National Burden of Disease Due to Ambient Air Pollution in the United Arab Emirate

The environmental burden of disease (EBD) is defined by the World Health Organization (WHO) as a quantification of the amount of disease among a population caused by environmental risk factors. In this research, we developed an integrated model to estimate the baseline EBD for the United Arab Emirates (UAE) based on the concentrations of contaminants in the environment. The model consists of seven modules that quantify the disease burden associated with the key environmental risk areas in the UAE including ambient air pollution, indoor air pollution, occupational exposures, climate change, drinking water contamination, coastal water contamination, and food contamination. The EBD caused by each of the seven risk factors was estimated using the method developed by WHO that involves exposure assessment, exposure-response assessment, attributable fraction derivation and attributable burden calculation, whereas significant improvement has been made by developing more sophisticated exposure assessment approaches using state-of-the-art scientific models, and by incorporating more comprehensive health endpoints associated with specific risks. The disease burden was first expressed in terms of the number of mortality or morbidity cases, and then converted into a standardized burden of disease metric - disability-adjusted life year (DALY), so that the health burden due to different risk factors can be compared as well as aggregated to obtain the national EBD in the UAE. Furthermore, in order to account for many potential sources of uncertainty in the quantification of EBD at the national level, systematic uncertainty analysis was performed to examine the overall uncertainty, to identify the assumptions that have the greatest effect on the calculated EBD and based on this analysis, to develop recommendations for the types of information that are most important to gather.