Assessing the Effect of Air Pollution and Heat Stress on Health in Nairobi City: A Geohealth Project (Kenya)

Abstract

The environmental and occupational burden of disease is ravaging the global economies, with the combined burden of disease and DALYs constituting at least 25%. This has reached alarming levels in developing countries, with over 60% of this burden borne by the Sub-Saharan Africa. To partly address these concerns, the Global Environmental and occupational health (GEOHealth) Eastern African Hub has been established. The five-year research, training and capacity building Hub runs from Sept 2015 till August 2020, with an aim of building capacity, training and conducting research to generate evidence for policy in air pollution, climate change and occupational health. The specific objectives are to: (i) assess the effect of ambient air pollution on cause-specific hospitalization and mortality; (ii) assess the effect of ambient and indoor air quality on child pulmonary function in Nairobi; and (iii) to assess the effect of heat stress on workers engaged in flower green houses in the neighbourhoods of Nairobi city. Multiple study designs will be used to meet the above objectives of the Nairobi based research as follows: (i) continuous measurement of the level of ambient air pollution (PM2.5) prospectively in a central site in the city in parallel with collecting secondary data on hospital admission and discharge in 6 hospitals; (ii) nephelometric measurement of micro-catchment air pollution around 10 schools, to be related to the spirometry tests of one thousand 10 year old pupils; and temperature and Relative humidity measurements to determine heat stress in occupational settings. Data will be collected using different equipment such as: air quality measuring instruments (Beta Attenuation Monitor and Nephelometer); Spirometer for pulmonary function test (PFT); and Easy Log RH / Temp Data loggers for Occupational Health stress. In addition, questionnaires will be used for background data, and data acquisition checklist for secondary data. Data will be entered and cleaned using Epi Info Ver 3.5.1, and the analysis done using SPSS V 20.0. Summary statistics, multivariate regression using Ors with 95% CI, exposure modelling will be utilized to describe the study subjects and exposure levels to air pollution. The Hub activities in Kenya are already ongoing, with progress made in many fronts. Ethical clearance and permission for data collection will be