Framework for assessing occupational health risks of municipal solid waste handlers for use by local government structures

Past studies have reported various occupational risks to municipal solid waste handlers (MSWHs). However, no generic framework has been developed for assessing the risks. Therefore, this thesis’ aim sought to develop a framework that local government structures can use for such purposes. To accomplish this task, the following objectives were formulated. The first objective was to review available literature regarding human health risks associated with municipal solid waste management operations. The PubMed literature search was used to identify relevant articles, published in the years 1995-2014. Also, references of potential articles were assessed to identify additional papers that conformed to the criteria for inclusion. 379 studies were found but only 72 met the concerned criteria. Methodological shortcomings such as usage of cross-sectional designs, small sample sizes, not enrolling reference groups, enrolling smaller reference groups, and not controlling possible confounders, were the major limitations of the studies. The proposed framework encourages local government structures to engage in or utilise methodologically sound studies that can yield valid and reliable findings. The second thesis objective determined the workplace hazards of MSWHs. Exposure assessments were done on various workplace hazards. Findings show that MSWHs are occupationally exposed to bioaerosols, chemicals, infectious material, physical and mechanical hazards. In light of the higher summer exposures of MSWHs to ultra-violet radiation and the reported health complaints, the study recommended: i) waste collection to be done at night or early morning and ii) regular breaks, rest and rehydration of MSWHs with oral fluids. A publication to disseminate these findings was made in an accredited open access journal. The findings partly constitute phase 1’ output 1 in the framework. The third thesis’ objective assessed the risky job actions of MSWHs. Postural measurements were performed using the Rapid Upper Limbs Assessment method. The findings indicate that MSWHs use unsafe work postures when performing the bin lifting, carrying and emptying tasks. The study recommended: i) mechanisation of refuse bin collection, where feasible, ii) training MSWHs on safe working postures and iii) supervision of waste collection tasks. Also, under phase 1’s output 1, the framework stresses the need to examine ergonomic risks of waste collection services. The findings on objective 3 were disseminated in form of a publication. Objectives 4-7 sought to develop, validate, refine and compile a framework for assessing occupational health risks of MSWHs. An SWOT analysis of available human and environmental risk assessment frameworks was done and the findings were used as a base for the draft framework. The developed draft framework validated and revised through iteration workshops in small, medium and large local government structures. This thesis proves that Mr Ncube is conversant with the nature and purpose of this relevant investigation. From his thesis Mr Ncube has published 3 articles in peer reviewed journals.Thesis (PhD)--University of Pretoria, 2017.School of Health Systems and Public Health (SHSPH)PhDUnrestricte

Trace elements in groundwater near an abandoned mine tailings dam and health risk assessment (NE Zimbabwe)

Groundwater from shallow hand-dug wells at an abandoned gold mine tailings dam was characterised for selected physicochemical parameters during dry and wet seasons of 2018 and 2019. Health risk exposure of the local population (adults and children) through ingestion and dermal exposure was assessed. Groundwater quality parameters were lower than international drinking water quality guidelines (p < 0.05). The parameters were significantly influenced by season of the year (As, Cl−, SO42−), nature (As, Cd, Cl−, Fe, NO3−, SO42−), depth (Cd, Cl−, Fe, Ni, SO42−) and direction of the well (Cu, Cl−, Fe, NO3−, Pb, SO42−) (p < 0.05) relative to the tailings dam. Groundwater did not pose non-carcinogenic risk due to studied trace elements. However, arsenic had the potential to cause medium to high cancer risk to the local population. We propose re-vegetation of the tailings dam, diversion of surface tailings drainage to a containment pond and the provision of continuous piped water supplies

A systematic critical review of epidemiological studies on public health concerns of municipal solid waste handling

AIMS : The ultimate aim of this review was to summarise the epidemiological evidence on the association between municipal solid waste management operations and health risks to populations residing near landfills and incinerators, waste workers and recyclers. To accomplish this, the sub-aims of this review article were to (1) examine the health risks posed by municipal solid waste management activities, (2) determine the strengths and gaps of available literature on health risks from municipal waste management operations and (3) suggest possible research needs for future studies.METHODS : The article reviewed epidemiological literature on public health concerns of municipal solid waste handling published in the period 1995-2014. The PubMed and MEDLINE computerised literature searches were employed to identify the relevant papers using the keywords solid waste, waste management, health risks, recycling, landfills and incinerators. Additionally, all references of potential papers were examined to determine more articles that met the inclusion criteria. RESULTS : A total of 379 papers were identified, but after intensive screening only 72 met the inclusion criteria and were reviewed. Of these studies, 33 were on adverse health effects in communities living near waste dumpsites or incinerators, 24 on municipal solid waste workers and 15 on informal waste recyclers. Reviewed studies were unable to demonstrate a causal or non-causal relationship due to various limitations. CONCLUSION : In light of the above findings, our review concludes that overall epidemiological evidence in reviewed articles is inadequate mainly due to methodological limitations and future research needs to develop tools capable of demonstrating causal or non-causal relationships between specific waste management operations and adverse health endpoints.http://pph.sagepub.comhb2017School of Health Systems and Public Health (SHSPH

Validation of the framework for assessing occupational health risks of municipal solid waste handlers

BACKGROUND : The occupational health risks associated with municipal solid waste handling are widely documented in literature. However, no framework has been developed for their assessment. The aim of this study was to develop and validate a tool for use by local government structures. METHODS : Epidemiological evidence on human health risks associated with municipal solid waste management (MSWM) was obtained from literature and primary data collected from the study sites. An analysis of strengths, weaknesses, opportunities and threats (SWOT) of available human and environmental risk assessment frameworks was done and the findings were used as a base for the framework. The proposed framework was validated through iteration workshops in small, medium and large local government structures. Also, it was presented in a safety and health conference, in order obtain the input of occupational health and safety practitioners, researchers and policy makers. RESULTS : A draft framework was produced, validated and revised to incorporate resolutions made from the iteration workshops. The final framework constitutes four inputs, six phases and four principles. Each phase has defined outputs. CONCLUSION : The applicability of the framework to situations of resource-constrained economies has been tested through validation workshops in small, medium and large local government structures of a low income country. In light of the multi-methods used in developing the framework and the input of practitioners in validation workshops, the framework appears relevant for the purposes of assessing occupational health risks of municipal solid waste handlers (MSWHs).http://www.ccsenet.org/journal/index.php/gjhs/indexam2019School of Health Systems and Public Health (SHSPH

Prevalence, predictors, and economic burden of mental health disorders among asylum seekers, refugees and migrants from African countries: A scoping review

Background: Asylum seekers, migrants, and refugees from African countries may have significant health needs, resulting in economic implications for receiving countries around the world. The risk of mental illness is higher in these communities because of factors like violence, deprivation, and post-immigration challenges. Objective: The purpose of this study was to examine the literature to determine the prevalence, predictors, and economic impacts of mental health (MH) disorders among asylum seekers, migrants, and refugees from African countries. Design and methods: In this scoping review, we followed the guidelines from PRISMA and CoCoPop. A modified version of the Appraisal Tool for Cross-Sectional Studies (AXIS) was used to assess study quality for cross-sectional studies, while an appraisal list was used for qualitative studies based on the Critical Appraisal Skills Programme (CASP). Inclusion criteria included peer-reviewed articles published in English, and articles based on official reports from credible institutions and organizations. Among the exclusion criteria were publications that were not peer reviewed or had not been sourced by credible sources, publications that did not meet the study topic or language criteria, mixed populations (including Africans and non-Africans), and research abstracts, reviews, news articles, commentary on study protocols, case reports, letters, and guidelines. Data sources: A systematic search was carried out in Medline (via PubMed), EMBASE, APA PsycINFO, Web of Science and EBSCO, to identify relevant articles that were published between 1 January 2000 and 31 January 2024. Results: A total of 38 studies met the inclusion criteria, including 22 from African countries and three qualitative studies. In terms of number of countries contributing, Uganda was the largest (n = 7), followed by Italy (n = 4). The most studied conditions, using multiple diagnostic tools, were Post-Traumatic Stress Disorder (PTSD, n = 19) and depression (n = 17). These studies all revealed elevated rates of mental health disorders among these groups, and these were related to migration, refugee-related factors, and traumatic events. Most of these groups are dominated by young males. There is, however, a prominent presence of minors and women who have suffered a variety of forms of violence, in particular sexual violence. Furthermore, mental illnesses, such as PTSD and depression, are not only persistent, but can also be transmitted to children. In accordance with our inclusion criteria, our review found only one study that examined the economic impact of MH disorders in these groups, leaving a significant knowledge gap. According to this randomized controlled trial, intervention to reduce psychological impairment can help young people stay in school, improve their quality-adjusted life year (QALY), and earn an incremental cost-effectiveness ratio (ICER) of $7260 for each QALY gained. Conclusion: Asylum seekers, migrants, and refugees from African countries are likely to experience MH needs, according to this scoping review. As well as posing persistent challenges, these disorders can also be transmissible to offspring. In addition to longitudinal studies of these groups, economic impact studies of mental illnesses are necessary

Commentary on the Organisation of Occupational Health and Safety in Southern Africa, the International Labour Organization and Policies in General

Background: The design and implementation of sound occupational health and safety (OHS) programmes require understanding of the main issues that need attention. This article highlights key issues regarding the (i) organisation of OHS services in southern Africa, (ii) role of the International Labour Organization (ILO) in the provision of OHS services and (iii) implementation of policies in general. Methods: Relevant peer-reviewed journal articles, ILO conventions and policies were identified and discussed. Results: Inadequacies that exist on the organisation of OHS services in southern Africa include (i) lack of some critical categories of OHS practitioners, (ii) no emphasis on the surveillance of the work environment (iii) disregard of the worker’s right to refuse to work in unsafe work environments and (iv)non-coverage of some sectors of the economy. Further research is needed to identify additional efforts that the ILO requires to effectively discharge its OHS promotion mandate. Conclusion: Responsible authorities need to attend to the shortcomings of the national OSH laws and intergovernmental pacts

Predictors of hand hygiene behaviours among primary and secondary school children in a rural district setting in Zimbabwe: A cross-sectional epidemiologic study

© 2020, IWA Publishing. All rights reserved. Hand hygiene is one of the most effective and efficient ways of controlling faecal–oral diseases. However, little is known about the predictors of hand hygiene behaviours among school children. A predesigned checklist guide was used to observe hygiene behaviours of 460 pupils from four rural schools in Shamva South district, Zimbabwe. A pretested questionnaire was administered to obtain demographic data of the observed school children. Membership of a Water, Sanitation and Hygiene (WASH) club, age, gender and the level of education were associated with hand hygiene practices (p \u3c 0.05). The findings indicated that investing in hand hygiene behaviour change processes among school children using the promotion, formation, resuscitation and empowerment of WASH clubs in schools is important in disease prevention among communities in developing countries

Contamination of Soil with Pb and Sb at a Lead-Acid Battery Dumpsite and Their Potential Early Uptake by Phragmites australis

Recycling of spent Lead-Acid Batteries (LABs) and disposal of process slag potentially contaminate soil with Pb and Sb. Total and available concentrations of Pb and Sb in three soil treatments and parts of Phragmites australis were determined by atomic absorption spectrophotometry. Soil with nonrecycled slag (NR) had higher total metal concentrations than that with recycled slag (RS). Low available fractions of Pb and Sb were found in the soil treatments before planting P. australis. After 16 weeks of growth of P. australis, the available fractions of Pb had no statistical difference from initial values (p>0.05) while available Sb fractions were significantly lower when compared with their initial values (p<0.05). Metal transfer factors showed that P. australis poorly accumulate Pb and Sb in roots and very poorly translocate them to leaves after growing for 8 and 16 weeks. It may be a poor phytoextractor of Pb and Sb in metal-contaminated soil at least for the 16 weeks of its initial growth. However, the plant established itself on the metalliferous site where all vegetation had been destroyed. This could be useful for potential ecological restoration. The long-term phytoextraction potential of P. australis in such environments as LABs may need further investigation

Perceptions of healthcare finance and system quality among Nigerian healthcare workers

Nigeria’s healthcare system faces significant challenges in financing and quality, impacting the delivery of services to its growing population. This study investigates healthcare workers’ perceptions of these challenges and their implications for healthcare policy and practice. A cross-sectional survey was conducted with 600 healthcare professionals from eight states across Nigeria, representing a variety of healthcare occupations. Participants completed a questionnaire that assessed their perceptions of healthcare financing, quality of care, job satisfaction, and motivation using a 5-point Likert scale, closed- and open-ended questions. Descriptive statistics, Chi-squared test, and regression analysis were used to analyze the data. The findings revealed that healthcare workers were generally not satisfied with the current state of healthcare financing and system quality in Nigeria. Poor funding, inadequate infrastructure, insufficient staffing, and limited access to essential resources were identified as major challenges. These challenges contributed to low job satisfaction, demotivation, and a desire to leave the profession. Socioeconomic factors, location State of practice, professional designation (clinical vs nonclinical), clinical designation (profession), and employment type (full-time vs part-time) were found to influence healthcare workers’ perceptions (p < 0.05). The findings indicated a need to improve healthcare workers’ satisfaction and retention, and quality of care in Nigeria, by increasing healthcare funding, transparent fund management protocols, investing in infrastructure and human resource development, and addressing regional healthcare disparities. By implementing these reforms, Nigeria can enhance the quality and accessibility of healthcare services and improve the health and well-being of its citizens.https://doi.org/10.1371/journal.pgph.00038814pubpub1

Critical review of healthcare financing and a survey of system quality perception among healthcare users in Nigeria (2010–2023)

Kelechi Eric Alimele - ORCID: 0009-0000-8888-3298 https://orcid.org/0009-0000-8888-3298Data availability statement: In compliance with the applicable reporting standards, the datasets supporting the conclusions of this article are available in the Dryad Digital Repository at http://datadryad.org/stash/share/ gZJC4g6cgMgi9cJhwLZalmdEPQGrdh72L7YuOWM7pps.Nigeria aims to enhance its healthcare quality index score of 84th out of 110 countries and its Sustainable Development Goals Index ranking of 146th out of 166. Due to increased population, disease burden, and patient awareness, healthcare demand is rising, putting pressure on funding and quality assurance. The Nigerian healthcare financing and its impacts are complex; this study gives insights into the trends. This questionnaire-based cross-sectional survey (conducted from June to August 2023) and 2010–2023 health budget analysis examined healthcare finance patterns and user attitudes (utilisation, preference and quality perceptions) in Nigeria. Data from government health budgets and a stratified random sample of 2,212 from nine states, obtained from the socioculturally diverse 237 million population, were analysed with a focus on trends, proportions, frequency distributions, and tests of association. Results show that the average rating of healthcare experiences did not vary significantly over the last decade. Healthcare system quality was rated mainly poor or very poor; structure (74.09%), services (61.66%), and cost (60.89%). While 87.36% used government healthcare facilities, 85.00% paid out-of-pocket, and 72.60% of them were dissatisfied with the value for money. Despite a preference for government facilities (71.43%), respondents cited high costs (62.75%), poor funding (85.65%), inadequate staffing (90.73%), and lack of essential medicines (88.47%) as major challenges. The budget analysis reveals an average government healthcare fund allocation of $7.12 compared with an estimated expenditure of$82.75 per person annually. Nigeria allocates only an average of 0.37% of GDP and 4.61% of the national budget to healthcare, comprising a maximum of 13.56% of total health expenditure. This study emphasises the urgent need for policy reforms and implementations to improve Nigeria’s healthcare financing and service quality. Targeted interventions are essential to address systemic challenges and meet population needs while aligning with international health services and best standards.https://doi.org/10.1371/journal.pgph.00046155pubpub