How air pollution in Nairobi is fueling preterm births – risks and dangers

It’s early Friday morning in Nairobi’s Industrial Area. Dark clouds of smoke furiously billow from the chimneys of the many industries dotting this area, and in unison, perhaps guided by a common goal, dash for the Nairobi skies.

The thick, dark clouds make the shiny sky cloudy, illustrating the city’s bustling manufacturing sector and its negative environmental impact.

Between three of the industries, resides Virginia Waithera, a business lady and mother of two, who runs business at Athi River town.

Waithera’s first two children were preterm babies. The first born came in 2006, and the second born in 2013.

The 37-year-old mother says her first pregnancy was normal, till the 30th week when she developed complications.

“In the 30th week, I noticed swelling of my legs, puffy face and after checking my pressure, it was too high, 199/100,” she says. “I went to hospital and doctors said I had a condition called preeclampsia.”

Living around Industrial Area, where most of industries in Nairobi are based, Waithera says she suffered from effects of industrial pollution during her first pregnancy.

“You see I am surrounded by three industries and I usually had problems at night during my pregnancies,” said Waithera. “When I was pregnant for my first born, I could feel nauseated, headache and the smell from fumes was really unbearable.”

She adds, “Even Athi River which is just a few metres from our area, there is a lot of dumping of dirt and raw sewage lines are directed to the river.”

Preterm babies surge in Nairobi

Nairobi City County tops in the list of top 10 counties with high rates of preterm births in Kenya. Data from the Ministry of Health shows that Nairobi leads with 5,338 babies born too soon. According to the data, the rate of premature births is at 12%.

Preterm birth refers to when a baby is born before completion of the 37 weeks of pregnancy.

The World Health Organisation (WHO) says preterm birth complications lead in causing death among children under the age of five, and contributed to an approximately one million deaths in the year 2015, globally.

However, experts warn that levels of air pollution in Kenya’s capital city could be one of the reasons the city is leading in preterm babies.

According to Waithera, the river stinks at night and they find it difficult to enjoy their sleep, and they have been forced to get used to it because of the hard economic times.

Waithera narrated how her son suffered a lot when he was young with unending flu and chest problems which he was forced to live with.

“I think we are now immune in this area as opposed to those who are moving into this area,” she said jokingly.

After being diagnosed with preeclampsia, Waithera did not bother to talk about the effects of industrial fumes. Preeclampsia is a pregnancy-related condition characterized by hypertension.

Dr. Bridget Nyanchama of Coptic Hospital says exposure to various air pollutants such as nitrogen oxide and sulfur dioxide and ozone may make it possible for a preterm baby.

“You see as one inhales polluted air into the body system, there is a possibility of placental inflammation which may lead to premature labor resulting to a preterm baby,” says Dr. Nyanchama.

The fumes from industries may contain toxic materials such as metals and some organic materials. She warns that the fumes can cause several health issues especially respiratory complications.

“Expectant women are most vulnerable due to high demand of oxygen and there are several body changes during pregnancy including respiratory changes,” Dr. Nyanchama explains.

Reduced oxygen and nutrient supply to the foetus, according to her, leads to reduced fetal growth and hence low birth weight. These conditions may lead to complications such as preeclampsia.

Like Virginia Waithera, Symphrose Okinda, a journalist and a mother of two, shares a similar story on her pregnancy journey.

Symphrose’s pregnancy had zero complications until the 32nd week when she noticed that her urine had some traces.

“At first I was not bothered because I was at work. I ignored and continued working hoping it would go away,” she said. “A few minutes later I went back to the washroom and this time I saw my mucus plug.”

At this point she knew that something was not right and her unborn baby was in danger and something must be done to save the baby. She was rushed to the hospital.

Symphrose normally uses her car to work because she is not comfortable with the fumes especially from public transport vehicles.

Dr. Nyanchama advises that those pregnant women who spend significant time in traffic or live near busy roads are exposed to high level of pollutants.

These pollutants, she says, will affect the placenta leading to reduced flow of blood and oxygen to the fetus which triggers preterm labour.

Prof. Paul Njogu, a research and data lecturer at Jomo Kenyatta University of Agriculture and Technology (JKUAT) says that air pollutants are released by both natural and human sources and that human sources constitute the biggest source which include; vehicles, industries, solid wastes burning and residential fires among others.

“Combustion or burning of fuels in industries, homes and vehicles constitute the single most cause,” he said. “Other gases such as carbon dioxide are not considered pollutants but are responsible of global warming as a result of trapping heat in the lower atmosphere.”

Prof. Njogu warns that the rate of air quality in Nairobi is deteriorating beyond acceptable levels set by the World Health Organization.

“This is as a result of increase in population which has seen a commensurate increase in consumption of goods and need for transport thus more burning of fuels for instance,” he added.

The open solid waste burning has also exacerbated the air pollution problem as well as use of old vehicles whose air pollution control devices have been removed or are not functioning properly.

Expectant mothers represent a vulnerable group among the population due to their compromised health condition.

“Expectant mothers are more likely to show ill symptoms even at low pollution exposure levels,” Prof. Njogu says. “These classes or members of the population should be protected or should take measures such as use of nose masks as well as other protective gear or avoid polluted areas during pregnancy if possible.”

Professor Augustine Afullo, an environmental health expert working with GeoHealth East African Hub argues that air pollution causes several complications including preterm births.

From his research, most the most affected area is the east part of Nairobi where most rubbish is burnt and every other industry is placed.

When pregnant mothers are exposed to air pollution, their lung capacity is compromised and may affect the unborn baby.

“When a pregnant mother is exposed to pollution, she is unable to breathe well and she may develop asthma or chronic obstructive pulmonary disease,” said Prof. Afullo. “Lung function is reduced and that may make the ability of the mother to supply enough oxygen to the unborn child to be compromised.”

He warns that if the exposure is repeated a number of times, then the body treats the unborn child as a foreign object and the body feels to throw it out.

For the safety of the foetus, the baby needs highest concentration of good quality food and oxygen but when exposed to pollution, the placenta may transmit the pollutants to the foetus that may lead to pre-term birth or worst, death of the foetus.

“If the body’s ability to supply food and oxygen to the young is compromised, wastes may accumulate and cause loose mother-child body contact causing preterm birth or abortion,” he warned. “Anything that happens in the body will easily compromise the foetus.”

Why the foetus is endangered

Prof. Njogu argues that studies have shown that some pollutants can enter the blood system and cross the umbilical cord thus exposing the foetus which in extreme cases can lead to miscarriage.

He warns that the smells from burning of tires, fuels and compounds of sulphur and nitrogen dioxide give pungent smells that can even shock some vulnerable members of the population.

He however insisted that air pollution problem is not localized, once released to the air the pollutants travel long distances and can be found in areas where they are not generated.

He says that there is no place in Nairobi that is safe from pollution even if some areas might have higher levels of pollutants due to continued release or poor removal by wind.

“Areas around industries, near roads with heavy traffic, next to areas with frequent incidences of open solid wastes burning, hospital incinerators and areas in valleys generally will have high levels of pollutants,” he warned.

The eastern part of Nairobi city is blamed to have high pollution levels relative to the other areas. The areas bordering cement industries in Athi River and Syokimau areas are shown as pollution hotspots in satellite images.

On tackling air pollution, Professor Njogu has advised several approaches to reduce its effects.

 “Simple actions like stoppage of open solid waste burning and using pooled transport will reduce emissions from private vehicles which constitute the largest population on our roads,” he advises.

He advocates for the use of clean energy sources such as solar and wind energy which are in abundance in Kenya and follow the footsteps of Sweden in walking and cycling which doesn’t result to fuel burning.

“Using public awareness where the community is educated on the impacts of the things we do can lead to behavioral change,” he suggested.

In the extremes he proposes good maintenance of combustion devices including cars and industrial furnaces and boilers and installation of air pollution reduction devices in cars among others.

“In order to reduce pollution from industries and car fumes, there is need to implement advanced pollution control technologies like scrubbers, filters and electrostatic precipitators,” Prof. Njogu said.

Prof. Afullo blames the government failure to embrace and award research efforts in the country which has led to many scientists and researchers to shun research for better paying jobs.

“Most hospitals have potential researchers on this issue but they are few and overwhelmed. They have no time for research,” he regretted.

“A few medical specialists are field researchers because majority of them are ward based. Once they become specialists, that is the end of it,” he said.

He cited lack of incentives for research and it does not happen in Kenya alone but in many developing countries.

This story was produced as part of Internews Earth Journalism Network’ 2024 Reporting fellowship [ The author, Zachary Mayieka is a News Reader at Egesa FM, one of the 13 radio stations under the RMS stable. He  is passionate about environmental reporting.