Environmental risk factors and the associated morbidity in a periurban area, Alexandria, Egypt.

BACKGROUND: According to the WHO, nearly 24% of the global disease burden is attributable to environmental risk factors (RFs). People living in periurban areas are particularly at risk due to lack of basic sanitation requirements.

OBJECTIVE: To investigate the possible association between environmental RFs and disease prevalence for a community living in a periurban area in Alexandria, Egypt.

MATERIALS AND METHODS: A cross-sectional study was conducted in 2012. The study sample consisted of 355 families. An interviewing questionnaire and an observation checklist were used for data collection. In addition, 10 drinking water samples were randomly collected for physical, chemical, and bacteriological analyses. The questionnaire included questions on indoor environmental RFs as well as morbidity in the study sample, and the observation checklist covered outdoor environmental RFs. The environmental risk was determined using a risk score whose calculation was based upon the presence/absence of 10 indoor and 12 outdoor environmental RFs. The association between risk scores and 14 morbidities was investigated using unconditional logistic regression analysis, expressed as odds ratio (OR) and 95% confidence interval (CI).

RESULTS: A significant association was found between the total environmental risk score and respiratory diseases (OR=2.298, 95% CI: 1.231-4.291), diarrhea (OR=2.083, 95% CI: 1.102-3.939), liver diseases (OR=2.491, 95% CI: 1.067-5.819), skin diseases (OR=1.821, 95% CI: 1.012-3.310), and bronchial asthma (OR=2.228, 95% CI: 1.066-4.565). Noncommunicable diseases such as cardiovascular diseases and musculoskeletal diseases did not show any significant association with environmental RFs.

CONCLUSION AND RECOMMENDATIONS: Environmental RFs have an adverse impact on health within communities living in periurban areas. It is recommended that sanitation be improved and various outdoor environmental RFs be addressed in these underprivileged areas, as well as health education campaigns be organized aiming at raising the awareness of residents on indoor environmental RFs and ways to prevent them.