Human Exposure to Carbon Monoxide in Urban Regions of Asia and the Global South

Dear Colleagues,

Developing countries in Asia and the Global South have witnessed increasing rates of motorization (vehicles per 1000 people) during the last two decades. In 2004, the World Health Organization (WHO) reported that road traffic injuries constitute a major public health crisis for these countries. More than half the people killed in traffic crashes in developing countries are young adults, who are often the main breadwinners of the family. The economic cost of traffic crashes to low- and middle-income countries ranged between one and two percent of their GNP, which exceeded the total development aid that these countries received. The WHO identified a variety of risk factors for road traffic injuries, but it did not specifically identify human exposure to carbon monoxide (CO) as a risk factor. Nevertheless, a World Bank report in 1997 recognized that certain human activities, if performed in combination, could increase a person’s risk to a motor vehicle crash. The report attributed that risk to elevated levels of carboxyhemoglobin (COHb) in the blood, caused by exposure to sources of CO emissions commonly found in daily life.

Incomplete combustion produces CO emissions from sources that burn organic matter or carbon-based fuels. Human exposure to ambient and microenvironmental CO concentrations occurs during a variety of daily activities such as active and passive smoking, traveling by a motor vehicle in congested traffic, and cooking food over an unvented stove. The WHO reported that three billion people cook and heat their homes using stoves that use organic matter or carbon-based fuels. Many of these people live in developing countries, where household pollution plays a role in the death of four million people every year from strokes, heart disease, lung cancer, pneumonia, and other ailments. Human exposure to CO elevates COHb levels and starves critical body organs, especially the heart and brain, of oxygen.

Diagnosis of CO poisoning is based on a COHb level of more than 3% among nonsmokers and more than 10% among smokers.  Elevated levels of 5–7.6% COHb have been shown to impair vigilance in healthy experimental subjects. Some studies have shown decreased vigilance in subjects with only 2–3% COHb, while other studies show no effects on vigilance or other health endpoints at COHb levels up to 12.6%.  Vigilance is essential to the ability of a pedestrian or motorist to safely navigate chaotic vehicular traffic conditions. These conditions often exist in urban regions of certain developing countries in Asia and the Global South. Compromised navigation skills in combination with other factors can increase one’s risk of being involved in a crash with a motor vehicle. 

This Special Issue of Sustainability aims to contribute to the study of human exposure to carbon monoxide and its relation to the risk of motor vehicle injuries and fatalities in urban regions of developing countries in Asia and the Global South. Authors are encouraged to submit manuscripts that address the following questions:

• What historical trends describe the number and composition of motor vehicles registered in urban regions of developing countries in Asia and the Global South? What factors explain these trends? What are the projections for the future? What is the status of and outlook for national motor vehicle emission standards and of inspection and maintenance programs to curb air pollutant emissions from the motor vehicle fleets of these countries? How prevalent and effective are inspection and maintenance programs in developing countries in reducing CO emissions from motor vehicles?
• What is chaotic motor vehicle traffic flow? How can it be described, measured, and assessed? How prevalent is chaotic traffic flow in urban regions of developing countries in Asia and the Global South? What are the underlying causes, consequences, and policy options to improve traffic safety? Does chaotic traffic flow substantially increase the risk of traffic injuries and fatalities in urban regions of these countries? If so, what factors besides CO exposure explain these increased risks, either individually or in combination?
• What are recent trends in CO emissions and ambient air quality concentrations in urban regions of developing countries in Asia and the Global South? What new methods are being used to measure and model personal exposure to CO concentrations in various microenvironments of urban areas of these countries? What are the typical CO concentrations or exposures in these microenvironments based on those measurements?
• What daily human activities increase the risk of injuries and fatalities caused by crashes with motor vehicles? To what extent are these activities related to elevated levels of COHb caused by daily exposure to CO emissions from the combustion of organic matter or carbon-based fuels? Is one’s occupation a risk factor? What levels of COHb affect vigilance and the performance of critical tasks related to driving in traffic? Does the lack of vigilance while driving increase the risk of an injury or fatality while navigating chaotic flows of motor vehicle traffic? To what extent can CO exposure be linked to subtle changes in driving behavior and the performance of critical tasks as measured by on-board automotive sensors?

Research and review articles are invited for submittal for a Special Issue of Sustainability on the topic of human exposure to carbon monoxide in urban regions of developing countries in Asia and the Global South.

Prof. Peter Flachsbart, Ph.D.
Guest Editor

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• Asia and the Global South
• carbon monoxide poisoning
• chaotic traffic flow
• psychomotor skills
• risk assessment
• traffic safety
• urban region