Archives of

 Introduction
Climate change is one of the most serious public health concerns of the twenty-first century, posing a significant threat to human society [1]. Climate change’s effects can take various forms, and these risks are not always obvious. Climate change is causing major political, economic, social, [2], and health [3] issues throughout the world, including dust storms and changes in meteorological parameters. Strong winds and hole storms remove significant volumes of sand and dirt off drylands, causing them to become movable and suspended in the air, resulting in haze [4]. Very small particles have a higher chance of causing major health problems [1]. Dust storms have become more common in recent years, both regionally and globally. The effects of these storms have been split into environmental and human categories [5,6]. The development of eastern waves, lower growth, and production of agricultural goods, as well as the escalation of insect and plant disease damage, are all examples of environmental consequences. Air pollution, the incidence of cardiovascular diseases such as coronary artery disease (CAD), business closures and drinking water pollution, increased road accidents due to reduced vision, an increase in per capita household treatment costs, closure of industrial, service, educational units, and financial losses [7,8], and psychological problems of humans [3] are among the most important human effects of dust storms [7,8]. High wind speeds, a lack of soil cover,
Dust Storm Effect and Climatological Factors on Cardiovascular and Cerebrovascular Respiratory Diseases: A Literature Review
Alireza Khammar1,2ID, Mehdi Nouri3, Elham Saber4, Ali Miri5, Javad Vatani6*ID, Mehran Maleki Roveshdi7*ID
1Zabol Medicinal Plants Research Center, Zabol University of Medical Sciences, Zabol, Iran
2Department of Occupational Health Engineering, School of Health, Zabol University of Medical Sciences, Zabol, Iran
3Department of Occupational Health Engineering, School of Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
4Department of Occupational Health Engineering, School of Health, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
5Department of Nutrition, School of Health, Zabol University of Medical Sciences, Zabol, Iran
6Department of Occupational Health Engineering, Guilan Road Trauma Research Center, School of Health, Guilan University of Medical Sciences, Rasht, Iran
7Department of Occupational Health Engineering, Mazandaran University of Medical Sciences, Sari, Iran
*Corresponding Author: Javad Vatani, Email: jvatani@gmail.com Mehran Maleki Roveshdi, Email: mehranmaleki383@gmail.com
Abstract
Background & Aims: Dust storms, which are considered natural occurrences, have harmed the global population’s health as a result of the broad increase in climate change. The most serious consequences of these alterations are cardiovascular, pulmonary, and cerebrovascular diseases. This review study focused on the effect of dust storms and climatic factors on mortality and morbidity in worldwide and assessed the prediction of these diseases based on changes in each of the meteorological factors and dust storms.
Materials and Methods: For data collection, English literature was searched using keywords “dust storm” and “respiratory disorders” or “cardiovascular disease” or “cerebrovascular disease” in PubMed, Web of Science, and Scopus as databases, along with Google Scholar as engine search. The first step was to use statistics on the number of instances of cardiovascular, cerebrovascular, and respiratory diseases. The association between the occurrence of these diseases and variations in climatic factors underwent assessment.
Results: Adverse repercussions could be noticed when dust storms were paired with changes in metrological parameters. More local information about the link of these diseases with dust storms and changes in metrological variables in the nation, as well as their capacity to anticipate them, is needed to prevent and reduce the health risk of these diseases.
Conclusion: In areas prone to dust storms, the population will be prone to its effects and consequences. Thus, preventive measures are beneficial at the community level.
Keywords: Climate change, Dust, Cyclonic storms, Risk factors, Environmental health, Disease
Received: September 3, 2022, Accepted: February 20, 2023, ePublished: May 31, 2023
https://jhygiene.muq.ac.ir/
10.34172/AHS.12.2.3.32
Vol. 12, No. 2, 2023, 99-104
Review Article
© 2023 The Author(s); This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Khammar et al
100 Arch Hyg Sci. Volume 12, Number 2, 2023
soil moisture, rainfall, deforestation, drought, changes in
land use, and various human activities are all elements
that influence the frequency of dust storms in a given area
[9-11]. Dust storms can be found on the beaches of North
Africa, southern Europe, the Middle East, and East Asia,
among other places [12]. Every year, millions of tons
of minerals are transported to remote locations by the
world’s two largest dust storms. Dust storms in Asia, which
primarily occur in the spring, originate in Mongolian
and Chinese deserts and can strike eastern China, Korea,
Japan, Taiwan, and even North America [13,14]. Strong
winds blow in the arid regions of southwestern Saudi
Arabia, which can transfer heat to other areas and, due
to its proximity to water, can also carry moisture [15].
Early in the summer, this phenomenon, particularly its
duration, intensifies, and powerful winds reach other
surrounding regions, including Iran, during this time
[16,17]. Even though Asian dust is a well-known natural
phenomenon, new epidemiological research shows that it
has negative health consequences [18]. As dust mixes with
other contaminants in city air as it travels through the
atmosphere, its effects become more hazardous [19,20].
This dust is also full of bacteria and biological chemicals
that can induce or worsen respiratory illnesses [21]. It can
potentially induce cardiovascular disease by inflaming
the lungs or allowing highly small dust particles to enter
the circulatory system [22-24]. Dust storms are becoming
more common in the Middle East [25]. The dust has
become a company of Iran in recent years as a result of
human and environmental forces in bilateral interactions
[26]. The financial and human problems and damages
to people’s lives caused by these storms are witnessed
every year due to Iran’s location in the semi-arid part of
the world and its expansion of around 50% in the arid
and desert region [27]. Wind erosion is one of the most
visible examples and key characteristics of damaging
desertification, and it is one of the most pressing issues
confronting most countries in extraterrestrial, dry,
and semi-arid bio-climates [28]. According to current
evidence, not only has wind erosion harmed substantial
lands in Iran, but the situation is also deteriorating at a
considerably faster rate than the global average [29]. This
review study focused on the effect of dust storms and
climatic factors on mortality and morbidity in worldwide.
2. Materials and Methods
This study is a narrative review. In this type of study,
researchers review the existing literature, and attempt to
summarize what has been written on a specific area and is
skewed toward the interpretation of prior knowledge [30].
For data collection, related literature was searched using
keywords such as “dust storm” and “respiratory disorders”
or “cardiovascular disease” or “cerebrovascular disease”
in PubMed, Web of Science, and Scopus databases, and
Google Scholar. Studies addressing the effects of dust
storms and climatic conditions on cardiovascular and
cerebrovascular disorders, as well as respiratory diseases
in worldwide, were considered for inclusion. Only 56
related research were found from the 163 obtained
articles. As a result, articles published between 1982
and 2022 were assessed, and the inclusion criteria were
studies on the effects of dust storms and climatic factors
on the cardiovascular and cerebrovascular diseases of
respiratory diseases related to human health.
3. Results
A total of 163 articles related to the effects of dust and
climatic changes on complications and mortality from
cardiovascular and cerebrovascular respiratory diseases
were found, of which, 37 and 70 articles were removed
because of duplication and the lack of relevance to our
study, respectively. Of these, 67 articles dealt with the
various effects of dust on health, except cardiovascular,
and cerebrovascular respiratory diseases effects. Among
them, 56 articles focused on the health effects of dust
on the incidence and mortality of cardiovascular and
cerebrovascular respiratory diseases. The extracted
articles are categorized in Table 1 by the author’s name,
type of study, year of publication, and the intended
outcome used for the research.
4. Discussion
4.1. Dust storm trends and impacts
Dust storms have been a natural event every year for
the past 50 years according to weather data. There have
been four key changes in the pattern of dust storms in
the country since a decade ago, including increased dust
storm frequency, increased dust storm concentration,
increased shelf life, and increased transmission distance
from the source location. According to a review of the
records for days with dust storms, the frequency of dust
storms has always fluctuated over the decades with no
consistent incremental trend. Dust concentration is
one of the indications that have risen considerably in
the last decade. The duration of dust and stability in
Khuzestan province has increased by almost four times
in recent years, and the amount of pollution has reached
up to 10 000 micrograms per cubic meter according to
a comparison of dust storm features in different years.
Other statistics research has represented that recent dust
storms in Asia had a substantial impact on the workload
in the health care systems of the nations involved, causing
the health care system, particularly the nursing system, to
be overburdened in caring for elderly patients afflicted by
the storm [29].
Dust storms were first observed in the southern regions
of Iran and Iraq between 1984 and 1988 according to an
examination of dust history. Until 2001, this phenomenon
was only temporary, but over the next few years, it
progressively extended throughout the country’s southern
Arch Hyg Sci. Volume 12, Number 2, 2023 101
Dust storm and climate change effects on human health
and western cities, eventually covering all 18 provinces
by 2008. According to research on dust storm statistics
in Khuzestan province, the chemical composition of
these dust storms contains heavy metals in quantities
extremely exceeding the permissible limit, which are
highly detrimental to human health [29]. The drying out
of many areas of the wind path wetlands that act as air
filters, notably the Great Hurricane, and the decrease in
the water of the Tigris and Euphrates Rivers and their
diversion, which has led to changes in the environment
over time, are two of the reasons of dust in Khuzestan
province [43]. The Gap Project is one of the primary
(and possibly indirect) sources of dust in Iran’s southern
cities. Turkey has begun large dam-building projects that
are expected to increase the country’s economy, tourism,
and jobs, but it is experiencing drought and dust storms
downstream in Iraq and Iran. Another significant effect
of the Turkish Gap Project will be a significant reduction
in the downstream inflows of the Tigris and Euphrates
rivers, as well as a lack of environmental water rights
to downstream water areas and the worsening of dust
storms [29]. Furthermore, control of the waters of the
Karun, Dez, Karkheh, Zohreh, and Jarahi rivers by several
dam chains, as well as the increased use of water from
these rivers, has resulted in a reduction in downstream
ecosystem environmental water rights, such as wetlands,
and the formation of dust storm hotspots [29].
4.2. Effects of dust storm on human health
The propensity of dust to convey numerous allergenic
and infectious particles was addressed in a study on the
condition of dust storms. The skin, eyes, ears, and throat
are the first organs to be affected by these toxins [44].
Considering the extent of the impact of dust on Iran, which
is caused by the impact of climate change and drought
in Iran, it is not implausible to expect consequences
such as health problems in a wide range of provinces in
the country, and paying attention to these health areas
in short- and long-term plans should be taken into
consideration. Choi et al studied the Asian dust storm
particles including a broad toxicological transcriptional
program in human epidermal keratinocytes. The
most common fungal infections were Aspergillus and
Cryptococcus according to reports [45]. Considering that
the most source of dust storms in Iran is from neighboring
countries, many fungal- and bacterial-related diseases
may be transferred to Iran through dust storms. Dockery
et al examined air pollution and mortality in six US cities
[46]. Different places in Iraq were evaluated in terms
of dust status in a study focusing on investigating dust
storms in Iraq using a geographical information system.
Particle samples were prepared and examined as well.
Perez et al identified and quantified plant particles,
microorganisms, and industrial particles, and discovered
fungus spores, plant pollen, and agriculture seeds as
Table 1. Some studies included in this research
Author Type of Study Year Findings
Ansari and
Ehrampoush [31]
Correlational 2018
It was found that an increase of one microgram per cubic meter of PM2.5 will result in an
additional 27 instances of fatalities due to air pollution in Tehran.
Sherbakov et al [32] Descriptive 2018
Heatwaves and temperature exposure can have independent effects on a variety of ailments,
including kidney, cardiovascular, brain, pulmonary, and gastrointestinal diseases according to
research.
Lai [33] Correlational 2018
It has been shown that when the Laoshan wind blows in conjunction with cold weather and
strong local winds, the incidence of respiratory disorders increases, which is also related to winter
and topographic factors.
Goggins and Chan [34] Descriptive-analytical 2017
It was discovered that minimizing cold exposure among people at risk of heart failure could
potentially minimize heart failure-related hospitalization and fatalities.
Ryti et al [35]
Systematic review
and meta-Analysis
2016
The cold wave was linked to an increase in mortality and other detrimental health effects in the
local population according to research.
Zheng et al [36] Correlational 2016
The incidence of primary ICH related to high blood pressure increases as the temperature changes
(a quick drop in hot weather or an increase in cold weather).
Vencloviene et al [37] Correlational 2015
The number of emergency calls and the likelihood of acute coronary syndrome were linked to
variations in daily air temperature, daily air pressure, and wind speed according to the study.
Son et al [38] Correlational 2014
It was revealed that in Korea, both high and low ambient temperatures are linked to the incidence
of hospitalization, particularly among women and young people.
Ebrahimi et al [39] Cross-sectional 2014
It was indicated that despite the statistically insignificant link between respiratory disorders and
dust storms, the number of cardiovascular diseases is significantly correlated to it.
Kang et al [40]
Descriptive-
Analytical
2013
According to the study, myocardial infarction was significantly higher one and two days after the
dust storm in Taiwan than on the other days without dust.
Brook et al [41] Review 2010
These storms could have a considerable impact on the incidence of cardiovascular disease.
Climate change, for example, is causing a health problem among migrants. However,
epidemiologists claim that there is no meaningful effect on the link between cardiovascular
diseases.
Staskiewicz et al [42] Descriptive-analytical 2010 There was a new relationship between weather and the incidence of pulmonary embolism in men.
Note. ICH: Intracerebral hemorrhage.
Khammar et al
102 Arch Hyg Sci. Volume 12, Number 2, 2023
common allergens linked with dust storms [47]. In 2010,
a study was undertaken in Korea to evaluate the impacts
of dust storm particles on gene expression in human skin
keratinocytes [48]. The researchers discovered that gene
stimulation caused particulate matter to increase or create
inflammatory cytokines or immune system regulators.
PM2.5 to PM10 dust particles are commonly found in
the atmosphere. In recent years, numerous studies have
demonstrated their impact on health and death. People
who are exposed to dust, even a short-time exposure,
were found to have a higher likelihood of hospitalization
and mortality [49]. Many studies have been conducted on
the impact of dust on human health and mortality rates
with mixed results. The findings of many studies suggest
a link between dust and respiratory diseases. The impact
of dust on cardiovascular disease has been highlighted in
investigations by Peters et al [50]. According to different
researchers, rising dust and air pollution concentrations
increase mortality and hospitalization, further increasing
the incidence of cardiovascular and acute respiratory
disorders in these types of disasters. These situations
are also more common in those who have a poor
socioeconomic position and are illiterate [41,51-56].
5. Conclusion
According to studies, the trend of the incidence of dust
storms around the world is increasing. In the field of health,
the effects of these storms on various diseases, especially
the incremental trend of the hospitalization process on
days with the occurrence of dust events, are emphasized
in many articles. The causes of these hospitalizations are
mostly respiratory, cardiovascular, and cerebrovascular
diseases, and as a result, the mortality associated with these
diseases in the studies is clear. However, some studies
failed to find statistical significance in the mentioned
cases. The type and size of particles in the dust have been
investigated in some studies, along with the effect of these
parameters on the incidence of disease or prolongation
of diseases, which often indicates contradictory results
in this field. However, most studies have been conducted
in capitals, metropolises, and industrial cities full of
various man-made pollutants. Given that the synergistic
effect of man-made pollutants and particles in dust
storms has been considered in some studies, the results
of studies are in a haze of ambiguity. The effect of
meteorological elements on some diseases has also been
evaluated, and the harmful effects of these factors on
some diseases, including cardiovascular, respiratory, and
cerebrovascular diseases, have been proven, although
some studies did not confirm these results. On the other
hand, there is no comprehensive study on the combined
effects of dust storms and meteorological elements on
health in the world; therefore, according to all aspects and
studies, it seems that there is still a need for further studies
in this field to clarify the many hidden angles that exist in
this area. With the help of the results of this research to
predict the occurrence of dust and the synchronization of
meteorological elements in the future, it will be helpful
to plan properly to reduce the effects, and prepare and
respond to this risk, leading to beneficial outcomes.
Acknowledgments
Thank all authors for the research in this field.
Authors’ Contribution
Conceptualization: Alireza Khammar, Mehdi Nouri.
Data curation: Mehran Maleki Roveshti, Javad Vatani.
Formal analysis: Javad Vatani, Ali Miri.
Funding acquisition: Alireza Khammar.
Investigation: Elham Saber, Ali Miri.
Methodology: Mehdi Nouri, Ali Miri.
Project administration: Alireza Khammar.
Resources: Mehran Maleki Roveshdi.
Software: Mehran Maleki Roveshdi.
Supervision: Alireza Khammar, Javad Vatani.
Validation: Elham Saber, Ali Miri.
Visualization: Mehdi Nouri.
Writing–original draft: Mehran Maleki Roveshti.
Writing–review & editing: Javad Vatani.
Competing Interests
The authors declare that they have no conflict of interests.
Ethical Approval
This article is a literature review with no human or animal sample.
However, this article is the background of a research study with
ethical considerations (IR.ZBMU.REC.1398.151).
Funding
This research was supported by Zabol University of Medical
Sciences, Zabol, Iran (grant No. 402000041).
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