Cardiovascular risk factors and kidney function among automobile mechanic and their association with serum heavy metals in Southwest Nigeria: A cross-sectional study.

IntroductionThe burden of cardiovascular disease (CVD) is huge due to its associated morbidity, mortality and adverse socio-economic impact. Environmental pollution as a risk factor contributes significantly to the burden of CVD, especially in the low and middle income countries. One of the effective strategies to reduce CVD burden is to prevent or detect cardiovascular risk factors early in at-risk population. This study determined some cardiovascular risk factors, kidney function, and their association with heavy metals among automobile mechanics.MethodThis was a cross-sectional study involving 162 automobile mechanics and 81 age and sex matched controls. Serum levels of lead, cadmium and some cardiovascular risks were assessed and compared in the two groups. Associations between serum lead, cadmium and some cardiovascular risks were determined using correlation analysis. P value of ResultsThe mean ages of the automobile mechanics and controls were 47.27±9.99 years and 48.94±10.34 years, respectively. The prevalence of elevated serum cadmium was significantly higher in the automobile mechanics (25.9% vs 7.9%; p = ConclusionAutomobile mechanics have notable exposure to heavy metals and a higher prevalence of some cardiovascular risk factors. Health education and sensitisation as well as policies that would regulate exposure of persons to heavy metals should be implemented in Nigeria

STROBE statement checklist.

IntroductionThe burden of cardiovascular disease (CVD) is huge due to its associated morbidity, mortality and adverse socio-economic impact. Environmental pollution as a risk factor contributes significantly to the burden of CVD, especially in the low and middle income countries. One of the effective strategies to reduce CVD burden is to prevent or detect cardiovascular risk factors early in at-risk population. This study determined some cardiovascular risk factors, kidney function, and their association with heavy metals among automobile mechanics.MethodThis was a cross-sectional study involving 162 automobile mechanics and 81 age and sex matched controls. Serum levels of lead, cadmium and some cardiovascular risks were assessed and compared in the two groups. Associations between serum lead, cadmium and some cardiovascular risks were determined using correlation analysis. P value of ResultsThe mean ages of the automobile mechanics and controls were 47.27±9.99 years and 48.94±10.34 years, respectively. The prevalence of elevated serum cadmium was significantly higher in the automobile mechanics (25.9% vs 7.9%; p = ConclusionAutomobile mechanics have notable exposure to heavy metals and a higher prevalence of some cardiovascular risk factors. Health education and sensitisation as well as policies that would regulate exposure of persons to heavy metals should be implemented in Nigeria.</div

Correlation between serum heavy metals and some parameters among automobile mechanic.

Correlation between serum heavy metals and some parameters among automobile mechanic.</p

Socio-demographic characteristics of study participants.

Socio-demographic characteristics of study participants.</p

Harmful occupational practices among automobile mechanics.

Harmful occupational practices among automobile mechanics.</p

Comparison of mean values of lipid parameters, NGAL, TAC and uric acid between the automobile mechanics and controls.

Comparison of mean values of lipid parameters, NGAL, TAC and uric acid between the automobile mechanics and controls.</p

Comparison of cardiovascular risk between the automobile mechanics and controls.

Comparison of cardiovascular risk between the automobile mechanics and controls.</p

Correlation between serum heavy metals and some parameters among automobile mechanic and controls.

Correlation between serum heavy metals and some parameters among automobile mechanic and controls.</p

Physicians' perception of task sharing with non-physician health care workers in the management of uncomplicated hypertension in Nigeria: A mixed method study.

IntroductionTask sharing and task shifting (TSTS) in the management of hypertension is an important strategy to reduce the burden of hypertension in low-and middle-income countries like Nigeria where there is shortage of physicians below the World Health Organization's recommendations on doctor-patient ratio. The cooperation of physicians is critical to the success of this strategy. We assessed physicians' perception of TSTS with non-physician health workers in the management of hypertension and sought recommendations to facilitate the implementation of TSTS.Materials and methodsThis was an explanatory sequential mixed method study. TSTS perception was assessed quantitatively using a 12-item questionnaire with each item assigned a score on a 5-point Likert scale. The maximum obtainable score was 60 points and those with ≥42 points were classified as having a good perception of TSTS. Twenty physicians were subsequently interviewed for in-depth exploration of their perception of TSTS.ResultsA total of 1250 physicians participated in the quantitative aspect of the study. Among the participants, 56.6% had good perception of TSTS in the management of hypertension while about two-thirds (67.5%) agreed that TSTS program in the management of hypertension could be successfully implemented in Nigeria. Male gender (p = 0.019) and working in clinical settings (p = 0.039) were associated with good perception. Twenty physicians participated in the qualitative part of the study. Qualitative analysis showed that TSTS will improve overall care and outcomes of patients with hypertension, reduce physicians' workload, improve their productivity, but may encourage inter-professional rivalry. Wide consultation with stakeholders, adequate monitoring and evaluation will facilitate successful implementation of TSTS in Nigeria.ConclusionThis study showed that more than half of the physicians have good perception of TSTS in hypertension management while about two-thirds agreed that it could be successfully implemented in Nigeria. This study provides the needed evidence for increased advocacy for the implementation of TSTS in the management of hypertension in Nigeria. This will consequently result in improved patient care and outcomes and effective utilization of available health care personnel