Diesel exposure in urban environment: evidence based approach to understand health risks

摘要

We evaluated urban population with low socioeconomic status for ambient air particulate matter (PM) and diesel exhaust exposure effects. In general there seems no urban health policy for reducing environmental exposure and improving environmental health in Rawalpindi city. Three spots i.e. Faizabad, Shamsabad, and Saddar in Rawalpindi city were studied. People living and working along roads with dense traffic were compared with sub-urban areas for health outcomes. Hospital admissions, asthma, respiratory infections and cardiovascular hospital admission rates were higher. Five times higher PM concentration around roads and highways was noted. Stops for buses and public transport where people standing in queues have 10 times higher PM_(10) than urban ambient air. PM_(10) concentrations average ～ 2 mcg/m3 but have been detected at 125 mcg/m3 above background in urban public transport stops Faizabad, Shamsabad and Saddar. Significant effect modification by age, smoking status and poverty level was evident among those with higher frequency of respiratory infections, asthma and previous admissions. Based on logistic regression, we found that people living in neighborhoods with dense traffic and higher diesel exposure had high prevalence of respirator infections (OR=3.15, 95% Cl=1.18-7.66) whereas location of occupational groups along roadsides have attributed substantial development of asthma (OR=4.02, 95% Cl=1.59-9.61). Response of people towards exposure prevention such as use of masks was substantially low whereas their expectation from local government was very high to control smoke emission from public transport. We propose two-pronged approach to minimize health risks in Rawalpindi. First, urban governance should deliver by initiating strict action against smoke emitting vehicles. Exposure prevention by urban population at individual levels is suggested as an alternate approach through adopting safety measures such as use of masks and gloves.