Spatiotemporal Associations Between Ambient Air Pollution and Neoplasm Morbidity in Eastern Kazakhstan: Age-Specific Patterns and Spatial Heterogeneity, 2014–2024

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

Spatiotemporal Associations Between Ambient Air Pollution And Neoplasm Morbidity In Eastern Kazakhstan: Age-specific Patterns And Spatial Heterogeneity, 2014–2024

 

This study aimed to assess the spatiotemporal associations between annual mean concentrations of priority air pollutants (NO₂, SO₂,H₂S, and CO) and primary neoplasm morbidity in the East Kazakhstan Region during 2014–2024. Here is my suggestion and comment based on the article submitted.

1. In the abstract, the results should be more effectively synthesized to highlight the key findings. Additionally, the implication statement is currently weak and should be strengthened, particularly in terms of its relevance to policy and public health implications.
2. The Introduction presents extensive background information on air pollution and carcinogenic risks, the specific research gap is not clearly articulated. What is lacking in current literature, particularly in the context of Central Asia and the East Kazakhstan region?
3. It is recommended to clearly define key terms such as ‘neoplasm morbidity’ and ‘API₅’ earlier in the Introduction to improve reader understanding
4. In Research Method, although the data sources are mentioned, additional information is needed regarding data quality, completeness, and the number and distribution of monitoring stations to enhance the credibility of the dataset.
5. It is recommended to insert a clear description of missing data handling procedures. The methods used to address them (e.g., exclusion, interpolation, or imputation), and to discuss the potential impact on the study findings.
6. In line 228, please insert the Table 1 caption.
7. In the Results section, some information is repeated between the text and tables. The authors should avoid duplication and instead highlight only key results in the text.
8. It is recommended to summarize the main findings at the end of each subsection to improve readability and emphasize their significance.
9. The authors should provide clearer explanations of key patterns, trends, and notable values (e.g., highest/lowest concentrations, strongest correlations).
10. In the Discussion section, the authors should strengthen the critical interpretation of their findings by explaining why the observed associations (e.g., age-specific differences and negative correlations) occur and how they contribute to advancing current knowledge.
11. The authors should more clearly articulate how the findings can inform environmental policy, air quality management, and public health interventions, particularly for vulnerable populations such as children and adolescents.
12. The Conclusion summarizes the study findings; however, it remains somewhat general and does not fully highlight the significance and practical implications of the results. It is suggested to clearly emphasize the main findings of the study, particularly the age-specific vulnerability and spatial heterogeneity observed, rather than restating general results.
13. How can the findings inform environmental policy, air quality management, and public health strategies, especially for protecting vulnerable populations?
14. Please briefly outline potential directions for future research.

Overall, this study provides valuable insights into the spatiotemporal and age-specific associations between air pollution and neoplasm morbidity; however, the manuscript would benefit from improved clarity, stronger methodological justification, and clearer articulation of its public health and policy implications.

Author Response

Please see the attachment

Author Response File: Author Response.pdf

Reviewer 2 Report

Comments and Suggestions for Authors

Line 20-29: The abstract presents spatial and temporal patterns but does not attempt to explain the underlying causes of the observed heterogeneity. Incorporating information on emission sources, industrial activities, or meteorological conditions would significantly strengthen the findings. 

Line 180: The paragraph introduces several indices (SI, HFE, API₅) without clearly defining them or explaining how they were calculated. For an international readership, these indicators are not universally standard. The authors must provide clear definitions, calculation formulas, and references in the Methods section, and briefly remind the reader of their meaning when first mentioned here.

Line 221: The claims of “substantial spatial heterogeneity” and “markedly higher” pollution levels are not supported by statistical analysis. No measures of variability (e.g., standard deviation, confidence intervals) or significance testing are presented. The authors should include appropriate statistical comparisons to validate differences among locations.

Line 231: The statement that SI values in Ust-Kamenogorsk exceed those in other cities by “15- to 26-fold” appears exaggerated and is not contextualized. It is unclear which specific sites are being compared and whether these comparisons are based on mean, median, or extreme values. This needs clarification and proper referencing to Table 1.

Line 227: Terms such as “critical,” “elevated,” and “episodic” pollution are used without defining threshold values or classification criteria. The authors must explicitly state how these categories are determined (e.g., regulatory standards, national guidelines, or literature-based thresholds).

Line 237: Although Table 1 and Figure 2 are referenced, the paragraph does not sufficiently engage with the data presented. For example, trends in API₅ are described qualitatively without referencing specific annual values or variability. The discussion should more explicitly link statements to the figures and tables.

Line 258: The discussion of API₅ trends over 2014–2024 is descriptive but superficial. The reported decreases (e.g., 66% in Ridder, 46% in Glubokoe) are not supported by statistical trend analysis (e.g., regression, Mann–Kendall test). Additionally, potential drivers of these trends (policy changes, industrial decline, emission controls) are not discussed.

Line 233: The conclusion that Altai experienced “the most substantial improvement” based solely on API₅ reaching zero may be misleading. This could reflect data limitations, methodological thresholds, or monitoring gaps rather than true absence of pollution. The authors should critically assess this result and provide supporting evidence.

*There are minor but important language issues affecting readability, such as the word break in “pro-nounced.” Additionally, some sentences are overly long and could be simplified for clarity.

 

 

Author Response

Please see the attachment

Author Response File: Author Response.pdf

Round 2

Reviewer 2 Report

Comments and Suggestions for Authors

its suitable for publication