Abstract
Chronic kidney disease (CKD) is a persistent, devastating, yet neglected, non-communicable disease, particularly in developing and emerging countries. The traditional risk factors for CKD, such as hypertension and diabetes have received relatively ample attention but do not sufficiently explain the high burden of CKD. Ambient air pollution is an emerging environmental risk factor for CKD; however, epidemiological data and evidence are lacking for susceptible populations in developing countries. The Niger Delta region of Nigeria is a petrochemical hub known for environmental degradation, including air pollution, and thus, serves as a good case study for investigating the association between air pollution and CKD. This brief is based on an exploratory mixed-methods study conducted in four communities situated near an oil and gas refinery in Warri, Nigeria, to explore perceived and actual air pollution risks and determine whether long-term exposure to ambient air pollution is associated with CKD. Air pollutant concentrations measured in partnership with citizen scientists using portable air sensors, showed that all except one air pollutant (ozone) exceeded the WHO acceptable limits in all four communities. PM (2.5) ranged from 22.8 to 28.0 μg/m (3), PM (10), 40.6 to 55.5 μg/m (3), and CO (2), 584-652 ppm. The overall prevalence of CKD was 12.3% but even higher (18%) in a socially deprived semi-urban community closest to the oil refinery. Hypertension, diabetes, other behavioral risk factors, and exposures associated with CKD were prevalent in the four communities and environmental health information was lacking. A multifaceted approach is required to mitigate air pollution and the associated NCD risks in the region. The government needs to invest in air monitoring services, cleaner technologies, and environmental risk communication through various media channels. We strongly recommend public inclusion in planning, designing, and implementing educational interventions. Lastly, environmental risk factors such as air pollution should feature prominently in strategic plans for NCD prevention.