Introduction
The United Nations Emirate is a federation of seven emirates each governed by a hereditary emir and the president. UAE has been associated with political, industrial and cultural activities. It is worth noting that UAE is number six world wide in term of oil production having a well developed economy in West Asia (Chen, 2004).
Additionally the federation is deemed to be in the list of the wealthiest countries having a per capital gross domestic product of USD 48, 600. Globally, it is ranked 30th in Human Development Index and 15th in purchasing power per capital on the Asian Continent (Hess-Kosa, 2002).
In general its classification is that of a high-income developing economy. The literature review is a thorough examination of dust event and respiratory diseases in the region
Dust Events in UAE
As suggested by Anderson, et al., 2001 besides all the good economy, development, and the wealth in possession, the United Arab Emirates has been found to be seriously affected by ambient air representing serious hazardous pollutants.
Between the years 2004 and 2005 a study by the ministry of health revealed that out of about 150,000 people who underwent treatment in public hospital every year, close to 90.0% were treated for diseases related to respiratory related health complications.
In 2007, studies based on the UAE facilities indicated that more than 600 deaths had been caused by man-made air pollution (Husar, 2001). Health professional have established that very tiny particles are capable of finding their way into human respiratory tract posing the greatest danger to mankind (Achudume & Oladipo, 2009).
According to the research conducted by the scientists from the University of North Carolina Chapel Hill in the United States, about over man-made air pollution the same claimed 609 live in 2007, 504 deaths were attributed to particulate matter (Brunekreef, 2005).
Additionally, in 2007 approximately 60 people lost their lives due to complications related to ozone smog. This study is said to have been conducted using the most sophisticated mapping techniques that it is no doubt the research reflect the real situation of what is happening on the on the ground (Malig, 2009).
The complications caused by the ozone exposure include diseases such as bronchitis and asthma, while those attributed to particulate matter pollutant include respiratory complications and the heart disease (Ko, 2007).
Further studies carried out to analyze previous studies related to the relationship between the particulate matter pollution natural occurrence and how much it comes about as a result of human activities have established consistence about the findings. The results indicated that natural occurrence of dust storms are the main factor for lung diseases in the region (Ko, 2007).
This is because United Arab Emirates is found in a desert region whereby sand and dust storms carrying millions of tinny airborne particles is rampant. Though to the lower level, man-made pollution such as industrial processes which involves the combustion of fossils-fuel in vehicles engines, refineries, and chemical composition are also a source of particulate matter pollution (Kanatani, 2010).
While pollution is a known trigger to respiratory diseases, the doctor urges the patients not to engage in cigarette smoking habit as it worsens their conditions (Abdelkarim, 2011). It has been shown that those particles that are ÂĽ of 100th millimeter in diameter have the greatest potential of reaching human lungs causing serious respiratory problems (Lei, 2004).
It was observed that even in this twenty first century millions of people are still working daily in very dusty environments (Wang, 1997). This people are exposed to different types of health hazard namely, fumes, gases, and dust. In cities like the emirate cities, there are a lot of occupations in process due to the demands for advancements.
This calls for cement industry which is involved in the development of modern world structures. In the process, cement dust is generated which causes lung function impairment, chronic obstructive lung disease, restrictive lung disease, pneumoconiosis and carcinoma of the lungs, stomach and colon (Malig, 2009).
As suggested by Brunekreef & Forsberg, 2005 cement particle to be small enough to be reparable. He indicates cement size to be between 0.05 and 5.0 micrometer in diameter meaning that the particle is capable of being taken down the tracheobronchial respiratory zone causing occupational lung disease (Al S uwaidi, 2010).
On the same note the respiratory tract offers cement dust an avenue to reach the body particularly through inhalation and swallowing in that order (Zhai, et al, 2011).
The ability of cement to be small in size, light in density among others makes it to have differing degree of impact on human health (Quing, 2007). Among the chemical properties influencing the respiratory tract’s response is the acidity or alkalinity of the inhaled agent. Sultan says that the deposition of the inhaled particle’s deposition depends on the particles size and is best described in an aerodynamic diameter (Choi, 2011).
In the study he adds that a particle with an aerodynamic diameter in excess of 10µm in diameter can be deposited throughout the tracheobronchial tree while those of diameter between 0.1 and 3µm are mostly deposited within the alveoli (Choi, 2011). Particles smaller than 0.1µm remain in air and are inhaled.
According to Brunekreef & Forsberg, 2005, many cement workers with ten and above years working in the cement industry in UAE have been diagnosed with diffuse swelling and proliferation of sinusoidal lining cells, sarcoid type granulomas and perisinusoidal and portal fibrosis in their livers (Kwon, 2002).
He associates the symptoms to be due to the inhaled cement dust that reach the liver through the blood streams. Besides, in his study he indicates that when such workers are taken for medical check-ups, cement particles are found in their livers by the doctors.
Indoor Dust Events in UAE
According to the study by Sabah A. Abdul-Wahab Al-Alaman in the book Sick building Syndrome in Public Buildings and Work Place, the author suggests that air conditioners tend to reduce the fresh air exchange rate to the minimum (Quing, 2007). According to his study, air conditioners trap contaminants re-circulating them to conserve cold air.
In the United Arab Emirates, it is recorded that people would prefer locking themselves indoors due to the sand storms and strong wind out side (Kanatani, 2010). However, this has not reduced the risks of being in touch with respiratory disease risks. According to researches done, indoor pollution effects have been ranked second after out door pollution’s effects (Qui, 2006).
This is because cigarette smoke, chemicals from furniture, dust from outside, insect remains and stove emissions are common indoor contaminants. It’s so unfortunate however; that so many people living in emirate cities and even the other parts of the world have not discovered the dangers of indoor air conditioners when these contaminants are in place (Miri et al., 2007).
Similarly air conditioners reduce the air exchange rate in a room. This thought has given rise to a question by some researchers wondering why the resources are being spent on burning fossil fuels to produce electricity which is spent to increase health risks by reducing the air exchange rate at home (Brunekreef & Forsberg, 2005).
The answer to this question becomes even more complicated considering the increased dust storms intensity and frequency over the past decade due to droughts, dams that reduced river flows and agriculture as well as overgrazing and urbanizations (Meng, 2007).
Is air conditioning system efficient at home? To answer this question, researchers have carried out studies and found out that this facility could only be a waste of resources to the people of United Arab Emirates and not necessarily guaranteeing health safety in their homes and offices (Peng, 2008).
It has been estimated that air conditioning is responsible to up to 70% of energy consumption at homes while at the same time may be responsible for Sick Building Syndrome (SBS), a phenomenon considered to be caused by poor architecture, exposure to some man-made building materials, air bone biological, chemical, dust and fiber hazards, low frequency noise, inadequate lighting and by inadequate ventilation/ air conditioning system (Choi, 2011).
To counter this challenge, the architects are coming up with new ways to replace the air conditions; among the already invented systems to counter for the air conditioners are systems such as floor cooling, adiabatic cooling and heat exchange between cooled exhaust air and outside air (Host S. e., 2008).
Is the indoors safest for the people of UAE?
In the United Arab Emirates, people are forced to stay indoors for more than 20 hours in a day due to man-made and natural occurrence of air pollution and the severe heat outside. This translates to about 90% of indoor operations (Malig, 2009). This behavior has caused most of the people to be victims of respiratory as a result of poor indoor quality of air (Abdelkarim, 2011).
According to the United States Environment Protection Agency on May 3rd 2011, there is a rising concern regarding asthma in the UAE region. According to their study, around 40% of children in the UAE suffer from allergic rhinitis, whilst one of every child is asthmatic.
During 2010, fifty two percent of children missed school due to this condition while in 2009, 30% of the adults missed work due to respiratory problems (Hess-Kosa, 2002). Health experts have at the same time warned that breathing allergies are expected to rise in the region up to about 70% due to uncontrollable measure and human activities in the region (Kwon, 2002).
According to a statement made by an asthmatic woman in Abu Dhabi, UAE is full of pollen and fertilizers owing to constant landscaping and urbanization (Husar, 2001). Most people also in the region are irresponsible; smoking in houses. This woman by the name Jaya wonders whether air purifiers might ever be the solution to the indoor air pollution.
As reported in their research report, United States Environment Protection Agency rates indoor air pollution to be one hundred times worse than outdoor pollution (Kanatani, 2010).
This statement is agreed by the Dr. Bassam Mahboub who is the Vice President of the Emirates Allergy & Respiratory Society. According to him, mold, pollen and dust mites trigger a host of reaction including coughs, colds, sneezing, watery eyes and nasal congestion.
In the study by the World Health Organization research in 2011, indoor pollution has been associated with a wide range of health outcomes that have been rated either strong, moderate or tentative (Brunekreef, 2005).
The study indicated that, indoor air pollution increases the risk of pneumonia and other acute lower respiratory infections (ALRI) among children under the age of five years (Lei, 2004). In adults above the age of 30 years it is associated with Chronic Obstructive Pulmonary Disease (COPD) and lung cancer.
Lung cancer was associated with exposure to indoor biomass smoke which was attributed to asthma, cataracts and tuberculosis. The smoke was also associated with adverse pregnancy outcomes particularly low birth weight, ischemic heart disease and nasopharyngeal and laryngeal cancers (Choi, 2011).
The smoke also found indoor contains small particles and several of the other pollutants causing inflammation of the airway, lungs and impaired immune response (Hefflin, et al., 1994).
Outdoor Dust Events
The United Arab Emirates (UAE) is no doubt one of the world regions experiencing rapid development leading to increased life expectancy and greater economic opportunities. This is according to the research carried t by the UNC-UAE National Strategy for Environmental Health projects. However, this development is also causing potential environmental and public health threats to the people within the region (Kwon, 2002).
In their research; the National Health for environmental health projects evaluated a number of things they thought to be responsible for health threats in the region. These included a study on water quality, food safety, and global climate change. From the study result, they were able to come out with a conclusion that out door air pollution is the top environmental threat to the country (Zhai, et al, 2011).
According to Dockery & Pope, 1994 on out door air pollution, researchers estimated that it is responsible for six hundred deaths that occur each year in the UAE. This study indicated that outdoor pollution is responsible for more deaths as compared to indoor pollution which was estimated to claim two hundred and fifty deaths yearly (Host S. e., 2008).
This is however contrary to some of the already conducted studies that indicated indoor pollution to be more dangerous as compared to outdoor pollution. From this contradiction however, a conclusion can be drawn that indoor and outdoor pollution are both big health hazards to the people of the United Arab Emirates (Dockery & Pope, 1994).
Air monitors used to measures dust particles in the atmosphere of UAE have so far identified seven harmful pollutants namely nitrogen dioxide, carbon monoxide, sulfur dioxide and particulate matter. Of the four, particulate matter pollutant has been given more focus due to its dangers associated characteristic to cause cardiovascular and respiratory diseases exacerbations and outcomes (Chen, 2004).
This pollutant as already mentioned, consists of sand particles carrying microbial fungi and other infections and results from diesel engines used for massive construction, oil and gas production, and car and barge traffic. Besides, the studies have shown that pollution from Europe and Eastern Asia blows into the UAE region making it even more hazardous for people living around this region (Qui, 2006).
In the research by NIEHS Scientists, people of the UAE suffer from respiratory illness such as allergies, asthma, chronic obstructive pulmonary disease, and lung cancer due to the long-term exposure to air pollutants that to some extent are unavoidable (Peng, 2008). Scholars have managed to clearly show that those in great danger when considering dust events globally UAE not being an exception are the elderly and the children.
A study by Abdelkarim, 2011 revealed that people residing in cities that are prone to dust events were at higher risk of being hospitalized as well as die at early ages from complications related to lung cancer as well as respiratory diseases such as asthma when compared to those living in cities that are less populated.
Research done to find out how much outdoor exposure to pollutants from vehicle and fossils fuel emissions in the region indicated hindrance lung development and limited breathing capacity for a life time (Abdelkarim, 2011). On the same note children who play outdoors are 5 times more likely to suffer from low lung functioning. This translates to children lung functioning performing at less than 80% of the normal performance.
Wind as Mode of Respiratory Disease Enhancer
According to researchers, there is a lot of dust that is blown off the coast of the Arabian Peninsula, reaching more or less the Saudi Arabia and the United Arab Emirates. This dust storms from the Arabian Peninsula and Sahara Desert are the most common casing the people UAE dust related misfortunes.
To be precise, it is estimated by researchers that the Rub’ al Khali, meaning “Empty Quarter” in Arabic, is one among the largest sand deserts in the world. it is said to occupy most of the southern third of the Arabian Peninsula including most of Saudi Arabia and areas of Oman, the united Emirates, and Yemen.
This desert which is said to give rise to the biggest amount of wind dispersed dust to the United Arab Emirates covers some 650,000 square kilometer in the area between long. 44º30’ -56º30’ East., and lat. 16º30’-23º00’N. It has been estimated to be 1,000 kilometers long and 500kilometers wide.
Its surface elevation varies from 800 meters south west to around sea level I the north. Research shows that some dust can be blown in the air south of the Arabian Peninsula, off the coast of Yemen and Oman.
The figure above shows dust by Arabian Pensula by March 3rd, 2012
Precipitation as a Respiratory Disease Enhancer in UAE
The United Arab Emirates is a region known for dusty atmosphere. This dust from the environment and industries combines with water particles during rainy season to water storage tanks etc; when ingested by humans, the dust in the water affects the respiratory tract which in most cases leads to respiratory related diseases.
Pulmonary and respiratory diseases
The study by the city hospital in Dubai indicated that damage to respiratory system occurs due to multiple factors like infections, pollution, allergy and smoking. This factors tally with the UAE environmental atmosphere whereby the above mentioned are present (Choi, 2011). This has been the reason behind the higher percentage of sick individuals in the region.
From the report given by the hospital, long exposure to dust particles, smoke and other pollutants affect the respiratory system which is made up of delicate organs that help the body to breath. This particles attack the lungs, trachea, bronchi and the diaphragm which together make up the breathing system.
When the breathing system is attacked, it becomes difficult for it to perform its purpose which is to deliver oxygen and take away carbon dioxide from the body (Al Suwaidi, 2010).
Some of the common breathing complications according to the city hospital are as follows: bronchial asthma, chronic obstructive pulmonary disease, pneumonia, intestinal lung disease, occupational related respiratory disease, sleep apnoe syndrome, diagnosis and staging of lung cancer, pulmonary embolism, chronic cough, bronchiectasis, and hamoptysis or coughing blood (Bates, 1995).
According to Zhai, et al, 2011 in situations where one does not undergo proper treatment for bronchitis, there are higher chances of that individual to suffer from chronic bronchitis or emphysema. These two are a pair of commonly occurring diseases of the lung which causes the narrowing of the respiratory airway.
This results to the patient’s difficulty in breathing meaning there is limitation of the air flow in and from the lungs. Medical practitioners have revealed that the problem is very serious since it is not possible to reverse the situation and over time, the problem gets out of hand (Al Suwaidi, 2010).
It is worth mentioning that chronic respiratory diseases have a close association with gas and particles that are toxic. This usually triggers an unusual inflammatory in human lungs.
However, the records in UAE drives to a conclusion that patients suffering from bronchiectasis posses the greatest risks to posses the disease if they involve themselves in the habit of smoking (Host S. e., 2008). When an individual is suffering from the disease, he or she feels abnormal inflammatory responses in the lung.
What is asthma, its common symptoms, who is affected with it, and what causes it?
Asthma also known as bronchial asthma is defined as a chronic disease affecting the airways of the lungs. It is characterized by the bronchospasm, inflammation and mucus production in the band ways of air passages (Brunekreef & Forsberg, 2005). Its symptoms are difficulty in breathing, wheezing and coughing.
When one suffer from this disease, the bands that surround the airways tighten making it difficult for air to move, this results to the swelling of the airways which leads to inflammations. When this happens, the walls of the air passages are stimulated to produce mucus which is thicker than in normal circumstances.
The symptoms of asthma as revealed in some of the researches already discussed are coughing especially at night, shortness of breath, wheezing, chest tightness, pain, or pressure (Brunekreef & Forsberg, 2005).
These symptoms however are not guaranteed to reveal to an asthmatic person at once; moreover they are not the same for everyone (Choi, 2011). According to an article Disease and Conditions, asthmatic symptoms can change from episode to episode in the same person. It is therefore possible that an individual can have only one symptom of asthma while the other is having all the symptoms but they are all asthmatic (Wilby, et al., 2005).
Asthma has been known to be a hereditary disease, meaning that it is a disease that can go down generation line. It has been found out in researches that people from the family history of asthma have got a greater risk of being victims of this disease (Brunekreef & Forsberg, 2005).
In the United Arab Emirates, it has been recorded that one of every five children under the age of five years old is asthmatic mainly due to indoor pollution that occurs due to poor architectural outcomes and limited knowledge in line with air conditioners.
This is however not the big issue, the issue is the surrounding economical, industrial and natural activities that increase the risk of individuals to suffer from the disease.
According to researchers, anybody can develop asthma anytime. It is however common in people who have allergies caused by factors such as dust (Qiu, Zou & Zhan, 2006). The risk to develop asthma is however more common to people who smoke or are exposed to tobacco smoke (Wang, 1997).
Another killer disease that is responsible for death in children in the UAE is pneumonia according to the research conducted by WHO. As suggested in the WHO report, it is no doubt that the major cause of death in children in UAE is pneumonia beating the death toll. UNICEF described this disease as “the forgotten killer” indicating that it kills more than two million children worldwide yearly (Meng, 2007).
Pneumonia can lead to a number of problems in children such as death, paralysis among others. It poses greater dangers to children under the age of five years since they lack the antibodies to fight infections (Wang, et al., 1997).
Dr. Ulrich Werney, a scientific director in the Central Veterinary Research Laboratory (CVRL) in Dubai reported an unusual out break of pneumonia in camels (Peng, 2008). Camels are known to be one of the animals resistant to a lot of diseases. The extent to which this bacterium is found in this animal species shows how dangerous the bacteria causing this disease can be.
The government of UAE has however taken note and some more advanced vaccines are being administered to all children below the age of eight years in the country; to prevent further increasing number of children lives being claimed by this disease (Choi, 2011).
According to Abdelkarim et al., 2011 changes in weather conditions which are characterized with dust events exacerbate chronic lung diseases particularly in those individuals deemed to be suffering from asthma. A study on children suffering from respiratory diseases in this region showed that the prevalence rate among children aged between 6 and 19 years stood at 13.0% (Choi et al., 2011).
Asthma in the region has been known to be responsible for higher morbidity rate as well as high rate of absenteeism in schools. Other causes of respiratory diseases in this region include cigarette smoking, genetic history of illnesses such as asthma, low birth weights among others (Wang et al., 1997). It is worth noting that the relationship between dust events and respiratory diseases in UAE is not well documented.
The goal of this research paper was to identify potential respiratory effects associated with dust events in the United Arab Emirate. The research has provided information about the potential health effects of the indoor and outdoor air pollutants and determining the general health and nutrition status of the Emirate people. It has also discussed some of the diseases associated with dust events in UAE and their potential effects to this society.
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