Phase 2 (2006 Deadline)
Association of Particulate Matter with Daily Morbidity in
PM2.5 air sampler in the Tibet Center district of Karachi.
David O. Carpenter and Haider Khwaja, University at Albany
Zafar Fatmi, Aga Khan University
Pakistani Funding (HEC): $148,739
US Funding: $126,295
Project Dates on US Side: February 1, 2007 - October 31, 2011 (Completed)
In recent years, interest in the health effects of air pollution in Asia has intensified due to increasing knowledge of the health effects of air pollution and to the alarmingly high levels of air pollution in Asia’s major cities. The rapid and continuing increase in the population, vehicular traffic, and industrial development combined with meteorological conditions, inadequate transport infrastructure, lax environmental legislation and enforcement, weak institutions, and lack of sufficient skilled research and policy personnel have resulted in poorly planed urbanization and severe air pollution problems in Pakistan with serious health impacts.
This study is investigating the effect of short-term exposure of fine particulate matter (PM2.5) in ambient air on hospital admissions and emergency room (ER) visits for respiratory and cardiovascular diseases among adults and young children in Karachi. PM2.5 mass samples are being collected over 24-hour periods at multiple sites in the city, and daily records of hospitalizations and ER visits for respiratory and cardiovascular diseases at six hospitals serving the areas will be examined to estimate associations with air pollution on ER visits or hospitalizations while controlling for long-term trends, seasonality, and weather. This first-of-its-kind study aims to provide Pakistani scientists and decision makers with scientific evidence on the magnitude of health effects related to air pollution in urban centers of Pakistan over the next few years.
- One of the first studies to investigate the association between particulate air pollution and morbidity due to cardiovascular and pulmonary diseases in a developing mega city, Karachi
- Determined that higher levels of PM2.5 are associated with a striking elevation in rates of emergency room visits and hospitalizations for cardiovascular diseases
- Provided the scientific community, policy makers, and the public with information about the health effects of poor ambient air quality in Pakistan and how it compares to other developing and developed countries of the world
- Provided a junior Pakistani faculty member with one year of intensive hands-on training in ion chromatography and other analytical methods for assessing airborne pollutants
Progress Report Summaries
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2011 Show summary || Hide summary || Download final report
Drs. Carpenter and Khwaja have continued to search for additional funding, which is also a major concern for this project at the current stage, as they hope to continue the collaboration. The research team's major focus in 2011 has been on completing their data collection and analysis and publishing the results. A Pakistani researcher on the project, Dr. Sheikh Mohiuddin of the University of Karachi, completed his 11-month training visit to Dr. Khwaja’s lab in Albany in late October 2011. During the visit, he gained new skills and experience in ion chromatography and other techniques for particulate analysis. During the project period, five Ph.D. students from University of Karachi were primarily involved in the air sampling data collection under the supervision of Dr. Siddique. The research team also includes three consultants, four postgraduate students in the field of environmental sciences, and a few research associates in both institutes.
2010 Show summary || Hide summary || Download full report
The research team achieved major progress in the fourth year (2010). They analyzed data collected over the past three years, presented results at three major meetings, and increased their training activities. A young researcher on the project, Dr. Sheikh Mohiuddin of the University of Karachi, arrived in Albany in November 2010 to begin a one-year training visit, during which he is gaining experience in ion chromatography and other techniques for particulate analysis. Meanwhile, the Karachi team has continued collecting air pollution data as well as data from major hospitals. In Albany the project has partially supported two Phd students and one Masters student who are working on various aspects of the project. As the researchers continue with data collection, they also started the analysis of the respiratory disease data from the first two year sampling period, as well as both respiratory and cardiovascular diseases from the recent sampling periods.
2009 Show summary || Hide summary || Download full report
The primary goal for 2009 was to complete particulate sampling at the present two sites over four periods of six weeks each in fall, winter, spring, and summer. Despite problems with electric power supply irregularities and vandalism of the sampling equipment, this effort was completed successfully. Training activities in 2009 included a one-day session at AKU on April 7, which provided the 24 participants with comprehensive understanding of the technical details of the project, primarily explaining basic concepts and theories of air pollution, ambient air sampling techniques, and the challenges encountered in data collection and analysis. The training included practical demonstrations of techniques for air sampling and measurement of specific pollutants, as well as relevant safety and quality control procedures. The trainees included two PhD students from the Chemistry Department of Karachi University, a research fellow doing a residency in Community Medicine at AKU Hospital, three MS students in Environmental and Occupational Health, four doctors from tertiary hospitals of Karachi, a biomedical engineer and eleven other staff members involved in this project.
Drs. Carpenter and Khwaja hoped to make at least one visit, but much of the further training on the project will be done by the Pakistani fellows who were already trained in Albany. As of January 2010, three Pakistani PhD students enrolled in the Chemistry Department of Karachi University had been trained to perform the air monitoring and are being train to analyze the air data. In addition, graduate students and physicians from the collaborating hospitals involved in the project were trained on how to collect and collate the information from hospital records and the outpatient department, and three postgraduate fellowship students in the Department of Community Medicine of Karachi University gained hands-on experience in project management, air monitoring, and data management. In Albany, Pakistani MPH student Zafar Aminov was being trained in data analysis, and he prepared to begin work toward his PhD, with data collected under this project forming the basis for his future dissertation.
2008 Show summary || Hide summary || Download full report
In 2008, Dr. Khwaja made two visits to Pakistan to provide training, and with funding from HEC two Pakistani trainees visited Albany (Dr. Manzoor Khattak and Dr. Azhar Siddique, January-April, 2008).
During the fall of 2008, the research team completed sampling for particulates at two sites in Karachi, one in a primarily industrial part of the city (Korangi), and the other in a residential area with major automobile and truck traffic (Tibet Center, pictured at left). Hospitalization data was collected during the same period at Jinnah Postgraduate Medical Center (JPMC), National Institute of Cardiovascular Diseases (NICVD), and AKU. The particulate samples were brought back to United States for analysis with the hospital data to follow.
2007 Show summary || Hide summary || Download full report
During the first year of the project (2007), the investigators were delayed by the slow process of obtaining the necessary institutional review board approvals from the various Pakistani and US entities involved. As of late October 2007, however, the problem was nearly resolved, and Dr. Carpenter and Dr. Khwaja visited AKU to confer with their partners on next steps. Thanks to other funding, Pakistani collaborator Dr. Aftab Turabi visited Albany for nine months in 2007 and helped to move the approval processes along after returning to Pakistan.
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