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Community Knowledge, Attitudes and Preventive Behaviour Towards the Cardiovascular Benefits of Reduced Exposure to Air Pollution in Nigeria: Evidence from the CARDINAL Study Cover

Community Knowledge, Attitudes and Preventive Behaviour Towards the Cardiovascular Benefits of Reduced Exposure to Air Pollution in Nigeria: Evidence from the CARDINAL Study

Global Heart
Volume 20 (2025): Issue 1
By: Adekunle Gregory Fakunle,  Temilade Bello,  Akintayo Olamide Ogunwale,  Oyewale Mayowa Morakinyo,  Olubunmi Ayinde,  Susan Motunrayo Kebu,  Oluwapelumi Peter Arinola,  Marvelous Adeoye,  Bosede Adebayo,  Iretioluwa Mary Bamtefa,  Akinkunmi Paul Okekunle,  Augustine Odili,  Mark R. Miller,  Amam C. Mbakwem and  Abiodun Moshood Adeoye  
Open Access
|Oct 2025

References

  1. 1Brauer M, Roth GA, Aravkin AY, Zheng P, Abate KH, Abate YH, et al. Global burden and strength of evidence for 88 risk factors in 204 countries and 811 subnational locations, 1990–2021: A systematic analysis for the Global Burden of Disease Study 2021. Lancet. 2024;403(10440):2162–2203. DOI: 10.1016/S0140-6736(24)00933-4
    Back to article
  2. 2(UN) UN. Department of Economic and Social Affairs, and Population Division, World Urbanization Prospects: The 2018 Revision. United Nations, New York; 2019.
    Back to article
  3. 3Sun B, Fang C, Liao X, Guo X, Liu Z. The relationship between urbanization and air pollution affected by intercity factor mobility: A case of the Yangtze River Delta region. Environ Impact Assess Rev. 2023;100:107092. DOI: 10.1016/j.eiar.2023.107092
    Back to article
  4. 4Dimitroulopoulou S, Dudzińska MR, Gunnarsen L, Hägerhed L, Maula H, Singh R, et al. Indoor air quality guidelines from across the world: An appraisal considering energy saving, health, productivity, and comfort. Environ Int. 2023;178:108127. DOI: 10.1016/j.envint.2023.108127
    Back to article
  5. 5World Health Organization. WHO global air quality guidelines: particulate matter (PM2.5 and PM10), ozone, nitrogen dioxide, sulfur dioxide and carbon monoxide. Geneva: WHO; 2021.
    Back to article
  6. 6Bereitschaft B, Debbage K. Urban form, air pollution, and CO2 emissions in large U.S. metropolitan areas. Prof Geogr. 2013;65(4):612–635. DOI: 10.1080/00330124.2013.799991
    Back to article
  7. 7(WHO) WHO. Ambient (outdoor) air pollution. [cited 2025 February 3]. Available from: https://www.who.int/news-room/fact-sheets/detail/ambient-(outdoor)-air-quality-and-health
    Back to article
  8. 8Liu Y, Ning N, Sun T, Guan H, Liu Z, Yang W, et al. Association between solid fuel use and nonfatal cardiovascular disease among middle-aged and older adults: Findings from The China Health and Retirement Longitudinal Study (CHARLS). Sci Total Environ. 2023;856(Pt 2):159035. DOI: 10.1016/j.scitotenv.2022.159035
    Back to article
  9. 9Balmes JR. Household air pollution from domestic combustion of solid fuels and health. J Allergy Clin Immunol. 2019;143(6):1979–1987. DOI: 10.1016/j.jaci.2019.04.016
    Back to article
  10. 10Bonjour S, Adair-Rohani H, Wolf J, Bruce Nigel G, Mehta S, Prüss-Ustün A, et al. Solid fuel use for household cooking: Country and regional estimates for 1980–2010. Environ Health Perspect. 2013;121(7):784–790. DOI: 10.1289/ehp.1205987
    Back to article
  11. 11Naz L, Ghimire U. Assessing the prevalence trend of childhood pneumonia associated with indoor air pollution in Pakistan. Environ Sci Pollut Res Int. 2020;27(35):44540–44551. DOI: 10.1007/s11356-020-10346-6
    Back to article
  12. 12Lim S, Barratt B, Holliday L, Griffiths CJ, Mudway IS. Characterising professional drivers’ exposure to traffic-related air pollution: Evidence for reduction strategies from in-vehicle personal exposure monitoring. Environ Int. 2021;153:106532. DOI: 10.1016/j.envint.2021.106532
    Back to article
  13. 13Lawin H, Ayi Fanou L, Hinson AV, Stolbrink M, Houngbegnon P, Kedote NM, et al. Health risks associated with occupational exposure to ambient air pollution in commercial drivers: A systematic review. Int J Environ Res Public Health. 2018;15(9):2039. DOI: 10.3390/ijerph15092039
    Back to article
  14. 14Schraufnagel DE, Balmes JR, Cowl CT, De Matteis S, Jung SH, Mortimer K, et al. Air pollution and noncommunicable diseases: A review by the forum of international respiratory societies’ environmental committee, Part 2: Air pollution and organ systems. Chest. 2019;155(2):417–426. DOI: 10.1016/j.chest.2018.10.041
    Back to article
  15. 15Chen J, Atkinson RW, Andersen ZJ, Oftedal B, Stafoggia M, Lim Y-H, et al. Long-term exposure to ambient air pollution and risk of lung cancer – A comparative analysis of incidence and mortality in four administrative cohorts in the ELAPSE study. Environ Res. 2024;263(Pt 3):120236. DOI: 10.1016/j.envres.2024.120236
    Back to article
  16. 16Liu CS, Wei Y, Danesh Yazdi M, Qiu X, Castro E, Zhu Q, et al. Long-term association of air pollution and incidence of lung cancer among older Americans: A national study in the Medicare cohort. Environ Int. 2023;181:108266. DOI: 10.1016/j.envint.2023.108266
    Back to article
  17. 17Fakunle AG, Olusola B, Jafta N, Faneye A, Heederik D, Smit LAM, et al. Home assessment of indoor microbiome (HAIM) in relation to lower respiratory tract infections among under-five children in Ibadan, Nigeria: The study protocol. Int J Environ Res Public Health. 2020;17(6):1857. DOI: 10.3390/ijerph17061857
    Back to article
  18. 18Fakunle AG, Jafta N, Smit LAM, Naidoo RN. Indoor bacterial and fungal aerosols as predictors of lower respiratory tract infections among under-five children in Ibadan, Nigeria. BMC Pulm Med. 2022;22(1):471. DOI: 10.1186/s12890-022-02271-w
    Back to article
  19. 19Adeoye AM FA, Aderonmu O, Tayo B. Short-term exposure to household air pollution and risk of hypertension among adults: A pilot study in Ibadan. J Health Environ Res. 2020;6(2):37–43. DOI: 10.11648/j.jher.20200602.12
    Back to article
  20. 20Alexeeff SE, Deosaransingh K, Van Den Eeden S, Schwartz J, Liao NS, Sidney S. Association of long-term exposure to particulate air pollution with cardiovascular events in California. JAMA Netw Open. 2023;6(2):e230561. DOI: 10.1001/jamanetworkopen.2023.0561
    Back to article
  21. 21Şahin B, İlgün G. Risk factors of deaths related to cardiovascular diseases in World Health Organization (WHO) member countries. Health Soc Care Community. 2022;30(1):73–80. DOI: 10.1111/hsc.13156
    Back to article
  22. 22Bourdrel T, Bind MA, Béjot Y, Morel O, Argacha JF. Cardiovascular effects of air pollution. Arch Cardiovasc Dis. 2017;110(11):634–642. DOI: 10.1016/j.acvd.2017.05.003
    Back to article
  23. 23Brook RD, Franklin B, Cascio W, Hong Y, Howard G, Lipsett M, et al. Air pollution and cardiovascular disease: A statement for healthcare professionals from the Expert Panel on Population and Prevention Science of the American Heart Association. Circulation. 2004;109(21):2655–2671. DOI: 10.1161/01.CIR.0000128587.30041.C8
    Back to article
  24. 24Lala MA, Onwunzo CS, Adesina OA, Sonibare JA. Particulate matters pollution in selected areas of Nigeria: Spatial analysis and risk assessment. Case Stud Chem Environ Eng. 2023;7:100288. DOI: 10.1016/j.cscee.2022.100288
    Back to article
  25. 25Onakpohor A, Fakinle BS, Sonibare JA, Oke MA, Akeredolu FA. Investigation of air emissions from artisanal petroleum refineries in the Niger-Delta Nigeria. Heliyon. 2020;6(11):e05608. DOI: 10.1016/j.heliyon.2020.e05608
    Back to article
  26. 26Giwa SO, Nwaokocha CN, Kuye SI, Adama KO. Gas flaring attendant impacts of criteria and particulate pollutants: A case of Niger Delta region of Nigeria. J King Saud Univ Eng Sci. 2019;31(3):209–217. DOI: 10.1016/j.jksues.2017.04.003
    Back to article
  27. 27NBS. Road industry data. Nigeria Bureau Statistics; (2019). [cited 2025 February 3]. Available from: https://wwwnigerianstatgovng/pdfuploads/Road_Transport_Data_Q4_2018pdf
    Back to article
  28. 28Croitoru L, Chang JC, Kelly A, editors. The cost of air pollution in Lagos 2020. DOI: 10.1596/33038
    Back to article
  29. 29Fabrigar L, Petty R, Smith S, Crites S. Understanding knowledge effects on attitude-behavior consistency: The role of relevance, complexity, and amount of knowledge. J Pers Soc Psychol. 2006;90(4):556–577. DOI: 10.1037/0022-3514.90.4.556
    Back to article
  30. 30Fakunle AG, Bello T, Ogunwale AO, Morakinyo O, Ayinde O, Kebu S, et al. Community-based cardiovascular risk reduction through novel air health behavioural change intervention (CARDINAL): Study protocol. Ann Med Health Sci Res. 2024;14:981–989.
    Back to article
  31. 31Oltra C, Sala R. Perception of risk from air pollution and reported behaviors: A cross-sectional survey study in four cities. J Risk Res. 2016;21(7):1–16. DOI: 10.1080/13669877.2016.1264446
    Back to article
  32. 32Gatersleben B, Uzzell D. The risk perception of transport–generated air pollution. IATSS Res. 2000;24(1):30–38. DOI: 10.1016/S0386-1112(14)60015-7
    Back to article
  33. 33Al-Shidi HK, Ambusaidi AK, Sulaiman H. Public awareness, perceptions and attitudes on air pollution and its health effects in Muscat, Oman. J Air Waste Manag Assoc. 2021;71(9):1159–174. DOI: 10.1080/10962247.2021.1930287
    Back to article
  34. 34Lynch KM, Mirabelli MC. Outdoor air quality awareness, perceptions, and behaviors among U.S. children aged 12–17 years, 2015–2018. J Adolesc Health. 2021;68(5):882–887. DOI: 10.1016/j.jadohealth.2020.07.040
    Back to article
  35. 35Shabani Isenaj Z, Moshammer H, Berisha M, Weitensfelder L. Determinants of knowledge, attitudes, perceptions and behaviors regarding air pollution in schoolchildren in Pristina, Kosovo. Children (Basel, Switzerland). 2024.11(1):128. DOI: 10.3390/children11010128
    Back to article
  36. 36Rendon-Marin S, Higuita-Gutiérrez LF, Gomez-Gallego DM. Knowledge, attitudes, and practices regarding air pollution among medical students. Int J Environ Res Public Health. 2024;21(6):789. DOI: 10.3390/ijerph21060789
    Back to article
  37. 37Susan Paul NS, Mathew P, Johns F, Abraham J. The feasibility of using remote data collection tools in field surveys. Int J Commun Med Public Health. 2017;5(1):81–85. DOI: 10.18203/2394-6040.ijcmph20175514
    Back to article
  38. 38Nassirou-Sabo H, Toudou-Daouda M. Assessment of knowledge, attitudes, and practices of occupational risks and diseases among healthcare providers of the Regional Hospital Center of Dosso, Niger. SAGE Open Medicine. 2024;12:20503121231224549. DOI: 10.1177/20503121231224549
    Back to article
  39. 39Debsarma D. Exploring the strategies for upgrading the rural unqualified health practitioners in West Bengal, India: A knowledge, attitude and practices assessment-based approach. Health Policy Open. 2022;3:100083. DOI: 10.1016/j.hpopen.2022.100083
    Back to article
  40. 40Kaur TP, Rana A, Perumal V, Sharma A, Dadhwal V, Kulshrestha V, et al. A cross-sectional analysis to evaluate knowledge, attitude and practices among pregnant women during COVID-19 pandemic. J Obstet Gynaecol India. 2021;71(Suppl 1):18–27. DOI: 10.1007/s13224-021-01558-y
    Back to article
  41. 41Adeoye M, Rahimzadeh S, Taylor S, Shrikhande S, Perel P, Shah A, et al. The impact of air pollution on cardiovascular health outcomes in African populations: A scoping review. JACC Adv. 2024;3(12, Part 2):101371. DOI: 10.1016/j.jacadv.2024.101371
    Back to article
  42. 42Manisalidis I, Stavropoulou E, Stavropoulos A, Bezirtzoglou E. Environmental and health impacts of air pollution: A review. Front Public Health. 2020;8:14. DOI: 10.3389/fpubh.2020.00014
    Back to article
  43. 43Farag D, Akpede N, Waterson H, Asogun D, Faustina Funmilayo B, Nnadi C, et al. The impact of education level on knowledge, attitudes and practices towards COVID-19 in Edo State, Nigeria. J Public Health (Oxford, England). 2023;45(Suppl 1):i63–i70. DOI: 10.1093/pubmed/fdac142
    Back to article
  44. 44Kim JB, Prunicki M, Haddad F, Dant C, Sampath V, Patel R, et al. Cumulative lifetime burden of cardiovascular disease from early exposure to air pollution. J Am Heart Assoc. 2020;9(6):e014944. DOI: 10.1161/JAHA.119.014944
    Back to article
  45. 45Ramírez AS, Ramondt S, Van Bogart K, Perez-Zuniga R. Public awareness of air pollution and health threats: Challenges and opportunities for communication strategies to improve environmental health literacy. J Health Commun. 2019;24(1):75–83. DOI: 10.1080/10810730.2019.1574320
    Back to article
  46. 46Agbo KE, Walgraeve C, Eze JI, Ugwoke PE, Ukoha PO, Van Langenhove H. A review on ambient and indoor air pollution status in Africa. Atmos Pollut Res. 2021;12(2):243–260. DOI: 10.1016/j.apr.2020.11.006
    Back to article
  47. 47Marín D, Calle N, Arango V, Betancur P, Pérez M, Orozco LY, et al. Knowledge, attitudes and practices about air pollution and its health effects in 6th to 11th-grade students in Colombia: A cross-sectional study. Front Public Health. 2024;12:1390780. DOI: 10.3389/fpubh.2024.1390780
    Back to article
  48. 48Alves RF. The relationship between health-related knowledge and attitudes and health risk behaviours among Portuguese university students. Global Health Promot. 2023;31(1):36–44. DOI: 10.1177/17579759231195561
    Back to article
  49. 49Ayanaw Eyayu R, Gudayu Zeleke T, Chekol WB, Yaregal Melesse D, Enyew Ashagrie H. Assessment of level of knowledge, attitude, and associated factors toward delirium among health professionals working in intensive care unit multicenter, cross-sectional study, Amhara region comprehensive specialized hospitals, Northwest Ethiopia, 2023. Front Public Health. 2024;12:1338760. DOI: 10.3389/fpubh.2024.1338760
    Back to article
  50. 50Marcantonio R, Javeline D, Field S, Fuentes A. Global distribution and coincidence of pollution, climate impacts, and health risk in the Anthropocene. PLoS One. 2021;16(7):e0254060. DOI: 10.1371/journal.pone.0254060
    Back to article
  51. 51Vlaev I, King D, Darzi A, Dolan P. Changing health behaviors using financial incentives: A review from behavioral economics. BMC Public Health. 2019;19(1):1059. DOI: 10.1186/s12889-019-7407-8
    Back to article
  52. 52Endalew M, Belay DG, Tsega NT, Aragaw FM, Gashaw M, Asratie MH. Household Solid Fuel Use and Associated Factors in Ethiopia: A Multilevel Analysis of Data From 2016 Ethiopian Demographic and Health Survey. Environ Health Insights. 2022;16:11786302221095033. DOI: 10.1177/11786302221095033
    Back to article
  53. 53Wu S. The health impact of household cooking fuel choice on women: Evidence from China. Sustainability. 2021;13(21). DOI: 10.3390/su132112080
    Back to article
  54. 54Yu C, Long H, Zhang X, Tan Y, Zhou Y, Zang C, et al. The interaction effect between public environmental concern and air pollution: Evidence from China. J Clean Prod. 2023;391:136231. DOI: 10.1016/j.jclepro.2023.136231
    Back to article
  55. 55Isezuo S, Sani MU, Talle A, Johnson A, Adeoye AM, Ulgen MS, et al. Registry for Acute Coronary Events in Nigeria (RACE-Nigeria): Clinical characterization, management, and outcome. J Am Heart Assoc. 2022;11(1):e020244. DOI: 10.1161/JAHA.120.020244
    Back to article
  56. 56Global burden of 87 risk factors in 204 countries and territories, 1990–2019: A systematic analysis for the Global Burden of Disease Study 2019. Lancet (London, England). 2020;396(10258):1223–1249. DOI: 10.1016/S0140-6736(20)30752-2
    Back to article
  57. 57Itzchakov G, Uziel L, Wood W. When attitudes and habits don’t correspond: Self-control depletion increases persuasion but not behavior. J Exp Soc Psychol. 2018;75:1–10. DOI: 10.1016/j.jesp.2017.10.011
    Back to article
  58. 58Kelly FJ, Fussell JC. Air pollution and public health: Emerging hazards and improved understanding of risk. Environ Geochem Health. 2015;37(4):631–649. DOI: 10.1007/s10653-015-9720-1
    Back to article
  59. 59Happell B, Stanton R, Hoey W, Scott D. Knowing is not doing: The relationship between health behaviour knowledge and actual health behaviours in people with serious mental illness. Mental Health and Physical Activity. 2014;7(3):198–204. DOI: 10.1016/j.mhpa.2014.03.001
    Back to article
  60. 60Hashem RB, Siddique AB, Rasel SM, Hossain MS. Assessment of knowledge, attitudes, and practices regarding air pollution among traffic polices in Dhaka city, Bangladesh: A cross-sectional study. BMC Public Health. 2024;24(1):3593. DOI: 10.1186/s12889-024-21086-4
    Back to article
DOI: https://doi.org/10.5334/gh.1482 | Journal eISSN: 2211-8179
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Language: English
Submitted on: Apr 17, 2025
Accepted on: Sep 22, 2025
Published on: Oct 9, 2025
Published by: Ubiquity Press
In partnership with: Paradigm Publishing Services
Publication frequency: 1 issue per year
Keywords:
knowledge,
attitude,
behaviour,
air pollution,
cardiovascular diseases,
Nigeria

© 2025 Adekunle Gregory Fakunle, Temilade Bello, Akintayo Olamide Ogunwale, Oyewale Mayowa Morakinyo, Olubunmi Ayinde, Susan Motunrayo Kebu, Oluwapelumi Peter Arinola, Marvelous Adeoye, Bosede Adebayo, Iretioluwa Mary Bamtefa, Akinkunmi Paul Okekunle, Augustine Odili, Mark R. Miller, Amam C. Mbakwem, Abiodun Moshood Adeoye, published by Ubiquity Press
This work is licensed under the Creative Commons Attribution 4.0 License.

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