Source: Dissertation Abstracts International, Volume: 79-12(E), Section: B.

Adviser: Michelle Bell.

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Globally, climate change impacts have been linked to various health risks and outcomes. Smaller nations such as those in the Eastern Caribbean (EC) are uniquely vulnerable to effects such as extreme weather events and environmental pollution. However, gaps in research, surveillance and response mechanisms yield uncertainty with regard to adaptive capacity. As such, a study was initiated to (1) evaluate adaptation, (2) assess air quality and (3) investigate health, all against present and potential climate change impacts in the EC islands of St. Kitts and Nevis (SKN).

Project 1: researchers obtained daily and extreme weather data from 1970 to 2017 via SKN meteorological records and external databases such as the National Oceanic and Atmospheric Administration. Extreme weather events (cyclones, floods, and drought) potentially induced or intensified by climate change were assessed and scored for impacts via review of local media and public records. 228 members of the general public and 25 administrative representatives of various organizations were surveyed between 2016 and 2017 about their ability to prepare for and respond to impacts. Responses were coded and converted into adaptive capacity scores, multivariate logistic and linear regressions then used to assess adaptation's effects on resident well-being.

Project 2: repeat active air quality sampling for nitrogen dioxide (NO 2), ozone (O3) and particulate matter (PM10 and PM2.5) was conducted from October 2015 to January 2017 across 28 urban sites in drought-affected SKN. Sites were categorized, per public records and field tours, as construction (n=5), recreation (n=8) and transport (n=15). Spatiotemporal trends were assessed using multivariate linear and logistic regressions as well as land use regression principles. District-specific exposure risk categories, based on concentrations of each pollutant, were also derived.

Project 3: Cross-sectional health and lifestyle surveys were performed in conjunction with spirometry for 277 persons between February and November 2017. Risk categories, derived in Project 2, were used to assign air pollution exposure risks; lower (1), moderate (2) and higher (3). Bivariate and multivariate logistic regressions were then used to evaluate the association between air pollution exposure during drought and lung function deficits.

About 47 tropical disturbances of varying intensity notably affected SKN between 1970 and 2017. An 8% decline in mean annual rainfall was observed during the 2013-2016 drought. 75% of commercial operations surveyed had poor overall adaptive capacity score (-0.5 to -18.5 out of 43); health and safety adaptive measures averaging 0.625 (sigma = 7.27) out of 13. Approximately 61% of residences were close to higher risk zones; coastline, low-lying ghaut or base of a steep incline. Proximity to low-lying areas was associated with mental health effect (OR: 1.91; 95% CI: 1.05, 3.47; p = 0.035). Reduced time outdoors elevated zika infection risk (OR: 3.42; 95% CI: 1.36, 8.62; p = 0.009). Individual total adaptive capacity averaged 38.6 (sigma = 19.2) out a possible 120. Overall and knowledge-based capacities were higher for adults (p<0.0001) and persons with higher education (p<0.0001).

NO2, O3, PM10 and PM2.5 levels averaged 27.1 (max=306) ppb, 10.9 (max=106) ppb, 52.3 (max=1,556) microg/m 3 and 26.8 (max=10,400) microg/m3 respectively during the drought. Pollutant concentrations were generally higher in St. Kitts; higher at construction sites relative to transport and recreation (ps<0.05). NO2 and O3 were moderately correlated (r = 0.54; p<0.01). NO2 was higher in the PM, in areas that were urban and having higher road density. O3 concentrations were higher in dry season (p<0.05) and increased with maximum temperature (p<0.05). PM10 reduced with rain (p=0.07) and traffic volume (p<0.05). Over 50% of parishes had moderate (category=2) exposure risk for all pollutants.

Almost 20% of respondents had asthma. Independent of preexisting illness, persons working in moderate to higher PM10 exposure zones had an increased risk of FEVI/FVC<70% deficit particularly when stably employed for at least 3 years (OR=2.05; 95% CI: 1.12, 3.76 p=0.019). Adjusting for pollution and physical activity, residents previously infected with chikungunya had an increased risk of deficit (OR=2.57; 95% CI: 1.24, 5.36 p=0.012) second only to the odds among former or current tobacco users (OR=2.98; 95% CI: 1.01, 8.79; p=0.048).

Adaptive capacity was evaluated both qualitatively and quantitatively as to functionally determine inadequacies on various levels in nations, like SKN, vulnerable to increasingly extreme weather, reduced air quality and other climate change impacts. Drought potentially modified the contribution of land use principles to spatial, temporal and exposure risk features of urban air pollution. Spirometry furthered evidence of associations between respiratory health and ambient air pollution concentration below external guidelines and introduced the possibility of an arbovirus, chikungunya, being linked to reduced lung function. Further research is warranted.