A Policy Support Analysis of Air Pollution Epidemiology and Hospital Admissions in Kuwait

Gulf Cooperation Council (GCC) countries have long lacked local epidemiological evidence demonstrating the health benefits of reducing air pollution. In Kuwait, however, the past decade has brought new, detailed health and environmental exposure data that now make such assessments possible.

To present an epidemiological basis in support for a strict air quality policy in Kuwait.

We collected all cardiopulmonary hospital admissions from six public hospitals in the country from 2010 to 2018. We then matched cases with daily population-weighted PM_2.5 exposure estimated at 1 km² resolution. For each hospital service region, we fitted generalized additive models with a negative binomial distribution that estimated the relative risk of admission per 10 µg/m³ increase in PM_2.5. We then calculated attributable admissions under three hypothetical policy scenarios: (1) maintaining the status quo ('do nothing'), (2) reducing PM_2.5 concentrations by 10 µg/m³, and (3) reducing by 20 µg/m³.

There was a total of 380,862 cardiopulmonary hospital admissions during the study period. Every 10 µg/m³ increase in PM_2.5 was associated with a 1% (95%CI: 0.6%-1.5%) increase in cardiopulmonary admission. Under the status quo, 3.4-3.9% of cases can be attributed to PM_2.5, totaling 1,536 (95%CI: 956-2,108) excess admissions/year. A 10 µg/m³ reduction could prevent up to 403 (95%CI: 252-551) admissions/year; a 20 µg/m³ reduction up to 810 (95%CI: 505-1,109) admissions/year.

Reducing air pollution, even modestly, offers measurable public health benefits. Data from Kuwait provide a model for evidence-based policymaking and can help guide other GCC countries with similar pollution profiles toward adopting stricter air quality standards aligned with WHO interim targets.