Assessing the relation between air quality indices and acute respiratory infection incidence at sentinel clinics in Melaka and Johor, Malaysia

Pollution is one of the most serious environmental issues confronting the world today, particularly air pollution, which is the focus of this study. The Department of Environment reported hazardous readings during the 2013 Sumatera and Kalimantan Forest fires, particularly at Bukit Rambai, Melaka, with 470, and Muar, Johor, with 750. Bandar Penawar in Johor was selected as the comparative site since it is a coastal town facing the South China Sea while the main study locations located on the Straits of Malacca. Lower respiratory tract infections predicted to account for 13.1% of all fatalities in children aged 5 years worldwide reported by WHO. According to Department of Statisitics, Malaysia, pneumonia was the top cause of mortality among people aged 0-14 years in 2019, accounting for 4.8% of all deaths. The focus of this study is to examine how air contaminants flow and spread throughout the study areas from 2015-2018 and identify the main air pollutants linked to acute respiratory infections in outpatients and age as risk factor. R-Programming and its open- air package were used to construct wind rose, pollutant rose, and calendar plots to depict the pattern of pollutants throughout the study areas. For descriptive analysis, Statistical Product and Service Solutions (SPSS Version 28) were employed, which described the main age group of patients who suffered ARI owing to air pollution and summarized the frequency of visits for ARI by age. It is also used to describe the contaminants and wind speed in the study areas. Correlation determines the association between outpatient visits for ARI at KKBR, KKBM and KKBP with API, SO2, NO2, O3, CO and PM10. One-way ANOVA used to compare age groups. This study used secondary data on pollutants provided by the Department of Environment from SMKBR, KVM, and SMKABP air quality monitoring stations. Secondary data on outpatient visits were obtained from KKBR, KKBM, and KKBP. The overall concentrations of pollutants are governed mainly by north-easterly winds and the average wind speeds were sufficient to aid in the dispersion of air pollutants. The northeast wind sectors recorded the highest value of API and PM10 at the three study areas. According to the calendar plot, concluded that local emissions, not transboundary pollution, are the key contributors to the air pollution index found in the study locations, as days with high API show a seasonal pattern. This study found a positive and significant correlation between API, PM10, SO2 and 03 with outpatient visits in KKBR, PM10 and outpatient visits in KKBM, API and PM10 with outpatient visits in KKBP. Most outpatient visits for acute respiratory infections were made by patients aged 13 to 59, followed by individuals aged 12 and younger and older than 60. The number of outpatient visits for acute respiratory infection at the three clinics varies considerably by age group. The findings of this study are anticipated to contribute to an improvement in air quality in the study areas and inspire further research in other areas to raise public awareness and promote environmental conservation.

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