This study was subject to several limitations. Data are
self-reported and may have been subject to response bias.
Specifically, the health outcomes derived did not account
for the type of health outcomes; for example, we did not
request information on the type of emphysema reported.This
is particularly relevant given that emphysema tends to be
common among older smokers but is not usually observed
among adolescents. However, given that multiple studies
report that subcutaneous or congenital emphysema can occur
in earlier ages due to trauma, infections, or injury, we opted
for exploring the link between emphysema and explanatory
variables while including respiratory outcomes in the latter.
Sampling led to lower representations of adolescents who
attend private schools in Dubai and among males who reside
in the UAQ. This is relevant as the population of Dubai
consists of a large proportion of expatriates; hence, results
related to the expatriate population in Dubai are likely to be
biased. Importantly, our study does not account for the actual
distances of participants’ residences from industrial plants,
gas stations, dumpsites, construction sites, overhead power
lines, or plants, which couldmodify the relationship between
exposure to poor air quality and health outcomes. Furthermore,
response to the self-administered survey may have
been influenced by the presence of social workers, with the
possibility of underreporting of tobacco use among females
given social norms. Despite these limitations, this study contributed
to knowledge of a detailed profile and environmental
predictors of respiratory conditions and symptoms among
UAE adolescents that is crucial for public health planning.