TABLE 1-1 Examples of Health Outcomesa Measured in Air-Pollution Exposure Studies

Effects related to short-term exposure

Inflammatory reactions in the lung

Respiratory symptoms

Adverse effects on cardiovascular system

Increase in use of medication (such as asthma medication)

Increase in hospital admissions

Increase in mortality

Effects related to long-term exposure

Increase in lower-respiratory symptoms

Reduction in lung function in children and adults

Exacerbation of chronic obstructive pulmonary disease

Reduction in life expectancy owing mainly to cardiovascular disease and lung cancer

aThese effects may not pertain to the military population.

Source: Adapted from WHO 2006.

PM originates from natural and human-made sources, and the composition and size of the particles depend on the source. Sources of coarse particles include resuspension of soil from roads and streets; disturbance of soil and dusts by agricultural, mining, and construction operations; and ocean spray (Wilson and Spengler 1996). Sources of fine particles include emissions from combustion of motor-vehicle fuel (EPA 2002, Pakbin et al. 2009, and Zhang et al. 2009); high-temperature operations such as smelters and steel mills; combustion of coal, oil, and wood; and atmospheric transformation products of nitrogen oxides, sulfur dioxide, and organics (Wilson and Spengler 1996).


There have been efforts to examine PM exposures in the Middle East, particularly with regard to how the composition and concentration of PM differ from those in the United States and other industrialized regions where fossil-fuel combustion and vehicle emissions are the primary sources of PM. In the Middle East, where climatic conditions may be more arid, PM sources may include dust storms, dust from motor-vehicle disturbance of the desert floor, agricultural activities, emissions from burn pits where trash is burned, lead-zinc smelters, battery-processing facilities, refineries, power stations, fertilizer plants, and emissions from vehicles that use leaded gasoline (UNEP 2007; Engelbrecht et al. 2009). Dust storms may carry pollutants great distances and in large amounts;

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