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The Coronavirus Disease 2019 (COVID-19) pandemic spread rapidly despite extraordinary screening and social distancing measures. Such rapid spread was due in part to the fact that the disease transmission, particularly via airborne spread, is poorly understood. Characterizing the airborne size distribution of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is essential to understanding the risk of airborne transmission. We collected size-fractionated (≤2.5, 2.5-10, and ≥10 μm) samples using a cascade impactor at more than 30 locations inside and outside Jaber Hospital and the nearby Temporary Quarantine Facility in Kuwait from April to July 2020. We hypothesized that airborne SARS-CoV-2 would be present in all size fractions, including fine particles, and in a size distribution that differed by sampling location. We found 6% of the samples (13 out of 210) were positive for SARS-CoV-2 RNA. Concentrations ranged from 3 to 25 copies/m 3 . The size distribution of particle-associated SARS-CoV-2 was different for each location. Large (≥10 μm) particles with the virus were found in symptomatic patient rooms. Fine (≤2.5 μm) particle-associated SARS-CoV-2 was detected in rooms with intubated patients and outside the hospital entrance gates. Coarse (2.5-10 μm) virus-laden particles were present in all locations with positive samples. This is the most comprehensive study to date on size-fractionated airborne SARS-CoV-2 RNA. Our findings support location-specific precautions that mitigate the spread of particles including fine particulate matter over distances greater than 1 meter, including in locations outside the hospital.

Abstract:Little information is available on the assessment of health impact concerning the Middle Eastern dust storms and PM 10 concentration levels despite the aridity of the region and frequent dust storms occurring in this part of the world. A prospective study was conducted to determine the association between dust particles and morbidity and mortality rates for respiratory and cardiovascular diseases in Kuwait. Spearman and Pearson's correlations were used to identify such associations. Results revealed a significant correlation between dust storms, suspended dust and rising dust (p < 0.01). Correlation between the occurrence of respiratory and cardiovascular diseases and dust storms showed that PM 10 concentrations were significantly correlated with bronchial asthma at the 0.05 level (Pearson r = 0.292). Significant correlations at the 0.01 level were shown between bronchial asthma and both acute lower respiratory tract infection (r = 0.737) and acute upper respiratory tract infection (r = 0.839). Respiratory and cardiovascular mortality rates were both equal to 0.62 per 10,000 persons, each corresponding to 8.7% proportionate mortality rate. This study provides a good evidence of the consistent relationship between dust storm events, PM 10 concentration levels, and respiratory diseases.

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The global rise of urbanization has led to the formation of surface urban heat islands and surface urban cool islands. Urban heat islands have been shown to increase thermal discomfort, which increases heat stress and heat-related diseases. In Kuwait, a hyper-arid desert climate, most of the population lives in urban and suburban areas. In this study, we characterized the spatial distribution of land surface temperatures and investigated the presence of urban heat and cool effects in Kuwait. We used historical Moderate-Resolution Imaging Spectroradiometer (MODIS) Terra satellite 8-day composite land surface temperature (LST) from 2001 to 2017. We calculated the average LSTs of the urban/suburban governorates and compared them to the average LSTs of the rural and barren lands. We repeated the analysis for daytime and nighttime LST. During the day, the temperature difference (urban/suburban minus versus governorates) was −1.1 °C (95% CI; −1.2, −1.00, p < 0.001) indicating a daytime urban cool island. At night, the temperature difference (urban/suburban versus rural governorates) became 3.6 °C (95% CI; 3.5, 3.7, p < 0.001) indicating a nighttime urban heat island. In light of rising temperatures in Kuwait, this work can inform climate change adaptation efforts in the country including urban planning policies, but also has the potential to improve temperature exposure assessment for future population health studies.

Ambient air pollution in terms of fine and coarse particulate matter (PM2.5 and PM10) has been shown to increase adult and infant mortalities. Most studies have estimated the risk of mortalities through attributable proportions and number of excess cases with no reference to the time lost due to premature mortalities. Disability adjusted life years (DALYs) are necessary to measure the health impact of Ambient particulate matter (PM) over time. In this study, we used life-tables for three years (2014–2016) to estimate the years of life lost (YLL), a main component of DALYs, for adult mortalities (age 30+ years) and postneonatal infant mortalities (age 28+ days–1 year) associated with PM2.5 exposure and PM10 exposure, respectively. The annual average of PM2.5 and PM10 concentrations were recorded as 87.9 μg/m3 and 167.5 μg/m3, which are 8 times greater than the World Health Organization (WHO) air quality guidelines of 10 μg/m3 and 20 μg/m3, respectively. Results indicated a total of 252.18 (95% CI: 170.69–322.92) YLL for all ages with an increase of 27,474.61 (95% CI: 18,483.02–35,370.58) YLL over 10 years. The expected life remaining (ELR) calculations showed that 30- and 65-year-old persons would gain 2.34 years and 1.93 years, respectively if the current PM2.5 exposure levels were reduced to the WHO interim targets (IT-1 = 35 μg/m3). Newborns and 1-year old children may live 79.81 and 78.94 years, respectively with an increase in average life expectancy of 2.65 years if the WHO PM10 interim targets were met (IT-1 = 70 μg/m3). Sensitivity analyses for YLL were carried out for the years 2015, 2025, and 2045 and showed that the years of life would increase significantly for age groups between 30 and 85. Life expectancy, especially for the elderly (≥60 years), would increase at higher rates if PM2.5 levels were reduced further. This study can be helpful for the assessment of poor air quality represented by PM2.5 and PM10 exposures in causing premature adult mortalities and postneonatal infant mortalities in developing countries with high ambient air pollution. Information in this article adds insights to the sustainable development goals (SDG 3.9.1 and 11.6.2) related to the reduction of mortality rates attributed to ambient air levels of coarse and fine particulate matter.