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Air pollution in Nairobi slums: sources, levels and lay perceptions
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
2017 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background

Air quality in Africa has remained a relatively under-researched field. Most of the African population is dependent on biomass for cooking and heating, with most of the combustion happening in low efficiency stoves in unvented kitchens. The resulting high emissions are compounded by ingress from poor outdoor air in a context of poor emissions controls. The situation is dire in slum households where homes are crowded and space is limited, pushing households to cook in the same room that is used for sleeping. This study assessed the levels of particulate matter with aerodynamic diameter £ 2.5 microns (PM2.5) in slum households and people's perceptions of and attitudes towards air pollution and health risks of exposure in two slum areas, Viwandani and Korogocho, in the Nairobi city.

Methods

The study employed both qualitative and quantitative methods. For the quantitative study, we used structured questionnaires to collect data about the source of air pollution among adults aged 18 years and above and pregnant women residing in the two study communities. We used the DustTrak™ air samplers to monitor the indoor PM2.5 levels in selected households. We also collected data on community perceptions on air pollution, annoyance and associated health risks. We presented hotspot maps to portray the spatial distribution of perceptions on air pollution in the study areas. For the qualitative study, we conducted focus group discussions with adult community members. Groups were disaggregated by age to account for different languages used to communicate with the younger and older people. We analysed the qualitative data using thematic analysis.

Results

Household levels of PM2.5 varied widely across households and ranged from 1 to 12,369μg/m3 (SD=287.11). The household levels of PM2.5 levels were likely to exceed the WHO guidelines given the high levels observed in less than 24 hours of monitoring periods (on average 10.4 hours in Viwandani and 11.8 hours in Korogocho). Most of the respondents did not use ventilation use in the evening which coincided with the use of cookstove and lamp, mostly burning kerosene. The levels of PM2.5 varied by the type of fuels, with the highest emissions in households using kerosene for cooking and lighting. The PM2.5 levels spiked in the evenings and during periods of cooking using charcoal/wood. Despite these high levels, residents perceived indoor air to be less polluted compared with the outdoor air, possibly due to the presence of large sources of emissions near the communities such as dumpsites and industries. The community had mixed perceptions on the health impacts of air pollution, with respiratory illnesses perceived as the main consequence while vector or sanitation related diseases such as diarrhoea was also perceived to be related to air pollution.

Conclusions

With poor housing and reliance on dirty fuels, households in slums face potentially high levels of exposure to PM2.5 with dire implications on health. To address the poor perception on air pollution and knowledge gaps on the health effects of air pollution, education programs need to be developed and tailored. These programs should aim to provide residents with information on air quality and its impact on the health; what they can do as communities as well as empower them to reach out to government/stakeholders for action on outdoor sources of pollution such as emissions from dumpsites or industries. The government has a larger role in addressing some of the key pollution sources through policy formulation and strong implementation/enforcement.

Place, publisher, year, edition, pages
Umeå: Umeå University , 2017. , p. 68
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 1903
Keywords [en]
Air pollution, perceptions, slums, health impacts, Nairobi
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Epidemiology; Public health
Identifiers
URN: urn:nbn:se:umu:diva-138293ISBN: 978-91-7601-739-5 (print)OAI: oai:DiVA.org:umu-138293DiVA, id: diva2:1133880
Public defence
2017-09-01, Sal 135, byggnad 9 A, Allmänmedicin, Norrlands universitetssjukhus, Umeå, 09:00 (English)
Opponent
Supervisors
Available from: 2017-08-18 Created: 2017-08-17 Last updated: 2018-06-09Bibliographically approved
List of papers
1. Household Air Pollution: Sources and Exposure Levels to Fine Particulate Matter in Nairobi Slums
Open this publication in new window or tab >>Household Air Pollution: Sources and Exposure Levels to Fine Particulate Matter in Nairobi Slums
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2016 (English)In: TOXICS, ISSN 2305-6304, Vol. 4, no 3, article id 12Article in journal (Refereed) Published
Abstract [en]

With 2.8 billion biomass users globally, household air pollution remains a public health threat in many low- and middle-income countries. However, little evidence on pollution levels and health effects exists in low-income settings, especially slums. This study assesses the levels and sources of household air pollution in the urban slums of Nairobi. This cross-sectional study was embedded in a prospective cohort of pregnant women living in two slum areasKorogocho and Viwandaniin Nairobi. Data on fuel and stove types and ventilation use come from 1058 households, while air quality data based on the particulate matters (PM2.5) level were collected in a sub-sample of 72 households using the DustTrak II Model 8532 monitor. We measured PM2.5 levels mainly during daytime and using sources of indoor air pollutions. The majority of the households used kerosene (69.7%) as a cooking fuel. In households where air quality was monitored, the mean PM2.5 levels were high and varied widely, especially during the evenings (124.6 mu g/m(3) SD: 372.7 in Korogocho and 82.2 mu g/m(3) SD: 249.9 in Viwandani), and in households using charcoal (126.5 mu g/m(3) SD: 434.7 in Korogocho and 75.7 mu g/m(3) SD: 323.0 in Viwandani). Overall, the mean PM2.5 levels measured within homes at both sites (Korogocho = 108.9 mu g/m(3) SD: 371.2; Viwandani = 59.3 mu g/m(3) SD: 234.1) were high. Residents of the two slums are exposed to high levels of PM2.5 in their homes. We recommend interventions, especially those focusing on clean cookstoves and lighting fuels to mitigate indoor levels of fine particles.

Keywords
household air pollution, cookstoves, PM2.5, slums, Nairobi
National Category
Public Health, Global Health, Social Medicine and Epidemiology Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-127636 (URN)10.3390/toxics4030012 (DOI)000385516600001 ()
Available from: 2016-11-23 Created: 2016-11-16 Last updated: 2018-06-09Bibliographically approved
2. "We are used to this": a qualitative assessment of the perceptions of and attitudes towards air pollution amongst slum residents in Nairobi
Open this publication in new window or tab >>"We are used to this": a qualitative assessment of the perceptions of and attitudes towards air pollution amongst slum residents in Nairobi
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2014 (English)In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 14, p. 226-Article in journal (Refereed) Published
Abstract [en]

Background: People's perceptions of and attitudes towards pollution are critical for reducing exposure among people and can also influence the response to interventions that are aimed at encouraging behaviour change. This study assessed the perceptions and attitudes of residents in two slums in Nairobi regarding air pollution. Methods: We conducted focus group discussions with residents aged 18 years and above using an emergent design in the formulation of the study guide. A thematic approach was used in data analysis. Results: The discussions revealed that the two communities experience air pollution arising mainly from industries and dump sites. There was an apparent disconnect between knowledge and practice, with individuals engaging in practices that placed them at high risk of exposure to air pollution. Residents appear to have rationalized the situation in which they live in and were resigned to these conditions. Consequently, they expressed lack of agency in addressing prevalent air pollution within their communities. Conclusions: Community-wide education on air pollution and related health effects together with the measures needed to reduce exposure to air pollution are necessary towards reducing air pollution impacts. A similar city-wide study is recommended to enable comparison of perceptions along socio-economic groups and neighbourhoods.

Place, publisher, year, edition, pages
London: BioMed Central, 2014
Keywords
Air pollution, Perceptions, Attitudes, Nairobi, Slums
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:umu:diva-87873 (URN)10.1186/1471-2458-14-226 (DOI)000332729600003 ()
Available from: 2014-04-15 Created: 2014-04-14 Last updated: 2018-06-08Bibliographically approved
3. Community perceptions of air pollution and related health risks in Nairobi slums
Open this publication in new window or tab >>Community perceptions of air pollution and related health risks in Nairobi slums
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2013 (English)In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 10, no 10, p. 4851-4868Article in journal (Refereed) Published
Abstract [en]

Air pollution is among the leading global risks for mortality and responsible for increasing risk for chronic diseases. Community perceptions on exposure are critical in determining people's response and acceptance of related policies. Therefore, understanding people' perception is critical in informing the design of appropriate intervention measures. The aim of this paper was to establish levels and associations between perceived pollution and health risk perception among slum residents. A cross-sectional study of 5,317 individuals aged 35+ years was conducted in two slums of Nairobi. Association of perceived score and individual characteristics was assessed using linear regression. Spatial variation in the perceived levels was determined through hot spot analysis using ArcGIS. The average perceived air pollution level was higher among residents in Viwandani compared to those in Korogocho. Perceived air pollution level was positively associated with perceived health risks. The majority of respondents were exposed to air pollution in their place of work with 66% exposed to at least two sources of air pollution. Less than 20% of the respondents in both areas mentioned sources related to indoor pollution. The perceived air pollution level and related health risks in the study community were low among the residents indicating the need for promoting awareness on air pollution sources and related health risks.

Keywords
perceived air quality, air pollution, perceived health risk, urban slum
National Category
Occupational Health and Environmental Health Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-84022 (URN)10.3390/ijerph10104851 (DOI)000330520500020 ()24157509 (PubMedID)
Available from: 2013-12-12 Created: 2013-12-12 Last updated: 2018-06-08Bibliographically approved
4. Lay perceptions of the health impacts of air pollution: voices from Nairobi's slums.
Open this publication in new window or tab >>Lay perceptions of the health impacts of air pollution: voices from Nairobi's slums.
(English)In: Article in journal (Refereed) Submitted
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-138292 (URN)
Available from: 2017-08-17 Created: 2017-08-17 Last updated: 2018-06-09

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