Science of the Total Environment 791 (2021) 148104

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Science of the Total Environment

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Fine particulate matter exposure in four transport modes of Greater Cairo

Rana Alaa Abbass a, Prashant Kumar a,b,⁎, Ahmed El-Gendy c
a
Global Centre for Clean Air Research (GCARE), Department of Civil and Environmental Engineering, Faculty of Engineering and Physical Sciences, University of Surrey, Guildford GU2 7XH, United
Kingdom
b
Department of Civil, Structural & Environmental Engineering, Trinity College Dublin, Dublin, Ireland
c
Department of Construction Engineering, School of Sciences and Engineering, The American University in Cairo, New Cairo 11835, Egypt

H I G H L I G H T S G R A P H I C A L A B S T R A C T

• PM2.5 exposure is assessed in four

modes of transport in Greater Cairo.
• Recirculation in car reduces PM2.5 expo-
sure by 61% compared with windows-
open.
• Microbus costs 45% of car with recircu-
lation but has 4-times PM2.5 inhaled
dose.
• Cyclists inhale 40-times PM2.5 doses
(μg/km) that of car users with recircula-
tion.
• 57% of premature deaths from PM2.5
transport exposure are microbus
commuters.

a r t i c l e i n f o a b s t r a c t

Article history: The number of daily commuters in Greater Cairo has exceeded 15 million nevertheless personal exposure studies
Received 14 March 2021 in transport microenvironments are limited. The aim of this study is to quantify PM2.5 exposure during peak
Received in revised form 18 May 2021 hours in four transport modes of Greater Cairo - car (windows-open, windows-closed with recirculation and
Accepted 24 May 2021
AC-on), microbus (windows-open), cycling and walking - and understand its underlying drivers. Data was
Available online 29 May 2021
collected using a pDR-1500 monitor and analysed to capture concentration variations, spatial variability,
Editor: Anastasia Paschalidou exposure doses, commuting costs versus inhaled doses, health burden and economic losses. Car with recircula-
tion resulted in the least average PM2.5 concentrations (32 ± 6 μg/m3), followed by walking (77 ± 35 μg/m3),
car with windows-open (82 ± 32 μg/m3), microbus with windows-open (96 ± 29 μg/m3) and cycling (100 ±
Keywords: 28 μg/m3). Evening hours observed average PM2.5 concentrations by 26–58% lesser than morning. Spatial vari-
Particulate matter ability analysis showed that 75th–90th percentile PM2.5 concentrations coincided with congested spots. Cycling
Transport mode and walking lanes are rare hence commuters are exposed to surges in PM2.5 concentrations when passing near
Commuters exposure construction and solid waste burning sites. Cycling and walking also resulted in inhaling 40-times and 32-
Developing countries
times higher PM2.5 dose per kilometre than for car with recirculation. Commuting by microbus cost (with
Cairo, Egypt
windows-open) ~45% of car cost (with recirculation) but it resulted in 4-times higher inhaled PM2.5 dose. As ex-
Health burden and economic loss
pected due to the lowest PM2.5 exposure concentrations, health burden resulting from car travel (with recircula-
tion) caused the least death rates of 0.07 (95% CI 0.07–0.08) prematures deaths per 100,000 commuters/year
while microbus with windows-open resulted in the highest death rates; 0.52 (95% CI 0.49–0.56). Microbus

⁎ Corresponding author at: Global Centre for Clean Air Research (GCARE), Department of Civil and Environmental Engineering, Faculty of Engineering and Physical Sciences, University
of Surrey, Guildford GU2 7XH, United Kingdom.
E-mail addresses: P.Kumar@surrey.ac.uk, Prashant.Kumar@cantab.net (P. Kumar).

https://doi.org/10.1016/j.scitotenv.2021.148104
0048-9697/© 2021 Elsevier B.V. All rights reserved.
R.A. Abbass, P. Kumar and A. El-Gendy
deaths represent 57% of national economic losses due to PM2.5 exposure amongst the four transport modes. This
study provides real-time exposure data and analyses its implications on commuter health as a first step in in-
formed decision-making and better urban planning.
1. Introduction
Greater Cairo commuters spend 138 h per year in traffic (Tomtom,
2020), which has an adverse impact on health. Commuters are exposed
to air pollutant concentrations that exceed World Health Organization
(WHO) standards, owing to their proximity to mobile pollutant sources
(Cepeda et al., 2017; Kumar et al., 2018a; Pant and Harrison, 2013;
Waked and Afif, 2012). Fine particulate matter with an aerodynamic di-
ameter ≤ 2.5 μm (PM2.5) is one of the most harmful air pollutants to
human health as it remains suspended in air for several weeks, can
travel over large distances (Kollanus et al., 2017; WHO, 2006), and pen-
etrates humans' respiratory system (Heal et al., 2012; Kioumourtzoglou
et al., 2016). Globally, around 36% of atmospheric PM2.5 concentrations
are caused by on-road traffic, resulting in 12% of a person's total daily in-
haled PM2.5 dose (Kumar et al., 2018b; Kumar et al., 2020; Nasser et al.,
2015). High exposure to PM2.5 results in higher susceptibility of popula-
tions to respiratory diseases including acute respiratory distress,
asthma, chronic obstructive pulmonary disease and lung cancer (Li
et al., 2018) while a lifetime exposure to PM2.5 has been associated
with an increased risk of cardiopulmonary mortality of 6–13% per 10
μg/m3 increase in PM2.5 above the WHO's 24-hour limit (WHO, 2013).
PM2.5 has been the focus of international research due to its evident
health impact, as is the case for this study.
Greater Cairo is the largest urban area in the Middle East and North
Africa (MENA) (Abbass et al., 2018; Huzayyin and Salem, 2013). It suf-
fers from congestion caused by more than 4 million on-road vehicles;
which is 36% of Egypt's fleet size (CAPMAS, 2020; Elmansy et al.,
2014; Moustafa and Zakey, 2018). Rapid economic advancement in
Egypt has caused Greater Cairo to suffer from inadequate urban plan-
ning and poor road design, leading to congestion (Abdel-Rehim, 2012;
Hegazy et al., 2017). Traffic in Greater Cairo causes considerable air pol-
lution due to unregulated exhaust emissions from older vehicles (17% of
private cars and 32% of taxis are over 25 years old) amongst other fac-
tors (Chapman, 2007; Huzayyin et al., 2009; Huzayyin and Salem,
2013; Waked and Afif, 2012). Furthermore, Greater Cairo lacks green
spaces, which has negatively impacted the quality of life (Keleg, 2018)
and roadside exposure (Barwise and Kumar, 2020; Kumar et al.,
2019). In 2017, the annual ambient PM2.5 concentrations in Greater
Cairo were reported as 76 ± 10 μg/m3, which is 7.6-times the WHO
standard, resulting in an estimated 12,600 premature deaths (Bjorn,
2019; WHO, 2018). Moreover, air pollution in Egypt was estimated to
incur a national annual cost of around $20.9 million (Heger et al.,
2018; Saade, 2016; Tsiouri et al., 2015).
Cars, shared taxis and microbuses (capacity: 9–15 passengers) are
the preferred mode of transport in Greater Cairo due to inadequate pub-
lic transport services and hence constitute ~72% of the city's fleet
(CAPMAS, 2020; Duquennois and Newman, 2009; World Bank, 2006;
El-Dorghamy et al., 2015). Despite the global trend to use public trans-
port, walking and cycling with the aim to reduce air pollution and
achieve sustainability (Hama et al., 2020), car-type vehicles dominate
the Greater Cairo vehicle mix as shown in Supplementary Information
(SI) Fig. S1 (CAPMAS, 2020). Nevertheless, some commuters in Greater
Cairo turn to non-motorised forms of transport due to the lack of alter-
natives or to switch between modes of transport, for example walking
to a microbus stop or walking to a parked car. Cycling is not a common
mode of transport in Greater Cairo and is limited to those who cycle for
professional purposes to transport goods and those who cycle for an im-
proved life-style (El Attar, 2016; Puttrowait, 2014). Global studies
(Betancourt et al., 2017; Do et al., 2014; Frey et al., 2020; Kumar et al.,
2
Science of the Total Environment 791 (2021) 148104
© 2021 Elsevier B.V. All rights reserved.
2018b; Rivas et al., 2017a) have focused on pollutant exposures in
both motorised; bus (Yang et al., 2015), taxi, car (Int Panis et al.,
2010) and motorcycle and active; walking and cycling (Brand et al.,
2019) modes as shown in Table 1 but similar studies are non-existent
for Greater Cairo.
Research on transport air pollution for Cairo is limited and inconsis-
tent where no studies have focused on PM2.5 exposures within different
transport modes (Abbas et al., 2016; Abbass et al., 2018; Abbass et al.,
2020; Huzayyin et al., 2009). Table 1 summaries some of the recent global
studies that investigate personal exposure to PM2.5 in different transport
modes. They present varying results. For example, Kumar et al. (2018a)
showed that PM2.5 concentrations are typically highest for car-users
with windows-open. Ham et al. (2017) highlighted that ventilation set-
tings of personal vehicles can reduce in-vehicle PM2.5 by up to 75%. Frey
et al. (2020) reported that PM2.5 exposure concentrations for walking
and cycling were quite similar and were notably higher than for bus
and car. Several studies concluded that the largest exposure to PM2.5
was observed during cycling; however, the route choice can reduce expo-
sures by 15–75% (Ham et al., 2017; Hernández-Paniagua et al., 2018). It
was clear from these studies that fixed-site monitoring did not properly
reflect personal exposure, especially during heavy traffic times, where
PM2.5 levels are significantly influenced by the mode of travel (Frey
et al., 2020; Huang et al., 2012; Kaur and Nieuwenhuijsen, 2009; Qiu
et al., 2017). Personalised air quality information could help commuters
adopt travel choices that reduce their exposure to harmful pollutants
(Wu et al., 2013; Yang et al., 2019). Greater Cairo is one of the few cities
in the region that has an air quality-monitoring network; however, real-
time environmental data collected through field surveys is limited
(Duquennois and Newman, 2009; EEAA, 2017; Huzayyin et al., 2009).
Data from fixed monitoring stations do not offer an opportunity to inves-
tigate pollutant concentrations at inhalation level, capture tempo-spatial
heterogeneity and identify pollution hotspots (Abbass et al., 2020;
Kumar et al., 2015). This study attempts to contribute to this data gap
through collecting and analysing PM2.5 personal exposure data in four
modes of transport in Greater Cairo.
In the best knowledge of the authors, this study for the first time
aims at comparing the exposure to PM2.5 concentrations during com-
mute in four modes of transport (car, microbus, cycling and walking)
in a high-activity zone (Abbass et al., 2020) of Greater Cairo during
peak traffic hours. The aim is to examine spatio-temporal variation in
PM2.5 concentrations for all modes to identify pollution hotspots, esti-
mate exposure doses, compare trip fares to inhaled doses and finally
to estimate resulting national health burden and economic losses. Ulti-
mately, this study aims to provide firsthand transport pollution data and
analysis to Greater Cairo commuters and policymakers alike.
2. Methodology
2.1. Description of study area
In this study Greater Cairo refers to Cairo and Giza governorates. The
metropolitan area is a densely populated megacity with 20 million in-
habitants (United Nations, 2018) and 4 million vehicles (CAPMAS,
2020). Commuters are exposed to poor air quality owing to anthropo-
genic activities and to the city's topography, its proximity to the desert
and meteorological conditions (Duquennois and Newman, 2009;
Huzayyin et al., 2009; Parry and Timilsina, 2015). Greater Cairo is bor-
dered in the east by the Mokattam Hills and to the west by the Abu-
Rawash Hills and the Western Desert (Hassanien and Abdel-Latif,
R.A. Abbass, P. Kumar and A. El-Gendy Science of the Total Environment 791 (2021) 148104

Table 1
Review on recent global studies investigating exposure to PM2.5 pollution during commuting with different transport modes.

Location Study focus Key findings Author (year)

Hamburg, Germany Evaluating population exposure to PM2.5 in modes of - In-car environment contributes 33% of the total annual exposure to PM2.5. Ramacher and Karl
transport using dynamic modeling - Walking and cycling result in 30% and 17% of annual PM2.5 exposures (2020)
while buses, subway and trains result in less than 10%.
Chengdu, China Air pollution in car, bus, subway and shared bike - Urban areas had highest PM2.5 concentrations. Liu et al. (2019)
- Car commutes were associated with lower PM2.5 exposures.
Chennai, India PM2.5 exposure in car, motorbike and bus - Maximum exposure concentration of PM2.5 was observed (709 μg/m3) Raj and Karthikeyan
in bus and minimum exposure concentration (29 μg/m3) in closed car. (2019)
Asian countries Levels of PM2.5, UFP and BC in Asian transport - PM2.5 concentrations while walking were 1.6 and 1.2 times higher in Kumar et al. (2018a)
microenvironments Asian cities (42 μg/m3) compared to cities in Europe (26 μg/m3) and the
USA (35 μg/m3).
- Average PM2.5 concentrations in car (74 μg/m3) and bus (76 μg/m3) in Asia
were approximately two to three times higher than in Europe and America.
Guildford, UK Coarse and fine particles exposure in bus, car, cycling - PM2.5 was high in car and lowest for cyclists. Kumar et al. (2018b)
and walking commutes - Respiratory dosages of fine particles were close for walk (5.5 ± 0.3
μg/h) and cycle (5.1 ± 1.2 μg/h), and were lower for bus (4.1 ± 0.7
μg/h) and car (2.0 ± 0.2 μg/h).
- Car mode had lowest respiratory dosages of PM2.5.
Mexico City PM2.5 exposure for walking, cycling, bus, conventional - Average PM2.5 exposure ranged from 16 ± 7 μg/m3 for walking to 82 ± Hernández-Paniagua
car and hybrid-electric car 9 μg/m3 for cycling et al. (2018)
- Maximum concentration for car was 111 μg/m3
- The mass of PM2.5 inhaled depended on mode of transport.
Salt Lake City, Utah, PM2.5 exposures for bicycle, walking, driving with - PM2.5 ranged from 5 μg/m3 for driving with windows closed to 15 Chaney et al. (2017)
USA windows open and closed, bus, and light-rail train μg/m3 for driving with windows open.
- Inhaled doses for 2.7 km route were 6.83 μg for walking, 2.78 μg for
cycling, 1.28 μg for light-rail train, 1.24 μg for driving with windows
open, 1.23 μg for bus and 0.32 μg for driving with windows closed.
- Exposure rates for cycling were 18.0 μg/h, 16.8 μg/h for walking and
3.7 μg/h for driving with windows-closed.
Sacramento, Pollution exposure in single-occupancy vehicles, high - Largest pollutant concentrations were measured during light-rail train Ham et al. (2017)
California occupancy vehicles, buses, light rail, train and cycling commutes.
- Ventilation settings of personal vehicles can reduce in-vehicle PM2.5,
BC and UFP by up to 75%.
- Bicycle route choice can reduce exposures by 15–75% with the lowest
in paths far from traffic sources.
- Largest exposure per mile occurred during bicycle commutes with
1.312 mg of PM2.5/mile.
Hong Kong PM2.5 exposure in transport microenvironments using - Mean PM2.5 concentration in winter was lowest for underground Li et al. (2017)
portable monitors sections of the metro system (31 mg/m3), whereas in summer all modes
had mean PM2.5 concentrations between 10 and 15 mg/m3.
Helsinki, Finland PM2.5 exposure during bicycle, bus and car - The highest mean PM2.5 (85 μg/m3) was recorded on the bus in Okokon et al. (2017)
Rotterdam, Thessaloniki.
Netherlands - Active- and public-transport commuters are at higher risk of air
Thessaloniki, Greece pollution exposure than private car users.
London, UK Exposure to air pollutants during commuting - No systematic relationship between income deprivation and pollutant Rivas et al. (2017b)
concentrations was found.
- Underground showed highest PM concentrations, then buses and
much lower concentrations in cars.
- Concentration in car and bus were governed by traffic conditions.
Exposures were reduced in trains with non-openable windows
compared to openable windows.
Delhi, India Personal exposure to PM2.5 and BC - Average PM2.5 for auto rickshaw, bus and two-wheeler were 78 ± 40, Pant et al. (2017)
51 ± 16, and 55 ± 29 μg/m3.
Xi'an, China PM levels in cars under four ventilation modes, subway - Commuters were exposed to the lowest concentrations of PM2.5 (10 ± Qiu et al. (2017)
trains and station platforms, buses under two 7 mg/m3) in a private car with air conditioning recirculation.
ventilation modes and pedestrians - Passengers waiting for a train on a subway station platform were
exposed to the highest PM concentrations (245 ± 43 mg/m3).
Montreal, Toronto Metro-commuter exposures to PM2.5-associated - Time spent in metro contributes to 21.2%, 11.3% and 11.5% of daily Van Ryswyk et al.
and Vancouver, elements PM2.5 exposure in Toronto, Montreal and Vancouver, respectively. (2017)
Canada - Air pollutant levels in Canadian metros are impacted by the systems
themselves.
Delhi, India Road exposure of PM2.5 concentrations for 11 transport - On-road PM2.5 concentrations exceeded the ambient measurements Goel et al. (2015)
microenvironments by an average of 40% for walking, 10% for cycle, 30% for motorised
two-wheeler, 30% for open-windowed car, 30% for auto rickshaw, 20%
for air-conditioned as well as for open-windowed bus, 20% for bus stop,
and 30% for metro station.
- Inhaled PM2.5 per kilometre for cycling is 9 times of car with AC.
Hong Kong Heterogeneity of passenger exposure in transit - Busy roadside and enclosed termini demonstrated the highest average Yang et al. (2015)
microenvironments particle concentrations while the lowest was found on the motor rail
platforms.
- Bus trips had the potential for higher integrated passenger exposure
compared to motor rail trips.
Jakarta, Indonesia Testing the effect of commute mode on PM2.5 exposure - PM2.5 in private cars is 91 ± 38 μg/m3. Both et al. (2013)
- PM2.5 in public transport is 22% higher than in cars
- Average commute times were longer for private car than public

(continued on next page)

3
R.A. Abbass, P. Kumar and A. El-Gendy
Table 1 (continued)
Location Study focus
Istanbul, Turkey PM2.5 levels for four public transport modes: bus,
metro–bus, car and walking
Pearl River Delta, Exposure to PM2.5 in bus, taxi and metro and walking, - Active modes resulted in higher PM2.5 concentration (76 μg/m3).
China bicycle and motorcycle
Barcelona, Spain Travel mode comparison of commuters' exposure to air - PM2.5 was 2–3 times higher in cars than for walking and cycling.
pollutants
Beijing, China Comparisons of personal exposure to PM2.5 during
different commuting modes
Brussels, Comparing exposure to PM2.5 of cyclists and car
Louvain-la-Neuve passengers
and Mol, Belgium
Sydney, Australia PM2.5 concentrations measured for train, bus, ferry and - Mean concentrations of PM2.5 ranged from 22.6 (automobile) to 29.6
automobile
London, UK PM2.5 at an intersection via walking, cycling, bus, car, - Traffic count explained little of the variability in the PM2.5
and taxi
UK The dynamics of PM inside train coaches and public
cars
London, UK Effects of travel mode on exposures to particulate air
pollution
2008). The city experiences low annual precipitation between 22 and
29 mm and high temperatures between 18 and 45 °C (Hassanien and
Abdel-Latif, 2008). This study focuses on routes in Greater Cairo's
high-activity zones namely Heliopolis and Nasr City located in the east
(Abbass et al., 2020).
2.2. Study design
This study focuses on the impact of mode of transport used by
Greater Cairo commuters on PM2.5 concentrations. The four modes
are; (i) car (windows-open and windows-closed) with recirculation-
on and AC-on (referred to as ‘recirculation’ for short from here on),
(ii) microbus (windows-open), (iii) walking, and (iv) cycling. Car runs
were carried out on weekdays during three times of the day (local
Cairo time): morning peak (MP) 07:00–10:00, off-peak (OP)
12:00–14:00 and evening peak (EP) 16:00–20:00. Runs were carried
out on several days. These were repeated during MP and EP periods
each day to reduce the effect of factors that cause variability between
the measured concentrations. An extensive car campaign was carried
out during OP hours where PM2.5 concentrations (Table 2) and trip du-
rations (SI Table S1) did not vary considerably from MP (p-values of
0.0037 and 0.00074 and hence statistically significant). Also, it has
been reported that OP hours for Greater Cairo are not between 12:00
and 14:00 as is conventionally the case on a global scale (Kumar et al.,
2021a). It is rather during early morning and late night hours (Nakat
et al., 2013). Hence no OP runs were carried out for the rest of the
modes and the focus of analysis (Section 3) remained on MP and EP. A
total of 136 trips were carried out, covering a distance of 1385 km and
taking 4617 min (SI Table S1). The same route was chosen for car and
microbus while cycling and walking were carried out on shorter and
safer routes within the same zone (Section 2.3). A portable air quality
monitor (Section 2.4) typically used in similar campaigns was used to
Science of the Total Environment 791 (2021) 148104
Key findings Author (year)
transport.
- The highest average PM2.5 concentration was measured inside a bus Onat and Stakeeva
(106 μg/m3) during rush hours. (2013)
- The highest single peak measurement of 316 μg/m3 was while walking
during non–rush hours.
Wu et al. (2013)
- The use of air-conditioning can effectively reduce exposure levels in
most cases (by at least 83%).
de Nazelle et al.
- Taking inhalation rates into consideration, pedestrians and cyclists (2012)
pollution doses were comparable to car drivers.
- Taxi commuters were exposed to lower PM2.5 concentrations (32 ± 20 Huang et al. (2012)
μg/m3) compared with bus commuters (42 ± 23 μg/m3) and cyclists (49
± 27 μg/m3).
- Taking inhalation rates and trip duration into consideration, cyclists
saw the highest exposures.
- Mean bicycle/car ratios for PM2.5 are close to 1 and rarely significant. Int Panis et al. (2010)
- Inhaled quantities and lung deposited dose are large for cyclists due to
their increased ventilation rates.
Knibbs and de Dear
(bus) mg/m3, respectively. (2010)
- Ferry resulted in highest mean PM2.5 exposure.
Kaur and
concentrations. Nieuwenhuijsen
(2009)
- For air-conditioned rail coaches, during peak times, the mean Nasir and Colbeck
concentrations of PM2.5 were 14 mg/m3 and levels were less than half (2009)
during off-peak journeys.
- Concentrations of PM2.5 in car journeys were similar during morning
and evening journeys.
- Mean exposures to fine particle while walking are 2.2 times while Briggs et al. (2008)
driving.
- Reduced in-car exposures are owed to the filtration system that helps
to prevent ingress of particles.
collect one-minute average PM2.5 readings. For each mode, the same ve-
hicle and the same persons were employed for all runs. For car and mi-
crobus, two non-smoking occupants, including the driver were present
in all runs and the monitor was set in a backseat near a window. For
walking and cycling, the field worker carried the monitor in a backpack
with its inlet tube set at breathing level.
2.3. Route selection
Routes were chosen from one of the city's high activity zones to sim-
ulate trips made by the average Greater Cairo dweller and hence pass
through congested arterial roads, commercial quarters, university pre-
mises, central urban locations and quieter residential areas. The same
route was chosen for car and microbus shown in SI Fig. S2, representing
a round trip commonly taken by students and other commuters be-
tween a residential area and one of the city's largest universities, located
near the centre of Greater Cairo. It starts from a residential area passing
through moderately congested Nozha street and before turning into the
main Al-Orouba street the route passes by a bridge construction area (at
the time of data collection). Al-Orouba street is considered an arterial
road that connects between Heliopolis and other zones within the cap-
ital and is hence heavily used by commuters on a daily basis (Kumar
et al., 2021a). The route then reaches a university located outside
Heliopolis then it returns through Sixth of October Bridge, the longest
bridge in Greater Cairo and then passes by El-Nasr Road, which sepa-
rates Heliopolis from Nasr City, known for its commercial outlets and
high-rise residential buildings. Finally the route turns back to its starting
point through El-Nozha street. The route chosen for car and microbus is
16 km long and was therefore impractical and unsafe for cycling and
walking commutes. Therefore cycling and walking runs were carried
out under safer conditions within the same zone (SI Fig. S2). Walking
within mega-city Greater Cairo is not sufficient for commuters to travel
4
R.A. Abbass, P. Kumar and A. El-Gendy
between destinations, however one walks from house or workplace to a
station or pick up point or to switch between different modes of trans-
port. Also the car and microbus route is not equipped with pedestrian
walks to accommodate for walking. Hence, three spots (SI Fig. S2)
were chosen within the route to simulate walking trips carried out by
car and microbus commuters. The first walking trip is in a residential
area around a garden and a gas station, the second is close to the bridge
construction site and the third is around an informal microbuses station
where a large number of pedestrians get off and on buses and micro-
buses. Cycling and walking routes were short compared with car and
microbus. These routes were within the same zone to present similar
urban background conditions to allow for possible comparison.
2.4. Data collection
Data were collected between September 2019 and January 2020
during three daytime periods MP, OP and EP as summarised in SI
Table S1. The campaign is carried out during the fall/winter season.
The ambient PM2.5 concentration data for the studied zone during the
time of data collection is not publicly available and hence were not
discussed as part of this work. Nevertheless, Greater Cairo experiences
variations within the ambient PM2.5, temperature and humidity
throughout the year (SI Table S2). The impact of ambient conditions
on exposure in transport microenvironments can only be further sub-
stantiated through a full year campaign. Moreover, since the car cam-
paign was carried out in September and December (SI Table S2), we
ensured that the data can be combined since the atmospheric stability
and mixing heights during these months are found to be comparable
(Bashter et al., 2019; El Shazly et al., 2012). These are important param-
eters affecting pollutant transport, dispersion and in turn the ambient
concentrations (Lowenthal et al., 2014; Mostafa et al., 2019; Rabeiy,
2017; Onat and Stakeeva, 2013; Mostafa et al., 2019). Furthermore,
the monitoring period is characterised by lower wind speeds, weaker
convection and a phenomenon known as the ‘black cloud’ that blankets
Greater Cairo due to rice straw burning causing a dense aerosol plume
(Mahmoud et al., 2008; Marchetti et al., 2019). One-minute averaged
PM2.5 concentrations were collected using a pDR-1500 personal air
quality monitor (ThermoFisher Scientific, 2017). The blue cyclone was
used for pDR-1500 as an inlet at flowrate of 2 L/min measuring particles
size between 1 and 4 μm with an aerodynamic diameter of 2 μm (re-
ferred to throughout the study as PM2.5, for simplicity). The monitor
was purchased just before the campaign. pDR-1500 was factory cali-
brated against a set of reference monitors that, in turn, are periodically
calibrated against a gravimetric standard traceable to the National Insti-
tute of standards and Testing (NIST). As an additional quality control
and assurance exercise to further validate pDR-1500 measurements,
co-location between the pDR-1500 and a research grade optical particle
spectrometer (GRIMM model-11c) was carried out over three consecu-
tive days. A reasonably high agreement with Pearson coefficient (r =
0.98) was obtained (SI Fig. S3). pDR-1500 has been widely used in
prior personal monitoring studies (e.g. Koehler and Peters, 2015; Lim
et al., 2019; Pant et al., 2017; Zhang et al., 2017). The private car used
for all runs was a 2011 Peugeot 207sw that had the engine size
1600 cc and running on gasoline fuel (Octane 92). The ventilation set-
tings for the car recirculation setting were kept constant with AC tem-
perature set to 16 °C and recirculation on. All the data were collected
on weekdays to simulate typical Greater Cairo commuting conditions.
Monitoring was not carried out on weekends, rainy or extreme weather
event days so the data are comparable. At least four runs have been car-
ried out for each mode and time of day, where the number of runs for
microbus, cycling and walking is less than 10 due to practical con-
straints. STRAVA app (https://www.strava.com/) was used as a GPS
tracker for continuous latitude and longitude recordings. Ambient tem-
perature, relative humidity and wind speed and direction data were col-
lected from the nearest local airport for the periods of every run and
were 23 ± 6 °C, 52 ± 14%, and 18 ± 10 ms−1, respectively.
5
Science of the Total Environment 791 (2021) 148104
2.5. Data analysis
The data collected for the different modes and times of day were
analysed to understand the factors affecting exposure rates in the trans-
port sector of Greater Cairo. A basic statistical analysis produces the
mean, standard deviation, minimum and maximum values for each
mode during both MP and EP, which are then used to plot bar charts
with error bars. This preliminary analysis (Section 3.1) provides an
overview and identifies highest and lowest average PM2.5 exposure con-
centrations within the studied transport mix. Then concentration maps
are produced using ArcMap (Esri Inc.) to carry out a hotspot analysis
(Section 3.2). One-minute averaged PM2.5 concentration data for all
modes for MP and EP are grouped together and segregated into five per-
centile groups to understand the variations in exposure concentrations.
These included (i) >P90 (referred hereafter as P90) representing peak
concentrations, (ii) P75–P90 (referred hereafter as P75) representing
high concentrations, (iii) P50–P75 (referred hereafter as P50)
representing upper-middle concentrations, (iv) P25–P50 (referred
hereafter as P25) representing lower-middle concentrations, and
(v) <P25 representing low concentrations (Sharma and Kumar, 2020;
Kumar et al., 2021a). The concentration percentile cutoffs are derived
for the whole data set to provide common references for relative
comparison.
A discussion based on the average PM2.5 concentration disregards
the impact of inhalation rates and trip durations. Hence, an analysis of
potential inhaled doses is carried out (Huang et al., 2012; Kumar et al.,
2018a). The potential inhaled dose is calculated per unit time basis (Dt
in μg/kg·h) using Eq. (1) and per unit distance basis (Dd in μg/km)
using Eq. (2), as discussed in Section 3.3 (Kumar et al., 2021a;
Nogueira et al., 2020). Inhalation rates for average male and female
commuters between the age of 31 and 40 was taken from the metabol-
ically derived human ventilation rates produced by the US-EPA (2009),
as summarised in SI Table S3. Since the inhalation rate ratios between
male and female are distinct and consistent for the same age group (SI
Table S3), we focused our discussion around male commuters for the
sake of brevity (Section 3.3). We considered commuting via cars and
microbus as a light-intensity, walking as a moderate-intensity, and cy-
cling as a high-intensity activity.
Dt ½μg=kg
hr ¼ C a  IRBW ð1Þ
Ca is the pollutant concentration (μg/m3), IRBW is the inhalation ratio
(m3/kg·h) adjusted to the corresponding average body weight (BW).
C a  IR  t
Dd ½μg=km ¼ ð2Þ
distance travelled ðkmÞ
t is the time of each trip in hours, IR is the inhalation ratio (m3/h) and
the distance traveled is the route length in kilometres. The inhaled dose
per kilometre (Dd) is then utilised to calculate the total inhaled dose per
trip for four predefined trips (Section 3.4) that reflect a combination of
different modes to simulate commuting options for Greater Cairo inhab-
itants. The car/microbus route (Section 2.2) is chosen for this analysis
whereas cycling was excluded as the route is not cycling friendly. The
total inhaled dose in μg is plotted against the trip cost in US$, which
can highlight any social discrepancies as regards to commuting costs
versus inhaled doses of PM2.5 and in turn the impact on health.
Finally, the health burden (HB) and economic loss (EL) (Section 3.5)
is estimated based on the number of premature deaths caused by excess
levels of PM2.5 exposure for the different modes (Fantke et al., 2019;
Gustafsson et al., 2018; Kumar et al., 2020; Maji et al., 2018; Nansai
et al., 2020). SI Table S4 lists all parameters used to calculate HB and
EL. Health impacts are quantified based on four components: the ex-
posed population size, the baseline incidence rate, the effect estimate
drawn from epidemiological studies and the change in air quality,
which is indicated by the measured PM2.5 concentrations in this case
R.A. Abbass, P. Kumar and A. El-Gendy
(Fann et al., 2012; Gustafsson et al., 2018). Eq. (3) was chosen to esti-
mate the health burden (Kumar et al., 2020;Maji et al., 2018; Nansai
et al., 2020).
 
RR−1
HB ¼  B  ExPop ð3Þ
RR
HB (# of premature deaths) is the health burden; the number of pre-
mature deaths in this case. [(RR − 1)/RR] (−) is the population attribut-
able risk-potential reduction in the incidence of mortality when an
entire population would be exposed to pollution above a reference con-
centration (Maji et al., 2018). B (deaths per 100,000 people) is country-
specific all-cause baseline mortality rates per 100,000 people. ExpPop (#
of commuters) is the exposed population size. RR is the relative risk
where in the case of exposure being below a set PM2.5 reference concen-
tration, there is a mortality risk of 1 where RR indicates the relative size
of the mortality risk arising from exposure to higher concentrations
(Nansai et al., 2020). Eq. (4) was chosen to estimate RR (Kumar et al.,
2020, 2021b; Maji et al., 2018).
RR ¼ e½βPM2:5 ðC i −C 0 Þ for C i >C 0 ð4Þ
RR ¼ 1 for C i ≤C 0
Ci is the average PM2.5 concentrations collected from the field cam-
paign as listed in Table 2 for each mode and each time of the day.
Since mean mortality variability is typically reported in literature with
95% confidence intervals (CI), standard deviation ranges of Ci (Table 2)
and sample sizes (SI Table S1) were used to produce Ci numbers with
95% CI to derive RR (SI Table S4) and, in turn, HB estimates with 95%
CI (Table 3). C0 is the threshold concentration below which no addi-
tional health impacts are calculated (Maji et al., 2018). βPM2.5 is the ex-
posure response coefficient, representing an increase in mortality due to
an increase in PM2.5 concentrations. It is typically derived based on long-
term cohort studies. A number of such studies have been carried out in
North America, China and Europe whereas the corresponding studies
(Wheida et al., 2018) are rarely available for developing countries in-
cluding Egypt (Bjorn, 2019). In the current study, we use it as 0.038%
for every 1 μg/m3 increase in PM2.5 based on a systematic review of
studies on short-term exposure to air pollution and daily mortality of
all ages (Andreão et al., 2018; Hu et al., 2015; Kumar et al., 2020; Shen
et al., 2020). The WHO standard for PM2.5 concentration is set at 10
and 25 μg/m3 for annual and 24-hour mean, respectively (WHO,
2018). However, the Egyptian regulation sets the corresponding limits
to 50 μg/m3 annual mean and 80 μg/m3 for 24-hour mean (EEAA,
2018). Hourly standards for PM2.5 do not exist. Therefore, we used 24-
hour mean WHO standard as C0 since it is more stringent than national
norms and provides global comparability with studies elsewhere
(Kumar et al., 2021b).
B (deaths per 100,000 people) for Greater Cairo is assumed equal to
Egypt's mortality rate due to lack of availability of city-specific data,
which is 566.83 (95% CI 452.26–704.33) deaths per 100,000 people in
2019 (GBD, 2019). This figure is used to derive the hourly baseline mor-
tality by dividing the annual rate into 365 days and 24 h, to accommo-
date for the hourly exposures focused on in this work. ExpPop (# of
commuters) for each transport mode group in Greater Cairo has been
estimated as a product of vehicle fleet size (# of vehicles/city) and aver-
age vehicle occupancy (# of commuters/vehicle), using Eq. (5).
ExPop ð#of commutersÞ ¼ vehicle fleet size  vehicle occupancy ð5Þ
For cars, 69% of private cars and 5% of taxis have AC and hence use
the recirculation setting while the rest resort to open-windows setting
(CAPMAS, 2020; Shalaby, 2010; IDSC, 2007). Car occupancy is reported
as 1.24 people/car for Greater Cairo (Osra, 2016). Eq. (5) was used for
cars only as data for the other modes has not been readily available in
that breakdown. Most microbuses are not formally licenced in Greater
6
Science of the Total Environment 791 (2021) 148104
Cairo (World Bank, 2006) where only 13,921 mircobuses were officially
registered in 2017 in Cairo alone. However, a recent study reported
three million commuters traveled using microbuses on a daily basis in
2017 in Giza alone (Abdelaal et al., 2017), which was used to derive
the microbus commuters population for Greater Cairo as a whole in
2019 (CAPMAS, 2019).
Cyclists are considered to be 3% of the Greater Cairo population (El
Heity, 2017). For walking mode, the sum of ExPop for all other modes
is used since it is assumed that all commuters inevitably walk within
their daily commutes. The analysis for walking mode is carried out for
the average exposure concentrations of walking in the different areas;
residential, construction site and informal bus station. SI Table S4 lists
the ExPop numbers for each transport mode.
Since RR and B are based on hourly observations and rates, the HB in-
dicates deaths resulting from hourly exposure to excess PM2.5 concen-
trations during commutes at peak hours. Average concentrations (Ci)
during MP and EP are used to produce corresponding RR values. ExPop
for each transport mode is used with each of the RR's derived for MP
and EP as it is assumed that the whole commuting population will prob-
ably travel for at least an hour during both time segments throughout
the year. Time spent by commuters during MP and EP for each mode
of transport is derived based on the average trip durations (SI
Table S1). It is assumed that a typical commuter does two trips (MP
and EP) per day during weekdays (5 days/week), allowing us to com-
pute the total number of hours spent in traffic per year (SI Table S4).
Then annual HB is calculated for each time of the day and summed to
produce the total (and deaths per 100,000 of each transport mode's
ExPop – referred to from here on as ‘per 100,000 commuters’) HB attrib-
uted to the excess PM2.5 traffic exposure.
To quantify the financial burden caused by the number of premature
deaths due to exposure to excess PM2.5 concentrations during com-
mutes, the national EL is calculated using Eq. (6) where HB is multiplied
by the Value of Statistical Life (VSL) (Kumar et al., 2020). VSL is defined
as the monetary value of the mortality risk reduction that would pre-
vent a statistical death, estimated based on this person's market produc-
tivity (Andresson and Treich, 2009). Most countries lack reliable
estimates of VSL (Andersson, 2020). Hence, an estimate was used for
Egypt (0.575 million) derived based on a U.S. based VSL adjusted to
Egypt's gross national income and income level classification for Egypt
(Viscusi and Masterman, 2017).
EL ¼ HB  VSL ð6Þ
3. Results and discussion
3.1. Modal concentrations variations
Car with recirculation resulted in the least average PM2.5 concentra-
tions of 32 ± 6 μg/m3, followed by walking (77 ± 35 μg/m3), car with
windows-open (82 ± 32 μg/m3), microbus with windows-open (96 ±
29 μg/m3) and finally cycling (100 ± 28 μg/m3), which resulted in the
highest PM2.5 exposure (Table 2; Fig. 1). Car with recirculation reduced
commuter exposure by 61% compared with windows-open setting, and
by 68% compared to cycling. These findings are in line with previous
studies, reporting a similar trend on recirculation mode in cars that re-
duces PM2.5 exposure by up to 5-times compared with windows-open
(Abbass et al., 2020; Goel et al., 2015; Kumar et al., 2021a; Wu et al.,
2013; Qiu et al., 2017). Three areas (residential areas, construction site
and roadside traffic) were investigated for walking to represent the di-
verse environments. The second least average PM2.5 exposure concen-
trations for walking (59 ± 17 μg/m3 in residential areas and 71 ± 15
μg/m3 near roadside traffic) were observed. However, walking near a
construction site resulted in average exposure concentrations as high
as 100 ± 48 μg/m3 that were comparable to cycling (100 ± 28 μg/
m3). This highlights the adverse impacts of inter-city construction that
R.A. Abbass, P. Kumar and A. El-Gendy
Table 2
PM2.5 measurements results summary. A preliminary statistical analysis is carried out for each mode and each time of the day where mean, minimum and maximum (in square brackets)
are set in μg/m3 and standard deviation is set as dimensionless between brackets. OP runs have only been carried out for car and disregarded for the rest of the campaign.
Mode Setting/area PM2.5 (μg/m3)
MP
Mean (SD)
Car Windows-open 100 (35)
Recirculation 38 (6)
Microbus Windows-open 124 (33)
Cycling 129 (29)
Walking Residential 88 (21)
Bridge construction 115 (30)
Bus stations/traffic 88 (16)
Average 97 (30)
can possibly be barricaded off to avoid exposure to excessive pollutant
levels during walking.
Microbus is the most common mode of transport in Greater Cairo
due to its affordability and flexibility (Section 1). However, commuters
traveling in microbus with windows-open were exposed to on average
~3-times the PM2.5 concentrations of traveling in car with recirculation.
The microbus commuters also walk more within their daily trips to
switch between trip legs; hence, their overall trip exposure is expected
to be higher (Section 3.4). Microbus commutes are therefore a problem
area where affordable and effective adjustments are needed to protect
commuter health.
Finally, cycling results in exposure to the highest average PM2.5 con-
centrations due to its close proximity to on-road vehicles. For example,
cycling during MP (run 1) and EP (run 3; indicated by red boxes in
Fig. 1d) has been disregarded from statistical analysis. These runs
reached average PM2.5 concentrations of 707 and 427 μg/m3, respec-
tively, because the cyclist was stuck behind the tailpipe of an idling mi-
crobus. The event was considered an anomaly that would have skewed
the averaged concentrations. However, it indicates a higher susceptibil-
ity of cyclists to such extreme pollution events that can commonly occur
on congested roads in urban areas (Hernández-Paniagua et al., 2018).
Other studies have also reported that cyclists are in the most vulnerable
position in terms of traffic pollution exposure (Chaney et al., 2017)
where it was estimated that an hour of cycling in Delhi during MP
caused 40% higher PM2.5 inhaled dose than an entire-days dose in
cities like Tokyo, London and New York (Goel et al., 2015; Wu et al.,
2013). Moreover, there are almost no cycling lanes in Greater Cairo.
Hence despite the evident health and environmental benefits of cycling,
it should only be encouraged when the designated space is provided.
Table 2 provides a breakdown of data for each transport mode into
MP and EP. PM2.5 concentrations for EP runs are 26–58% less than MP
runs for all modes and settings, which is consistent with findings of
Kumar et al., 2021a for Greater Cairo. Pie charts in Fig. 1a–d show that
EP trips are longer than MP indicating higher congestion, as was also re-
ported earlier (Abbass et al., 2020). Higher concentrations could possi-
bly be due to higher background PM2.5 concentrations during MP
compared with EP as Greater Cairo is characterised by the ‘black
cloud’ phenomenon during the time of data collection in fall/winter
(Section 2.4) where low-elevated thermal inversion layers contribute
to intensifying pollution levels (Aboel Fetouh et al., 2013; EEAA, 2021;
El-Askary and Kafatos, 2008). This inversion phenomenon results in
the morning fog characteristic of Greater Cairo during that time of the
year as pollutants produced during night time are caught under an in-
version layer (Abdelkader, 2007; Kandil and Abdelkader, 2006; Marey
et al., 2010). As the day progresses dispersion conditions improve due
to higher ambient temperatures and solar radiation, resulting in lower
background PM2.5 levels during EP (Kumar et al., 2021a; Mostafa et al.,
2019). This shows that commuters are impacted by other pollution
sources and meteorological conditions on top of traffic pollution.
Science of the Total Environment 791 (2021) 148104
OP EP
[Min, max] Mean (SD) [Min, max] Mean (SD) [Min, max]
[59, 221] 68 (25) [38, 160] 71 (30) [40, 211]
[30, 53] 30 (7) [22, 50] 28 (6) [21, 45]
[65, 211] – – 74 (25) [39, 163]
[67, 182] – – 78 (28) [147, 189]
[71, 147] – – 37 (14) [24, 79]
[74, 178] – – 85 (62) [35, 254]
[69, 121] – – 52 (13) [40, 86]
[64, 193] – – 58 (39) [28, 228]
3.2. Spatial variability and hotspot analysis
In order to understand spatial variability of PM2.5 concentrations and
identify pollution hotspots, PM2.5 concentration data is analysed accord-
ing to five percentile groups as discussed in Section 2.4. The threshold
concentrations for the whole data group were 135 μg/m3 for P90,
82 μg/m3 for P75, 52 μg/m3 for P50 and 30 μg/m3 for P25. The percentile
groups are color coded in the concentration maps (Fig. 2) allowing for a
geographical representation of spots with high PM2.5 concentrations. As
discussed in Section 3.1, the cleanest route is experienced by car with
recirculation where concentrations are mainly in the <P25 and P25
range (Fig. 2b). For car with windows-open (Fig. 2a), there are no
<P25 segments indicating high exposure throughout the whole trip.
P75 and P90 are observed at U-turns (typical bottlenecks in Greater
Cairo) and on arterial routes like Al-Orouba street, Sixth of October
Bridge and El-Nasr road, which are typically congested and hence result
in exposure to high PM2.5 levels. Similarly, for the microbus route
(Fig. 2c), the same concentration trends are observed indicating high
exposure throughout the trip with concentration surges at bottlenecks
and in arterial roads. The cycling route exhibits the highest concentra-
tions at all points (Fig. 2d) where PM2.5 concentrations are mainly in
the P75 and P90 range, confirming the vulnerability of cyclists to traffic
pollution (Section 3.1). For walking, three maps are set out in Fig. 2e, f, g
where the greenest route is in the residential area (<P25 and P25) and
the largest number of red and dark red dots (P75 and P90) is at the
bridge construction site. These observations agree with research find-
ings that PM2.5 measurements exhibit larger spatial heterogeneity in
the exposure levels for cycling and walking than those protected from
external conditions such as car with recirculation (Hernández-
Paniagua et al., 2018).
To investigate events (Ex for event x) that cause concentration peaks,
Fig. 3 shows selected trips represented on radar plots. Fig. 3a has two car
with recirculation trips indicated in red where no fluctuations in con-
centration are observed, owing to the effect of an isolated environment.
E1 was a result of a traffic jam at an informal intersection at the begin-
ning of the route. E2 is a peak observed by more than one trip where
the route passes through the bridge construction site. E3 represents
the car passing through Sixth of October Bridge which has a limited
number of lanes resulting in congestion while E4 is owed to congestion
at U-turns. The microbus with windows-open trips in Fig. 3b mimic the
events observed by the car E2, E3 and E4 in E5, E6 and E7, respectively.
The consistency in peaks between car and microbus that follow the
same route, reflects the impact of route characteristics on commuters'
exposure to PM2.5. For E8, the microbus was stuck behind a large aging
bus that stopped for passengers to get off and on. Fig. 3c shows how ex-
posure during cycling is typically higher than exposure in motorised
trips with larger concentration circles up to 800 μg/m3. E9 represents
when the cyclist was held up behind the tailpipe of an old microbus
(Section 3.1). For walking trips (Fig. 3d), E10 was caused by smoke
7
R.A. Abbass, P. Kumar and A. El-Gendy
from a vendor grilling sweet potatoes in the residential area. E11 was at
the bridge construction site but was exceptionally high due to wood and
roadside solid waste burning nearby at that point in time. E12 was also
experienced at the bridge construction site with a higher peak caused
by a drilling job taking place at the time as well as typical congestion ex-
perienced in roads with construction activities. Overall, the greatest
peaks in PM2.5 concentrations coincided with the high traffic density
and external events such as construction and roadside solid waste burn-
ing (Hama et al., 2021).
Fig. 4a and b provides a comparison for the percentage of time spent
in each concentration percentile group across the different modes of
transport during MP and EP. The percentage of time spent at P90 for
all modes during MP is much higher than for EP as discussed in
Section 3.1 and shown in Fig. 4 and SI Table S1. Car with recirculation
is the only mode/setting that has consistently low percentile concentra-
tions during MP (no P75 nor P90). On the other hand, car with
windows-open and microbus with windows-open have no <P25 con-
centrations during MP with microbus experiencing P90 concentrations
during ~40% of the time. Cyclists are exposed to P75 concentrations
for ~60% of the time during MP, the highest amongst all modes. Walking
in a residential area, like car with recirculation, experience favorable
conditions with <P25 concentrations of PM2.5 during ~40% of the time
during MP. For EP hours, cars with recirculation has <P25 concentra-
tions during ~70% of the time while car with windows-open result in ex-
posure to P50 concentrations during ~60% of the time. Microbus with
windows-open results in only ~5% of the time during EP at <P25 con-
centrations while having ~40% at P75 concentrations. Walking by the
construction site results in the highest percentage of time of 20% at
P90 concentrations during EP. Overall, it is evident that hotspots domi-
nate most routes within Greater Cairo, leading to high PM2.5 exposure
for a large percentage of their daily trips. Despite car with recirculation
having the least PM2.5 exposure, car occupants need to be cautious
when using this setting for extended trip durations as it may result in
the build-up of carbon dioxide (Angelova et al., 2019; Atkinson et al.,
2017; Constantin et al., 2016; Luangprasert et al., 2017). Instead vehicle
users can turn on recirculation mode at pollution hotspots to reduce in-
gress of fresh emissions due to idling, acceleration-deceleration or stop-
start conditions (Goel, 2017; Goel and Kumar, 2015; Jung et al., 2017;
Kumar et al., 2021a). Hence, the availability of hotspot data allows com-
muters to navigate routes and directs policymakers to focus efforts on
the most problematic zones.
3.3. Exposure dose
Potential inhaled doses per unit time (Dt) and per unit distance (Dd)
take inhalation rates and trip durations into consideration hence
underlining the impact of active mode commuting on PM2.5 dosage
levels. The upcoming discussion verifies literature and concentration
findings discussed in Sections 3.1 and 3.2 where cycling and walking
in an urban environment expose commuters to more pollution. Active
modes of transport require more effort than motorised modes which
translates into higher inhalation rates (SI Table S3) and hence results
in larger amounts of inhaled pollutants. According to SI Table S5, the
Dt in μg/kg·h by an average male cyclist is 5-times that of a commuter
in car with windows-open and 14-times that in a car with recirculation
during MP hours. Dd further emphasizes the difference between
motorised and active modes of transport where less distance is covered
by active commuters within in the same time due to naturally lower
travel speeds. Cycling and walking result in inhaling 40-times and 32-
times more PM2.5 per kilometre than commuters in car with recircula-
tion. While commuters in car with windows-open and microbus with
windows-open inhaled only ~2-times the PM2.5 doses inhaled per
kilometre during car with recirculation for MP trips. The analysis has fo-
cused on male commuters and MP hours for brevity; however it also ap-
plies to EP as well as male and female commuter groups between the
ages of 31 and 40 (SI Table S5). Nevertheless, other studies show
8
Science of the Total Environment 791 (2021) 148104
lower pollutant inhaled doses while cycling in designated routes reflects
the importance of mindful urban design before encouraging non-
polluting modes of transport (Cepeda et al., 2017).
Fig. 4c and d further depict how inhaled doses per kilometre vary
greatly between motorised and non-motorised modes of transport de-
spite being within relatively the same range of average PM2.5 concentra-
tions for both MP and EP. Car and microbus with higher travel speeds
(larger bubble sizes) are at the bottom of the y-axis with low inhaled
doses while lower speed modes like cycling and walking (smaller bub-
ble sizes) are at the top with considerably higher inhaled doses. Fig. 4e
and f also reflect how PM2.5 concentration exposures and Dt (μg/kg·h)
vary across the different modes of transport especially evident for cy-
cling. The red line peaks for Dt for cycling commutes (MP and EP)
while its PM2.5 concentration is within the same range of the other
modes. Fig. 4c–f show that EP Dt (μg/kg·h) and Dd (μg/km) are less
than those of MP. An exception was observed for car with windows-
open where Dd during EP was higher than during MP since the average
trip duration for EP is significantly longer than MP, despite higher MP
average concentrations (Eq. (1)). The above discussion highlights the
significance of considering inhaled dose analyses, not only exposure
concentrations, for transport management and design to limit the ad-
verse health impacts on active commuters.
3.4. Commuting cost versus inhaled dose of PM2.5
The car with recirculation exhibited the lowest PM2.5 exposure
(Section 3.1) and inhaled doses (Section 3.3). However, the majority
of Greater Cairo commuters resort to microbus due to being cheap
and flexible in terms of destinations and stops. SI Table S6 summarises
the five trip options (description, cost and inhaled PM2.5 doses) to inves-
tigate the practicality and feasibility of the conclusions derived from this
study. Comparing recirculation and windows-open settings in trips A
and B show negligible differences in cost and 50% less inhaled dose for
car with recirculation. It is also noted that for windows-open, the in-
haled dose for EP is slightly higher than for MP despite having 30%
less PM2.5 exposure concentrations as trip duration has been factored
in where EP trips are longer. Uber car cost is more than double the travel
costs of private car for the same trip and result in the same PM2.5 inhaled
doses nevertheless, some people still choose Uber as they might not
have private cars, are below driving age or choose to save the effort
needed to drive in Greater Cairo. A large percentage of Greater Cairo
commuters resort to the microbus whose cost is 45% of the cost of a
trip carried out by a private car and 20% of the cost of hiring an Uber.
However, the inhaled dose (for the average male commuter between
age of 31 and 40) for microbus with windows-open is 2-times the in-
haled dose in case of traveling in car with windows-open and 4-times
the inhaled dose for car with recirculation, during MP hours. Fig. 5a
(MP) and b (EP) show cost versus inhaled dose where it is evident
that the microbus stands on its own with low cost and high inhaled
dose. It is followed by car with both its settings at higher cost and
lower inhaled dosage. Finally, Uber with both its settings is most expen-
sive with the same inhaled dosage levels as car. Bubble sizes indicate
trip durations, which do not vary between trips considerably, but EP
(Fig. 5b) trips are longer than MP trips (Fig. 5a).
Overall, there is a social discrepancy in inhaled doses of PM2.5 where
commuters who do not own a private car or cannot afford Uber, resort
to the microbus with windows-open for transport and inhale up to 4-
times the PM2.5 doses inhaled by commuters in car with recirculation.
Hence considerations need to be taken to improve conditions in micro-
buses such as providing more comprehensive route options to reduce
the amount of walking needed to change between trip legs (Section 1;
SI Table S6) and providing the option of using recirculation setting at
pollution hotspots (Section 3.2). The same is advised for private car
owners and Uber passengers where recirculation seems to have a negli-
gible impact on cost. Inhaled doses during EP for car windows-open are
slightly higher than MP despite having less concentrations further
R.A. Abbass, P. Kumar and A. El-Gendy
confirming the importance of overall dosage analysis in reflecting the
situation more accurately to commuters and policymakers.
3.5. Health burden and economic losses
Table 3 compares between the four modes of transport in terms of
HB (deaths per year) and corresponding EL (US$ millions). For each
mode of transport, the number of deaths per year caused by PM2.5 expo-
sure during MP is higher than during EP owing to higher PM2.5 concen-
trations experienced during MP hours (Table 2). First the absolute
number of deaths resulting from PM2.5 exposure within each transport
microenvironment is derived. The highest absolute number of prema-
ture deaths/year resulting from PM2.5 exposure are observed within
the population using microbus with windows-open at 37 (95% CI
35–40), followed by walking 16 (95% CI 15–17), car with windows-
open 7 (95% CI 6–7), cycling 3 (95% CI 3–3) and finally car with recircu-
lation 2 (95% CI 2–2). Fig. 5c shows the relation between average PM2.5
concentrations (μg/m3) and the total annual HB (deaths/year) where
higher PM2.5 levels do not necessarily correspond to higher HB. Car
with windows-open (82 ± 32 μg/m3) and cycling (100 ± 28 μg/m3)
have higher PM2.5 concentrations than walking (77 ± 35 μg/m3) never-
theless walking results in more than 2-times and 5-times deaths caused
by car with windows-open and cycling, respectively. This is due to
variations in ExPop size that plays a role in determining HB (Eq. (3))
where the walking population incorporates all types of commuters
and is 9-times and 19-times the car with windows-open and cycling
populations, respectively (SI Table S4). Such observations indicate that
to address the transport pollution exposure issue, both pollution levels
and transport mode population size are of equal importance in under-
standing the problem. Providing solutions to microbus and walking
commuters is of primary importance due to their large numbers and
hence incur the largest national HB contributions. Bubble sizes in
Fig. 5c indicate the EL ($millions) resulting from each transport mode
(Table 3), which is a direct product of the number of deaths (HB) within
each mode. This analysis has shown that a total of 64 (95% CI 60–69)
deaths and a national EL of 37 (95% CI 35–39) US$ million occur every
year in Greater Cairo due to PM2.5 exposure during peak hour transport
using the studied four modes of transport.
HB and EL were first calculated in absolute number of deaths and US$
millions lost. However to add perspective, HB has also been calculated as
death rate per 100,000 commuters of each transport mode (Table 3) as
typically discussed in literature to allow for normalised comparisons.
The deaths caused by exposure to ambient PM2.5 levels in Egypt (as-
sumed the same for Greater Cairo) is reported as 91.41 (95% CI
67.45–117.97) deaths per 100,000 people per year (GBD, 2019). On the
other hand, deaths caused by PM2.5 exposure during peak hours are
highest for cars with windows-open at 0.54 (95% CI 0.52–0.57) deaths
per 100,000 commuters/year. This number eliminates the impact of
Table 3
HB indicates the absolute number of deaths within the commuting population owing to hourly exposure to high PM2.5 levels for each transport mode during MP and EP and the sum of all
three-time segments resulting from all commutes within one year. Numbers are represented as averages with a CI of 95% of (lower-upper). The corresponding annual EL is listed based on
the total absolute number of deaths. The total annual HB is calculated per 100,000 people of each transport commuting population to be compared with the deaths per 100,000 in 2019
reported by GBD resulting from ambient PM2.5 pollution. Finally the actual ambient PM2.5 pollution number of deaths/year resulting within the exposed population (ExPop) of each trans-
port mode to be compared with total HB (deaths/year).
Transport mode HB for different
time segments
(deaths/year)
MP EP
Car windows-open 3 (3–4) 3 (3–3)
Car recirculation 1 (1–1) 0 (0–0)
Microbus windows-open 23 (21–24) 15 (13–16)
Cycling 2 (2–2) 1 (1–1)
Walking 11 (10−11) 5 (4–6)
a
Referenced to GBD of ambient PM pollution (deaths per 100,000) of 91.41 (67.45–117.97).
b
Derived based on GBD ambient PM pollution deaths per 100,000 and ExPop in SI Table S4.
Science of the Total Environment 791 (2021) 148104
population size and hence is highest for car, microbus and cycling
(Table 3) due to high PM2.5 levels (Table 2). This analysis also shows
that deaths rates occurring due to peak hour transport are a negligible
percentage of the deaths occurring due to ambient PM2.5 exposure. This
indicates that PM2.5 levels are also caused by other anthropogenic activi-
ties besides transport including construction sites, solid waste burning
and industrial activities. Table 3 also applies the GBD death rate attributed
to ambient PM2.5 to each transport mode ExPop (SI Table S4) to allow for a
comparison with absolute death numbers discussed earlier. Fig. 5d com-
pares transport mode PM2.5 personal exposure deaths with ambient
PM2.5 deaths, which again shows the impact of population size. Applying
the GBD death rate to each population size shows how the walking and
microbus populations also suffer the highest deaths due to ambient
PM2.5 exposure having the largest ExPop. Overall, translating pollution
concentrations data into the impact on health and economy, makes the
issue more relatable to policymakers and commuters alike and empha-
sizes the value of transport management and planning.
4. Conclusions and future work
We quantified commuter exposure to PM2.5 levels while traveling
during peak hours using car with windows-open, car with recirculation,
microbus with windows-open, cycling and walking in Greater Cairo.
Collected data was processed and analysed to understand concentration
variations, spatial variability and hotspots, exposure doses, commuting
cost versus inhaled doses as well as health burden and economic losses
estimates. The key conclusions drawn from this study are as follows:
• Car with recirculation resulted in the least average PM2.5 concentra-
tions of 32 ± 6 μg/m3 followed by walking in residential areas and
roadside traffic (59 ± 17 μg/m3 and 71 ± 15 μg/m3). Recirculation re-
duces exposure by 61% compared with windows-open in cars. How-
ever, microbus with windows-open is the most common mode of
transport in Greater Cairo where commuters were exposed to ~3-
times higher PM2.5 concentrations than for car with recirculation.
• When urban settings do not have dedicated lanes for active modes of
transport, pedestrians and cyclists become at a risk of high exposure
levels (~3.1-times car with recirculation). Cycling under such condi-
tions in Greater Cairo resulted in PM2.5 concentration averages of up
to 707 μg/m3.
• EP hours observe average PM2.5 concentrations between 26% and 58%
less than MP hours despite having higher traffic congestion. This could
possibly be due to higher background PM2.5 levels during MP
(reflected in the morning fog during that time of the year in Greater
Cairo) reversing the expected trend of higher pollution caused by con-
gestion.
• Spatial variability and hotspot analysis showed that route characteris-
tics directly affect pollution levels where concentration peaks for
Absolute-total HB EL HB (deaths per Absolute-deaths/year
(deaths/year) ($million/year) 100,000 transport ambient PM pollution
mode within transport mode
commuters/year)a commuter population
(GBD)b
7 (6–7) 3.86 (3.69–4.04) 0.54 (0.52–0.57) 1131 (834–1459)
2 (2–2) 0.97 (0.91–1.04) 0.07 (0.07–0.08) 2198 (1622–2836)
37 (35–40) 21.39 (19.98–22.8) 0.52 (0.49–0.56) 6530 (4819–8428)
3 (3–3) 1.63 (1.54–1.72) 0.47 (0.45–0.5) 548 (405–708)
16 (15–17) 9.12 (8.4–9.83) 0.14 (0.13–0.15) 10,407 (7679–13,431)
9
R.A. Abbass, P. Kumar and A. El-Gendy Science of the Total Environment 791 (2021) 148104

200
(a)
MP
150 39%
PM2.5 (μg/m3)
61% EP

100

50

0
MP EP
80
(b)
60 40% MP
PM2.5 (μg/m3)

60% EP
40

20

0
MP EP
200
(c) MP
150 44%
EP
PM2.5 (μg/m3)

56%

100

50

0
MP EP
(d) MP
600
PM2.5 (μg/m3)

44%
56%
400 EP

200

0
MP EP
250
(e)
200 MP
49%
PM2.5 (μg/ m3)

51% EP
150

100

50

0
MP EP

Fig. 1. Bar charts show the average PM2.5 concentrations for each trip carried out during the field campaign at the different times of day (MP and EP) and for the studied modes. Black dots
are median values and error bars represent the standard deviation. Sub-figure (a) car with windows-open, (b) car with recirculation, (c) microbus with windows-open, (d) cycling where
red boxes identify the runs that have been excluded from the statistical analysis and (e) walking average of all trips in the studied spots. The pie charts on the top-right of each sub-figure
indicate the percentage of time spent for MP trips versus EP.

10
R.A. Abbass, P. Kumar and A. El-Gendy
motorised modes coincided with traffic congestion at U-turns and ar-
terial roads. Active commuters are vulnerable to external conditions
where concentration peaks resulted from being near tail pipe emis-
sions, smoke from grilling sweet potatoes and roadside solid waste
burning.
• Greater Cairo routes are dominated by PM2.5 hotspots where the
mode/setting and route choices are most effective in protecting com-
muters. Car with recirculation has no P75 and P90 concentrations dur-
ing MP and <P25 concentrations during ~70% of EP trips. Walking in a
residential area has <P25 concentrations of PM2.5 during ~40% of MP
hours. Car with windows-open and microbus with windows-open
have no <P25 concentrations during MP. Cyclists are exposed to P75
concentrations for ~60% of the time during MP. Walking by the
construction site has P90 concentrations during 20% of EP hours.
(a)
(c)
(e) (f)
<P25 P25
Fig. 2. Concentration maps indicate the routes followed for each mode of transport with concentration percentiles indicated in the legend at the bottom. Map (a) car with windows-open,
(b) car with recirculation, (c) microbus with windows-open, (d) cycling, (e) walking in residential area, (f) walking near construction site and (g) walking near traffic.
11
Science of the Total Environment 791 (2021) 148104
Recirculation setting would only be recommended for use at hotspots,
not for the whole trip duration to avoid carbon dioxide buildup inside
a vehicle.
• The amount of pollutants inhaled during active modes is a multiple of
that inhaled during motorised travel (with PM2.5 concentrations being
in the same range) since more effort is exerted (meaning higher
inhalation rates). Cycling and walking result in inhaling 40-times
and 32-times more PM2.5 per kilometre than commuters in car with
recirculation during MP. Inhaled dosage analysis further highlights
the importance of designated space for active commuters to reduce
their exposure to pollution.
• There is a social discrepancy where commuters who cannot afford
private travel inhale more pollution. The majority of Greater Cairo
commuters resort to the microbus whose cost is 45% of private car
(b)
(d)
(g)
P50 P75 P90
R.A. Abbass, P. Kumar and A. El-Gendy Science of the Total Environment 791 (2021) 148104

1 1
(a) 41 42 2 3 33
34 2
3
39
40 4
5
(b) 32 160 4
160
38 6 31 E8 5
37 120 7 30 120 6
36
E1 8
80 29 80 7
35 E2 9
34 10 28 E5 8
40 40
33 11 27 9
0 0
32 12 26 E7 10
31 13
30
E4 14
25 11

29 E3 15 24 12
28 16 23 13
27 17 E6
22 14
26 18
25 19 21 15
24 23 21 20 20 16
22 19 17
18

1 1
(c) 18 800 2 (d) 40
41 42 2 3
4
39 400 5
17 3
600 38 6
37 300 7
16 E9 4 36 8
400 200
35 9
200 34 100 E10 10
15 5
33 11
0 0
32 12
14 6 31 13
30 14
13 7 29 15
28 16
12 8
27 E12 E11 17
26 18
25 19
11 9 24 23 21 20
10 22

Fig. 3. Radar plots represent the concentration-time series relationship for each mode of transport. The numbers indicated around each circle are time in minutes and concentric circles
indicate PM2.5 concentrations in μg/m3. The colored lines indicate concentration variations against time for selected runs for each mode of transport. Ex marked on each plot indicate event x
discussed in text. Sub-figure (a) is for car with windows-open and red lines are for recirculation runs. Sub-figure (b) is for microbus with windows-open runs and (c) is for cycling runs.
Sub-figure (d) is for walking runs.

and 20% of Uber trip costs. The inhaled dose for microbus with
windows-open is 2-times the inhaled dose of car with windows-
open and 4-times the inhaled dose for car with recirculation, during
MP hours.
• Both pollution levels and transport mode's population size contribute
to the national HB (deaths/year) and corresponding EL ($millions)
caused by transport exposure to PM2.5 and are hence of equal impor-
tance in solving the problem. Death rates resulting from annual PM2.5
exposure in the four transport microenvironments were least for car
with recirculation at 0.07 (95% CI 0.07–0.08) premature deaths per
100,000 commuters/year, for walking it was 0.14 (95% CI 0.13–0.15),
for cycling 0.47 (95% CI 0.45–0.5), for microbus with windows-open
0.52 (95% CI 0.49–0.56) and for car with windows-open 0.54 (95% CI
0.52–0.57). The total health burden per year incurred a total national
cost of 37 (95% CI 35–39) US$ million per year.
These findings provide novel insights into commuters' exposure and
allow building an informed choice on the most suited mode, route and
time of travel. Earlier studies have indicated the importance of route
choice (Brand et al., 2019) which was further confirmed here, for exam-
ple, how U-turns and bottlenecks during peak hours affect exposure
levels and how polluting events such as roadside solid waste burning
and construction works affect inhalation doses. Furthermore, findings
also provide decision makers with information that can be used for im-
proved transport management and urban design where exposure doses
analysis indicates health impacts more accurately than exposure con-
centrations. The study also confirmed the universal suggestion to dedi-
cate effort to separate between road vehicles and pedestrians and
cyclists (Brand et al., 2019; Briggs et al., 2008; Kumar et al., 2018b;
Kumar et al., 2019). Fortunately, Egyptian cities are working on dedicat-
ing more lanes to pedestrians and cyclists (El Attar, 2016; ITDP, 2018;
Zayed, 2016). Furthermore, several mass transport projects are in the
pipeline in Greater Cairo (Ahmed and Abd El Monem, 2020; Abdalla
and Ferro, 2017). Nevertheless, our study showed mass transport com-
muters such as microbus commuters are exposed to high pollution
levels, calling for sustainable solutions to reduce adverse impacts on
health such as using cleaner fuels, upgrading vehicle technologies and
providing more route options (Ahmed and Abd El Monem, 2020).

12
R.A. Abbass, P. Kumar and A. El-Gendy Science of the Total Environment 791 (2021) 148104

(a) (b)
100% 100%

% of time in each percentile

% of time in each percentile

75% 75%

50% 50%

25% 25%

0%
0%

P90 P75 P50 P25 <P25

(c) (d)
60 60

40 Dd (μ g/km) 40
Dd (μg/km)

20 20

0
0 0 25 50 75 100
0 25 50 75 100 125 150
Average PM2.5 concentrations (μg/m3)
Average PM2.5 concentrations (μg/m3)
Car-Windows-open Car-Recirculation Microbus
Cycling Walk-Residential Walk-Bridge Construction
Walk-Bus Stations/Traffic Walk-Overall
(e) (f)
6 6

Average PM2.5 concentrations (μg/m3)

Average PM2.5 concentrations (ug/m3)

120 120
Dt (μg/h.kg)

4 4
Dt (μg/h.kg)

80 80

2 2
40 40

0 0
0 0

Average PM2.5 (ug/m3) Dt (ug/h.kg)

Fig. 4. Plots (a) MP and (b) EP show percentage of time spent in each concentration percentile as indicated by the legend for each mode of transport. The other plots compare exposure
dose parameters with average PM2.5 concentrations for the studied modes. Sub-figure (c) and (e) are for MP and sub-figure (d) and (f) are for EP. Sub-figures (c) and (d) show PM2.5
concentrations against Dd in μg/km and the bubbles sizes indicate the average trip speed. For sub-figures (e) and (f); the red line indicates Dt in μg/kg·h on the primary axis and the
blue bars indicate the PM2.5 concentrations in μg/m3 with values on the secondary axis.

Finally, epidemiological studies deriving the exposure-response coeffi- other parts of Greater Cairo during different seasons. Such a database
cient for developing countries such as Egypt are needed to allow for ac- will allow one to further build a holistic view of pollution exposure
curate health burden estimates. This work provides a promising and help planners and decision makers to make exposure friendly deci-
foundation for future research works that could consider covering sions for the commuting population.

13
R.A. Abbass, P. Kumar and A. El-Gendy Science of the Total Environment 791 (2021) 148104

(a) (b)
100 100

80

Inhaled dose of PM2.5 (μg)

Inhaled dose of PM2.5 (μg)
80

60 60

40 40

20 20

0 0
0.5 1.5 2.5 3.5 4.5 0.5 1.5 2.5 3.5 4.5
Trip Cost (USD) Trip Cost (USD)
Trip A Trip A' Trip B Trip B' Trip C

(c) (d)
40
10

Ambient PM2.5 exposure HB

8
Total HB (deaths/year)

30

(‘000 deaths/year)
6
20
4

10
2

0 0
0 25 50 75 100 0 10 20 30 40
Average PM2.5 (μg/m3) Personal PM2.5 exposure HB (deaths/year)

Car Windows-open Car Recirculation Microbus Cycling Walking

Fig. 5. Plots depict the trips described in SI Table S6 where total trip cost is plotted against total inhaled dose of PM2.5 in μg per trip. Sub-figure (a) is for MP trips and (b) for EP trips. Bubbles
sizes in sub-figure (a) and (b) indicate trip durations under the same scale where the shortest trip is 38 min (smallest bubble) and longest trip is 55 min (largest bubble). Bubble plot in
sub-figure (c) contrasts average PM2.5 concentrations (μg/m3) with absolute annual HB (deaths/year) where bubble sizes indicates the EL (US$ millions) corresponding to HB numbers as
indicated in Table 3 with smallest bubble size represents US$ 0.97 million and largest represents US$ 21.39 million; (d) compares number of deaths resulting from annual exposure to
PM2.5 during commutes using the four modes of transport with number of deaths in thousands within each exposed population (ExPop) resulting from exposure to ambient PM2.5
concentrations (GBD, 2019) where the bubble sizes are the percentage of PM2.5 personal exposure deaths of ambient PM2.5 deaths; smallest bubble represents 0.09% and largest
represents 0.57%.

CRediT authorship contribution statement Appendix A. Supplementary data

Rana Alaa Abbass: Formal analysis, Data curation, Methodology, Supplementary data to this article can be found online at https://doi.
Writing – original draft, Investigation, Validation. Prashant Kumar: org/10.1016/j.scitotenv.2021.148104.
Conceptualization, Methodology, Funding acquisition, Resources,
Supervision, Project administration, Writing – original draft, Writing – References
review & editing. Ahmed El-Gendy: Writing – review & editing.
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Declaration of competing interest ation of Public Transport.
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strategies for health and climate change related emissions in the Middle East and
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