title: Outdoor particulate matter (PM) and associated cardiovascular diseases in the Middle East.
abstract: Air pollution is a widespread environmental concern. Considerable epidemiological evidence indicates air pollution, particularly particulate matter (PM), as a major risk factor for cardiovascular diseases (CVD) in the developed countries. The main objective of our review is to assess the levels and sources of PM across the Middle East area and to search evidence for the relationship between PM exposure and CVD. An extensive review of the published literature pertaining to the subject (2000-2013) was conducted using PubMed, Medline and Google Scholar databases. We reveal that low utilization of public transport, ageing vehicle fleet and the increasing number of personal cars in the developing countries all contribute to the traffic congestion and aggravate the pollution problem. The annual average values of PM pollutants in the Middle East region are much higher than the World Health Organization 2006 guidelines (PM2.5 = 10 μg/m(3), PM10 = 20 μg/m(3)). We uncover evidence on the association between PM and CVD in 4 Middle East countries: Iran, Kingdom of Saudi Arabia, Qatar and the United Arab Emirates. The findings are in light of the international figures. Ambient PM pollution is considered a potential risk factor for platelet activation and atherosclerosis and has been found to be linked with an increased risk for mortality and hospital admissions due to CVD. This review highlights the importance of developing a strategy to improve air quality and reduce outdoor air pollution in the developing countries, particularly in the Middle East. Future studies should weigh the potential impact of PM on the overall burden of cardiac diseases.
authors.affiliation: Free University of Brussels, Brussels, Belgium (Research Center in Epidemiology, Biostatistics and Clinical Research, School of Public Health). znasser@ulb.ac.be.
authors.forename: Zeina
authors.initials: Z
authors.lastname: Nasser
authors.affiliation: Lebanese University, Beirut, Lebanon (Clinical and Epidemiological Research Laboratory (LCER), Faculty of Pharmacy).
authors.forename: Pascale
authors.initials: P
authors.lastname: Salameh
authors.affiliation: Ministry of Public Health, Beirut, Lebanon (Epidemiological Surveillance Unit).
authors.forename: Wissam
authors.initials: W
authors.lastname: Nasser
authors.affiliation: Free University of Brussels, Brussels, Belgium (Research Center in Epidemiology, Biostatistics and Clinical Research, School of Public Health).
authors.forename: Linda
authors.initials: L
authors.lastname: Abou Abbas
authors.affiliation: American University of Beirut, Beirut, Lebanon (Department of Surgery, Division of Neurosurgery).
authors.forename: Elias
authors.initials: E
authors.lastname: Elias
authors.affiliation: Free University of Brussels, Brussels, Belgium (Research Center in Epidemiology, Biostatistics and Clinical Research, School of Public Health).
authors.forename: Alain
authors.initials: A
authors.lastname: Leveque
mesh_terms: D000393:Air Pollutants / Q000009:adverse effects*; D002318:Cardiovascular Diseases / Q000139:chemically induced / Q000453:epidemiology*; D006801:Humans; D008877:Middle East / Q000453:epidemiology; D009017:Morbidity / Q000639:trends; D052638:Particulate Matter / Q000009:adverse effects*; D012307:Risk Factors
chemical_list: D000393:Air Pollutants; D052638:Particulate Matter
keywords: Middle East; PM10; PM2.5; air pollution; cardiovascular diseases; particulate matter