Conducting Environmental Health Research in the Arabian Middle East: Lessons Learned and Opportunities

Article excerpt

BACKGROUND: The Arabian Gulf nations are undergoing rapid economic development, leading to major shifts in both the traditional lifestyle and the environment. Although the pace of change is brisk, there is a dearth of environmental health research in this region.

OBJECTIVE: We describe challenges and successes of conducting an environmental epidemiologic study in the United Arab Emirates (UAE), a Gulf nation in the Middle East, with an interdisciplinary team that includes in-country academic and government collaborators as well as U.S. academic collaborators.

DISCUSSION: We present several issues, including study and data collection design, exposure assessment, scheduling and time coordination, quality assurance and quality control, and institutional review board protocols. These topics are considered in a cultural context. Benefits of this research included building linkages among multinational, interdisciplinary team members, generating data for local environmental decision making, and developing local epidemiologic research capacity. The Middle Eastern culture of hospitality greatly benefited the project team.

CONCLUSION: Cultural differences impact multiple aspects of epidemiologic research and should be respectfully addressed. Conducting international population-based environmental research poses many challenges; these challenges can be met successfully with careful planning, cultural knowledge, and flexibility. Lessons learned are applicable to interdisciplinary research all over the world. The research conducted will benefit the environmental and public health agencies of the UAE and provide the nation's leadership with country-specific environmental health data that can be used to protect the public's health in a rapidly changing environment.

KEY WORDS: environmental epidemiology, indoor air, international issues, policy, population health. Environ Health Perspect 120:632-636 (2012).[Online 22 February 2012]

In the past 50 years, Arabian Gulf nations have experienced a great increase in wealth from oil, accompanied by rapid urbanization. The United Arab Emirates (UAE) is a prime example of this swift modernization. The UAE is of scientific interest to environmental health researchers for many reasons, including the rapid transformation of its physical environment from desert to cities, with subsequent increases in traffic-and industry-related pollutants; the potential for unique pollutant mixtures; naturally occurring, extremely high temperatures; and rapid changes in lifestyle and dietary patterns. However, little environmental health-related research has been published on this region despite accelerated environmental changes.

A recent PubMed search (conducted in December 2010) for "environmental health" and "United Arab Emirates," "Kuwait," "Oman," Bahrain, "Saudi Arabia or Qatar (combined population 38 million) yielded < 300 articles, whereas the same search with "United States" (population 307 million) identified 30,000 articles. Thus, on a per capita basis, approximately 12 times as many published articles pertain to environmental health in the United States compared with the Arabian Gulf nations. Similarly, a recent Thomson Reuters global research report (Adams et al. 2011) indicated that for 2005-2009, the Middle East region (Arabian, Persian, and Turkish Middle East) published 47,201 publications in clinical medicine and 4,676 publications in environment/ecology, with 4.37% and 3.24% of the world's output, respectively, on-Thomson Reuters Web of Knowledgesm in these areas (Adams et al. 2011). Annual research publication output for Bahrain, Kuwait, Qatar, Oman, and the UAE was < 1,000 papers per year for these countries in 2009, although growth rates are rising steeply and show a large potential for enhanced scientific research in the region (Adams et al. 2011).

In 2008, the Environment Agency Abu Dhabi (FAD) undertook an ambitious project to develop an environmental health research and policy agenda to guide the newly forming regulatory and scientific institutions of the UAE. …