Health Impact

8/7/2019 Health Impact

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HEALTH IMPACTS OF

PARTICULATE MATTER

PROPOSED METHODOLOGY


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INTRODUCTION AND BACKGROUND

The effect of particulate matter in the health of

the people as the most important impact of airpollution have been identified as the key problem

as shown from various studies in developedcountries (UNEP, 2007).

The size of the particles is most important andthe recent studies have identified fine particle

fraction called PM2.5 (with a mean aerodynamic

diameter of or smaller than 2.5 microns) as beingespecially harmful because they penetratedeeply, persist in the lungs and may reach thealveolar region. 2


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Basically, developed countries are concerned

about outdoor air pollution, as; indoor airpollution is not a major issue in their context.

Developing countries like Nepal are at doublejeopardy; as the problem of outdoor as well asindoor air pollution is growing fast, and those

pollutions are interchangeable.

Numerous studies suggest that PM10 and PM2.5contribute to excess mortality andhospitalizations for the cardiac and respiratorytract disease (McGranahan and Murray, 2002). 3


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RATIONALE

Relatively fewer studies are made in the

developing countries than in developed countries.

With the increasing pollution, the concentration

of air pollutants in major cities are higher andthe source and chemical composition of particlesin cities in developed and developing countriesmay differ.

Consequently information is needed to assess theimpacts of the much higher concentrations of

PM10 (with a mean aerodynamic diameter of orsmaller than 10 microns) and PM2.5 found in thelarge cities of developing countries. 6


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As most lung alveoli are formed postnatal,

changes in the lungs continue throughadolescence and the developing lungs of children

are more vulnerable to the adverse effects of airpollution than adult lungs.

Children are more susceptible to the exposure tothe harmful particles than adults because of their

higher susceptibility to higher ventilation rates,

higher relative concentrations of particles intosmaller lung volumes and higher levels ofphysical activity.

The impact of air pollutant and its adverse effect

may harm child till their adulthood.

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As child health is an essential indicator for the

overall assessment of country health status, thisstudy will certainly provide a basis to understand

the effect of air pollutants on the health of thechildren. This study can address the need for theinformation on the effects of air pollution on

health in South Asia at the high concentrationcommonly found in large cities in South Asia, and

provide locally-gathered evidence to supportactions by government to control particulateemissions.

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NATIONAL STANDARDS - AMBIENT AIR

Parameter AVG Time Conc., Max.

TSP 24 hour 230 g/m3

PM10 24 hour 120 g/m3

NO2 Annual24 hour

80 g/m3

40 g/m3

SO2 Annual

24 hour

70 g/m3

50 g/m3

CO 8 hour

15 minute

10,000 g/m3

100,000 g/m3

Lead Annual 0.5 g/m3

Benzene Annual 20 g/m3


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NATIONAL INDOOR AIR QUALITYSTANDARD

AND IMPLEMENTATION GUIDELINES 2009

Pollutant Maximum

concentration

Averaging

time

Particulate Matter(PM10) 120 g/m3 24 hour

200 g/m3 1 hour

Particulate Matter(PM2.5) 60 g/m3 24 - hours

100 g/m3 1 hour

Carbon Monoxide (CO) 9 ppm (mg/m3) 8 hour

35 ppm (mg/m3) 1 hour

Carbon Dioxide (Co2) 1000 ppm (mg/m3) 8 - hours


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STUDYTOPIC

Impacts of particulate matter on the respiratory

health ofSchool Children

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OBJECTIVES OF THE STUDY

General Objective

To assess the impact of air pollution (ParticulateMatter) in respiratory health of school children ofselected school(s) in Kathmandu

Specific Objective

To determine whether there is an associationbetween daily PM10 and PM 2.5 concentration andrespiratory health and lung function in children

To determine the level of relationship of PM andrespiratory health

To assess the severity of impacts of PM onrespiratory health

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VARIABLES

Dependent Variable

y Respiratory health and lungfunction

o Independent variables

Socio-demographic and

economic variables

Air pollution related

variables

Confounding variables

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VARIABLES.

Socio-demographic andeconomic variables Age

Sex

Parents education

Economic status of thefamily

Air pollution relatedvariables Preventive measures

taken

Infrastructure of theschool

Confounding variables

Other systemic

illnesses

Housing conditions

Simultaneous

exposure to other

pollutants

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CONCEPTUAL FRAMEWORK

Sociodemographic& EconomicVariables

Air Pollution relatedvariables

Protective Factors Hindering Factors

RespiratoryHealth/Lung

Function

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METHODOLOGY

Study sign

y Correlational study a longitudinal study usingquantitative methods

Study Site

y Putalisadak (Kathmandu): School near by AQMS

S

tudy Durationy 3 months

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METHODOLOGY. Study Population

Children of selected schools of age between 9-14 years

Inclusion Criteria

Age between 9-14years

Studying in the school

at least since 1 year

School located close to

the AQMS

Exclusion Criteria

Smokers Use of solid fuel at

home

Residing more than 3

km from AQMS

Child having asthmaor other chronicrespiratory illness

Child with smoker inthe home

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SAMPLING

Sampling technique

y Purposive selection of schools

y Proportionate random sampling

Sampling unit

y Children of the selected schools within the age limit

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SAMPLING.

Sample selection

y Schools finalized

y List of students between age 9-14

y

Randomly select the required sample (500)y Consider them for the initial baseline survey

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SAMPLING.

For the health impact aspect

y Exclude the subjects as per the exclusion criteria

y Exclude voluntary exclusions (if any)

y

Obtain consent both from the subject as well asparents

y Finalize the number of participants to undergo theregular study

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DATACOLLECTION

Tools

Structured questionnaire

Health check up check list

The questionnaire will be translated into Nepali and the

language will be kept simple and understandable

Techniques Self/parental administration of questionnaires

Completing the check list by the medical

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DATACOLLECTION

Methods

y Recording the PEFR readings in the standard sheets

y

Daily notes of any illness particularly that ofrespiratory health to be noted in a diary provided

y Diary writing will be supervised by the trainedteachers or technicians/paramedics

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DATA FROM THE SUBJECTS

PEFR readings will be collected everyday in the

school may be at the end of the day

This process will be continued altogether for 6weeks including days of high and low pollution

Data of PEFR reading as well as information

from the questionnaire will be obtained in bothdry as well as wet season

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PARTICULATE AND WEATHER DATA

Daily data of PM10 and PM 2.5 as well as that of

other pollutants if available will be taken.

Relevant meteorological data such as maximum,minimum and average temperature, relativehumidity and wind speed for the same period willbe obtained from the department of meteorology

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PRETESTING

The questionnaires will be pretested in a school

other than the school to be used for study.

The school for pretesting will have similarconditions as well as near by the AQMS

Necessary amendments will be made after this in

the questionnaires

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DATAANALYSIS

Data obtained from these procedure will beentered in Epi Info and then imported in SPSSfor analysis.

Simple descriptive analysis will be done for thegeneral characteristics of the participants

To see the correlation of the PM concentration

with respiratory health regression analysis willbe done

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LIMITATION OF THE STUDY

Expected findings may not be generalized due to

various factors:

y

Purposively selected school

y Limited number of school

y Possibility of various confounding factors

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THANK YOU28

Health Impact

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