all the diseases considered in this study). Major study limitations included (1) a lack of information needed to translate health-care facility visits to quality-adjusted-life-year estimates and (2) insufficient spatial coverage of environmental data.ConclusionsBased on international comparisons, the UAE's environmental disease burden is low for all factors except outdoor air pollution. From a public health perspective, reducing pollutant emissions to outdoor air should be a high priority for the UAE's environmental agencies.

Project description:BackgroundThe purpose of the article was to assess students' perception of the learning environment at the College of Medicine and Health Sciences, United Arab Emirates University using the 'Medical School Learning Environment Survey' (MSLES). Evaluating the learning environment and working towards its improvement is crucial for the physical and mental well-being of medical students, as it contributes to fostering an optimal learning environment.MethodsStudents participated in four groups: Year-1 (pre-medical), Year-2 (pre-medical), Year-3/Year-4 (pre-clinical), and Year-5/Year-6 (clinical). MSLES data was collected from each group using an online survey tool (Qualtrics XM). Latent factor structures in the learning environment constructs were assessed using 'exploratory factor analysis'; and reliability was measured by Cronbach's alpha. Differences among groups were assessed by 'single factor ANOVA'.ResultsThree hundred seventy-seven (65%) of the 584 eligible students completed the survey. Exploratory factor analysis revealed four factors: (Genn J. AMEE Medical Education Guide 23 (Part 1): Curriculum, environment, climate, quality and change in medical education-a unifying perspective. Med Teach. 2001;23(4):337-44.) Learning experience (∝=0.71), (Maudsley RF. Role models and the learning environment: essential elements in effective medical education. Acad Med. 2001;76(5):432-4.) Student-student interaction (∝=0.69), (Gruppen LD, Irby DM, Durning SJ, Maggio LA. Conceptualizing learning environments in the health professions. Acad Med. 2019;94(7):969-74.) Student-faculty interaction (∝=0.62), and (Soemantri D, Herrera C, Riquelme A. Measuring the educational environment in health professions studies: A systematic review. Med Teach. 2010;32(12):947-52.) Academic support (∝=0.62). Students in Y3-Y6 rated the learning environment statistically significantly lower than that in Y1-Y2. Student-student interaction in Y2 was significantly lower than that in other years. Student-faculty interaction in Y1 was significantly higher than that in Y2. Academic support was significantly higher in Y1 than that in Y2-Y6.ConclusionThe MSLES revealed variabilities in learning domains across the years. Improvement efforts should foster student-student collaboration in Y2 and improve academic support approaches for Y2-6. These findings provide valuable insights for medical educators to enhance the medical school learning environment and foster an optimal learning environment in lifelong medical education.

Project description:BackgroundSince the time of declaration of global pandemic of COVID-19 by World Health Organization (WHO), falsified hand sanitizers surfaced regularly in markets, posing possible harm to public due to unlisted inclusion of methanol. The current research is an attempt to develop and validate a tool to document falsified hand sanitizer in the UAE community.MethodA descriptive cross-sectional community-based study was conducted among 1280 randomly selected participants. Respondents were sent a web-based electronic link to the survey via email. Content validity, factor analyses and known group validity were used to develop and validate a new scale to identify falsified hand sanitizer. Test-retest reliability, internal consistency, item internal consistency (IIC), and intraclass correlation coefficients (ICCs) were used to assess the reliability of the scale. SPSS version 24 was used to conduct data analysis.ResultsA total of 1280 participants were enrolled in the study. The content validity index (CVI) was 0.83 with the final scale of 12 items. The Kaiser-Meyer-Olkin (KMO) value was 0.788, with the Bartlett test of sphericity achieving statistical significance (p < 0.001). Our factor analysis revealed a 3-component model. The 3-factor solution was confirmed by PCFA analysis and had associations with good fit values. The PCFA for NFI was 0.970, CFI 0.978, and TLI 0.967. All values were in excess of 0.95, with RMSEA values below 0.06 at 0.03; all of these values indicated a good model fit. The Cronbach's alpha was good overall (0.867). All factors had a Cronbach's alpha value in excess of 0.70. The instrument demonstrated that every item met the IIC correlation standard ≥0.40. The scale displayed good overall ICC statistics of 0.867 (95% CI 0.856-0.877) with statistical significance (p < 0.001). The scale's test-retest reliability was assessed through correlation of the falsified hand sanitizer identification score of respondents at the two time points. The test-retest correlation coefficient was 0.770 (p value < 0.01). Participants with post-graduate education were more likely to identify the falsified hand sanitizer compared to those with high school education. (p < 0.001).ConclusionsThis study developed and validated a new scale for the measurement of falsified hand sanitizer. This is expected to improve and promote collaboration between the health regulators and the public and hereby encourage customer satisfaction and participation.

Project description:BackgroundComprehensive global data on the health effects of indoor air pollutants are lacking. There are few large population-based multi-air pollutant health assessments. Further, little is known about indoor air health risks in the Middle East, especially in countries undergoing rapid economic development.ObjectivesTo provide multifactorial indoor air exposure and health data, we conducted a population-based study of indoor air pollution and health in the United Arab Emirates (UAE).MethodsWe conducted a cross-sectional study in a population-based sample of 628 households in the UAE. Indoor air pollutants [sulfur dioxide (SO2), nitrogen dioxide (NO2), hydrogen sulfide (H2S), formaldehyde (HCHO), carbon monoxide (CO), and particulate matter] were measured using passive samplers over a 7-day period. Health information was collected from 1,590 household members via in-person interviews.ResultsParticipants in households with quantified SO2, NO2, and H2S (i.e., with measured concentrations above the limit of quantification) were twice as likely to report doctor-diagnosed asthma. Participants in homes with quantified SO2 were more likely to report wheezing symptoms {ever wheezing, prevalence odds ratio [POR] 1.79 [95% confidence interval (CI) 1.05, 3.05]; speech-limiting wheeze, POR 3.53 (95% CI: 1.06, 11.74)}. NO2 and H2S were similarly associated with wheezing symptoms. Quantified HCHO was associated with neurologic symptoms (difficulty concentrating POR 1.47; 95% CI: 1.02, 2.13). Burning incense daily was associated with increased headaches (POR 1.87; 95% CI: 1.09, 3.21), difficulty concentrating (POR 3.08; 95% CI: 1.70, 5.58), and forgetfulness (POR 2.68: 95% CI: 1.47, 4.89).ConclusionsThis study provides new information regarding potential health risks from pollutants commonly found in indoor environments in the UAE and other countries. Multipollutant exposure and health assessments in cohort studies are needed to better characterize health effects of indoor air pollutants.

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

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

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