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Title: Ambient air pollution and health in Sub-Saharan Africa: Current evidence, perspectives and a call to action
Authors: Katoto, Patrick D. M. C.
Byamungu, Liliane
Brand, Amanda S.
Mokaya, Jolynne
Strijdom, Hans
Goswami, Nandu
DE BOEVER, Patrick 
Nemery, Benoit
Issue Date: 2019
Source: ENVIRONMENTAL RESEARCH, 173, p. 174-188
Abstract: Background: People from low- and middle-income countries are disproportionately affected by the global burden of adverse health effects caused by ambient air pollution (AAP). However, data from Sub-Saharan Africa (SSA) are still scarce. We systematically reviewed the literature to describe the existing knowledge on AAP and health outcomes in SSA. Methods: We searched PubMed, Medline-OVID, EMBASE and Scopus databases to identify studies of AAP and health outcomes published up to November 15, 2017. We used a systematic review approach to critically analyze and summarize levels of outdoor air pollutants, and data on health effects associated with AAP. We excluded occupational and indoor exposure studies. Results: We identified 60 articles, with 37 only describing levels of AAP and 23 assessing the association between air pollution and health outcomes. Most studies (75%) addressing the relation between AAP and disease were cross-sectional. In general, exposure data were only obtained for selected cities in the framework of temporary international collaborative research initiatives without structural long-term continuation. Measurements of AAP revealed 10-20 fold higher levels than WHO standards. Of the 23 studies reporting health effects, 14 originated from South Africa, and most countries within SSA contributed no data at all. No studies, except from South Africa, were based on reliable morbidity or mortality statistics at regional or country level. The majority of studies investigated self-reported respiratory symptoms. Children and the elderly were found to be more susceptible to AAP. Conclusion: AAP and its negative health effects have been understudied in SSA compared with other continents. The limited direct measurements of air pollutants indicate that AAP in SAA cities is high compared with international standards. Efforts are needed to monitor AAP in African cities, to identify its main sources, and to reduce adverse health effects by enforcing legislation.
Notes: [Katoto, Patrick D. M. C.; Nawrot, Tim S.; Nemery, Benoit] Katholieke Univ Leuven, Ctr Environm & Hlth, Dept Publ Hlth & Primary Care, Herestr 49 706, B-3000 Leuven, Belgium. [Katoto, Patrick D. M. C.] Catholic Univ Bukavu, Dept Internal Med, Fac Med, Bukavu, DEM REP CONGO. [Katoto, Patrick D. M. C.] Catholic Univ Bukavu, Expertise Ctr Min Governance CEGEMI, Bukavu, DEM REP CONGO. [Byamungu, Liliane] Univ KwaZulu Natal, Dept Pediat, Fac Med & Hlth Sci, Durban, South Africa. [Brand, Amanda S.; Mokaya, Jolynne] Stellenbosch Univ, Div Epidemiol & Biostat, Dept Global Hlth, Fac Med & Hlth Sci, Cape Town, South Africa. [Mokaya, Jolynne] Kenya Govt Med Res Ctr, Nairobi, Kenya. [Strijdom, Hans] Stellenbosch Univ, Div Med Physiol, Dept Biomed Sci, Fac Med & Hlth Sci, Cape Town, South Africa. [Goswami, Nandu] Med Univ Graz, Dept Physiol, Graz, Austria. [Goswami, Nandu] Med Univ Graz, Otto Loewi Res Ctr, Graz, Austria. [De Boever, Patrick] Flemish Inst Technol Res VITO, Environm Risk & Hlth Unit, Mol, Belgium. [De Boever, Patrick; Nawrot, Tim S.] Hasselt Univ, Ctr Environm Sci, Hasselt, Belgium.
Keywords: Outdoor air pollution;Urban health;Cardio-respiratory diseases;Environmental justice;Global health
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ISSN: 0013-9351
e-ISSN: 1096-0953
DOI: 10.1016/j.envres.2019.03.029
ISI #: 000469162200018
Rights: 2019 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY license (
Category: A1
Type: Journal Contribution
Validations: ecoom 2020
Appears in Collections:Research publications

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