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Owusu C, Ofori A, Adusei-Mensah F, Adjei JK, Hadzi GY, Bentum JK, Quansah R, Essumang DK. Health Risk Assessment of Occupational Exposures of Polycyclic Aromatic Hydrocarbons, Phthalates, and Semi-Volatile Chlorinated Organic Compounds in Urine of Commercial Fish Smokers, Ghana. ENVIRONMENTAL HEALTH INSIGHTS 2024; 18:11786302241306932. [PMID: 39697378 PMCID: PMC11653465 DOI: 10.1177/11786302241306932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2024] [Accepted: 11/26/2024] [Indexed: 12/20/2024]
Abstract
Occupational exposure to smoke and polycyclic aromatic hydrocarbons (PAHs) poses significant health risks, especially for commercial fish smokers who are regularly exposed to high levels of smoke and particulate matter. This study aimed to evaluate the exposure levels and assess the health risks associated with PAHs, phenols, phthalates, and substituted benzenes among 155 fish smokers in Ghana. A total of 155 urine samples from fish smokers across selected coastal regions in Ghana were collected and analyzed. The sample preparation was conducted using the Quick, Easy, Cheap, Effective, Rugged, and Safe (QuEChERs) method, as standardized by the Association of Official Analytical Chemists (A.O.A.C.). Analysis was performed utilizing the Shimadzu GC-MS QP 2020. The type of firewood used by fish smokers significantly influenced the levels of PAHs detected in the urine samples. Hardwoods such as odum, acacia, and cocoa, with their dense structures and combustion characteristics, were found to produce higher levels of PAHs. In contrast, softer woods like sugar cane and palm kernel released lower PAH levels during combustion. The findings indicate that fish smokers utilizing various wood types and unfiltered ovens, specifically the "Chorkor Oven," are exposed to elevated levels of PAHs, phenols, phthalates, and substituted benzenes through inhalation during work hours. Cancer risk assessments revealed risk levels for PAHs ranging from 6.00E-04 to 4.14E-01, phenols from 0.00E+00 to 3.70E-01, substituted benzenes from 9.04E-08 to 1.99E-01, and phthalates from 3E-04 to 2.09E+04. These values exceed the limits by the U.S. Environmental Protection Agency (U.S.E.P.A.) of 10E-06. Furthermore, the estimated non-cancer hazard quotient values for hydrocarbons ranged from 8.42E+00 to 1.99E+01, all exceeding the threshold of 1, as outlined by both the U.S.E.P.A. and the World Health Organization (WHO), indicating substantial potential health risks for commercial fish smokers.
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Affiliation(s)
- Charity Owusu
- Department of Chemistry, School of Physical Science, University of Cape Coast, Cape Coast, Ghana
| | - Albert Ofori
- Department of Chemistry, School of Physical Science, University of Cape Coast, Cape Coast, Ghana
| | - Frank Adusei-Mensah
- Institute of Public Health and Clinical Nutrition, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Joseph Kweku Adjei
- Department of Chemistry, School of Physical Science, University of Cape Coast, Cape Coast, Ghana
| | - George Yaw Hadzi
- Department of Chemistry, School of Physical Science, University of Cape Coast, Cape Coast, Ghana
| | - John Kwesi Bentum
- Department of Chemistry, School of Physical Science, University of Cape Coast, Cape Coast, Ghana
| | - Reginald Quansah
- Department of Biological, Environmental and Occupational Health, University of Ghana, Accra, Ghana
| | - David K Essumang
- Department of Chemistry, School of Physical Science, University of Cape Coast, Cape Coast, Ghana
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Khan Y, Banerjee R. Exposure to air pollution as a risk factor for anaemia: a global scoping review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2024; 34:3847-3859. [PMID: 38461370 DOI: 10.1080/09603123.2024.2327532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Accepted: 03/03/2024] [Indexed: 03/11/2024]
Abstract
Anaemia is an important global health issue with various factors responsible for its occurrence. Though nutritional deficiency is one of the main causes of the disease, evidence suggests a potential link between long-term exposure to ambient air pollution and an increased risk of developing anaemia. Our scoping review evaluates studies conducted across the world to examine possible associations between anaemia and ambient air pollution. Six databases were searched, 153 sources were identified, and 21 articles were included in the review. Apart from one article which showed no significant effect, studies reported positive associations between anaemia and air pollution. This was true for both indoor and outdoor air pollution, various types of particulate matter exposure, and across demographic groups. The review highlights the importance of recognizing exposure to air pollution as a potential risk factor for anaemia and emphasizes the imperative for focused interventions and policy measures to mitigate air pollution.
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Affiliation(s)
- Yasmin Khan
- Department of Health Management, International Institute of Health Management Research, Dwarka, New Delhi, India
| | - Rupsa Banerjee
- Department of Health Management, International Institute of Health Management Research, Dwarka, New Delhi, India
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Adane F, Aryeetey R, Aryeetey G, Nonvignon J. The costs of implementing anaemia reduction interventions among women fish processors in Ghana. COST EFFECTIVENESS AND RESOURCE ALLOCATION 2024; 22:69. [PMID: 39289741 PMCID: PMC11409671 DOI: 10.1186/s12962-024-00559-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 06/08/2024] [Indexed: 09/19/2024] Open
Abstract
BACKGROUND Anaemia among women of reproductive age (WRA) remains persistently high in Ghana, affecting 41% in 2022. Women in low-income communities in Ghana engaged in fish processing activities are at increased risk of anaemia due to inadequate diets, exposure to infectious pathogens, and pollutants. The Invisible Fishers (IFs) project was implemented among women fish processors in their reproductive age in Central and Volta regions of Ghana to mitigate anaemia. Despite the efficacy, feasibility and scalability of the intervention, the cost of implementing the intervention is unknown. The objective of this study was to estimate the costs of implementing the IFs project in Ghana. METHODS We used micro-costing approach to analyse the costs of implementing the IFs project. Data were collected as part of a pilot randomized control trial with three interventions: Behaviour Change Communication (BCC), Strengthening Market Engagement of fish processors plus Behaviour Change Communication (SME + BCC), and Fish Smoking Technology and Practices plus Behaviour Change Communication (FST + BCC). The interventions were delivered to 60 women fish processors in the Central region and 60 in Volta region. The cost of the intervention was estimated from the societal perspective. Economic costs were categorized as direct costs (i.e. personnel, transportation, meetings, training, and monitoring) and indirect cost (i.e. value of productive time lost due to women and community volunteers' participation in the activities of the IFs project). RESULTS The FST + BCC had the highest average cost per beneficiary (US$11898.62), followed by the SME + BCC (US8962.93). The least expensive was the BCC (US$4651.93) over the intervention period of 18 months. Recurrent costs constituted the largest component of economic costs (98%). Key drivers of direct costs were personnel (58%), administrative expenses (14%), and transportation (7%). CONCLUSION There is a high cost for implementing interventions included in the IFs project. Planning and scaling -up of the interventions across larger populations could bring about economies of scale to reduce the average cost of the interventions.
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Affiliation(s)
- Francis Adane
- Department of Health Policy, Planning and Management, School of Public Health, University of Ghana, Legon, Accra, Ghana.
| | - Richmond Aryeetey
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Legon, Accra, Ghana
| | - Genevieve Aryeetey
- Department of Health Policy, Planning and Management, School of Public Health, University of Ghana, Legon, Accra, Ghana
| | - Justice Nonvignon
- Department of Health Policy, Planning and Management, School of Public Health, University of Ghana, Legon, Accra, Ghana
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Adarkwa SA, Oduro MS, Morgan AK, Arhin-Donkor S. Association between exposure to smoke from cooking fuels and anaemia among women of reproductive age in Ghana. Sci Rep 2024; 14:15664. [PMID: 38977757 PMCID: PMC11231134 DOI: 10.1038/s41598-024-66602-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 07/02/2024] [Indexed: 07/10/2024] Open
Abstract
In low- and middle-income countries, indoor air pollution (IAP) is a serious public health concern, especially for women and children who cook with solid fuels. IAP exposure has been linked to a number of medical conditions, including pneumonia, ischemic heart disease, stroke, chronic obstructive pulmonary disease (COPD), lung cancer, and anaemia. Around 500 million women of reproductive age (WRA) suffer from anaemia globally, with an estimated 190 million cases in sub-Saharan Africa (SSA). This study, which is based on prior research, investigates the relationship between IAP exposure and anaemia among WRA in Ghana. A diverse sample of 2,406 WRA living in Ghana were interviewed, of which 58.06% were anaemic and used high-pollutant fuels for cooking. Age, place of residence, region, education level, religion, ethnicity, wealth index, type of drinking water, type of toilet facility, and type of cooking fuels were all found to be significantly linked with anaemic state by bivariate analysis. Type of cooking fuels utilized, age, region of residence, and the type of residence were shown to be significant predictors of anaemia status using sequential binary logit regression models. The results emphasise the critical need for efforts to promote the usage of clean cooking fuel in an attempt to lower anaemia prevalence in Ghana. To reduce dependency on solid fuels for cooking, initiatives should promote the use of cleaner cooking fuels and enhance the socioeconomic status of households. These interventions could have significant public health effects by reducing the burden of anaemia and improving maternal and child health outcomes due to the prevalence of anaemia among WRA. Overall, this study sheds light on the relationship between IAP exposure and anaemia in Ghana and highlights the demand for focused public health initiatives to address this serious health problem.
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Affiliation(s)
| | - Michael Safo Oduro
- Pfizer Worldwide Research and Development, Pharm Sci and PGS Statistics, Groton, CT, 06340, USA
| | - Anthony Kwame Morgan
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
| | - Seth Arhin-Donkor
- Humana Inc., Market Finance Analysis - Sr - Prd - Regional, Louisville, KY, 4020, USA
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Appiah-Dwomoh C, Tettey P, Akyeampong E, Amegbor P, Okello G, Botwe PK, Quansah R. Smoke exposure, hemoglobin levels and the prevalence of anemia: a cross-sectional study in urban informal settlement in Southern Ghana. BMC Public Health 2024; 24:854. [PMID: 38504235 PMCID: PMC10953235 DOI: 10.1186/s12889-024-18304-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 03/07/2024] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND In sub-Saharan African cities, more than half of the population lives in informal settlements. These settlements are close to smoky dumpsites, industrial plants, and polluted roads. Furthermore, polluting fuels remain their primary sources of energy for cooking and heating. Despite evidence linking smoke and its components to anaemia, none of these studies were conducted on populations living in urban informal settlements. This study investigated the risks of anemia/mean Haemoglobin (HB) levels in an informal settlement in Accra, Ghana. Exposure to smoke was examined across various sources, encompassing residences, neighborhoods, and workplaces. METHODS The study was a facility-based cross-sectional design among residents at Chorkor, an informal settlement in the Greater Accra region of Ghana. A questionnaire was administered at a community hospital during an interview to gather data on sources of smoke exposure in the household, in the neighbourhood, and in the workplace. A phlebotomist collected blood samples from the participants after the interview to assess their anaemia status. RESULTS The population (n = 320) had a high prevalence of anemia, with 49.1% of people fitting the WHO's definition of anemia, while the average HB level was 12.6 ± 2.1 g/dL. Anemia was associated with the number of different types of waste burnt simultaneously [(1 or 2: prevalence ratio (PR): 95% confidence interval (CI), 1.14, 0.99-1.28: 3+: 1.16, 1.01-1.63, p-for-trend = 0.0082)], fuel stacking [(mixed stacking: 1.27, 1.07-1.20: dirty stacking:1.65, 1.19-2.25, p-for-trend = 0.0062)], and involvement in fish smoking (1.22, 0.99-1.06). However, the lower limit of the CIs for number of different forms of garbage burned simultaneously and engagement in fish smoking included unity. Reduced mean HB levels were associated with the number of different types of waste burnt simultaneously [(1 or 2: regression coefficient (β): 95% confidence interval (CI), -0.01, -0.97- -0.99: 3+: -0.14, -0.77- -0.05)], current smoker [(yes, almost daily: -1.40, -2.01- -0.79: yes, at least once a month: -1.14, -1.79- -0.48)], Second-Hand-Smoking (SHS) (yes, almost daily: -0.77, -1.30- -0.21), fuel stacking [(mixed stacking-0.93, -1.33-0.21: dirty stacking-1.04, -1.60- -0.48)], any smoke exposure indicator in the neighbourhood (-0.84, -1.43- -0.25), living close to a major road (-0.62, -1.09- -0.49), and fish smoking (-0.41,-0.93- -0.12). CONCLUSION Although the cross-sectional design precludes causality, smoke exposure was associated with mean HB levels and anaemia among populations living in informal settlements.
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Affiliation(s)
- Cyril Appiah-Dwomoh
- School of Public Health, University of Ghana, P.O. Box LG 30, Legon, Accra, Ghana
| | - Prudence Tettey
- School of Public Health, University of Ghana, P.O. Box LG 30, Legon, Accra, Ghana
| | - Enoch Akyeampong
- School of Public Health, University of Ghana, P.O. Box LG 30, Legon, Accra, Ghana
| | - Prince Amegbor
- School of Global Public Health, New York University, New York, USA
| | - Gabriel Okello
- Institute for Sustainability Leadership, University of Cambridge, Cambridge, UK
- African Centre for Clean Air, Kampala, Uganda
| | - Paul K Botwe
- School of Public Health, University of Ghana, P.O. Box LG 30, Legon, Accra, Ghana
| | - Reginald Quansah
- School of Public Health, University of Ghana, P.O. Box LG 30, Legon, Accra, Ghana.
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Kanno GG, Geremew T, Diro T, Musarapasi SV, Wyk RV, Seboka BT, Alembo A, Hussen R, Soboksa NE, Aregu MB. The link between indoor air pollution from cooking fuels and anemia status among non-pregnant women of reproductive age in Ethiopia. SAGE Open Med 2022; 10:20503121221107466. [PMID: 35814308 PMCID: PMC9260590 DOI: 10.1177/20503121221107466] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Accepted: 05/30/2022] [Indexed: 11/17/2022] Open
Abstract
Objective: The effect of indoor air pollution from different fuel types on the anemia
status among non-pregnant women is rarely studied. This study aimed to
assess the link between indoor air pollution from different fuel types and
anemia among non-pregnant women of reproductive ages in Ethiopia. Method: The secondary data from the 2016 Ethiopian Demographic and Health Survey data
have been employed for this study. The anemia status of women in
reproductive age was the outcome variable with multiple outcomes as
(moderate to severe, mild, and no anemia) and households using biomass fuel
and clean fuel were selected for this study. Multinomial logistic regression
was employed to estimate the association of biomass fuel use with the anemia
status controlling for the predictor variables. Relative risk ratio was
calculated at 95% confidence interval. An independent-sample t-test was used
to assess the mean difference in blood hemoglobin level (g/dL) between the
two fuel users. A p value < 0.05 was considered significant. Result: From the total of 10,961 participants included in this study, the proportion
of anemia in women of non-reproductive age was 41.8% and 19.4% among biomass
fuel and clean fuel users, respectively, with a mean blood hemoglobin level
of 12.71 (±1.81) g/dL. In the final model, women using biomass fuel for
cooking were 47% more likely to have mild anemia than households who use
cleaner fuels, whereas the association was insignificant for moderate to
severe anemia. Biomass fuel users were also found to have 5.8 g/dL lower
blood hemoglobin level than the clean fuel user (p < 0.001). Conclusion: The use of biomass fuel was associated with reduced blood hemoglobin levels
and significantly associated with mild anemia levels in women of
reproductive age in Ethiopia. National efforts should be in place to reduce
indoor air pollution from biomass fuels.
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Affiliation(s)
- Girum Gebremeskel Kanno
- College of Medicine and Health Sciences, Department of Environmental Health, Dilla University, Dilla, Ethiopia
| | - Temesgen Geremew
- Austrian Red Cross International Cooperation, Addis Ababa, Ethiopia
| | - Tesfaye Diro
- International Organization for Migration, Addis Ababa, Ethiopia
| | | | - Renay Van Wyk
- Department of Environmental Health, University of Johannesburg, South Africa
| | - Binyam Tariku Seboka
- College of Medicine and Health Sciences, School of Public Health, Dilla University, Dilla, Ethiopia
| | - Awash Alembo
- College of Medicine and Health Sciences, Department of Environmental Health, Dilla University, Dilla, Ethiopia
| | - Robel Hussen
- College of Medicine and Health Sciences, School of Public Health, Dilla University, Dilla, Ethiopia
| | - Negasa Eshete Soboksa
- College of Medicine and Health Sciences, Department of Environmental Health, Dilla University, Dilla, Ethiopia
| | - Mekonnen Birhane Aregu
- College of Medicine and Health Sciences, Department of Environmental Health, Dilla University, Dilla, Ethiopia
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