Air Pollution and Respiratory Hospital Admissions in Kuwait: The Epidemiological Applicability of Predicted PM 2.5 in Arid Regions

Dust is a major component of fine particulate matter (PM 2.5 ) in arid regions; therefore, concentrations of this pollutant in countries such as Kuwait exceed air quality standards. There is limited understanding on the impact and burden of high PM 2.5 concentrations on morbidity in these countries. In this study, we explore the association of PM 2.5 and the risk of respiratory hospital admissions in Kuwait. A time-series regression model was used to investigate daily variations in respiratory admissions and PM 2.5 concentrations from 2010 to 2018. Due to the lack of historical air quality sampling in Kuwait, we used estimated daily PM 2.5 levels from a hybrid PM 2.5 prediction model. Individual and cumulative lag effects of PM 2.5 over a 5-day period were estimated using distributed lag linear models. Associations were stratified by sex, age, and nationality. There were 218,749 total respiratory admissions in Kuwait during the study period. Results indicate that for every 10 μg/m 3 increase in PM 2.5 , a 1.61% (95% CI = 0.87, 2.35%) increase in respiratory admissions followed over a 5-day cumulative lag. Our estimates show that a 10 μg/m 3 reduction in average exposure will potentially avert 391 yearly respiratory admissions (95% CI = 211,571), with 265 fewer admissions among Kuwaitis (95% CI = 139,393) and 262 fewer admissions among children under 15 years of age (95% CI = 125,351). Different strata of the Kuwaiti population are vulnerable to respiratory hospitalization with short-term exposure to PM 2.5 , especially those under 15 years of age. The findings are informative for public health authorities in Kuwait and other dust-prone countries.