Back
The disproportionately high prevalence and severity of CKD in the young population of LMICs despite preventive interventions, is a matter of global concern. Air pollution is the leading environmental risk factor for NCDs and an emerging risk factor for CKD that is typically ignored in preventive interventions.
AIM: To comprehensively investigate long-term exposure to ambient air pollution in communities near petrochemical industries in the Niger Delta, and any link with CKD risk.
An exploratory mixed methods study was used to first qualitatively explore the public’s perception of air pollution health risks and the findings used to modify an existing health survey questionnaire. A citizen science inquiry was introduced within the quantitative study to involve eight community volunteers in monitoring ambient air pollutant levels in their communities. Twenty-four participants selected purposively participated in three focus groups and one individual interview while 1460 participants from four communities were involved in the health survey.
Six themes were inductively generated – 1) Negative perception of the environment 2) the refinery is to blame 3) Air pollution is seen or smelt 4) Air pollution is associated with health and non-health risks 5) Poor response to air pollution: everyone is to blame and 6) Government is primarily responsible for healthy air quality’. There was poor knowledge and concern about air pollution-related health risks which was crowded-out by other socioeconomic needs.
The mean PM2.5, PM10, and VOCs concentrations exceeded the WHO acceptable limits in all four communities. CO2 was acceptable only in the farthest community from the refinery, while O3 was within acceptable limits in all communities. The overall prevalence of CKD was 12.3%; it was 17.3% in the community closest to the refinery and 8.0% in the farthest community. The independent risk factors of CKD were increasing age, lower level of education, proximity to the refinery and hypertension.
Findings from the focus group were largely consistent and transferable to the larger survey population and both study arms were complementary.
Communities near petrochemical industries are exposed to unacceptable air pollutant levels associated with increased CKD risk. Public environmental health literacy is low. More collaborative epidemiological studies; public and professional air pollution health education are needed to improve environmental health literacy and foster positive behavioural, practice and policy changes to mitigate air pollution and its health risks.