Exposure to air pollution in epidemiological studies in Kuwait: A systematic review

Abstract Objective To systematically review the epidemiological studies of human exposure to air pollution in Kuwait. Methods Specific keywords related to air pollution and health effects in Kuwait were systematically searched using PubMed and BASE search engines for published research in English language from the year 1990 up to June 2020. Non eligible studies were those which published in non-English studies, studies on animals, plants, exposure to pollutants other that air pollutants, studies related to oil fires caused by Iraqi invasion to Kuwait in 1991. After duplicates were removed, titles and abstracts of eligible studies were screened and full text of publications meeting the inclusion criteria was read. Non-epidemiological studies were included only to compare their numbers to the epidemiological studies, and to help in future studies. Results Total of 85 studies including epidemiological and non-epidemiological studies, only 8 of them found to be an epidemiological study, which 4 of them concerned with mortality and 3 with morbidity, and 1 with both morbidity and mortality. Two of these studies concern with respiratory disease, 1 of them concerned with atopic dermatitis and was the only study measured indoors (i.e. house), and 1 study concerned with rheumatoid arthritis. One study measured ETS, 4 studies measured dust, 2 studies measured PM10 and PM2.5, and 1 study measured NO2, SO2, O3, CO. All studies found that exposure to air pollution has adverse effect on health problems (i.e. respiratory problems, atopic dermatitis, rheumatoid arthritis) and mortality except one study found no significant correlation between exposure to air pollution (i.e. dust) and mortality. Conclusion Epidemiological studies related to human exposure to air pollution in Kuwait are underestimated and insufficient, there are extremely limited studies that cannot be compared to each other. Since currently Kuwait have many major constructions in major roads in and out the capital which alters the air pollution, adding to that the new study which found that the new current global epidemic namely coronavirus COVID-19 is correlated to air pollution (i.e. NO2), new researches need to be done measuring the different pollutants in both indoor and outdoor exposure examining different health problems, these researches need to be done during and after these circumstances for comparison.