HEALTH IMPACTS OF
PARTICULATE MATTER –
PROPOSED METHODOLOGY
INTRODUCTION AND BACKGROUND
The effect of particulate matter in the health of the
people as the most important impact of air pollution have
been identified as the key problem as shown from
various studies in developed countries (UNEP, 2007).
The size of the particles is most important and the recent
studies have identified fine particle fraction called PM 2.5
(with a mean aerodynamic diameter of or smaller than
2.5 microns) as being especially harmful because they
penetrate deeply, persist in the lungs and may reach the
alveolar region.
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Basically, developed countries are concerned about
outdoor air pollution, as; indoor air pollution is not a
major issue in their context. Developing countries like
Nepal are at double jeopardy; as the problem of outdoor
as well as indoor air pollution is growing fast, and those
pollutions are interchangeable.
Numerous studies suggest that PM10 and PM2.5 contribute
to excess mortality and hospitalizations for the cardiac
and respiratory tract disease (McGranahan and Murray,
2002).
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STATEMENT OF PROBLEM
The overall average of Kathmandu Valley has been reduced
by 12% from 2003 to 2007 (MOEST 2007).
However, the steady decrease in the years 2003-2006, there is
practically no change in the annual valley average PM10
concentration.
The air quality deteriorates drastically during the dry period
(Dec-May) and improves during the wet period (June-Nov).
During Dec, Jan and Feb the 24 hour average concentrations
of PM10 exceeds the NAAQS of 120 µg/m3 almost everyday
at the urban area stations (Putalisadak, Patan and Thamel)
(MOEST 2007)
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RATIONALE
Relatively fewer studies are made in the developing
countries than in developed countries.
With the increasing pollution, the concentration of air
pollutants in major cities are higher and the source and
chemical composition of particles in cities in developed
and developing countries may differ.
Consequently information is needed to assess the
impacts of the much higher concentrations of PM10 (with
a mean aerodynamic diameter of or smaller than 10
microns) and PM2.5 found in the large cities of
developing countries.
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As most lung alveoli are formed postnatal, changes in
the lungs continue through adolescence and the
developing lungs of children are more vulnerable to the
adverse effects of air pollution than adult lungs.
Children are more susceptible to the exposure to the
harmful particles than adults because of their higher
susceptibility to higher ventilation rates, higher relative
concentrations of particles into smaller lung volumes and
higher levels of physical activity.
The impact of air pollutant and its adverse effect may
harm child till their adulthood.
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As child health is an essential indicator for the overall
assessment of country health status, this study will
certainly provide a basis to understand the effect of air
pollutants on the health of the children. This study can
address the need for the information on the effects of air
pollution on health in South Asia at the high
concentration commonly found in large cities in South
Asia, and provide locally-gathered evidence to support
actions by government to control particulate emissions.
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NATIONAL STANDARDS - AMBIENT AIR
Parameter AVG Time Conc., Max.
TSP 24 hour 230 µg/m3
PM10 24 hour 120 µg/m3
NO2 Annual 80 µg/m3
24 hour 40 µg/m3
SO2 Annual 70 µg/m3
24 hour 50 µg/m3
CO 8 hour 10,000 µg/m3
15 minute 100,000 µg/m3
Lead Annual 0.5 µg/m3
Benzene Annual 20 µg/m3
NATIONAL INDOOR AIR QUALITY
STANDARD AND IMPLEMENTATION
GUIDELINES 2009
Pollutant Maximum Averaging time
concentration
Particulate Matter(PM10) 120 Цg/m3 24 – hour
200 Цg/m3 1 – hour
Particulate Matter(PM2.5) 60 Цg/m3 24 - hours
100 Цg/m3 1 – hour
Carbon Monoxide (CO) 9 ppm (mg/m3) 8 – hour
35 ppm (mg/m3) 1 – hour
Carbon Dioxide (Co2) 1000 ppm (mg/m3) 8 - hours
STUDY TOPIC
Impacts of particulate matter on the respiratory health of
School Children
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OBJECTIVES OF THE STUDY
General Objective
To assess the impact of air pollution (Particulate Matter) in
respiratory health of school children of selected school(s) in
Kathmandu
Specific Objective
To determine whether there is an association between daily
PM10 and PM 2.5 concentration and respiratory health and
lung function in children
To determine the level of relationship of PM and respiratory
health
To assess the severity of impacts of PM on respiratory health
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VARIABLES
Dependent Variable o Independent variables
Respiratory Socio-demographic and
health and lung
function economic variables
Air pollution related
variables
Confounding variables
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VARIABLES….
Socio-demographic and • Confounding variables
economic variables
Age
• Other systemic
Sex illnesses
Parents education
• Housing conditions
Economic status of the family
Air pollution related • Simultaneous
variables exposure to other
Preventive measures taken pollutants
Infrastructure of the school
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CONCEPTUAL FRAMEWORK
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METHODOLOGY
Study sign
Correlational study – a longitudinal study using quantitative
methods
Study Site
Putalisadak (Kathmandu): School near by AQMS
Study Duration
3 months
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METHODOLOGY….
Study Population
Children of selected schools of age between 9-14 years
Inclusion Criteria Exclusion Criteria
Age between 9-14 years Smokers
Studying in the school at Use of solid fuel at home
least since 1 year Residing more than 3 km
School located close to from AQMS
Child having asthma or
the AQMS
other chronic respiratory
illness
Child with smoker in the
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SAMPLING
Sampling technique
Purposive selection of schools
Proportionate random sampling
Sampling unit
Children of the selected schools within the age limit
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SAMPLING….
Sample selection
Schools finalized
List of students between age 9-14
Randomly select the required sample (500)
Consider them for the initial baseline survey
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SAMPLING….
For the health impact aspect
Exclude the subjects as per the exclusion criteria
Exclude voluntary exclusions (if any)
Obtain consent both from the subject as well as parents
Finalize the number of participants to undergo the regular
study
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DATA COLLECTION
Tools
Structured questionnaire
Health check up check list
The questionnaire will be translated into Nepali and the language
will be kept simple and understandable
Techniques
Self/parental administration of questionnaires
Completing the check list by the medical practitioners
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DATA COLLECTION
Methods
Recording the PEFR readings in the standard sheets
Daily notes of any illness particularly that of respiratory
health to be noted in a diary provided
Diary writing will be supervised by the trained teachers or
technicians/paramedics
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DATA FROM THE SUBJECTS
PEFR readings will be collected everyday in the school –
may be at the end of the day
This process will be continued altogether for 6 weeks
including days of high and low pollution
Data of PEFR reading as well as information from the
questionnaire will be obtained in both dry as well as wet
season
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PARTICULATE AND WEATHER DATA
Daily data of PM10 and PM 2.5 as well as that of other
pollutants if available will be taken.
Relevant meteorological data such as maximum,
minimum and average temperature, relative humidity
and wind speed for the same period will be obtained
from the department of meteorology
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PRETESTING
The questionnaires will be pretested in a school other
than the school to be used for study.
The school for pretesting will have similar conditions as
well as near by the AQMS
Necessary amendments will be made after this in the
questionnaires
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DATA ANALYSIS
Data obtained from these procedure will be entered in
Epi Info and then imported in SPSS for analysis.
Simple descriptive analysis will be done for the general
characteristics of the participants
To see the correlation of the PM concentration with
respiratory health regression analysis will be done
……………..
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LIMITATION OF THE STUDY
Expected findings may not be generalized due to various
factors:
Purposively selected school
Limited number of school
Possibility of various confounding factors
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THANK YOU
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