Spatial Associations Between Contaminated Land and Socio Demographics in Ghana

Associations between contaminated land and socio demographics are well documented in high-income countries. In low- and middle-income countries, however, little is known about the extent of contaminated land and possible demographic correlations. This is an important yet sparsely researched topic with potentially significant public health implications as exposure to pollution remains a leading source of morbidity and mortality in low-income countries. In this study, we review the associations between several socio demographic factors (population, population density, unemployment, education, and literacy) and contaminated sites in Ghana. Within this context, both correlation and association intend to show the relationship between two variables, namely contaminated sites and socio demographics. Aggregated district level 2010 census data from Ghana Statistical Service and contaminated site location data from Pure Earth’s Toxic Sites Identification Program (TSIP) were spatially evaluated using the number of sites per kilometer squared within districts as the unit of measurement. We found a low to medium positive correlation (ρ range: 0.285 to 0.478) between contaminated sites and the following socio demographics: higher population density, higher unemployment, greater education, and higher literacy rate. These results support previous studies and suggest that several socio demographic factors may be reasonably accurate predictors of contaminated site locations. More research and targeted data collection is needed to better understand these associations with the ultimate goal of developing a predictive model

Burden of disease resulting from lead exposure at toxic waste sites in Argentina, Mexico and Uruguay

Background: Though lead contaminated waste sites have been widely researched in many high-income countries, their prevalence and associated health outcomes have not been well documented in low- and middle-income countries. Methods: Using the well-established health metric disability-adjusted life year (DALY) and an exposure assessment method developed by Chatham-Stephens et al., we estimated the burden of disease resulting from exposure to lead at toxic waste sites in three Latin American countries in 2012: Argentina, Mexico and Uruguay. Toxic waste sites identified through Pure Earth’s Toxic Sites Identification Program (TSIP) were screened for lead in both biological and environmental sample media. Estimates of cardiovascular disease incidence and other outcomes resulting from exposure to lead were utilized to estimate DALYs for each population at risk. Results: Approximately 316,703 persons in three countries were at risk of exposure to pollutants at 129 unique sites identified through the TSIP database. Exposure to lead was estimated to result in between 51,432 and 115,042 DALYs, depending on the weighting factor used. The estimated burden of disease caused by exposure to lead in this analysis is comparable to that estimated for Parkinson’s disease and bladder cancer in these countries. Conclusions: Lead continues to pose a significant public health risk in Argentina, Mexico, and Uruguay. The burden of disease in these three countries is comparable with other widely recognized public health challenges. Knowledge of the relatively high number of DALYs associated with lead exposure may be used to generate support and funding for the remediation of toxic waste sites in these countries and others

The Global Burden of Lead Toxicity Attributable to Informal Used Lead-Acid Battery Sites

BackgroundPrior calculations of the burden of disease from environmental lead exposure in low- and middle-income countries (LMICs) have not included estimates of the burden from lead-contaminated sites because of a lack of exposure data, resulting in an underestimation of a serious public health problem.ObjectiveWe used publicly available statistics and detailed site assessment data to model the number of informal used lead-acid battery (ULAB) recyclers and the resulting exposures in 90 LMICs. We estimated blood lead levels (BLLs) using the US Environment Protection Agency’s Integrated Exposure Uptake Biokinetic Model for Lead in Children and Adult Lead Model. Finally, we used data and algorithms generated by the World Health Organization to calculate the number of attributable disability adjusted life years (DALYs).ResultsWe estimated that there are 10,599 to 29,241 informal ULAB processing sites where human health is at risk in the 90 countries we reviewed. We further estimated that 6 to 16.8 million people are exposed at these sites and calculate a geometric mean BLL for exposed children (0-4 years of age) of 31.15 μg/dL and a geometric mean BLL for adults of 21.2 μg/dL. We calculated that these exposures resulted in 127,248 to 1,612,476 DALYs in 2013.ConclusionsInformal ULAB processing is currently causing widespread lead poisoning in LMICs. There is an urgent need to identify and mitigate exposures at existing sites and to develop appropriate policy responses to minimize the creation of new sites

A Simplified Risk-Ranking System for Prioritizing Toxic Pollution Sites in Low- and Middle-Income Countries

Background: In low- and middle-income countries (LMICs), chemical exposures in the environment due to hazardous waste sites and toxic pollutants are typically poorly documented and their health impacts insufficiently quantified. Furthermore, there often is only limited understanding of the health and environmental consequences of point source pollution problems, and little consensus on how to assess and rank them. The contributions of toxic environmental exposures to the global burden of disease are not well characterized. Objectives: The aim of this study was to describe the simple but effective approach taken by Blacksmith Institute’s Toxic Sites Identification Program to quantify and rank toxic exposures in LMICs. This system is already in use at more than 3000 sites in 48 countries such as India, Indonesia, China, Ghana, Kenya, Tanzania, Peru, Bolivia, Argentina, Uruguay, Armenia, Azerbaijan, and Ukraine. Methods: A hazard ranking system formula, the Blacksmith Index (BI), takes into account important factors such as the scale of the pollution source, the size of the population possibly affected, and the exposure pathways, and is designed for use reliably in low-resource settings by local personnel provided with limited training. Findings: Four representative case studies are presented, with varying locations, populations, pollutants, and exposure pathways. The BI was successfully applied to assess the extent and severity of environmental pollution problems at these sites. Conclusions: The BI is a risk-ranking tool that provides direct and straightforward characterization, quantification, and prioritization of toxic pollution sites in settings where time, money, or resources are limited. It will be an important and useful tool for addressing toxic pollution problems in LMICs. Although the BI does not have the sophistication of the US Environmental Protection Agency’s Hazard Ranking System, the case studies presented here document the effectiveness of the BI in the field, especially in low-resource settings. Understanding of the risks posed by toxic pollution sites helps assure better use of resources to manage sites and mitigate risks to public health. Quantification of these hazards is an important input to assessments of the global burden of disease

Burden of Disease from Toxic Waste Sites in India, Indonesia, and the Philippines in 2010

Background: Prior calculations of the burden of disease from toxic exposures have not included estimates of the burden from toxic waste sites due to the absence of exposure data. Objective: We developed a disability-adjusted life year (DALY)-based estimate of the disease burden attributable to toxic waste sites. We focused on three low- and middle-income countries (LMICs): India, Indonesia, and the Philippines. Methods: Sites were identified through the Blacksmith Institute’s Toxic Sites Identification Program, a global effort to identify waste sites in LMICs. At least one of eight toxic chemicals was sampled in environmental media at each site, and the population at risk estimated. By combining estimates of disease incidence from these exposures with population data, we calculated the DALYs attributable to exposures at each site. Results: We estimated that in 2010, 8,629,750 persons were at risk of exposure to industrial pollutants at 373 toxic waste sites in the three countries, and that these exposures resulted in 828,722 DALYs, with a range of 814,934–1,557,121 DALYs, depending on the weighting factor used. This disease burden is comparable to estimated burdens for outdoor air pollution (1,448,612 DALYs) and malaria (725,000 DALYs) in these countries. Lead and hexavalent chromium collectively accounted for 99.2% of the total DALYs for the chemicals evaluated. Conclusions: Toxic waste sites are responsible for a significant burden of disease in LMICs. Although some factors, such as unidentified and unscreened sites, may cause our estimate to be an underestimate of the actual burden of disease, other factors, such as extrapolation of environmental sampling to the entire exposed population, may result in an overestimate of the burden of disease attributable to these sites. Toxic waste sites are a major, and heretofore underrecognized, global health problem

Estimating the Prevalence of Toxic Waste Sites in Low- and Middle-Income Countries

BackgroundExposure to heavy metals at contaminated industrial and mining sites, known also as hot spots, is a significant source of toxic exposure and adverse health outcomes in countries around the world. The Toxic Sites Identification Program (TSIP) developed by Pure Earth, a New York–based nongovernmental organization, is the only systematic effort to catalogue contaminated sites globally. To date, TSIP has identified and catalogued 3282 sites in low- and middle-income countries. The TSIP methodology is not designed to survey all contaminated sites in a country. Rather sites are prioritized based on their perceived impact on human health, and only a limited number of the most highly hazardous sites are surveyed. The total number of contaminated sites globally and the fraction of contaminated sites captured by TSIP is not known.ObjectiveTo determine the TSIP site capture rate, the fraction of contaminated sites in a country catalogued by TSIP.MethodsGhana was selected for this analysis because it is a rapidly industrializing lower middle income country with a heterogeneous industrial base, a highly urban population (51%), and good public records systems. To develop an estimate of the fraction of sites in Ghana captured by TSIP, assessors targeted randomly selected geographic quadrats for comprehensive assessment using area and population statistics from the Ghana Statistical Service. Investigators physically walked all accessible streets in each quadrat to visually identify all sites. Visual identification was supplemented by field-based confirmation with portable x-ray fluorescence instruments to test soils for metals. To extrapolate from survey findings to develop a range of estimates for the entire country, the investigators used 2 methodologies: a “bottom-up” approach that first estimated the number of waste sites in each region and then summed these regional subtotals to develop a total national estimate; and a “top-down” method that estimated the total number of sites in Ghana and then allocated these sites to each region. Both methods used cluster random sampling principles.FindingsThe investigators identified 72 sites in the sampled quadrats. Extrapolating from these findings to the entire country, the first methodology estimated that there are 1561 sites contaminated by heavy metals in Ghana (confidence interval [CI]: 1134-1987), whereas the second estimated 1944 sites (CI: 812-3075). The estimated total number of contaminated sites in Ghana is thus 7-9 times the number of sites captured through TSIP. On a population basis, it was estimated that there are between 31 and 115 contaminated sites per million inhabitants in Ghana.ConclusionsThe findings of this study indicate that the TSIP methodology provides a sound statistical basis for policy formulation. The statistical approaches used in this study can be replicated in other countries to improve estimates of the prevalence of contaminated sites. This information provides important input to calculations of the global burden of disease attributable to hazardous exposures at contaminated sites

Niveles de Plomo en Sangre en México y su Implicación para la Carga Pediátrica de la Enfermedad

Antecedentes: Aunque con la gasolina libre de plomo ha habido éxito en la reducción de la exposición, en México la exposición al plomo continúa amenazando la salud de millones, la mayoría debido a la greta (óxido de plomo) que se utiliza en la alfarería donde el plomo se mezcla con la comida. Objetivos: Se condujo una revisión histórica extensiva y un análisis de datos de niveles de plomo en sangre en poblaciones mexicanas. Se usó una media geométricamente calculada para evaluar el efecto del plomo en la carga de la enfermedad de la población infantil. Métodos: Una búsqueda bibliográfica extensiva identificó 83 artículos publicados de 1978 al 2010 con datos de NPS en poblaciones mexicanas representando 150 puntos de datos de más de 50,000 participantes de los estudios. Se categorizaron los valores de estas publicaciones en varias agrupaciones. Enseguida se calcularon las incidencias de enfermedad y los AVAD resultantes de estos NPS, usando las hojas de cálculo de carga de enfermedad de la OMS para el retraso mental ligero. Resultados: Al revisar los estudios relevantes, las medias geométricas de niveles de plomo en sangre en México para áreas urbanas y rurales fueron de 8.85 μg/dL y 22.24 μg/dL respectivamente. A partir de la introducción de la gasolina libre de plomo, la media en áreas urbanas fue de 5.36 μg/dL y se espera que el promedio en áreas rurales sea mayor. El límite máximo de niveles de plomo en sangre para los CDCDC de EUA en niños menores de 6 años es de 5 μg/dL y el promedio actual en EUA es 1.2 μg/dL. Nuestros resultados indican que más del 15% de la población experimentará un decremento de más de 5 puntos en el coeficiente intelectual (CI)) a raíz de la exposición al plomo. El análisis también nos lleva a creer que el plomo es responsable de 820,000 AVAD por retraso mental ligero provocado por el plomo en niños de 0 a 4 años. Conclusión: En México el plomo continúa amenazando la salud de millones y sigue siendo una causa significativa de discapacidad. Se necesitan intervenciones adicionales en la reducción o manejo de óxido de plomo para proteger la salud pública