Association between household solid waste disposal and health, Belo Horizonte (MG), Brasil]

There are few published studies about the effects of inadequate solid waste collection on the health of the population exposed to this situation. The objective of the present work was to describe this association in a sample of children under 5 years of age living in seven low-income neighborhoods and favelas in the city of Belo Horizonte, state of Minas Gerais, Brazil. We defined as "exposed" those children whose families were not served by waste collection; "not-exposed" were children who lived in areas with waste collection. The study employed data collected in 1994 and organized as a database by the municipal department of health. We employed a cross-sectional design, in which a "case" was defined as a child whose outpatient clinic record indicated a diagnosis of diarrheal, parasitic, or dermatological disease. Other diagnoses for the same age group composed the control group. Our epidemiological study revealed an association between the absence of domestic solid waste collection and public health. Our results suggest that the children exposed to the absence of solid waste collection have a 40% higher odds (OR = 1.40) of presenting diarrheal, parasitic, and dermatological diseases than not-exposed children. In addition, the calculation of attributable risk revealed that the presence of waste collection could prevent (based on the 1995 situation) 512 cases in the neighborhoods studied and (based on the 1994 conditions) 2316 cases among children in the entire city of Belo Horizonte.     

Housing and health in three contrasting neighbourhoods in Accra, Ghana

Although the literature on housing and health is extensive, most research comes from developed countries. Relatively little work on the topic has been done in developing countries such as Ghana where socio-economic and cultural characteristics are generally different. This paper reports on primary research that investigates the relationship between housing and self reported general and mental health in Accra, Ghana. The study focused on how the social and economic dimensions of housing, specifically, demand, control and material attributes (affordability, dwelling type) influence individuals’ attachment to their home as a refuge for daily living. A cross-sectional survey was administered to a randomly selected sample (n = 562) in three contrasting neighbourhoods. Overall, housing conditions, demand and control residents have to where they live, emerged as significant predictors of self reported general and mental health status. The influence of these variables superseded well known correlates of health status, income and educational attainment, attesting to their importance in a worsening housing environment. The findings point to the need for policy that recognizes that housing is not only a physical shelter but also an important health resource.     

Understanding the Continuum of Maternal Morbidity in Accra,Ghana

The objective was to determine the levels of maternal morbidity from no complications to near miss and describe factors associated with different levels of morbidity. We conducted an observational study of all women delivering at a tertiary hospital in Accra, Ghana between October 2010 and March 2011. We examined the factors associated with the continuum of maternal outcomes in terms of severity using multinomial logistic regression. Data were extracted from women’s maternal care files with the main outcome measures of no complications, non-life threatening complications, potentially life-threatening conditions (PLTC), and near miss as defined by World Health Organization. Our study includes 1,586 women with no complications, 1,205 women with non-life threatening complications, 516 women with PLTC, and 94 near-miss cases. All of the factors associated with PLTC and near-miss cases were similar. None of the socio-demographic variables remained significant in the multivariate analysis comparing different levels of severe morbidity with no complications. Women with no complications shared similar characteristics with women who experienced non-life threatening complications. As compared to women who had no complications, women who had severe morbidity were significantly more likely to have had no antenatal care. Our results underline the concept that morbidity is a continuum and indicate that if the underlying causes of poor maternal health outcomes are addressed, it is likely that changes such as better access to antenatal care will improve health outcomes across the continuum of morbidity. However, by only monitoring near-miss cases and mortality, we underestimate the impact on women who will live with non-life threatening, yet serious maternal morbidities.     

Epidemiological Transition and the Double Burden of Disease in Accra,Ghana

It has long been recognized that as societies modernize, they experience significant changes in their patterns of health and disease. Despite rapid modernization across the globe, there are relatively few detailed case studies of changes in health and disease within specific countries especially for sub-Saharan African countries. This paper presents evidence to illustrate the nature and speed of the epidemiological transition in Accra, Ghana’s capital city. As the most urbanized and modernized Ghanaian city, and as the national center of multidisciplinary research since becoming state capital in 1877, Accra constitutes an important case study for understanding the epidemiological transition in African cities. We review multidisciplinary research on culture, development, health, and disease in Accra since the late nineteenth century, as well as relevant work on Ghana’s socio-economic and demographic changes and burden of chronic disease. Our review indicates that the epidemiological transition in Accra reflects a protracted polarized model. A “protracted” double burden of infectious and chronic disease constitutes major causes of morbidity and mortality. This double burden is polarized across social class. While wealthy communities experience higher risk of chronic diseases, poor communities experience higher risk of infectious diseases and a double burden of infectious and chronic diseases. Urbanization, urban poverty and globalization are key factors in the transition. We explore the structures and processes of these factors and consider the implications for the epidemiological transition in other African cities.     

Quantification of the health risk associated with wastewater reuse in Accra, Ghana: a contribution toward local guidelines

Quantitative Microbial Risk Assessment (QMRA) models with 10,000 Monte Carlo simulations were applied to ascertain the risks of rotavirus and Ascaris infections for farmers using different irrigation water qualities and consumers of lettuce irrigated with the different water qualities after allowing post-harvest handling. A tolerable risk (TR) of infection of 7.7 x 10(-4) and 1 x 10(-2) per person per year were used for rotavirus and Ascaris respectively. The risk of Ascaris infection was within a magnitude of 10(-2) for farmers accidentally ingesting drain or stream irrigation water; approximately 10(0) for farmers accidentally ingesting farm soil and 10(0) for farmers ingesting any of the irrigation waters and contaminated soil. There was a very low risk (10(-5)) of Ascaris infection for farmers using pipe-water. For consumers, the annual risks of Ascaris and rotavirus infections were 10(0) and 10(-3) for drain and stream irrigated lettuce respectively with slight increases for rotavirus infections along the post-harvest handling chain. Pipe irrigated lettuce recorded a rotavirus infection of 10(-4) with no changes due to post harvest handling. The assessment identified on-farm soil contamination as the most significant health hazard.     

Non-inert industrial solid waste disposal in landfill dumps: evaluation of toxicity and implications for the environment and human health

According to Brazilian recommended technical procedures (mainly NBR 10,004), solid waste must be previously classified in order to be disposed of adequately. Non-inert industrial solid waste is being dumped in landfill areas, most of which operate inefficiently and are located near the population and important ecosystems. In order to evaluate the potential toxicity of solid waste produced by various types of industries, 21 samples were analyzed according to NBR 10,004 procedures. Of these, 18 were classified as non-inert solid waste. The main substances contributing to the classification of these samples as non-inert waste were: aluminum, iron, manganese, phenol, and surfactants. Aluminum, manganese, and phenol are the main toxicologically relevant substances for human and environmental health because they can alter the quality of groundwater situated under solid waste disposal areas.     

Quantification of the health risk associated with wastewater reuse in Accra, Ghana: a contribution toward local guidelines

Quantitative Microbial Risk Assessment (QMRA) models with 10,000 Monte Carlo simulations were applied to ascertain the risks of rotavirus and Ascaris infections for farmers using different irrigation water qualities and consumers of lettuce irrigated with the different water qualities after allowing post-harvest handling. A tolerable risk (TR) of infection of 7.7 × 10^-4 and 1 × 10^-2 per person per year were used for rotavirus and Ascaris respectively. The risk of Ascaris infection was within a magnitude of 10^-2 for farmers accidentally ingesting drain or stream irrigation water; ~10⁰ for farmers accidentally ingesting farm soil and 10⁰ for farmers ingesting any of the irrigation waters and contaminated soil. There was a very low risk (10^-5) of Ascaris infection for farmers using pipe-water. For consumers, the annual risks of Ascaris and rotavirus infections were 10⁰ and 10^-3 for drain and stream irrigated lettuce respectively with slight increases for rotavirus infections along the post-harvest handling chain. Pipe irrigated lettuce recorded a rotavirus infection of 10^-4 with no changes due to post harvest handling. The assessment identified on-farm soil contamination as the most significant health hazard.     

Environmental health risks perception,attitude, and avoidance behaviour toward municipal solid waste incinerator

This study aims to assess the relationship between risk perception, attitude, and avoidance among residents toward an urban incinerator in Taichung, Taiwan. A cross-sectional study was conducted and three schools were enrolled. The case group was composed of 514 residents who live near an incinerator. The control group was composed of 264 people nearly the same age and who have lived in that area basically the same period of time. All participants were interviewed using a structured questionnaire. Results of this study showed that there was no significant difference between the exposure group and the control group in risk perception and attitude regarding the incinerator. However, the exposure group showed a significantly higher desire to move within one year or move sometime in the future than the control group. Therefore, these people should encourage the Environmental Protection Administration (EPA) to do everything it can to make sure that the incinerator operates safely.     

Metabolic syndrome in collection and disposal of solid waste sector

Objectives  

This study aims to assess the frequency and factors relevant to metabolic syndrome in workers employed in the collection and disposal of solid waste sector.     

Solid waste management in informal urban neighbourhoods. Occupational safety and health practices among tricycle operators in Kumasi,Ghana

ABSTRACT

The study examines the nature of activities and assess knowledge on occupational safety and health (OS&H) risks and practices among solid waste collectors in two low-income informal neighbourhoods in Kumasi (Aboabo and Asawase). Using observations and semi-structured interviews with 83 participants and relevant institutions, the findings indicate that informal tricycle waste collectors provided spot-to-spot waste collection using improvised sirens to signal their arrival. Workers generally had low knowledge, expressed less about occupational health risks, and thus adopted less safe work practices. The study however showed significant differences between knowledge of health risks (p < 0.000, R = 0.83) and years of working experience (p < 0.01, R = 0.74) and adoption of safe practices. Workers who had knowledge the associated health risks of the activity and also have been in the activity for more than 2 years were more likely to use at least one PPE/PPC. The study recommends that targeted interventions to mitigate risks and improve the health and safety of workers require effective risk communication. The study concludes that insight into OS&H is important to offer opportunities for better waste management strategies in the informal urban areas.     

Childbearing and Economic Work: The Health Balance of Women in Accra,Ghana

Objectives This study aims to investigate (1) whether the health of working women with young children differs from that of working women without young children, and (2) which social factors mediate the relationship between economic and maternal role performance and health among mothers with young children. Methods The analyses uses panel data from 697 women present in both waves of the Women’s Health Study for Accra (WHSA-I and WHSA-II); a community based study of women aged 18 years and older in the Accra Metropolitan Area of Ghana conducted in 2003 and 2008–2009. Change in physical and mental health between the survey waves is compared between women with a biological child alive at WHSA-II and born since WHSA-I and women without a living biological child at WHSA-II born in the interval. To account for attrition between the two survey waves selection models were used with unconditional change score models being used as the outcome model. Results We found in our sample of working women that those who had a child born between WHSA-I and WHSA-II who was still alive at WHSA-II did not experience a change in mental or physical health different from other women. Among working women with young children, educational status, relationship to the household head and household demography were associated with change in mental health at the 5 % level, whilst migration status and household demography was associated with change in physical health scores. Conclusion The results suggest there are no health penalties of combining work and childbearing among women with young children in Accra, Ghana.     

Infectious waste. A survey of handling practices in Lincoln, Nebraska.

Concerns surrounding the issue of infectious waste prompted a City-County Health Department survey of infectious waste handling in Lincoln, Neb. (pop. 205,000). A detailed questionnaire was mailed to 347 facilities identified as possible infectious waste generators. The participation rate was 38 percent overall and 49.5 percent for reported generators. Treatment and storage deficiencies were found in eight of 11 categories.     

When urban taps run dry: sachet water consumption and health effects in low income neighborhoods of Accra, Ghana

Intraurban differentials in safe drinking water in developing cities have been exacerbated by rapid population growth that exceeds expansion of local water infrastructure. In Accra, Ghana, municipal water is rationed to meet demand, and the gap in water services is increasingly being filled by private water vendors selling packaged "sachet" water. Sachets extend drinking water coverage deeper into low-income areas and alleviate the need for safe water storage, potentially introducing a health benefit over stored tap water. We explore correlates of using sachets as the primary drinking water source for 2093 women in 37 census areas classified as slums by UN-Habitat, and links between sachet water and reported diarrhea episodes in a subset of 810 children under five. We find that neighborhood rationing exerts a strong effect on a household's likelihood of buying sachet water, and that sachet customers tend to be the poorest of the poor. Sachet use is also associated with higher levels of self-reported overall health in women, and lower likelihood of diarrhea in children. We conclude with implications for sachet regulation in Accra and other sub-Saharan cities facing drinking water shortages.     

Social marketing and communication: changing health behavior in the third world

Abstract Development communication, particularly within the health sector, is relatively new and still shrouded in mystique. Many health planners and policy-makers in developing countries and elsewhere do not yet fully appreciate the role communication plays in primary health care interventions. Nevertheless, communication theory, embracing diffusion of innovations and social marketing, can make a significant contribution in improving health status. This paper explores, through an examination of the literature and the experience of a worldwide research and development project, the synthesis of development communication, diffusion, social marketing, and primary health care. It attempts to demonstrate the value of integrating these paradigms within the context of a public health communication model. Focusing on the use of radio and interpersonal communication, the paper describes model projects in India and Honduras and reveals through their example the role of communication in changing health behavior in Third World settings.     

AIDS: Awareness and blood handling practices of health care workers in Lagos,Nigeria

A questionnaire survey of 260 health care workers from 13 randomly selected health care facilities was undertaken. Their knowledge, attitude, belief and blood handling practices regarding HIV/AIDS were enquired about. Virtually all (99.0%) respondents had heard about AIDS but only 57.0% had seen an AIDS patient before. Although 83.0% knew that AIDS is caused by a virus, a high proportion still confuses mode of transmission with causative agent. Deficient knowledge was exhibited when asked about groups of people who were at a higher risk of contracting HIV and AIDS: Only 54.6% and 51.5% identified homosexuals and IV drug users as being at a higher risk. Almost all (97.0%) of our respondents claimed to have been more careful in their blood handling practices since the emergence of AIDS, 68.5% wore gloves for all procedures involving handling of blood and 28.5% sometimes although as many as 30.4%, 40.4% and 18.1% do not wear gloves for cleaning up blood stained materials, nursing procedures and taking obstetric delivery respectively. It was evident from their responses that not all the health workers knew the correct method for disposing of used bloodstained instruments and left-over blood samples and neither were they all adhering to the safety guidelines recommended for handling these materials. Education of all health care workers in Nigeria on the Universal Precautions Guidelines issued by the Centers for Disease Control (CDC) in 1987 regarding blood, body fluids and contaminated instruments' handling precautions is urgently recommended.     

Quantitative Microbial Risk Analysis to evaluate health effects of interventions in the urban water system of Accra, Ghana

A quantitative microbial risk assessment was applied to evaluate the microbial risks of the Accra Urban Water System (AUWS). The exposure assessment was based on the count of indicator organisms in waste water from open roadside drains and in water and sand samples from the beach. The predicted total disease burden generated in a representative catchment of the AUWS (Odaw Catchment) was 36,329 Disability Adjusted Life Years (DALYs) per year, of which 12 and 88% are caused by, respectively, shortcomings in the water supply system and inappropriate sanitation. The DALYs per person per year were above the WHO reference value. The open roadside drain had the highest contribution to the disease burden. Of four possible interventions evaluated for health risk reduction, the highest efficiency in terms of DALYs averted per euro invested would be achieved by providing covers for the open roadside drains.     

Environmental health indicators and a case study of air pollution in Latin American cities

Environmental health indicators (EHIs) are applied in a variety of research and decision-making settings to gauge the health consequences of environmental hazards, to summarize complex information, or to compare policy impacts across locations or time periods. While EHIs can provide a useful means of conveying information, they also can be misused. Additional research is needed to help researchers and policy-makers understand categories of indicators and their appropriate application. In this article, we review current frameworks for environmental health indicators and discuss the advantages and limitations of various forms. A case study EHI system was developed for air pollution and health for urban Latin American centers in order to explore how underlying assumptions affect indicator results. Sixteen cities were ranked according to five indicators that considered: population exposed, children exposed, comparison to health-based guidelines, and overall PM₁₀ levels. Results indicate that although some overall patterns in rankings were observed, cities’ relative rankings were highly dependent on the indicator used. In fact, a city that was ranked best under one indicator was ranked worst with another. The sensitivity of rankings, even when considering a simple case of a single pollutant, highlights the need for clear understanding of EHIs and how they may be affected by underlying assumptions. Careful consideration should be given to the purpose, assumptions, and limitations of EHIs used individually or in combination in order to minimize misinterpretation of their implications and enhance their usefulness.     

中国伴生放射性固体废物处理处置现状分析

我国伴生放射性固体废物累积贮存量大,迫切需要对其进行科学规范地处理处置。通过调研我国伴生放射性固体废物的处理处置现状及相关技术、辐射环境保护法规标准体系,提出需要进一步完善的法规标准、适合推广应用的处理处置技术,为我国矿产资源绿色和可持续发展提供重要参考。     

Environment, wealth, inequality and the burden of disease in the Accra metropolitan area, Ghana

The study examines environmental problems and adverse impacts on the health of urban households in the Accra metropolitan area, Ghana. Accra is faced with severe inadequacy of urban infrastructure in the face of rapid population growth in the metropolis. More than half of the city's population do not have access to solid waste collection services. Only 39.8% of households have indoor pipe and over 35.0% of households depend on unsanitary public latrines whilst 2.5% do not have access to toilet facilities. Human excrement, garbage and wastewater are usually deposited in surface drains, open spaces and streams in poor neighbourhoods. The resultant poor sanitation has serious health impacts as more than half of reported diseases are related to poor environmental sanitation. The majority of households depend on solid fuels for cooking and this leads to indoor air pollution and high incidence of respiratory infections. Poor households bear a disproportionately large share of the burden of environmental health hazards than their wealthy counterparts, due to their particular vulnerability resulting from inadequate access to environmental health facilities and services.     

A primer for health care managers: data sanitization, equipment disposal, and electronic waste

In this article, security regulations under the Health Insurance Portability and Accountability Act concerning data sanitization and the disposal of media containing stored electronic protected health information are discussed, and methods for effective sanitization and media disposal are presented. When disposing of electronic media, electronic waste-or e-waste-is produced. Electronic waste can harm human health and the environment. Responsible equipment disposal methods can minimize the impact of e-waste. Examples of how health care organizations can meet the Health Insurance Portability and Accountability Act regulations while also behaving responsibly toward the environment are provided. Examples include the environmental stewardship activities of reduce, reuse, reeducate, recover, and recycle.