Particulate Matter Pollution and Health Impacts in Six North African Countries

This paper addresses the issue of outdoor particulate matter pollution in six North African countries-Algeria, Egypt, Libya, Morocco, Sudan, and Tunisia. Major particulate matter sources include various industries and transportation systems, dust storms, and sandstorms. It has been shown that there is a need to increase public awareness and participation and enhance capacities regarding ground-based monitoring of particulate matter, using satellite data, and assessing the health impacts of exposure to particulate matter. There is also a need for improved legislation and better governance regarding its implementation and enforcement. If possible, examples of potential impacts of particulate matter pollution on the Gross National Product (GNP) for various economic and health sectors will be reported. As outdoor particulate matter pollution is one of the major sources of loss to the GNP, air quality management needs to be strengthened.

Introduction

As early as 2006, the United Nations Environmental Programme, Regional Office for West Asia (UNEP/ROA), in collaboration with the Economic and Social Commission for Western Asia (ESCWA) and the League of Arab States (LAS), identified unplanned urbanization, migration of people from rural areas, settlement of migrants, high birth rates, industrialization, motorized transportation, and natural episodes of dust storms and sandstorms as driving forces in the interaction between society and environment in North African countries (UNEP/ESCWA/LAS, 2006). These driving forces result in pressures such as air pollution, land use changes, and population growth, which in turn reduce air quality and increase the exposure of people to air pollutant concentrations with concurrent effects on public health and the environment.

Industrial development, climate change, political upheaval, and war have left a legacy of environmental impacts and health problems. Unprecedented unplanned urbanization, industrialization, and migration of traditionally rural peoples and resettlement of political refugees and foreign workers strain city services and give rise to air pollution (Mostafaet al., 2018; UNEP/ESCWA/LAS, 2006).

The inhabitants of this region endured recurring drought episodes of varied nature, severity, and impacts. In particular, Algeria, Egypt, Morocco, Tunisia, the north coastal areas of Libya, and Sudan suffer serious adverse impacts from recurring droughts (UNEP/ESCWA/LAS, 2006). These impacts include reduction of productivity, degradation of rangelands and rained cultivated areas, human and societal conditions, and immediate and deferred economic considerations. Droughts also exacerbate dust storms and sandstorms, which carry fine sand and dust over long distances, obstructing activities such as flights, road traffic, and supply chains. The frequency and severity of these dust episodes have increased during the last three decades (IPCC, 2021), exacerbating adverse health impacts such as respiratory diseases (Abumoghli & Gonçalves, 2020).

Air pollution due to anthropogenic activities, especially particulate matter (PM), has become an increasingly important environmental issue in the region. The concentrations of particulate matter (PM₁₀, particles smaller than 10 µm; PM_2.5, particles smaller than 2.5 µm) are estimated to be very high, exceeding substantially the air quality guideline values of the World Health Organization (WHO) of 2005 and even more the most recent ones, published in 2021 (Abumoghli & Gonçalves, 2020; WHO, 2005, 2021a).

The toxicity of particles depends on their size and chemical composition. Particles with a diameter between 2.5 and 10 μm (PM_10-2.5) are deposited in the upper respiratory tracts. The fine particles (PM_2.5) are capable of penetrating deep into the respiratory system. They reach the terminal airways, settle on the lung tissue, and can also convey toxic compounds, allergens, mutagens, or carcinogens, such as polycyclic aromatic hydrocarbons and metals, where they can be absorbed into the blood and tissue (WHO, 2021a).

In North African countries, anthropogenic PM concentrations are contaminated with dust episode-related natural particles, which are a medium for pathogenic micro-organisms and may contain toxic biological allergens (Dominguez-Rodriguezet al., 2019). For southern Europe, it was established that increases of 10 μg/m³ in anthropogenic and desert-related PM₁₀ were associated with increases in premature mortality of 0.55% and 0.65%, respectively (Münzelet al., 2019).

Short-term exposure (from one to four days) to particulate matter causes significant adverse effects, especially in people suffering from chronic heart and lung disease who are at higher risk of premature death. Depending on the size of the inhaled particles, they deposit in the lungs and cardiovascular system, migrating to other organs, including the brain, ultimately affecting body functions. Positive associations were established between all-cause mortality and short-term exposure to PM_2.5 (RR: 1.0065; 95% CI: 1.0044–1.0086) and PM₁₀ (RR: 1.0041; 95% CI: 1.0034–1.0049). PM₁₀ and PM_2.5 were also positively associated with cardiovascular, cerebrovascular, and respiratory mortality (Orellanoet al., 2020). Results were assessed to be robust in sensitivity analyses.

According to substantially increased new scientific evidence on the health effects of particulate matter, long-term exposure to PM_2.5 concentrations in the reviewed studies was significantly associated with all causes of death (Chen & Hoek, 2020; WHO, 2021a). Chen and Hoek (2020) evaluated the mortality from ischaemic heart disease (IHD), cerebrovascular disease (stroke), and respiratory diseases, in particular chronic obstructive pulmonary disease (COPD), acute lower respiratory infections (ALRI), and lung cancer. The Risk Ratio (RR) for PM_2.5 was 1.08 (95% CI 1.06, 1.09) times the risk of natural cause mortality per each increase of 10 µg PM_2.5/m³. Analyzing studies at exposure levels of PM_2.5 below 25 µg/m³ resulted in similar or even higher risk ratios as the one of the overall RR, indicating non-linear exposure-response relationships in some studies. For most studies, the risk of bias was insignificant. The meta-analyses for PM_2.5 led to the conclusion that the association of PM_2.5 and circulatory mortality was graded as “highly certain evidence,” while for respiratory mortality, evidence was only “moderate.” PM₁₀ exposure was significantly associated with most but not all causes of death. The evidence for an association between PM₁₀ and cause-specific mortality was rated as less certain (“moderate” for IHD COPD and “low” for stroke mortality).

A more recent meta-analysis of studies on stroke incidence showed that exposure to PM_2.5 (and other pollutants) was associated with an increased risk of hospital admissions, incidence, and mortality (Niuet al., 2021).

The growing body of scientific evidence has indicated that women who are subject to long-term particulate matter exposure are more likely to give birth to babies of low weight or born prematurely (HEI, 2020). The wealth of new studies on the health effects of particulate matter (and other criteria pollutants) has urged the World Health Organization (WHO) to update its 2005 guideline values (WHO, 2005; WHO, 2021a).

Table I depicts the WHO’s new guideline values for PM_2.5 and PM₁₀ in comparison with the corresponding standards for the six North African countries. The previous WHO guideline values of 2005 are also included. Since some countries still monitor standards for total suspended particulate matter (TSP), these and the old WHO guideline values for TSP are also included.

Table I. WHO Guideline Values and North African Standards for PM

Country/ organization	PM2.5 [µg/m3]		PM10 [µg/m3]		TSP [µg/m3]		Remarks	Source
	Annual mean	24 h	Annual mean	24 h	Annual mean	24 h
International	5	15	15	45	–	–		WHO, 2021a
	10	25	20	50	–	–		WHO, 2005
	–	–	–	–	70	120	In conjunction with sulfur dioxide	WHO, 1987
	–	–	–	–	60–90	150–230		WHO, 1979
Algeria	–	–	50				Target value	Abderrahimet al., 2016; Algeria Decree, 2006a;
	–	–	80	–	–	–	Limit value
Egypt	50	80	70	150	90	230		Egypt PM, 1995; Mohammed & Saleh, 2020
Libya	–	–	–	–	–	–	No standards	Nassar et al ., 2017
Morocco	–	–	50	–	–	–	Annual mean as 90.4 percentile of daily means	Morocco Decree, 2010a
Sudan	10	25	73	125	80	270	May be exceeded three times a year	UNEP, 2020
Tunisia	20	35	40	50	–	–	Valid after 1 Jan. 2021	Tunisia Decree, 2018

Most studies on the health impacts of particulate matter were performed in North America, Europe, East Asia, and Australia. Studies conducted in low-and middle-income countries are still very limited (WHO, 2021a).

The World Health Organization (WHO) estimated PM_2.5 concentration for urban and rural areas based on the available data (WHO, 2023). The PM_2.5 concentrations in the six North African countries are summarized in Table II for urban and rural areas, cities, and towns. Correspondingly, the WHO estimated the number of deaths per country and the disability-adjusted life years (DALYs) shown in Table III (WHO, 2022a, 2022b). The numbers of deaths and DALYs related to the incidences of IHD, stroke, lung cancer, COPD, and ALRI in children.

Table II. PM_2.5 Estimates for Urban, Rural, Cities and Towns in Six North African Countries

Country	Urban			Rural			Cities			Towns
	Lower	Median	Upper	Lower	Median	Upper	Lower	Median	Upper	Lower	Median	Upper
Algeria	15	22	35	14	23	35	15	24	36	14	21	34
Egypt	41	64	94	32	47	68	42	66	95	38	59	90
Libya	19	29	49	15	30	52	10	28	59	11	28	49
Morocco	11	14	17	10	13	17	12	14	17	11	13	17
Sudan	12	23	44	10	21	37	13	24	46	11	22	41
Tunisia	19	27	38	16	25	37	21	29	40	16	25	35

Table III. Number of Deaths and Disability-adjusted Life Years (Dalys) due to PM_2.5

Country	Number of deaths			Number of DALYs
	Lower	Median	Upper	Lower	Median	Upper
Algeria	11,689	17,295	22,818	239,106	351,065	468,623
Egypt	52,649	69,402	86,014	1,462,881	1,887,640	2,436,114
Libya	1,490	2,264	2,976	40,814	61,537	81,432
Morocco	13,338	19,303	25,071	310,768	445,314	575,576
Sudan	8,709	14,110	19,519	251,692	418,341	593,625
Tunisia	4,971	6,880	8,765	102,667	140,258	178,187

Recent values of the World Bank for country-wide annual mean PM_2.5 concentrations, averaged over 27 years, in the six North African countries are summarized in Table IV.

Table IV. PM_2.5 Mean Annual Exposure 1990–2017 in µG/M³ in Six North African Countries

Algeria	Egypt	Libya	Morocco	Sudan	Tunisia
39	87	54	33	55	38

Comparing the PM_2.5 mean annual values used by the World Bank, Table IV, with urban or rural values used by WHO, Table II, no approximate agreement of numbers appears to exist, while for the six countries, the concentration differs between 11 and 32 µg/m³. This discrepancy could be explained by the fact that the concentrations of Table II are for one year only, while those of Table IV are averaged over 27 years.

Except for Egypt and Libya, the concentrations noted in Table IV are consistent with those used for the Global Burden of Disease (GBD) study 2019 (GBD, 2019; HEI, 2020; see Table V), which also shows the number of annual deaths per 100,000 people and the number of premature deaths per country. However, the median number of annual premature deaths estimated in 2022 (Table III) and in 2019 (Table V) are substantially smaller by 22%, 12%, 36%, 34%, and 60% for Algeria, Egypt, Libya, Morocco, and Sudan, respectively. Only for Tunisia, the median number of annual premature deaths lies within the range presented in Table V.

Table V. Estimates of Deaths from the Most Recent Global Burden of Disease Study

Country	Population [thousands]	PM2.5 (low) [µg/m3]	PM2.5 (high) [µg/m3]	Deaths/100000 (low)	Deaths/100000 (high)	Deaths (low)	Deaths (high)
Algeria	43,053	30	45	52	79	22,388	34,012
Egypt	100,388	45	75	80	176	80,310	176,683
Libya	6,777	30	45	52	79	3,524	5,354
Morocco	36,472	30	45	80	176	29,178	64,191
Sudan	42,813	45	75	80	176	34,250	75,351
Tunisia	11,695	30	45	52	79	6,081	9,239
Sum						175,731	364,829

The main objectives of this paper are:

• Identify the sources of outdoor particulate matter.
• Summarize the current legislation and regulations to manage air pollution.
• Describe the efforts for surveillance of outdoor particle mass concentrations.
• Report the attempts to assess health effects of particulate matter in terms of mortality and morbidity.
• Describe the estimated percentages on the grand national product (GNP).

for the six North African countries. Although indoor air pollution by particulates is also a big problem in these countries, it will not be considered in the chapter.

Methodology

Literature searches were performed in English, French, and Arabic, as needed, using Google Search, PubMed, and Medline-OVID databases. Search keywords included particulate matter, PM_2.5, PM₁₀, air pollution, outdoor air quality monitoring, and each individual North African country. Additional references were also identified from the reference lists of all selected publications. The selection was restricted to the following:

1. Published papers in peer-reviewed English or French language journals.
2. Articles containing PM_2.5, PM₁₀, or TSP monitoring data; and
3. Original articles, as well as review articles that present or refer to identifiable PM monitoring data.

If the particle content of heavy metals, polycyclic aromatic hydrocarbons (PAHs), and other organic compounds was assessed, this will be mentioned in passing only. Air quality standards for these compounds do not exist in the six countries, and most authors usually do not compare compound concentrations with respective WHO guideline values for non-carcinogenic compounds and unit risks for carcinogenic compounds.

The Constitutions and the Legislations (laws and regulations) of the six North African countries were identified through a Google search and existing review articles on this topic.

Results and Discussion

Algeria

Sources

The most important industries are petroleum, natural gas, mining, steel and metallurgy manufacture, electricity generation, petrochemical manufacture, waste incineration, and light industries such as food processing, among others (UNEP, 2015a). The mining steel industry and metallurgy emit NO₂, SO₂, toluene, and benzene and are considered the most polluting in the Northeast of Algeria (Kharytonovet al., 2016). One of the largest iron deposits was opened in summer 2022 (Euronews, 2022). Algeria is supposed to produce 40 to 50 million tons of iron in 2026 (Zawya, 2023). Vehicle emissions are the most important sources of air pollution in Algerian urban centres (Merabet, 2017; Chetta & Nait, 2021; Boudaliaet al., 2023). Challenges include vehicle fleet growth of old second-hand passenger cars, lorries, trucks, motorcycles, dirty fuel, and poor public transport through municipal bus and tram services. Open burning outdoors in public dumps or municipal uncontrolled ones is also a challenge in Algerian cities.

Legislation

According to Article 20, Paragraphs 1, 2, 4, and to Article 67 of the Constitution, citizens have the right to a healthy environment within the framework of sustainable growth (Algeria Constitution, 2020). Article 220 defines the National Social Economic and Environmental Council; its responsibilities are regulated in Article 221. Article 67 notes the framework of ‘sustainable growth’ instead of sustainable development. The latter emphasizes economic growth and means something different because development might also include economic and ecologic balance. The law determines the obligations of natural and legal persons for the protection of the environment.

Algeria’s updated law for general environmental protection was promulgated in 2003 (Algeria Law, 2003). This law aims at implementing a national policy for environmental protection within the framework of sustainable development (Yoshida, 2018). It sets out to protect the environment, restore damaged environments, and prevent and abate any form of environmental pollution, including, among many others, atmospheric pollution. Article 46 of the law emphasizes the responsibility of polluters (industry, commerce, agriculture, residential buildings, vehicle manufacture, and their use) to implement all necessary arrangements to avoid, remove, or reduce air pollutant emissions.

Several decrees implement the law for general environmental protection. These include a decree, the purpose of which is to define the regulations applicable to classified establishments, in particular their environmental planning, operation, inspection, environmental impact assessment (EIA), modalities of authorization, suspension, and withdrawal, as well as the terms and conditions of their control (Algeria Decree, 2006b). However, this decree, as well as others, focused mostly on water pollution (Yoshida, 2018). Air pollution in the decree is only superficially mentioned in terms of “other emissions.” This observation is also in line with the lack of results from a project initiated by the International Atomic Energy Agency (IAEA) aiming to contribute to air quality management in Africa by improving monitoring and analytical characterization using nuclear attenuation techniques (NATs) and understanding of pollution sources using apportionment tools (IAEA, 1998–2023). A meeting of African air pollution professionals was held in Algeria to strengthen air quality monitoring capacities by use of NATs (IAEA, 2018). The experts reviewed the outcome of the four regional training courses conducted as part of the project and agreed on a comprehensive action plan to be developed by the end of 2019. Although the project was to be terminated by December 2019, it is still active, and no final report on the project appears to have been published (IAEA, 1998–2023).

Algeria has set an annual mean limit for PM_10, which is defined as a level based on scientific knowledge, with the aim of avoiding, preventing, or reducing the harmful effects of this substance on human health or on the environment, see Table I (Algeria Decree, 2006a). The law also incites a Ministerial Decree to set short-term values for information and alert the public as a maximum level of concentration of polluting substances in the atmosphere, determined based on scientific knowledge (Abderezak, 2009; Abderrahimet al., 2016). It appears that these values were not yet set by 2017 (Merabet, 2017) or even later (Imaneet al., 2022).

Surveillance

In Algiers, the pollution levels were measured during the early 2000s by the SAMASAFIA (meaning Clear Sky) monitoring networks, consisting of four stations: Ben Aknoun, EL Hamma, Premier Mai, and Bab El Oued. Among other compounds, this National Air Pollution Monitoring Network continuously monitored PM₁₀ concentrations using automatic beta attenuation monitors (Abderrahimet al., 2016). In their paper, the authors quote daily mean concentrations in the years 2002–2006 at the El Hamma station between less than half the WHO PM₁₀ guideline value and more than 400 µg/m³. After August 2003, PM₁₀ concentrations decreased to most values below 100 µg/m³.

Total suspended particulate matter (TSP) was measured for several months at the Institute of Nuclear Studies in the east of Algier (southeast of Bab El Oued), which is located near a busy road, the most important source of TSP (Bouhila, 2010). Observed values during a sampling time of 48 and 72 hours ranged between 29 µg/m³ in July 2008 and 164 µg/m³ in December 2008.

Levels of PM₁₀, PM_2.5 (actually PM₃ [particles smaller than 3 µm]), and PM₁ (particles smaller than 1 µm) at two urban sites, one traffic site, one peri-urban site, and a remote site in Greater Algiers were monitored over 10 months (Kerbachiet al., 2009). Values varied between 27 µg/m³ and 80 µg/m³ for PM₁₀ and between 18 µg/m³ and 43 µg/m³ for PM_2.5. All PM₁₀ values except one complied with the Algerian limit value (Table I). All monitored PM₁₀ and PM_2.5 results exceeded the WHO 2021 annual mean guideline values by factors of approximately 1.8 to 5.3 and 3.6 to 8.6, respectively.

In another study, annual mean PM₁₀, PM_2.5 (actually PM₃), and PM₁ levels at a traffic site were reported from July 2002 to June 2003 (Oucher & Kerbachi, 2012). Annual means amounted to 75 µg/m³, 40 µg/m³, and 26 µg/m³ for PM₁₀, PM_2.5, and PM₁, respectively. PM₁₀ and PM_2.5 mean exceeded WHO 2021 guideline value by factors of 5 and 8, respectively.

However, only a few studies on more recent data on particulate matter air pollution have been reported in cities of Algeria due to the non-access and insufficiency of monitoring data and the failure of the SAMA SAFIA air quality monitoring stations since 2009 (Belhoutet al., 2018). For this reason, this author developed for Algiers an emissions inventory of point sources, area sources, and road traffic and used “The Air Pollution Model” (TAPM) to estimate PM₁₀ (and NO₂) concentrations in Algiers and apply a neural network-based meta-modelling approach for estimating the spatial distribution of PM₁₀ concentration levels (Wahidet al., 2013). These spatial estimates indicate that in larger areas of Algiers, the WHO 2005 annual PM₁₀ guideline value is exceeded by factors 2 to almost 6.

In a more recent study, the authors assessed particulate matter levels in Algiers at a roadside site from 1 January to 30 September 2015 and at an urban site from 4 March to 30 November 2016 (Talbiet al., 2017). The annual means of PM₁₀ and PM_2.5 were estimated to be almost equal for the two sites and amount to approximately 60 µg/m³ and 33 µg/m³, respectively, exceeding the 2021 WHO guideline values by factors of 4 and 6.6, respectively.

In a study at an urban site in northern Algier (Bab Ezzouar), daily levels of PM₁₀, PM_2.5, PM_1, and their associated PAHs were studied from January 2018 to January 2019 (Teffahiet al., 2021). The annual average of mass concentrations reached (94.8 ± 11.4) μg/m³ for PM₁₀, (46.3 ± 7.3) μg/m³ for PM_2.5, and (31.1± 6.4) μg/m³ for PM₁. The corresponding Algerian limit value for PM₁₀ was exceeded, as was the WHO guideline value for PM_2.5 (see Table I). The daily concentrations for PM₁₀ and PM_2.5 ranged from 23 μg/m³ to 260 μg/m³ and 13 μg/m³ to 180 μg/m³, respectively. The WHO 24-hour guideline values for PM₁₀ and PM_2.5 were exceeded most of the time.

The most recent annual mean PM_2.5 concentration for Algeria as a whole, estimated as an average of the years 1990 to 2017 for the Global Burden of Disease Study 2017, is 39 µg/m³ (World Bank, 2021a). It exceeds the WHO guideline by a factor of almost 8, cp. Table I.

Air Quality Data for Algiers is available since April 2019 (AQICN, 2008–2023a). However, there is currently no known continuous air quality monitoring information for Algeria.

Health Impacts

In a descriptive statistics approach of asthma and chronic obstructive pulmonary disease (COPD) rates due to traffic in urban and suburban Bejaia City, Northern Algeria, and a rural area, the authors used carbon monoxide (CO) as a proxy for air pollutants emitted from vehicles, including transport-related particulate matter (Benaissaet al., 2014). They established a relationship between CO and the number of vehicles and observed a strong correlation between CO, asthma, and COPD rates. The usefulness of CO as a proxy for traffic-related air pollutants has recently been reiterated by Bertrandet al. (2020). In a further study, the authors established for each decrease of 5 µg PM₁₀/m³, a corresponding decrease in pulmonary and cardiovascular diseases of 5% and 3%, respectively (Benaissaet al., 2016).

Health data do not appear to be available from exposure to populated areas in Algeria (Bouetet al., 2019). Anenberget al. (2019) estimated population-weighed PM_2.5-attributable mortality in 2016 for the 250 most populous urban areas, including an area in Algiers and several cities in Egypt and Morocco, see Table VI.

Table VI. PM_2.5-Attributable Mortality in Populated Areas of Algeria, Egypt, and Morocco

City	Country	PM2.5 [µg/m3]	Deaths	IHD [%]	Stroke [%]	COPD [%]	IC [%]	IRI [%]	Deaths 2.5prctl	Deaths 97.5prctl
Algiers	Algeria	38	1310	60%	17%	8%	3%	13%	680	1990
Cairo	Egypt	139	25480	56%	17%	9%	2%	14%	16540	36970
Shibin el Kom		113	30	57%	17%	9%	2%	14%	20	50
Asyut		190	2510	56%	18%	10%	3%	15%	1690	3620
Sohag		185	4530	56%	18%	10%	3%	15%	3040	6530
Marrakesh	Morocco	30	360	62%	15%	8%	5%	11%	180	540
Casablanca		24	1360	63%	15%	8%	4%	10%	640	2120
Rabat		22	470	64%	15%	7%	4%	10%	220	740

The table shows the population weighed PM_2.5 concentrations, the number of deaths and their 97.5 confidence intervals, and the attributed percentages of health endpoints.

More recently, Imaneet al. (2022) emphasize one study of 2021 in Algeria that links asthma and bronchitis hospital admission to air pollution due to a variety of emission sources. Collected data on PM₁₀, PM_2.5, and PM₁ were 60 µg/m³, 32 µg/m³, and 18 µg/m³, respectively.

Abbasi-Kangevariet al. (2023) quote the age-standardized death rates per 100,000 attributable to outdoor PM pollution in 2019 as 77 (95% CI: 54–102) and to age-standardized DALYs per 100,000 as 1,838 (95% CI: 1,330–2,406). The average life expectancy reduction in Algeria would amount to 1.1 years if outdoor PM pollution had been lowered to the theoretical minimum risk.

Air Quality Management

Air quality management (AQM) in the sense of more than ad hoc action in times of air pollutant episodes seems to be completely absent in Algeria. There appears to be no legislative base for clean air implementation plans or for long-term action plans for air pollution abatement.

Percentage of GNP Due to PM2.5 Exposure

The annual health damages (deaths and year of life with disability) and costs (in per cent Gross National Product of outdoor PM_2.5) were estimated for the year 2016 for the six North African countries as compiled in Table VII (World Bank, 2021a). For Algeria, the annual expenditures for the health impacts amount to 5.5% of the GNP.

Table VII. Percentage of GNP Loss due to Outdoor PM_2.5-Attributable Mortality and Years of Life with Disability (YLD), 2020

Country	Annual PM2.5 [µg/m3]	Deaths	YLD	% GNP
Algeria	33	21,613	89,757	5.5
Egypt	68	90,559	240,586	8.6
Libya	39	3,368	18,094	5.4
Morocco	35	27,063	81,819	7.3
Sudan	55	16,634	42,558	5.5
Tunisia	30	7,337	31,432	6.5

The percentage of the GNP in Table VII is calculated for outdoor air pollution and solid fuel use. The contribution of solid fuel use, however, is less than 3.4 10⁻³ in the case of all MENA countries except Sudan, where solid fuel use contributes approximately 70% to the GNP, and Morocco, for which the contribution of solid fuel use amounts to 6.5%.

Egypt

Sources

Transport, agricultural slash and burn, industrial power and electricity generation, and the mismanagement of waste, desert dust, biomass burning, and domestic combustion are the most important sources of PM_2.5 in urban areas of Egypt (CAF, 2023). The small and medium-scale industries are textile manufacturers, food processing, chemicals, pharmaceuticals, construction, and light manufacturing, among others (UNEP, 2015b). Garbage and medical sanitary waste, as well as open-air burning and burning of agricultural waste, are leading sources of PM₁₀. A key challenge for PM emissions is the old and growing second-hand vehicle fleet using dirty fuels. Public transport is operated by municipal buses, and tram services are poor in major cities.

The Greater Cairo (GC) region has long been suffering from deteriorated air quality, which is caused by high levels of anthropogenic activities, such as traffic, industries, and agricultural biomass burning events, as well as natural sources of particulate matter, such as dust and sand events (Mostafaet al., 2018).

Legislation

According to Article 46 of the Egyptian Constitution, every individual has the right to live in a healthy, sound, and balanced environment. The state is committed to taking the necessary measures to preserve it in a sustainable development (Egypt Constitution, 2019).

Law No. 4 of 1994, as amended by Law No. 9 of 2009, regulates in Articles 34 to 41 the protection from air pollution due to industrial and commercial facilities, open-air waste disposal and burning, and vehicle emissions (Egypt Law, 1994, 2009). Stationary and mobile sources must comply with emission standards and procedures set in executive regulations; this includes organizations undertaking activities in the field of exploration, drilling, extraction, and production of crude oil, refining, and processing. Open-air disposal and burning of garbage are absolutely prohibited. The Prime Minister’s Decree of 1995 promulgates the executive regulations of the 1994 Law (Egypt PM, 1995). This decree and the annexes include the responsibilities and permissions of the Egyptian Environmental Affairs Agency (EEAA); the environmental protection fund; the pollution protection of the land and the air; emission limits; the establishment of the environmental impact assessment; and maximum limits of outdoor air pollutants.

Law No.105 amends Law 4 with respect to banning the import, circulation, and use of coal and petroleum coke without a permit from the concerned authorities (Egypt Law, 2015).

Surveillance

Particulate matter air pollution is measured by annual mean levels of fine particulate matter PM_2.5 in cities (Egypt MPED, 2021). As of 2017, Egypt’s Ministry of Environment was managing 60 air pollution monitoring stations in urban-residential and mixed areas, 31 of which were in Greater Cairo, five in Alexandria, 10 in the Delta region, 12 in Upper Egypt, and two in Sinai and Canal cities. There exist nine roadside stations in GC and one in Upper Egypt. It is not reported if all stations monitor particulate matter.

Unfortunately, there is also no recent information available for real-time air quality data. The Cairo University Center for Environmental Hazard Mitigation (CEHM) has an air quality laboratory, but real-time air quality data is unfortunately not available either (AQICN, 2008–2023b).

The WHO database of the Global Health Observatory reports measured PM₁₀ data up to 2016 and converted them into PM_2.5 estimates, see Table VIII (WED, 2018; WHO, 2021b).

Table VIII. Monitored PM₁₀ and Converted PM_2.5 Annual Means for Greater Cairo, Delta Region, and 19 Provinces in 2015/2016

City/region	Site type	PM10 [µg/m3]	PM2.5 [µg/m3]*	TSP [µg/m3]	Source
Delta region	18 Stations	249	102	–	WHO, 2021b
Greater cairo	13 Stations	284	117	475	WED, 2018
Alexandria	–	120	48	345	WED, 2018
Port said	–	99	40	152
Suez	–	127	51	191
Damietta	–	152	61	–
Qalyubia	–	232	93	332
Dakahlia	–	206	82	–
Sharqia	–	182	73	265
Gharbia	–	350	140	711
Monufia	–	277	111	–
Beheira	–	144	58	340
Ismailia	–	153	61	–
Faiyum	–	274	110	376
Beni Suef	–	410	164	730
Minya	–	329	132	563
Asyut	–	304	122	513
Sohag	–	299	120	505
Qena	–	157	63	–
Aswan	–	256	102	335

Comparing PM₁₀ monitored values with the Egyptian annual PM₁₀ standard of 70 µg/m³ (see Table I) shows that in 19 provinces, the Delta region and GC PM₁₀ concentrations exceed the Egyptian standard by factors between approximately 1.4 and 5.9 for Port Said and Beni Suef, respectively; the WHO guideline value for PM₁₀ of 15 µg/m³ is exceeded by factors between approximately 6.6 and 27.3. The PM_2.5 converted concentrations exceed the corresponding Egyptian PM_2.5 standard of 50 µg/m³ by factors between approximately 1 and 3, except for Alexandria and Port Said. Similarly, the WHO PM_2.5 guideline value of 5 µg/m³ is exceeded by approximate factors between 7 and 33 for all locations monitored. Therefore, in the parts of Egypt in which monitoring data have been reported, substantial health impacts on the general population can possibly be expected. This is in line with a recent request that WHO’s stricter guideline values for particulate matter calls for revision of Egyptian standards (EIPR, 2021).

The most recent annual mean PM_2.5 concentration for Egypt as a whole, estimated as an average of the years 1990 to 2017 for the Global Burden of Disease Study 2017, is 87 µg/m³ (World Bank, 2021a). It exceeds the WHO guideline by a factor of almost 16, cp. Table I. This value is compatible with the upper estimate in Table II but less so with those of Table V.

Health Impacts

Excess mortality attributable to long-term exposure to PM_2.5 (and other pollutant) concentrations was estimated for GC using monitoring results from 18 stations in different areas of the megacity (Wheidaet al., 2018). PM_2.5 concentrations were varying from 50 µg/m³ to more than 100 µg/m³. The authors assume an average of 75 µg/m³ for a city-representative PM_2.5 concentration and a log-log shape of the concentration-response function. Under these assumptions, 11% (95% CI 9%–14%) of premature non-accidental mortality in the population older than 30 years can be attributed to PM_2.5 exposure. This percentage corresponds to 12,520 annual premature deaths in Greater Cairo.

Marchettiet al. (2019) determined that from December 2016 to November 2017, PM_2.5, its elemental concentration, and polycyclic aromatic hydrocarbons (PAHs) assessed the biological effects of PM_2.5 in vitro in GC. The authors established the dependence of the toxic potential of PM_2.5 on seasonal changes in chemical composition.

The effect of air pollution on mortality, morbidity, and life expectancy based on the GBD 2019 was determined by Abbasi-Kangevariet al. (2023). They quote for the age-standardized death rates per 100,000 attributable to outdoor PM pollution in 2019 as 158 (95% CI: 118–2002) and for age-standardized DALYs per 100,000 as 3,993 (95% CI: 3,004–5,104). The average life expectancy reduction in Egypt would amount to 2.0 years if outdoor PM pollution had been lowered to the theoretical minimum risk.

Air Quality Management

Although PM monitoring is performed regularly in Egyptian cities, air quality management (AQM) is still weak. To strengthen AQM, the World Bank is supporting Egypt’s efforts to improve the quality of its environment through three projects (World Bank, 2021b):

• The GC Air Pollution Management and Climate Change Project, launched in 2015, aims to modernize Egypt’s AQM System and support solid waste management to reduce open-air burning of solid waste.
• The Pollution Management and Environmental Health aiming project, launched in 2015, and mining to provide increased support for AQM.
• The Sustainable Persistent Organic Pollutants Management Project, launched in 2014, aims to dispose of a total of about 1,000 tons of highly hazardous pesticides from all over Egypt.

Percentage of GNP Due to PM2.5 Exposure

The challenge of air pollution remains one of GC’s most significant environmental issues, with an estimated annual economic cost of PM_2.5 exposure on health (mortality, morbidity) of up to 1.4% of Egypt’s GNP (World Bank, 2019; Egypt MPED, 2021). Comparing this percentage with the value of 8.6% reported in Table VII, the annual economic costs for the whole of Egypt become evident.

Libya

Sources

The main sources of air pollution in Libya are road traffic, power plants, mining, quarries, burning of solid waste, petrochemical factories, iron and steel industries, cement-and small and medium scale manufacture such as textiles, handicrafts, food processing, among others (Nassaret al., 2017; UNEP, 2015c).

Legislation

Neither the Constitution of 2011 (revised 2012) nor the Constitutional Declaration of 2011 or the Consolidated Draft Constitution of 2017 consider the human right to a healthy environment (Libya Constitution, 2012; Libya Constitutional-Declaration, 2011; Libya Constitution, 2017, Cherif, 2021; KAS, 2021).

Air pollution is regulated under Article 10–17 of law n^o. 15 of 2003 (Libya Law, 2003). The law regulates the protection and control of air quality, issues of plant permits, emissions, environmental impact assessment, and environmental planning (Omar, 2010). Article 11 establishes that all factories and laboratories shall register and report to the responsible authority quantities, qualities, and compounds of emitted air pollutants. The responsible authority may give instructions to any industrial facility regarding any changes in the installation and used fuels and, if needed, close the facility for some time (Article 12). Article 13 regulates the obligations of industrial facilities in case of an emergency. Article 14 prohibits the open-air burning of hazardous materials in or near residential areas. According to Article 15, hazardous materials with the potential to release dust or fine particles must not be transported without security measures. Article 16 provides for the licensing and control of emissions from vehicles. A responsible authority may survey roadside air pollution (Article 17).

Surveillance

There is currently no known continuous air quality readings information for Libya (AQICN, 2008–2023c). As concentration data for particulate matter are not regularly monitored, the Meteoblue company, using models of NOAA/NCEP, provides daily forecasts of concentrations of PM_2.5, PM₁₀, and desert dust (and other pollutants) for Africa, Europe, South America, and Southeast Asia, which are useful where monitored data do not exist (Meteoblue, 2006–2023a). A typical example of a forecast for Tripoli is shown in Fig. 1 (Meteoblue, 2006–2023b).

Fig. 1. Desert dust, PM_2.5, and PM₁₀ concentration forecast for Tripoli December 11–15, 2023.

The forecast in Fig. 1 shows the overwhelming influence of desert dust as compared to PM₁₀ and PM_2.5 during the forecast dates. This situation, however, is not prevailing throughout the year. PM₁₀ appears to show values below 30 µg/m³ for much of the time.

Real-time US EPA air quality index data are also modelled using satellite data and can be converted into PM_2.5 concentrations (IQAir, 2023a). AQI values are available for three locations: Zliten, Awjilah, and Benghazi. These data are published on the IQAir website daily. The PM_2.5 value of 16 December 2023 amounts to 2.7 µg/m³ and currently meets the WHO 24-hour guideline value.

The most recent annual mean PM_2.5 concentration for Libya as a whole, estimated as an average of the years 1990 to 2017, is 54 µg/m³ (World Bank, 2021a). It exceeds the WHO 2021 guideline by a factor of almost 11 cp. Table I and is consistent with the upper values quoted in Table II.

Total particulate matter was assessed around Zawiya City from June 2007 to December 2008 at four sampling sites (Busheinaet al., 2017). Mean TSP values ranged between 117 and 199 µg/m³. The authors observed that TSP concentrations of natural origin were lower than 10 µg/m³.

Health Impacts

Apart from the WHO publication, the World Bank publication, and the GBD 2019 for the estimation of premature deaths, years of life lost, and disability-adjusted life years, see Tables III, V, and VII, health impact estimates do not appear to exist for Libya and its cities (GBD, 2019; WHO, 2016).

Air Quality Management

AQM is virtually non-existent in Libya, as a study concluded that this country is extensively at risk of drought (Bellizziet al., 2020).

Abbasi-Kangevariet al. (2023) quote the age-standardized death rates per 100,000 attributable to outdoor PM pollution in 2019 as 70 (95% CI: 49–96) and for age-standardized DALYs per 100,000 as 1,930 (95% CI: 1,402–2,546). The average life expectancy reduction in Libya would amount to 1.5 years if outdoor PM pollution had been lowered to the theoretical minimum risk.

Percentage of GNP Due to PM2.5 Exposure

Table VII notes the economic annual loss of Libya as 5.4% of its GNP, as estimated by the World Bank 2021a.

Morocco

Sources

Emissions of particulate matter from industries emanate from phosphate mining and processing, construction, and energy generation, and from small and medium enterprises such as food processing, leather goods, and textile manufacture, among others (UNEP, 2015d). Trash burning is common as a means of solid waste disposal.

Vehicle emissions are the most important sources of air pollution in Morocco’s urban centers, contributing 50 to 60% of PM air pollution (UNEP, 2015d).

Legislation

Article 31, bullet point nine, of the Moroccan Constitution warrants the right of its citizens to a sound environment (Morocco Constitution, 2011). Bullet point 10 of this Article and paragraph three of Article 35 warrant the right of citizens to a durable development. Article 151 institutes the Economic and Environmental Council, and Article 153 states that the modalities of the functioning of the Council are regulated by law.

The Law no. 11-03 defines “air” as “the gaseous envelope that surrounds the earth and the modification of whose physical or chemical characteristics may be detrimental to living beings, to ecosystems and to the environment in general” (Morocco Law, 2003a). It relates to the protection and improvement of the environment and regulates in Articles 30–32 the protection of the atmosphere from the various forms of pollution that contribute to the degradation of its quality. The emission of particulate matter (and that of other air pollutants) beyond set standards is prohibited.

Law no. 12—03 establishes the list of projects that, by reason of their nature, size, or location, are likely to have adverse impacts on the human environment and must, therefore, be the subject of an environmental impact study (Morocco Law, 2003b). The Ministry of Energy Transition and Sustainable Development has specified the terms of reference for environmental impact studies regarding industrial projects and the development of industrial zones (Morocco Directive, 2016a, 2016b).

Law no. 13—03 specifically refers to preventing and fighting against the emissions of atmospheric pollutants likely to cause adverse effects on human health and other receptors (Morocco Law, 2003c). It applies to any natural or legal person subject to public or private law, owning, using, or operating industries and manufactures and to vehicles and other machines or devices.

Decree n°. 2-97-377 specifies the responsibilities of the traffic police (Morocco Decree, 1998). This decree prevents the use of cars in urban and rural traffic that do not comply with emission values of 4.5% carbon monoxide and 70% opacity. The control may happen on-road or at special technical institutions.

Decree n°. 2-09-286 promulgates air quality standards for particulate matter (PM₁₀), lead (Pb), and Cadmium (Cd) in particles, among other pollutants (Morocco Decree, 2010a). The decree also defines the procedures for setting up air quality monitoring networks for urban agglomerations.

Decree n°. 2-09-631 sets the emission limit values of air pollutants from stationary sources and the methods of their control (Morocco Decree, 2010b). Limits are set for the emission of particles (dust) for a mass flow greater than or equal to 0.5 kg/h: the emission of dust must not exceed a total of 50 mg/Nm³; the emissions for various inorganic particulate substances contained in the dust must not exceed 0.2 mg/Nm³ for a class 1 substance at a mass flow of 1 g/h; 1 mg/Nm³ for a class 2 substance at a mass flow of 5 g/h; and 5 mg/Nm³ for a class 3 substance at a mass flow of 25 g/h. Examples of class 1 particulate substances include mercury and thallium and their compounds; class 2 includes non-carcinogenic nickel and cobalt and their compounds; and in class 3, most other heavy metals are included, such as non-carcinogenic chrome, copper, lead, manganese, and their compounds. Similarly, classified limits are set for organic particulate non-carcinogenic and carcinogenic substances (Morocco Decree, 2010b). The decree also describes the modalities of emission control and analysis of substances contained in dust.

Decree n°. 2-147-782 specifies the organization and responsibilities of the environmental police (Morocco Decree, 2015). The environmental police help concerned governmental authorities enhance the capacity of agents responsible for prevention, control, inspection, research, examination, and infraction in matters of the environment, increase of human resources, unification of work tools, the control of environmentally related inspections, and the amelioration of prevention measures. These agents are called ‘inspectors of the environmental police.’ These inspectors operate independently, according to the questions asked by the concerned governmental authorities or following the plan of environmental control.

Order No. 3400-12 fixes the conditions to approve the pollutant emissions of compression ignition engines, which are intended for non-road engines and mobile machinery (Morocco Order, 2012). The dispositions of this order apply to diesel motors and vehicles circulating after the first January of 2015.

Order 1653-14 defines the methods and the calculation of the air quality index AQI machinery (Morocco Order, 2014). AQI is defined for SO₂, NO₂, O₃, and PM₁₀. For PM₁₀, the index value, the quality, and the color are defined by the average daily means in the annex.

Order 3750-14 establishes the conditions for information and alert thresholds and fixes the rules for emergencies relating to air quality monitoring (Quoted in Chirmataet al., 2017). When at least one air pollutant reaches the information threshold, the public must be informed. If the alert threshold is exceeded, the concerned Governor must apply all necessary emergency measures to comply with the Morocco Decree (2010a). Both thresholds are exceeded when concentrations are correspondingly high at an urban and a rural station. For PM₁₀, the Moroccan information threshold lies at 150 µg/m³, and the alert threshold is at 200 µg/m³.

Order 1504-18 fixes the emission values for cement industry production and the involved waste co-incineration (Morocco Order, 2018). Emission values are fixed in three annexes: For cement production, emission values are set for dust, total volatile organic compounds, and heavy metals. For co-incineration of waste, emission values are given for dust, organic substances (expressed in carbon), hydrogen chloride, hydrogen fluoride, sulfur dioxide, and nitrogen dioxides NO_x. The second annex also sets the emission values for heavy metals and for dioxins and furanes. The third annex presents the formula for the calculation of the emission values.

Order 2323-20 sets emission values from ceramic activities (Morocco Order, 2021). Emission limits are defined in an annex for total particulate matter, heavy metals, volatile organic compounds, and gases.

The emissions of the automobile, the petrochemical, and the agro-food industries have only recently started to be surveyed (Medias24, 2018a). This belated enforcement of the laws and regulations referred to above is due to a delay in the installation of environment police, which is responsible for the control, inspection, investigation, assessment, and reporting of infringements and for the provision of necessary support of administration concerned to enforce environmental legislation (Morocco Decree, 2015). The environmental police were officially created only in 2017 (Medias24, 2018a).

The National Program for the Improvement of Air Quality 2017–2030 aims to reduce pollution resulting from industrial facilities and means of transport, especially related to particulate matter exposure, to consolidate the legal framework in terms of combating air pollution, and to strengthen awareness and communication of air pollution issues (MAP, 2018; Medias24, 2018b). The Secretary of State for Sustainable Development, in partnership with concerned parties, has set up a national network within the framework of monitoring and control of air quality, made up of 29 fixed stations in several cities. It is planned to extend this monitoring network to 81 stations by 2030 (MAP, 2018).

In 2022, UNECE has reviewed Morocco’s environmental performance for a second time (UNECE, 2022). The second review of Morocco assesses progress since 2012 on air quality and other environmental issues in chapter 8 towards relevant targets and indicators of the Sustainable Development Goals (SDGs).

This chapter covers air quality in Casablanca, which appears to be one of the most polluted cities in the country, exposed to industrial and road traffic pollution (Imaneet al., 2022). Furthermore, the UNECE report discusses trends in emission levels, the performance and gaps in air quality monitoring, pressures on air quality, vehicle increase between 2015 and 2020, legal policy and institutional framework, and promotes recommendations to the Government.

Surveillance

In Morocco, in general, very little data is available on particulate matter exposure. Indeed, despite the existence of surveillance networks for certain agglomerations, little data concerning these networks is published. This is still the case in 2021 since the network of 29 fixed monitoring stations is spatially limited and does not provide sufficient time resolution (Sekmoudiet al., 2021; UNECE, 2022). In particular, the UNECE quotes a report by the Moroccan Department of Sustainable Development that observes that some monitoring stations were not operational in 2016, and the annual average and 24-hour values for all working PM₁₀ stations were above local standards and the European Union limits. Moreover, the UNECE (2022) report refers to the performance and gaps in air pollution monitoring networks, which consist of 36 stationary stations in 15 cities. The report states that Morocco is currently experiencing peaks in air pollution, and the current number of stations does not allow a comprehensive review of air pollution monitoring.

The WHO database of the Global Health Observatory reports only measured PM₁₀ data from 2008 to 2016 and converted them for all cities, except Meknès, in PM_2.5 estimates, see Table IX.

Table IX. Monitored PM₁₀ and Converted PM_2.5 Annual Means for Moroccan Cities in Various Years

City	Site type	PM10 [µg/m3]	PM2.5 [µg/m3] *	Year
Benslimane	1 N.A.	63	(39)	2016
Casablanca	1 N.A.	43	(27)	2016
Fes	1 N.A.	37	(23)	2016
Khouribga	1 N.A.	35	(22)	2016
Marrakech	1 N.A.	46	(28)	2016
Meknes	1 station, urban	47	29	2008
Safi	1 station, urban background station	21	(9)	2011
Sale	1 station, urban background station	31	(13)	2011
Settat	1 N.A.	40	(25)	2016
Tanger	1 station, urban background station	57	(24)	2013

The most recent annual mean PM_2.5 concentration for Morocco as a whole, estimated as an average of the years 1990 to 2017, was estimated to be 33 µg/m³ (World Bank, 2021a). It exceeds the WHO guideline by a factor of almost 7, cp. Table I.

Health Impacts

According to a recent paper, air pollution health impact studies in Morocco are scarce (Bouchritiet al., 2023). This study identified 1230 documents and selected and examined 20 documents, including the health effects of particulate matter and heavy metals. There was only one study on PM_2.5, eight studies on or including PM₁₀, four studies each on PM and heavy metals, and three studies on coarse particles PM_10-2.5 and PM₁₀ or PM_2.5. These studies have shown a causal association between particulate matter and sort-and long-term health impacts such as mortality, morbidity, emergency department visits, asthma, respiratory, and cardiovascular diseases.

Another study estimated in several Moroccan cities the premature mortality related to IHD, stroke, COPD, and lung cancer in adults and ALRI in children due to exposure to urban and rural PM_2.5 (Croitoru & Sarraf, 2017). They used established exposure-response relationships to estimate premature mortality for each health endpoint. In eight cities, outdoor PM_2.5 pollution was responsible for approximately 2,200 deaths in 2014, as shown in Table X. The authors also made a rough estimate of premature deaths due to household PM_2.5 exposure, assuming an average PM_2.5 concentration of 100 μg/m³ in rural households that use solid fuel for cooking. According to their estimate, about 1,350 premature deaths were attributed in 2014 to household air pollution, which caused the above health endpoints.

Table X. Number of Premature Deaths in Urban Areas due to Exposure to Outdoor PM_2.5 Causing IHD, Stroke, COPD, Lung Cancer, and ALRI

City	No. of deaths
Casablanca	1,030
Tangiers	340
Marrakesh	300
Fès	270
Mohammedia	90
Settat	70
Khouribga	70
Benslimane	30
Total	2,200

Abbasi-Kangevariet al. (2023) quote the age-standardized death rates per 100,000 attributable to outdoor PM pollution in 2019 as 97 (95% CI: 73–122) and for age-standardized DALYs per 100,000 as 2,426 (95% CI: 1,865–3038). The average life expectancy reduction in Morocco would amount to 1.4 years if outdoor PM pollution had been lowered to the theoretical minimum risk.

Air Quality Management

Morocco gives increasing attention to air pollution problems from growing industrial activities or heavy traffic, due to their direct and harmful impact on human health, especially on children. Indeed, the cost of air degradation and its impacts have been assessed at 3.6 billion dirhams (approximately USD393 million) a year, which represents about 1.03% of GNP (AQICN, 2008–2023d).

To remedy this situation, the government has decided to make the mitigation of air quality degradation a priority for the national environmental protection policy and public health. As such, it has taken measures to monitor air quality, strengthen the legal instruments, and reduce air pollution.

Casablanca, among 20 other world cities, is a target city for the Heavy-Duty Diesel Initiative of the Climate and Clean Air Coalition (ICCT/UNEP/CMMC/C40/CCAC, 2017). The aim of the initiative is to virtually eliminate black carbon and fine particulate emissions from the on-road vehicle fleet by 2030.

In the immediate term, Morocco may also consider low-carbon biogas from landfill methane, a transformation that may reduce black carbon emissions but does not necessarily decrease Morocco’s contribution to GHGs (ICCT/UNEP/CMMC/C40/CCAC, 2017).

Percentage of GNP Due to PM2.5 Exposure

Table VII notes the annual economic loss of Morocco as 7.3% of the GNP. An estimate performed in the same year even quotes the number of 18% (Dettner & Blohm, 2021). As indicated above, other estimates appear to be much smaller (AQICN, 2008–2023d; Croitoru & Sarraf, 2017).

Sudan

Sources

Main sources in Sudan include the production and processing industry, power stations, cement production, brick factories, chemical factories, sugar manufacture, tanneries, and agricultural processing (UNEP, 2015e, 2020). Transport is the main source of air pollutants in Sudan’s urban centres due to vehicle fleet growth, an aged second-hand fleet, poor maintenance, dirty fuel, and inefficient public transport. Cement manufacturing is a dominant source of PM emissions in peripheral Sudan. Insufficient disposal of industrial and residential waste is also a significant source of PM pollution (Aliet al., 2021). The most worrying source of indoor air pollution is the biomass cooking stoves used in rural households, which can cause respiratory illnesses, mainly in women and children (Sulimanet al., 2021).

Legislation

Sudan’s transitional constitution does not provide the human right of a clean environment, but it requests in Chapter 2, no. 14 that state agencies be committed to “work on maintaining a clean natural environment” (Sudan Constitution, 2019). This is a somewhat weaker statement than the formulation in Chapter II, Article 11.1 of the historic Constitution, which states that the “people of the Sudan shall have the right to a clean and diverse environment” (Sudan Constitution, 2005). In Chapter 11, n^o 40, the Sovereignty Council may declare a state of emergency to handle any urgent danger that threatens the unity of the state or part thereof.

The aims of the Environment Protection Act of 2001 are, among others, to:

• Protect and conserve the environment.
• Develop and improve the environment.
• Assure and confirm responsibilities of the competent authorities for the protection of the environment.
• Provide for pollution control standards and methods (FAO, 2021; Sudan Law, 2001).

Article 9 of Sudan’s Environmental Law n^o 1 of 2009 prohibits any person from engaging in any activity that causes air pollution and affects human health (Sudan Law, 2009). It is also prohibited to establish industrial facilities in or near residential areas. The law does not appear to specify control actions to reduce PM concentrations but hints at regulation on minimum distances between industrial and residential areas.

Surveillance

Very few data on PM concentrations are available for Sudan. With respect to source apportionment and emission inventories, Faridiet al. (2022) stated that no studies exist on Sudan. A study exists on the environmental impacts of air pollution in a residential area in Omdurman, Khartoum State, which comprises small and medium enterprises such as food and beverages, textile, leather, and wood manufacture, among others (Marimet al., 2016). Particulate matter monitoring using a Casella APEX air sampler was performed from February to June 2013 at nine locations in Omdurman. Unfortunately, the paper does not specify the PM exposure time or the fraction of PM that was monitored. In addition, the paper quotes PM concentrations in ppm instead of the usual µg/m³.

A more recent study around 15 fuel stations in Greater Khartoum, Khartoum North, and Omdurman attempted to assess PM₁₀ concentrations (Mohamedet al., 2018). The authors reported PM₁₀ concentrations of 40–240 µg/m³, 150–250 µg/m³, and 150–250 µg/m³ at five stations each for Khartoum North, Greater Khartoum and Omdurman, respectively. The authors compared their results with the OSHA 8-hour recommended occupational limit quoted as 1,000 µg/m³. It is, therefore, not clear if the samples were exposed to the usual 24 hours or 8 hours only.

The most recent annual mean PM_2.5 concentration for Sudan is estimated as an average of the years 1990 to 2017 to amount to 55µg/m³ (World Bank, 2021a). It exceeds the WHO 2021 guideline by a factor of 11, cp. Table I.

The real-time PM_2.5 of 16 December in Khartoum is almost 2.2 times the WHO 24-hour guideline value (IQAir, 2023b).

Health impacts. The WHO publication on air quality health impacts estimates of Sudan and its cities the values of Tables III and V for estimating premature deaths, years of life lost, and disability-adjusted life years (GBD, 2019; WHO, 2022a, 2022b).

Abbasi-Kangevariet al. (2023) quote the age-standardized death rates per 100,000 attributable to outdoor PM pollution in 2019 as 89 (95% CI: 54–131) and for age-standardized DALYs per 100,000 as 2,354 (95% CI: 1,440–3,438). The average life expectancy reduction in Sudan would amount to 1.3 years if outdoor PM pollution had been lowered to the theoretical minimum risk.

Air Quality Management

The legislation of Sudan does not appear to be implemented and enforced. Unfortunately, no ansatz seems to exist for effective control of air pollution, especially particulate matter, with a clear approach to tackle particle air pollution beyond ad hoc approaches in emergency situations.

Percentage of GNP Due to PM2.5 Exposure

Table VII notes the economic annual loss of Sudan as 5.5% of the GNP.

Tunisia

Sources

Tunisia’s largest source of particulate matter emissions is the growing old vehicle fleet that uses dirty fuels and lacks efficient public transport. The second largest contributor to particulate matter emissions includes industrial installations such as phosphate mining and processing; construction and power plants, petrochemical processing, and small and medium-scale industries such as agri-food processing and textile manufacturing, among others (EEA, 2014; UNEP, 2015f).

Legislation

Article 45 of the Tunisian Constitution guarantees each citizen’s right to a healthy and balanced environment, including the right to participate in climate protection (Tunisia Constitution, 2014). The state is obliged to “provide the necessary means to eliminate pollution of the environment.” Laws on public health and the environment are deemed necessary in Article 65, bullet point 15. The Commission for Sustainable Development and the Rights of Future Generations shall be consulted in economic, social, and environmental issues according to Article 129. The obligation of the Tunisian Constitution is reiterated in the voluntary national report on the implementation of the Sustainable Development Goals in Tunisia (Tunisia Report, 2021).

In section 8.3.8, this report promotes the milieu and environmental control to prevent adverse impacts of pollution on children’s health through an “environmental health program” that focuses on protecting children as a particularly sensitive and fragile population exposed to environmental pollution. In the context of children’s environmental health, Tunisia aims to take the following measures regarding air pollution (Tunisia Report, 2021):

• Reactivation of the national health and environment plan drawn up in 2011,
• Strengthen national capacities for the assessment of environmental risks as well as those for monitoring and alerting these risks,
• Information of the population on possible sources of pollution, including those of indoor air pollution as well as their impact on health, in particular that of children,
• Stimulation of children’s interest in maintaining a balanced environment and instilling in them a sense of ownership over their environment,
• Mobilization of local and regional authorities to better protect environments reserved for children and better solve the problem of pollution,
• Training of professionals on environmental risks and how to manage them.

In the context of the voluntary report, the protection against exposure to outdoor air pollution of the general population, including other vulnerable fractions such as the elderly, pregnant women, the handicapped, and the predisposed to illness, the 17 goals of sustainable development play a most important role.

The law no. 2007-34 on air quality aims to prevent, limit, and reduce air pollution from industrial and mobile sources and their adverse impacts on human health and the environment. The law also sets air quality control procedures to make the citizens’ right to a healthy environment and ensure sustainable development effective (Tunisia Law, 2007).

Tunisia Decree No. 2018-447 sets short-term and long-term limit values for concentrations of PM₁₀ and PM_2.5, with a view to protecting the health and the environment (Tunisia Decree, 2018). The values indicated in Table I are valid for the beginning of 2021. The regulation sets intermediate values for the years 2018, 2019, and 2020. In addition, the decree also sets limits for several particulate heavy metals.

Regulation n^o 2010-2519 sets general and specific emission limits for air pollutants from all kinds of stationary sources, including particulate matter and particulate heavy metals (Tunisia Decree, 2010).

The environmental impact assessment (EIA) of air pollution is regulated in a decree that defines the categories of facilities and projects subject to an environmental impact study and specifies the ingredients of such a study (Tunisia Decree, 2005; ANPE, 2016a).

The National Environmental Protection Agency (Agence Nationale de Protection de l’Environnement, ANPE) is responsible for the implementation of a national network for real-time monitoring of the quality of air; the development of air quality conservation plans for large cities or those at potential risk of air pollution, and to control pollutant emissions in the atmosphere and assess possible infractions (Khedira, 2018).

Surveillance

The network is made up of 30 fixed stations equipped with one to several automatic analyzers of particulate matter and other air pollutants, as well as meteorological variables (ANPE, 2016b; Lac, 2019). The measurements and verified results are archived at the ANPE and disseminated through its website and periodic reports (ANPE, 2019). In practice, however, the last air quality bulletin was published in August 2010, and the exceedances of national standards and potential health risks have not been reported for years since then (Lac, 2019).

Unfortunately, the ANPE website does not provide monitored PM₁₀ values (or those of other pollutants); rather, it presents a simulation of the trend between 2004 and 2018 (ANPE, 2019). Another website, ANPE, provided monthly data from 2001 to 2010 (ANPE, 2021).

There is currently no known continuous air quality reporting information for Tunisia (AQICN, 2008–2023e). The WHO database of the Global Health Observatory reports only measured PM₁₀ data of 2010 and converted them into PM_2.5 estimates, see Table XI (WHO, 2021b).

Table XI. Monitored PM₁₀ and Converted PM_2.5 Annual Means for Tunisian Cities in 2010

City	Site type	PM10 [µg/m3]	PM2.5 [µg/m3]*
Bizerte	1 station, urban residential/traffic/commercial	80	(34)
Sfax	1 station, urban	87	(37)
Sousse	1 station, urban residential/traffic/commercial	58	(25)
Tunis	1 station, urban	90	(38)

The most recent annual mean PM_2.5 concentration for Tunisia as a whole, estimated as an average of the years 1990 to 2017, is 38 µg/m³ (World Bank, 2021a). It exceeds the WHO guideline by a factor of almost 8, cp. Table I.

Health Impacts

Apart from the WHO publication on the GBD, air quality health impact estimates do not appear to exist for Libya, Sudan, and Tunisia; for the estimates of the numbers of deaths and DALYs, see Table III (WHO, 2022a, 2022b).

Abbasi-Kangevariet al. (2023) quote the age-standardized death rates per 100,000 attributable to outdoor PM pollution in 2019 as 63 (95% CI: 43–87) and for age-standardized DALYs per 100,000 as 1,579 (95% CI: 1,139–2,100). The average life expectancy reduction in Tunisia would amount to 1.2 years if outdoor PM pollution had been lowered to the theoretical minimum risk.

Air Quality Management

Although the legislation of Tunisia is quite comprehensive it does not appear to be implemented and enforced in a rigorous way. Unfortunately, effective control of particulate matter, which exhibits a clear approach to tackle particle air pollution beyond ad hoc approaches in emergency situations, does not seem to exist. Also, the general sounding plan of environmental and social management (CGES) for less developed regions of Tunisia refers to industrial projects and constitutes an extended environmental and social impact assessment (Tunisia Report, 2017).

Percentage of GNP Due to PM2.5 Exposure

Table VII notes the economic annual loss of Tunisia as 6.5% of the GNP.

Conclusions and Outlook

Air quality management (AQM) is usually based on effective and sufficient legislation, public awareness, and participation, demands, and realization of the needs of the community and decision-makers. Air pollution management requires technical and institutional capacity enhancement; ground-based monitoring systems; use of satellite air quality observation data; use of reliable sensor arrangements instead of more expensive monitoring devices; health and social impact assessments; repeated clean air implementation plans; institutional networks for proper operation of these tactical approaches; political will; and sufficient financial means. In developing countries, instruments for a suitable AQM have been developed and refined in more than five decades. Necessary legislation and strategic and tactical instruments developed in the course of time in developed countries could be adopted and adapted in developing countries and countries in transition to tackle particulate matter pollution and protect the health of the population.

In all six countries, AQM and the implementation and enforcement of laws and regulations are weak. In particular, the legislation in Libya and Sudan regarding air pollution is insufficient; in Libya, even the right to clean air is not granted in the Constitution, in contrast to the other five North African countries. Real-time concentration data are not published regularly in all countries, including Egypt and Morocco, which are in possession of an extensive air pollution monitoring network. In addition, it is doubtful that the few monitoring results identified in North African countries are of known quality, which would require the application of a rigorous air quality assurance (QA) and air quality control (QC) system during data capture.

Therefore, the following recommendations are made to improve AQM in the six North African countries:

1. Improve ground-level air quality monitoring networks, either equipped with analyzers or reliable sensors. Such networks must be subject to rigorous QA/QC regimes to ensure that the air quality measurements generated are of known quality and reliable for informing the design, implementation, and enforcement of interventions to reduce air pollution and protect public health. Results from these ground-based monitoring could be augmented by satellite observation. Effective AQM programs would also include reliable emission inventories; application of models to understand the transport and fate of air pollutants; assessment of costs of control measures and the reduction of costs of health impacts avoided by the implementation of such control measures; monetization of other benefits; and public outreach and stakeholder engagement. Beyond initial investments in air quality monitoring networks, governments need to ensure effective funding for sustained operation and maintenance of such programs in the long term.
2. To reduce air pollution, governments need to apply and enforce command-and-control instruments (e.g., air quality standards, emission standards for all kinds of sources, fuel quality regulations, and inspection and maintenance programs) and economic instruments (e.g., air pollution charges, elimination of fossil fuel subsidies, discouragement of nitrogen-based fertilizers as precursors of secondary PM formation).