Examination of the links between environmental atmospheric air pollution in Iraq and human respiratory diseases

Table of Contents

LIST OF FIGURES ... iv

LIST ABRIVATIONS ... v

DEDICATION ... v

ACKNOWLEDGEMENTS ... vi

ABSTRACT ... vii

CHAPTER ONE ... 1
1.0 INTRODUCTION ... 1
1.1 Study Area ... 4
1.2 Problem statement ... 5
1.3 Aims and objectives ... 5
1.4 Research Structure ... 6

CHAPTER TWO ... 7
2.0 LITERATURE REVIEW ... 7
2.1 Pollution due to Military Activities during War ... 8
2.2 Particulate Matter Increase in Iraq Air ... 9
2.3 Outdoor Air Pollution in Iraq ... 12
2.4 Air Pollution from Transport/Traffic ... 15
2.5 Industrial Pollution ... 16
2.6 Air Quality in Iraq ... 18

CHAPTER THREE ... 22
3.0 METHODOLOGY ... 22
3.1 Collection of data ... 22
3.2 Questionnaire Design ... 23

CHAPTER FOUR ... 31
4.0 Analysis of results ... 31
4.1 Air pollution ... 34
4.2 Air pollution as a topic of discussion among Iraq people ... 36
4.3 Are Iraq people aware of effects of Air pollution? ... 37
4.4 Actual/Potential Sources of air pollution in Iraq ... 37
4.5 Health problems caused by air pollution ... 38
4.6 Environmental effects of air pollution in Iraq ... 39
4.7 Gases and particles that causes major air pollution in Iraq ... 40
4.8 Indoor pollutants in Iraq ... 42
4.9 Is air pollution a major problem in Iraq? ... 43
4.10 Air pollution increase in Iraq between 2003 and 2013 ... 44
4.11 Overall air quality in Iraq compared to previous years ... 45

CHAPTER FIVE ... 47
5.0 Discussion ... 47
5.1 Air pollution perspectives in Iraq ... 47
5.2 Air pollution conversation among Iraq people ... 48
5.3 Actual/ potential sources of air pollution in Iraq ... 49
5.4 Health problems caused by air pollution ... 50
5.5 Environmental effects of air pollution in Iraq ... 53
5.6 Gases and particles that causes major air pollution in Iraq ... 54
5.7 Wars in Iraq and Air pollution ... 57
5.8 Conclusion and Recommendation ... 58

LIST of FIGURES

Figure 1.1: Map of Iraq ... 4
Figure 2.1: Level of dissatisfaction of countries citizens ... 18
Figure 2.2: Environmental performance index ... 19
Figure 4.1: Percentage response of the universities chosen ... 31
Figure 4.2: responses based on Individual age groups of the universities ... 32
Figure 4.3: Overall age group of respondents ... 33
Figure 4.4: Average Qualification of the respondednts ... 33
Figure 4.5: Responses based on Number of male and female respondents ... 34
Figure 4.6: Responses on Air pollution based on sex and qualification ... 35
Figure 4.7: Air pollution as topic of discussion among Iraq people ... 36
Figure 4.8: Knowledge on the effects of air pollution ... 37
Figure 4.9: potential or actual sources of air pollution ... 38
Figure 4.10 : Health problems due to air pollution ... 39
Figure 4.11: Environmental effects of air pollution ... 40
Figure 4.12: Gases and particles that causes major air pollution in Iraq ... 41
Figure 4.13: Major indoor pollutants in Iraq ... 42
Figure 4.14: Air pollution as a problem to Iraq ... 43
Figure 4.15: level of air pollution In Iraq in the last decade ... 45
Figure 4.16: Overall air quality in Iraq ... 46
Figure 5.1: World Bank’s data on Iraq’s Hospital beds ... 52

LIST ABBREVIATIONS

WHO - World Health Organization
DU - Depleted Uranium
CMS - Dragger
UOTI - University Of Technology Iraq
UOB - University Of Bagdad
AU - Al-Nahrain University
UB - University Of Basrah
AUOI - American University If Iraq
COPD - Chronic Obstructive Pulmonary
DEFRA - Department Of Environment Food and Rural Affair

DEDICATION

The research work is dedicated to my parents, brothers and sisters.

ACKNOWLEDGEMENTS

All praise is due to almighty Allah for his blessings. May his and blessings be upon his beloved messenger Muhammad (SAW).

First, I would like to thank my supervisor Ian Hooper, for his patience in reading through my work and making necessary and important suggestions. I am also grateful to my internal assessor Brian Shiplee for his brilliant ideas both in class and while during this research. However, I would like to thank all my lecturers in the department of Biology, Geography and Environment for their good ideas throughout my MSc Program.

My parents, brothers and sisters are my source of inspiration for their constant support and courage during my MSc program, I pray may almighty preserve you bountifully. Family My classmates also deserve a warm thanks for sharing many moments, I say thank you all. Lastly I would like to say a very big thank you to anyone who took part in the survey for taking their time to read and fill my questionnaires. Thank you all.

ABSTRACT

Five universities in Iraq; University of Technology Iraq, Al-Nahrain University and University of Baghdad, University of Basrah and The American University of Iraq were chosen for a survey in order to examine the link between the atmospheric environmental pollution and the respiratory health diseases in Iraq; questionnaires were distributed to students at different levels of education to assess how air pollution affect respiratory health, air quality, and how wars also contributes to air pollution. University of Technology Iraq, Al-Nahrain University and University of Baghdad located in the capital were used to judge inside Iraq, while University of Basrah and The American University of Iraq was used for outside city capital and Kurdistan respectively. All the three classified regions had shown knowledge on air pollution which few talk about and very rare. Women especially from Kurdistan were also found to be less aware of issues on air pollution. And the major sources of air pollution were found to be oil refineries and military conflicts emitting mostly particulate matter and sulphur dioxide which affects the respiratory health of most Iraqis mainly though asthma and cough as a result of rapid smog noticed by the respondents. While indoor pollution mainly is associated with use of pesticides and activities leading to release of carbon monoxide. Processes and activities were recommended for Iraq government to fish out itself from the worst performing countries in the global environmental performance index

CHAPTER ONE

1.0 INTRODUCTION

The World Health Organization (WHO) has defined air pollution as “contamination of the indoor or outdoor environment by any chemical, physical or biological agent that modifies the natural characteristics of the atmosphere” (WHO, 2013). Air pollution is most commonly caused by different activities, including both human and natural activities like combustion activities, forest fires, transport, industrial facilities, military wars, and conflicts; and wild fires. The major pollutants that can be fatal to human health include particulate matter, nitrogen and sulfur dioxides, carbon monoxide and ozone (WHO, 2013).

The sources of the air pollutants vary like the product of ‘Ozone’ which are combinations of a series of complex reactions between sunlight, hydrocarbons and nitrogen dioxide. Although local communities tend to have a greater ozone concentration due to the urban centers having nitric oxide generated during traffics, which scavenges the ozone (Brunekreef and Holgate, 2002). Pollutants like nitrogen oxides are formed from the burning of fossil fuels in the course of power generation, automobiles, or heating in the domestic activities. The particular matter comprises of both solids and liquids, coming in forms of smoke, dust, fumes, aerosols, ash, fly, and mist (Bell and Holloway, 2007). They are mainly sourced from both human and natural activities, which include industrial and agricultural processes, combustion of fossils and wood fuels, dust generated from the roads, wind-blown dust from wildfires and the construction and demolition activities. However, there are certain pollutants, which are considered as precursors to particulate matter formation. They include Ammonia, NOx, VOCs and Sox (Brook and Rajagopalan, 2009).

The Sulfur oxide (SO_x) is mainly generated from industrial processes and also from volcanic reactions. However, combustion of petroleum and coal produces Sulfur oxide due to the presence of sulphur in petroleum and coal. Acid rain is the mainly triggered by the Sulfur oxide (SO_x) in the presence of NO₂ (Peng Guo et al., 2012). Sulfur oxide (NO_x) originates from combustions, which involves high temperature; however, they can be generated as a result of electric discharge through thunderstorms. The NO_2, assists in the formation of acid rain, affects plants growth_, and forms toxic substances when it reacts with other pollutants. It can also affect human being by causing visual impairment, causes respiratory problems due to formation of aerosols, and when high levels of NOx are inhaled it leads to swelling of throat, burning spasms, buildup of fluids in the lungs. Other pollutant of major concern is Carbon monoxide (CO) which is produced from the incomplete combustion of fuels like coal, wood and natural gas, as well as vehicle exhausts (Brunekreef and Holgate, 2002). Carbon monoxide can react with aldehydes to generate peroxy radicals through a photochemical reaction, thereby increasing the ratio of NO and NO₂. And an exposure to Carbon monoxide reduces the carrying capacity of human blood, thereby causing several health problems and can possibly lead to death (Meyer et al., 2010).

There had been several studies put forward in order to study the relationship between air pollution and health effects. Diverse respiratory health problems, cardiovascular diseases, increased rate of hospitalization, life shortening and even mortality rate were associated with an exposure to pollutants like ozone and particulate matter (Brunekreef and Holgate, 2002). Human health can be affected due to poor air quality. But in general, the health status of person can determine how susceptible he is to air pollution, because young and healthy people can resist a moderate exposure to air pollution. But a long and serious exposure to air pollution can affect human health by causing respiratory health problems, and can worsen the condition, by causing diseases like cancer and heart diseases (DEFRA, 2013). While people with an already existing heart or lung problems are more vulnerable than other, an exposure to high levels of Nitrogen Dioxide, Sulphur Dioxide, and Ozone can irritate the airways of the lungs, increasing the symptoms of those, suffering from lung diseases. Fine particles can be carried deep into the lungs, where they can cause inflammation and a worsening of heart and lung diseases. While Carbon monoxide gas prevents the uptake of Oxygen by the blood, this can lead to a significant reduction in the supply of oxygen to the heart, particularly in people, suffering from heart disease (DEFRA, 2013).

Air pollutions can be controlled by introducing severe measures which will regulate the emissions generated by fossil fuel cars through ratification of programs, which will look after new models of automobiles, encouraging the use of low sulphur and unleaded fuels. While construction companies should be required to use low emission engineering and machineries, while incorporating prevention of pollution in their yearly budgets (Shu-Hwei Fang and Hsiung-Wen Chen (1996). In the case of indiscriminate deforestation, which takes away the carbon capturing resources, strong laws should be endorsed to punish the perpetrator of such act while a huge compensation should be authorized, also public awareness should be publicized to mobilize people on the effects and consequences of air pollution to both health and environment. However, at workplaces if legislations like clean indoor air acts are established, then it can control smokes from affecting people.

1.1 Study Area

Iraq has an estimated population of about 32 million people (as at 2012) living in 438,317 km² area of land (World Bank, 2013). The country shares boarders with Turkey to the North, Saudi Arabia to the South, Iran to the East, Jordan to the West and Syria and Saudi by the northwest and southwest, respectively as shown in figure 1.1. The central and southern parts of Iraq are predominantly composed of sedimentary soil, the average temperature in Iraq is 37.4˚C with a maximum of about 45˚C, the summer periods are characterized by hot days and average annual rainfall of 100 mm/year, it has an annual humidity of less than 50%, and 30% by the day time (Hadeel, et al., 2010). The country has riches of both human and natural resources, and it has been a middle-income country for the last four decades, but the recent conflicts and wars had subject the country to a downfall in terms of economy and environment.

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Figure 1.1: Map of Iraq (About, 2013)

1.2 Problem statement

There had been a great increase in the number of possible factors that can lead to air pollution in Iraq. The country had been in Wars and conflicts for about two decades, and there had been historical use of poisonous and toxic gases, which can lead to air pollution All this added to the incessant urbanization, leading to high traffic, and increased use of fossil fuels in both transport and industrial processes, coupled with the indoor pollution, coming from the domestic sources. However, the insecurity in the country had led to the downfall of many sectors in the country, including that of health, which encouraged the spread, development and contact of many health problems and diseases, among which are respiratory health problems. Therefore, there is a need to carry out a study in order to see the possibility of examining the links between the atmospheric environmental pollution and the respiratory health problems.

1.3 Aims and objectives

The major aim of the research is to examine the links between environmental atmospheric air pollution in Iraq and human respiratory diseases through the use of a questionnaire. The following objectives are hoped to be achieved:

a) To find out whether Iraq’s air quality has been affected by air pollution

b) To find out the effects of wars in Iraq

c) To find out the relationship between air pollution and respiratory health problem

1.4 Research Structure

Chapter one will introduce reader to the concept of air pollution and it health effects, followed by the state of war, which Iraq had gone through, and the possible interaction of wars on the environment. It will also introduce the reader to the background information on the country, in order to give the reader a comprehensive understanding of the country; likewise the chapter will state the aims and objectives of the study.

Chapter two of this study will review the past and current literature on the sources, effects and analysis, carried out on air pollution; it will also look at some respiratory health effects, associated with air pollution, and the effects of wars in the country and other countries.

Chapter Three will present the methodology followed by the study in order to arrive at its findings, which will include data collection, design of questionnaire and how the responses from the questionnaire were analyzed in order to arrive at a specific result.

Chapter Four and Five While chapter four of the study analyzes and states the physical findings from the result and compares the findings between one another, chapter five will discuss the possible reasons of the difference and occurrence of the results, while comparing them with the available analyzed data on the same aspect. Finally, a conclusion and recommendations will be drawn to round up the study.

CHAPTER TWO

2.0 LITERATURE REVIEW

There are several human and physical activities, including military activities in Iraq for the last ten years, as well as those arising from industry and transportation, which can lead to the emission of air pollutants into the environment that can be negative to human health. These pollutants can be differentiated based on their mode of emission and transportation, reactions, chemical composition, environmental persistence, and their health impacts on the living organisms (Kampa and Castanas, 2008). They include gaseous pollutants like NOx, SO₂, CO, ozone and volatile organic compounds; organic pollutants like dioxins, heavy metals like lead, arsenic and mercury; particulate matter. The routes of exposure to these pollutants are mainly via inhalation and ingestion, but there are minor circumstances which may involve skin or dermal exposure which can lead to negative effects. The pollutants can also contaminate food and water thereby going through the food chain (Ristovski et al, 2012; Kampa and Castanas, 2008). There are several health problems caused by air pollution, including atherosclerosis, inflammation, blood pressure changes, autonomic dysfunction, oxidative stress, endothelial dysfunction, lung problems, asthma and several cardiovascular problems (Kardesoglu et al, 2011; Bernstein et al, 2004). Even though the environment in Iraq cannot be said to be pristine, the Gulf war has caused much ecological destruction. This has turned the gulf region into a disease zone due to the emission of pollutants from fires, bombs, mines litter and depletion of uranium, which are predicted to have a prolonged effect on the region and its people (Ross et al, 1997). However, the subsequent wars after the Gulf War in Iraq created several further environmental problems such as air pollution, poor water quality, waste management, decline in ecosystems and rampant contaminated sites even though there were several environmental issues in existence already which were not given priority before the war (Aenab and Singh, 2012).

This review will explore two aspects of the research project: the sources and consequences of the reported increase in fine particulate matter, and outdoor pollution, which has been reported to have highly increased due to anthropogenic activities in Iraq the impact of both of these elements, will also, and be linked to human health.

2.1 Pollution due to Military Activities during War

According to Richardson (1994), wars are characterized by the emission of harmful chemicals to the water and air. This can cause severe health impacts both at the point of emission and outside the emission point as a result of wind movement. Therefore, factors to be considered whilst assessing the environmental impacts of war include; ecosystems, modes of transport of used during the war, weapons used, the production process of the weapons, as well as the existence of military camps (Leaning, 2000). During the war in Iraq there have been many environmental damages including large amounts of toxic smoke generated from the oil fires, formation of acid rain, incessant bombing campaigns leading to the enhanced environmental degradation, destruction of ecosystems as a result of using weapons enriched with depleted uranium and increased sand storms due to the movement of large and heavy armoire tanks.

Taking an example of a dense depleted uranium shells, this can simply go through steel armour and causes a burn impact. This releases toxic radioactive and microscopic dust particles in form of uranium oxide, which can transported by the wind and affects human beings when ingested or inhaled. Its effects include a weakening of the immune system, and other health problems like pneumonia, gastrointestinal or renal illnesses, kidney and lung damage (Hassoon, 2010). The magnitude and the duration of war are major factors which determine the environmental effects conflict can cause in a specific location or region. Other factors iimpacting on the environment include the type of ecosystem present in different geographic locations, the type of weapons used during the war and their production processes, along with the effects of any military campaign itself (Bernstein et al., 2004). However, researchers have specified four major activities that can have pervasive and prolonged environmental impacts on populations. These include nuclear weapons production and testing, storage or use of military toxins, waste and military despoliants, naval and aerial attack of terrain dispersal and persistence (Leaning, 2000).

2.2 Particulate Matter Increase in Iraq Air

A decade or more after the war in Iraq, being taken to include both the Gulf and recent war, Ehrenberg (2008) conducted air sampling at an interval of 90 minutes at different cities in Iraq. He detected fine particulate matter (2.5micro meters) made up of many elements, including silica, sulphates and heavy metals, such as lead, arsenic, cadmium and mercury which are detrimental to health. This is similar to details reported by Ebi et al, (2008) who asserted that several studies had indicated serious health problems due to an exposure to increased level of air pollutants like sulphur dioxide, carbon monoxide, lead, nitrogen dioxide, ozone and the particulate matter. Fine particulate can cause both acute and chronic health problems and WHO had estimated that fine particulate cause 9% death in lung cancer patients, 5% in cardiopulmonary patients and 1% in respiratory infections. This issue is critical in countries with middle-incomes like Kurdistan and some parts of Iraq (WHO, 2013). Hence, it is clear that there have been various substances released with differing magnitudes and modes of infection. The present study will examine health problems in the light of these substances and rates or periods of exposure.