Investigating the Disproportionate Impacts of Air Pollution on Vulnerable Populations in South Africa: A Systematic Review

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

Major Comments:

 

As a reader I would like to know what is unique about South Africa? Would not nearly all of the conclusions in this paper apply to other countries as well.  

 

Your discussion of the results of the 47 studies is very general.  Could you add some interesting details from the 47 studies.  I’m not sure I learned anything new here.  I do not think there is enough new here to be worthy of publication. 

 

Could you give more details on what air quality regulations are in place in South Africa and how they compare to other countries, and how well they are enforced.  How effective are current mitigation measures. 

 

You state that only 25% of the studies focused on women and that that percentage is too low.  Why? Are there too many studies focused on children or the poor? Is it the total number that is too low? Justify. 

 

L159:  How many of the studies focused on more than one vulnerable population? 

 

L227: Could you give more details on what guidelines are in place due to the Air Quality Act. 

L243: Could you give an example of a tailored solution that could be used. 

 

Table S1 is informative.  Be sure to refer to it more.  Also, add more information on the difference between various study types (HRA, cross section, comparative cross sectional, prospective cohort etc.) 

 

Minor Comments:

L12: and the integrated --- and determining the integrated

 

L22: 25.53% --- 26% (Only use the two most significant digits throughout the manuscript). 

 

L38: low-and middle-income what?

 

L39: as South Africa ---- such as South Africa

 

L97: In Figure 1, you alternative between “n = “ and “n –“.   I’d suggest using “n = “ everywhere. 

 

L97: In Figure1, what is the difference between a database and a register? 

 

L125: What do you mean by meta-analyses?

 

L204: In the caption, briefly describe what PM4, OPE, PAH, BTEX, etc. are.  Also, you list OPE twice. 

 

 

L229: The Paris Agreement is aimed to mitigate the effects of global warming.  It will only have a secondary effect on air quality. 

 

L248: 700,000? 

 

L252: Mannucci and Franchini reference is not consistent with other references. 

 

 

 

 

 

Author Response

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Author Response File: Author Response.pdf

Reviewer 2 Report

Comments and Suggestions for Authors

Frazenburg et al. reviewed studies on impacts of air pollution on vulnerable populations in South Africa. Although this work is meaningful, it requires a major revision before it can be accepted for publication. My major concern is that the authors did not provide in-depth discussions. The Results and Discussion parts seem to be unrelated.

Some specific comments:

1.      L56: Add a comma after ‘populations’.

2.      Reference(s) for PRISMA guidelines should be added.

3.      Sections 2.1 and 2.2 should be combined. Also, Consider revising the title to ‘Selection process and criteria’.

4.      L118: The version of the software should be provided.

5.      L128-144: These two parts should be moved to the Method section.

6.      Figure 2: The authors should explain why the percentages exceed 100% when summed. The numbers in this figure are too precise. I have the same comments on Figure 4.

7.      L162-164: References are missing.

8.      Figure 3: The authors should explain why the percentages exceed 100% when summed. Also, meanings of some air pollutants (such as BTEX, OPE) should be provided.

9.      L206-224: How were the percentages calculated? Does ‘stricter environmental regulations’ represent ‘Policy and Governance’ in the figure. I am really confused. As I stated before, the numbers are too precise.

10.   L226: -232: I don’t see how this paragraph is related to the topic of this study.

11.   Section 4.1: This part merely repeats findings of previous studies and lacks the authors’ own perspective. I have the same comment on Section 4.2.

Comments on the Quality of English Language

The manuscript needs a grammar check.

Author Response

see response report attached in pdf

Author Response File: Author Response.pdf

Reviewer 3 Report

Comments and Suggestions for Authors

The paper looks more a librarian repor than a research issue. I do not feel myself an expert in discussing regulatory frameworks, policy making or environmental health programs, but I suppose many of the readers of Atmosphere would prefer to know whether the mentioned measures work, which of them work better than others, and what are actual proposals aimed at improving the situation, rather than to come across the statement that children and women are the most vulnerable groups, repeated much more than three times in the paper. The authors seem to have access to the publications they discuss, so it would be reasonable to  discuss also the measures undertaken and the results achieved, if these issues are considered in those publications. I believe this information indeed can be found in some of them. 

The authors often use statements like, for example, "This concentrated focus on children underscores the critical importance of protecting this demographic from environmental hazards", but the essence of trends revealed and measures proposed in the cited publications always remain outside the review framework. I suppose these issues should be addressed in the review.

Comments on the Quality of English Language

Moderate editing is required. Some sentences seem to be just drafts and need improvement. For example: "children are the most affected by poor air quality" (line 19), "studies excluded include those published..." (line 91), "The data were analysed USING descriptive statistics USING the..." (lines 117-118).

A general remark concerning the quality of English Language is that the authors use both British and American spelling ("analySe", "urbaniZation"). They should choose only one style to follow all over the paper.

Author Response

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Author Response File: Author Response.pdf

Reviewer 4 Report

Comments and Suggestions for Authors

The publication is interesting and reflects the problems of the region, starting from pollution sources, health effects and specific prevention possibilities.

You discuss and evaluate 47 publications in the paper, but only 22 publications are listed in the publication list. Were the remaining 25 not used, not cited?

There are editorial errors, as in lines 134, 211, 229

Section: 2.3. Data Extraction: Descriptive and Statistical Analysis: No statistical methods are used, no comparisons are made. Only simple percentages taken from publications are given. You have to provide the analysis, the number of cases evaluated, the reliabilities. This is not provided. Therefore, please provide more detailed information with statistical data in the figures. What is presented now really did not require statistical programs, as you claim in the methods section.

 

Author Response

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Author Response File: Author Response.pdf

Reviewer 5 Report

Comments and Suggestions for Authors

The paper is ok.

Author Response

Comment 1: The paper is okay

Response: Thank you for the comment

Reviewer 6 Report

Comments and Suggestions for Authors

This is a review paper on the impact of air pollution on different population groups. It is up-to-date and provides a good vision of the current scientific interests.

My only concern is that the authors could not consider the interactions between population groups. For example, in Figure 2, the proportion of studies focused on children is equal to those focused on low-income children. Then, we have no vision of how the study focuses can differ for children born in low-income and high-income families. To address this issue, it may be a good idea to define a salary cut-point for the word "low-income." Moreover, the difference between "low-income" groups and "low-income" families is yet not clear (to me).

A minor question: The authors reviewed 47 studies. Then why only 22 references are cited?

Author Response

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Author Response File: Author Response.pdf

Round 2

Reviewer 1 Report

Comments and Suggestions for Authors

Overall Comments:

The authors provide a useful summary of recent South African articles on the effect of air pollution on vulnerable populations in South Africa.  They also emphasize the need for more studies of the impacts of poor air quality on women. 

 

Major Comments:

 

None.  Although some of the information is repetitive and certain sections could be shortened (see below). 

 

Minor Comments:

 

L39-50: Some of the information in the paragraph that begins on line 50 duplicates information in the paragraph beginning on line 39.  Please combine paragraphs. 

 

L140: What do you mean by meta-analyses? 

 

L193: Expand ZAR acronym. 

 

L303:  How much higher were the rates of cardiovascular disease?

 

L435-440: Delete this paragraph because this is covered in section 4.2 or in lines 422-424. 

 

Grammatical Comments: 

 

L284: ailments .  ailments. 

 

L292: highlighted those children  who highlighted that children

 

L299: outcomes. [18].  outcomes [18].

 

L380: SHowever  However

 

L410-L413 includes a run-on sentence.  

I suggest ending the sentence with “emissions standards” and to delete the remainder of the sentence. i.e., delete “in order to improve monitoring is critical to addressing air pollution in vulnerable populations”. 

 

L509: housing scheme  housing

 

L578: Furthermore, The  Furthermore, the

 

Author Response

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Author Response File: Author Response.pdf

Reviewer 2 Report

Comments and Suggestions for Authors

I have no other comments except that the manuscript needs a grammar check.

Comments on the Quality of English Language

Must be improved.

Author Response

see attached 

Author Response File: Author Response.pdf

Reviewer 3 Report

Comments and Suggestions for Authors

The paper has been revised, and some necessary information has been added. Some kind of scientific soundness can now be traced over the text. The methodology of choosing the papers for review appears to be rather mechanical, but it may work well for poorly studied regions with intense industries. Some measures against heavy air pollution look rather helpless, for example staying home to avoid pollution episodes, because one cannot be sure that low-income groups have air-purification systems in their homes. Neither can increased distance from residential areas to industrial grounds be considered as mitigation, at least because this would cause traffic intensification. However, the main problems are formulated, and some ways to solve them are outlined. I suppose the paper can be published in its present form.

Author Response

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Author Response File: Author Response.pdf

Reviewer 4 Report

Comments and Suggestions for Authors

The authors have corrected the article, but there are still some editorial errors, which I think will be corrected during the layout.

Author Response

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Author Response File: Author Response.pdf

Reviewer 6 Report

Comments and Suggestions for Authors

The work is well revised.

Again, please ensure all your reviewed papers are cited and listed in the main text, not just the supplementary material.

Author Response

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Author Response File: Author Response.pdf