Department of Biological, Environmental and Occupational Health
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Item A qualitative study of lived experience and life courses following dam release flooding in Northern Ghanaian communities: Implications for damage and loss assessment(PLoS ONE, 2024) Asamoah, M.; Dzodzomenyo, M.; Gyimah, F.T.; et al.Background Dams provide water for industrial, agricultural, and domestic use, particularly in arid regions. However, controlled dam releases due to heavy rainfall may affect downstream communi ties’ livelihoods and life courses such long-term impacts may be omitted from damage and loss assessments. This study aims to assess the lived experiences and long-term conse quences of dam release flooding for downstream populations, comparing these with the typ ical scope of a damage and loss assessment (DaLA). Methods This research was conducted in two flood-prone districts in the White Volta basin, Ghana, subject to dam spillage. Four Focus Group Discussions (FGDs) with community opinion headers, household heads, chiefs, local politicians, and institutional staff were conducted and analysed, alongside semi-structured interviews with twelve opinion leaders and disas ter-related institutions. Results Flood-affected communities struggled to attract partners for marriage due to stigmatisation from flooding impacts. Women outside flooded areas rejected male members’ marriage pro posals, while communities offered young girls for marriage to wealthy men for greater finan cial security. Out-migration of female members to seek better livelihoods frequently led to divorce, subsequently affecting children’s education and well-being. Participants reported long-term trauma from flood-related contact with dangerous wildlife, travel disruption, disease risk, livelihood loss, and accidents. Such life course events and long-term trauma would be omitted from a DaLA exercise. Conclusion Beyond its immediate impacts, flooding undermines family relationships and marriage, impairing children’s education and traumatises affected communities. We recommend liveli hood diversification programmes, psychological support and family counselling to address these long-term impacts, with expansion of DaLA’s scope to underpin such support.Item Household cost of road traffic accident-related injuries: A case study of St. Joseph Hospital, Koforidua in Ghana(Heliyon, 2024-08-12) KPE, A.P.; Otoo, D.D.; Owusu, R.; Bawua, A.S.Road traffic accidents (RTAs) are a prominent contributor to both mortality and morbidity, particularly affecting individuals aged 5–29 years. Road traffic Injuries impose substantial physical and economic burden on individuals, households, and governments, particularly in African nations. Thus, our study focuses on assessing the economic cost of road traffic accidents within the context of St. Joseph Hospital, Koforidua. A cross-sectional survey was conducted at the Emergency Unit of the St. Joseph Hospital with a sample size of 291 patients. A patient perspective was used in costing the management of RTAs. Data was descriptively analyzed with Microsoft Excel with means and standard deviations estimated for direct, indirect, and intangible costs to the patient. Total direct and indirect cost of road traffic accidents were approximately GHS1,973,801.28 (US$164,483.44) and GHS520,309.46 (US$43,359.12) respectively which represents 79.1 % and 20.9 % of the total cost. The annual average economic cost for all cases was GHS8,570.83 (US $714.24). Intangible costs were also found to be high, with 54.2 % patients rating their RTA burden to be between mild to moderate, 10.8 % as moderate to severe and 1.4 % as severe. RTA cost burden is huge for all households. Uninsured patients bear significantly higher costs than insured patients. Intangible costs were also high, prompting the need to provide psychological care to RTA victims and their families. Concerted efforts should be directed at strict enforcement, training, improvement of road infrastructure and legislation to reduce or curb road traffic accidents in LMICs.Item Household cost of road traffic accident-related injuries: A case study of St. Joseph Hospital, Koforidua in Ghana(Heliyon, 2024-08-12) Kpe, A.P.; Otoo, D.D.; Owusu, R.; Bawua, A.S.Road traffic accidents (RTAs) are a prominent contributor to both mortality and morbidity, particularly affecting individuals aged 5–29 years. Road traffic Injuries impose substantial physical and economic burden on individuals, households, and governments, particularly in African nations. Thus, our study focuses on assessing the economic cost of road traffic accidents within the context of St. Joseph Hospital, Koforidua. A cross-sectional survey was conducted at the Emergency Unit of the St. Joseph Hospital with a sample size of 291 patients. A patient perspective was used in costing the management of RTAs. Data was descriptively analyzed with Microsoft Excel with means and standard deviations estimated for direct, indirect, and intangible costs to the patient. Total direct and indirect cost of road traffic accidents were approximately GHS1,973,801.28 (US$164,483.44) and GHS520,309.46 (US$43,359.12) respectively which represents 79.1 % and 20.9 % of the total cost. The annual average economic cost for all cases was GHS8,570.83 (US $714.24). Intangible costs were also found to be high, with 54.2 % patients rating their RTA burden to be between mild to moderate, 10.8 % as moderate to severe and 1.4 % as severe. RTA cost burden is huge for all households. Uninsured patients bear significantly higher costs than insured patients. Intangible costs were also high, prompting the need to provide psychological care to RTA victims and their families. Concerted efforts should be directed at strict enforcement, training, improvement of road infrastructure and legislation to reduce or curb road traffic accidents in LMICs.Item Comparison of ergonomic risk factors and work-related musculoskeletal disorders among dismantler and burners of electronic waste in Agbogbloshie, Accra Ghana(Proceedings of the 2021 HFES 65th International Annual Meeting, 2021) Acquah, A.A.; Arko-Mensah, J.; D'Souza, C.; et.alRudimentary methods for electronic waste (e-waste) recycling employed in developing countries are a source of work-related musculoskeletal disorders (WRMSDs). Summarized comparison of WRMSDs and preliminary exposure assessment among e-waste dismantlers (D) and burners (B) in Agbogbloshie, Ghana is presented. A cross-sectional study was conducted to investigate WRMSDs and associated risk factors using the Cornell Musculoskeletal Discomfort Questionnaire and a newly developed ergonomic assessment tool. Results indicated higher WRMSD prevalence in the lower back (68% D vs. 52% B; p = 0.172), shoulder (41% D vs. 29% B; p = 0.279), and upper arm (33% D vs 5% B; p = 0.010). Moderate to severe trunk flexion, high force exertion, repetition, and vibration were prevalent risk factors among workers and were significantly higher in dismantlers than burners (p 0.001). Detailed ergonomic studies investigating the relationship between physical exposures and WRMSDs is needed to provide a deeper understanding of WRMSD causation in e-waste workers and more particularly in unstructured, unregulated work.Item Processes and challenges associated with informal electronic waste recycling at Agbogbloshie, a suburb of Accra, Ghana(Human Factors and Ergonomics Society, 2019) Acquah, A.A.; Arko-Mensah, J.; D'Souza, C.; et.alElectronic waste (e-waste) is a worldwide problem in terms of increasing production rate in the global waste stream. Its recycling is known to be associated with adverse health outcomes. The recycling site at Agbogbloshie is a major e-waste recycling hub which presents enormous health threats to the residents in this community as a result of exposure to complex mixtures of chemicals associated with the poor work methods employed. This paper describes the processes involved in e-waste recycling at Agbogbloshie and discusses some of the associated health and psychosocial challenges. Direct field observations and in-depth interviews of eight e-waste workers were conducted from November, 2017 to December, 2017. Results from a thematic analysis of the data gathered; suggest that inappropriate recycling methods, financial constraints, and the high physical demands of e-waste recycling work were associated with adverse musculoskeletal health conditions among the workers. A more systematic ergonomic study is currently being undertaken to quantify the associations between physical work exposures and worker musculoskeletal health among e-waste workers in Agbogbloshie. Further studies that focus on locally adapted ergonomic interventions for effective recycling of e-waste and reducing the health risk to workers are needed.Item Multiple aspects of energy poverty are associated with lower mental health-related quality of life: A modelling study in three peri-urban African communities(SSM - Mental Health, 2022) Shupler, M.; Quansah, R.; Baame, M.; et al.Objective: Over 900 million people in sub-Saharan Africa (SSA) live in energy poverty, relying on cooking polluting fuels (e.g. wood, charcoal). The association between energy poverty and mental and physical health-related quality of life (HRQoL) among women in SSA, who are primarily tasked with cooking, is unknown. Methods: Females (n = 1,150) from peri-urban Cameroon, Kenya and Ghana were surveyed on their household energy use and mental and physical health status using the standardized Short-Form 36 (SF-36) questionnaire. Random effects linear regression linked household energy factors to SF-36 mental (MCS) and physical component summary (PCS) scores. A binary outcome of ‘likely depression’ was derived based on participants' MCS score. Random effects Poisson regression with robust error variance assessed the relationship between household energy factors and odds of likely depression. Results: The prevalence of likely depression varied by a factor of four among communities (36%). -Mbalmayo, Cameroon; 20%-Eldoret, Kenya; 9%-Obuasi, Ghana). In the Poisson model, the coefficient of determination (R2) ) ¼ 0.28), females sustaining 2 or more cooking-related burns during the previous year had 2.7 (95% CI: [1.8, 4.1]) times the odds of likely depression as those not burned. Females cooking primarily with charcoal and wood had 1.6 times (95% CI: [0.9, 2.7]) and 1.5 times (95% CI: [0.8, 3.0]) the odds of likely depression, respectively, as those primarily using liquefied petroleum gas. Women without electricity access had 1.4 (95% CI: [1.1, 1.9]) times the odds of likely depression as those with access. In the MCS model (R2 ¼ 0.23), longer time spent cooking was associated with a lower average MCS score in a monotonically increasing manner. In the PCS model (R2 ¼ 0.32), women injured during cooking fuel collection had significantly lower (4.8, 95% CI: [-8.1, 1.4]) PCS scores. Conclusion: The burden of energy poverty in peri-urban communities in SSA extends beyond physical conditions. Experiencing cooking-related burns, using polluting fuels for cooking or lighting and spending more time cooking are potential risk factors for lower mental HRQoL among womenItem Assessment of occupational stress among certified registered anesthetists in the Greater Accra region(Frontiers in Public Health, 2024) Sabblah, D.E.; Owusu, R.; Bawua, S.A.; et al.Background: Work-related stress is a prevailing concern within the community of Certified Registered Anesthetists (CRAs), significantly impacting both the health and professional performance of these individuals. This study aimed to assess work-related stress and its influencing factors among CRAs practicing in the Greater Accra region was examined. Methods: Using convenience sampling techniques, data were gathered from 140 participants via a Google form questionnaire distributed through WhatsApp. Descriptive statistics were employed to analyze the collected data, focusing on frequencies and proportions for categorical variables. For continuous variables, bivariate analysis (Chi-square) and ordinal logistic regression were conducted using STATA 16. A p-value <0.05 was considered significant. Results: Among the 140 CRAs, 20 individuals (14.3%) reported experiencing mild stress levels according to the Weiman Occupational Stress Scale. Approximately 3 out of 4 CRAs (73.6%) reported having moderate stress levels, and 12.1% reported severe stress levels. This indicated that the majority of CRAs experienced moderate levels of stress, which was notably affected by the type of health facility and the use of inadequate or sub-standard equipment in the hospitals. Conclusion: Based on these findings, the study recommends educational programs and counseling for CRAs to heighten awareness of the demanding nature of their job. Additionally, it suggests the provision of proper resources and standard equipment for CRAs. Facility-level motivation for CRAs is also advised to alleviate their stress. Finally, the study proposes further investigations into the factors contributing to work-related stress among CRAs.Item Household concentrations and female and child exposures to air pollution in peri-urban sub-Saharan Africa: measurements from the CLEAN-Air(Africa) study(Articles, 2024) Shupler, M.; Quansah, R.; Tawiah, T.; et alBackground Relatively clean cooking fuels such as liquefied petroleum gas (LPG) emit less fine particulate matter (PM2·5) and carbon monoxide (CO) than polluting fuels (eg, wood, charcoal). Yet, some clean cooking interventions have not achieved substantial exposure reductions. This study evaluates determinants of between-community variability in exposures to household air pollution (HAP) across sub-Saharan Africa. Methods In this measurement study, we recruited households cooking primarily with LPG or exclusively with wood or charcoal in peri-urban Cameroon, Ghana, and Kenya from previously surveyed households. In 2019–20, we conducted monitoring of 24 h PM2·5 and CO kitchen concentrations (n=256) and female cook (n=248) and child (n=124) exposures. PM2·5 measurements used gravimetric and light scattering methods. Stove use monitoring and surveys on cooking characteristics and ambient air pollution exposure (eg, walking time to main road) were also administered. Findings The mean PM2·5 kitchen concentration was five times higher among households cooking with charcoal than those using LPG in the Kenyan community (297 μg/m³, 95%CI216–406, vs 61 μg/m³, 49–76), but only 4 μg/m³ higher in the Ghanaian community (56 μg/m³, 45–70, vs 52 μg/m³, 40–68). The mean CO kitchen concentration in charcoal-using households was double the WHO guideline (6·11 parts per million [ppm]) in the Kenyan community (15·81 ppm, 95%CI 8·71–28·72), but below the guideline in the Ghanaian setting (1·77 ppm, 1·04–2·99). In all communities, mean PM2·5 cook exposures only met the WHO interim-1 target (35 μg/m³) among LPG users staying indoors and living more than 10 min walk from a road. Interpretation Community-level variation in the relative difference in HAP exposures between LPG and polluting cooking fuel users in peri-urban sub-Saharan Africa might be attributed to differences in ambient air pollution levels. Thus, mitigation of indoor and outdoor PM2·5 sources will probably be critical for obtaining significant exposure reductions in rapidly urbanising settings of sub-Saharan Africa. Funding UK National Institute for Health and Care Research. Copyright © 2024 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.Item Simultaneous targeted and non-targeted analysis of plastic-related contaminants in e-waste impacted soil in Agbogbloshie, Ghana(Science of the Total Environment, 2024) Zheng, J.; Mittal, K.; Fobil, J.N.; Basu, N.; Bayen, S.An LC-MS based analytical method was developed and validated for the simultaneous targeted analysis and suspect screening of plastic-related contaminants in e-waste impacted soils. Satisfactory recoveries (97 ± 13 %) were achieved using ultrasound-assisted extraction for 14/15 of the targeted analytes (7 bisphenols and 8 plasticizers) in a range of agricultural and non-agricultural soils. The method was applied to 53 soil samples collected in May 2015 in the region of Agbogbloshie (Ghana) at e-waste facilities (incl. Dump, trade, and burn sites), neighboring non-agricultural (incl. upstream, downstream, and community) and agricultural fields, and at two control agricultural sites away from e-waste recycling facilities. Bisphenol A (BPA) and bis(2-ethylhexyl) phthalate (DEHP) were the two dominant contaminants in e-waste soil (with concentrations up to 48.7 and 184 μg g− 1 , respectively), especially at the trade site, where e-waste was sorted and dismantled. The non-targeted workflow was successfully applied to identify additional plastic-related contaminants previously unreported in e waste impacted soils, including bis(2-propylheptyl) phthalate, diisononyl phthalate, trioctyl trimellitate, 4-dode cylbenzenesulfonic acid, perfluorooctanesulfonic acid, perfluorobutanesulfonic acid, diphenyl phosphate, and triethylene glycol monobutyl ether. The agricultural soils surrounding the e-waste sites were also contaminated by plastic-related chemicals (especially DEHP), highlighting the impact of e-waste activities on the surrounding agricultural system.