M. K. C. Sridhar

Medical waste management in Ibadan, Nigeria: Obstacles and prospects

Quantification and characterization of medical waste generated in healthcare facilities (HCFs) in a developing African nation has been conducted to provide insights into existing waste collection and disposal approaches, so as to provide sustainable avenues for institutional policy improvement. The study, in Ibadan city, Nigeria, entailed a representative classification of nearly 400 healthcare facilities, from 11 local government areas (LGA) of Ibadan, into tertiary, secondary, primary, and diagnostic HCFs, of which, 52 HCFs were strategically selected. Primary data sources included field measurements, waste sampling and analysis and a questionnaire, while secondary information sources included public and private records from hospitals and government ministries. Results indicate secondary HCFs generate the greatest amounts of medical waste (mean of 10,238 kg/day per facility) followed by tertiary, primary and diagnostic HCFs, respectively. Characterised waste revealed that only approximately 3% was deemed infectious and highlights opportunities for composting, reuse and recycling. Furthermore, the management practices in most facilities expose patients, staff, waste handlers and the populace to unnecessary health risks. This study proffers recommendations to include (i) a need for sustained cooperation among all key actors (government, hospitals and waste managers) in implementing a safe and reliable medical waste management strategy, not only in legislation and policy formation but also particularly in its monitoring and enforcement and (ii) an obligation for each HCF to ensure a safe and hygienic system of medical waste handling, segregation, collection, storage, transportation, treatment and disposal, with minimal risk to handlers, public health and the environment.

Lead levels in new enamel household paints from Asia, Africa and South America.

In 2006 a report on the analysis for lead in 80 new residential paints from four countries in Asia revealed high levels in three of the countries (China, India and Malaysia) and low levels in a fourth country (Singapore) where a lead in paint regulation was enforced. The authors warned of the possible export of lead-painted consumer products to the United States and other countries and the dangers the lead paint represented to children in the countries where it was available for purchase. The need for a worldwide ban on the use of lead in paints was emphasized to prevent an increase in exposure and disease from this very preventable environmental source. Since the earlier paper almost 300 additional new paint samples have been collected from the four initial countries plus 8 additional countries, three from Asia, three from Africa and two from South America. During the intervening time period two million toys and other items imported into the United States were recalled because the lead content exceeded the United States standard. High lead paints were detected in all 12 countries. The average lead concentration by country ranged from 6988 (Singapore) to 31,960ppm (Ecuador). One multinational company sold high lead paint in one country through January 2007 but sold low lead paint later in 2007 indicating that a major change to cease adding lead to their paints had occurred. However, the finding that almost one-third of the samples would meet the new United States standard for new paint of 90ppm, suggests that the technology is already available in at least 11 of the 12 countries to produce low lead enamel paints for domestic use. The need remains urgent to establish effective worldwide controls to prevent the needless poisoning of millions of children from this preventable exposure.

Heavy metal analysis of groundwater from Warri, Nigeria.

The levels of some ions of heavy metals known to be associated with petroleum industry operations, including Pb, Ni, V, Cr, Cd, Zn and Fe, were studied in untreated groundwater from Warri area, Nigeria, by atomic absorption spectroscopy. Warri area is characterized by petroleum industry activities including a Refinery. With this in mind, the residential area was divided into Effurun junction, Waterside, Ekpan village and the Refinerys vicinity. The concentrations of Pb, Ni and Fe measured (in mg l -1 ) in the groundwater samples of all areas studied ranged from 0.06 to 0.44, 0.008 to 0.19 and 0.315 to 2.753 respectively, while V, Cr, Zn and Cd were present in very low concentrations, 0-0.85 2 10 -3 . The levels of Pb, Ni and Fe exceeded the threshold limits (0.01, 0.02 and 0.3 mg l -1 , respectively) set by the WHO health-based guideline for drinking water and this could portend environmental hazards.

Lead poisoning associated with malaria in children of urban areas of Nigeria

The principal objectives of this study are to (a) investigate the prevalence of elevated blood lead levels (EBLLs) in children of three major cities of Nigeria with different levels of industrial pollution; (b) identify the environmental, social and behavioral risk factors for the EBLLs in the children; and (c) explore the association between malaria (endemic in the study areas) and EBLLs in the pediatric population. The study involved 653 children aged 2-9 years (average, 3.7 years). The mean blood lead level (BLL) for the children was 8.9+/-4.8microg/dL, the median value was 7.8microg/dL, and the range was 1-52microg/dL. About 25% of the children had BLL greater than 10microg/dL. There were important differences in BLLs across the three cities, with the average value in Ibadan (9.9+/-5.2microg/dL) and Nnewi (8.3+/-3.5microg/dL) being higher than that in Port Harcourt (4.7+/-2.2micro/dL). Significant positive associations were found between BLL and a childs town of residence (p<0.001), age of the child (p=0.004), length of time the child played outside (p<0.001), presence of pets in a childs home (p=0.023), but negatively with educational level of caregiver (p<0.001). This study is one of the first to find a significant negative association between BLL and malaria in a pediatric population, and this association remained significant after controlling for confounding diseases and symptoms. The shared environmental and socio-demographic risks factors for lead exposure and Plasmodium (most common malaria parasites) infection in urban areas of Nigeria are discussed along with possible ways that lead exposure may influence the host response to infection with malarial parasites.

Palm Oil Industry Residues

Oil palm industry generates a large quantity of residues and wastes in the form of empty fruit bunch, palm kernel shells, trunk of the plant, fibre, leaves and others. When palm oil is extracted and processed, it also produces effluents with high organic matter, suspended matter and oil and grease. These wastes cause ecosystem degradation and affects health of the communities. This chapter describes the methods of managing or treating the residues and wastes as these are untapped resources. Some of the byproducts derivable from these wastes when appropriately managed are energy, mulch, compost or organic fertilizer from empty fruit bunches shells and sludges from effluent treatment. Empty fruit bunches and palm kernel shells were successfully converted into compost by enriching with goat manure or poultry manure and were useful in developing oil palm nurseries and other food crops. Biogas and electricity are generated from effluent management, and several biochemicals such as ethanol, fatty acids, waxes and others which could be obtained through application of biotechnology. Palm oil wastes contribute to Green House Gases (GHG) and conversion to energy is a good means of obtaining carbon credit facility for sustainable management. The spent materials are also used in cultivating mushrooms. These technologies find wider application in developing African and Asian countries where oil palm plantations are major economic resource.

Environmental risk factors and health outcomes in selected communities of the Niger delta area, Nigeria.

Aims: The main aim of this study was to assess the prevalence of various health outcomes associated with exposure to environmental risk factors including industrial pollution in selected communities of Nigerias oil-rich Niger delta area (NDA). Methods: The study involved both laboratory experiments and community health surveys using questionnaires and hospital records. A total of 14 air samples, 16 grab soil samples and 18 surface water samples were collected and analyzed for physicochemical parameters including heavy metals and polycyclic aromatic hydrocarbons (PAHs) using standard methods. A 77-item questionnaire was administered on randomly selected 349 subjects. A five-year record was collected from health facilities located in the two communities. Results: The laboratory results indicated that the median PAH level at Eleme as compared to Ahoada East was higher than the guideline limit 50 ng/l for surface waters. The mean TSP level at Eleme was higher than the level at Ahoada East and the guideline limit 100 µg/m3. The median PAH level at Eleme was higher than the level at Ahoada East and the guideline limit < 100 ng/m3 for air. The survey results showed that at Eleme air pollution in the community was significantly associated with painful body outgrowths (p = 0.027) and the effect the air contaminants has was significantly associated with respiratory health problem ( p = 0.044). At Ahoada East commonly consumed aquatic food was highly significantly associated with painful body outgrowth ( p < 0.0001) while use of domestic cooking fuel types was also highly significantly associated with child deformities (p < 0.0001). Hospital records showed high proportions of respiratory disorder among males (3.85%) and females (4.39%) at Eleme as compared to the proportion of respiratory disorder among males (3.68%) and females (4.18%) at Ahoada East. Conclusions: The study shows that industrial communities such as Eleme, which are exposed to higher levels of air pollution, are more predisposed to respiratory morbidities, skin disorders and other related health risks.

A study on the characteristics of refuse in Ibadan, Nigeria

A study has been undertaken on the quantity and characteristics of refuse generated among families in high, middle and low socio-economic groups in Ibadan City, Nigeria. These three groups generate, respectively, 0.428, 0.289 and 0.132 kg refuse per capita. A major portion of the refuse is generated in high and middle socioeconomic groups and contained 66–71% of putrescible organic matter represented by garbage. The refuse also contained 1.1–2.6% total Kjeldahl nitrogen and 1.6–3.3% total phosphorus. The presence of leaves which contribute to volume are attributed to the traditional food habits of the people.

Assessment of noise and associated health impacts at selected secondary schools in Ibadan, Nigeria.

Background. Most schools in Ibadan, Nigeria, are located near major roads (mobile line sources). We conducted an initial assessment of noise levels and adverse noise-related health and learning effects. Methods. For this descriptive, cross-sectional study, four schools were selected randomly from eight participating in overall project. We administered 200 questionnaires, 50 per school, assessing health and learning-related outcomes. Noise levels (A-weighted decibels, dBA) were measured with calibrated sound level meters. Traffic density was assessed for school with the highest measured dBA. Observational checklists assessed noise control parameters and building physical attributes. Results. Short-term, cross-sectional school-day noise levels ranged 68.3–84.7 dBA. Over 60% of respondents reported that vehicular traffic was major source of noise, and over 70% complained being disturbed by noise. Three schools reported tiredness, and one school lack of concentration, as the most prevalent noise-related health problems. Conclusion. Secondary school occupants in Ibadan, Nigeria were potentially affected by exposure to noise from mobile line sources.

An examination of knowledge, attitudes and practices related to lead exposure in South Western Nigeria

BackgroundLead is a highly toxic and pervasive metal. Chronic exposure to low levels is responsible for significant health effects, particularly in children. Prevention remains the best option for reducing childhood lead exposure, however the knowledge, attitudes and practices to lead exposure in many developing countries is not known.Methods: We conducted four focus group discussions (FGD) to evaluate knowledge attitudes and practices to lead exposure in Nigeria. An FGD guide was developed from the literature and preliminary discussion with members of the public. Participants in the FGD were randomly selected from adults living in Ibadan, South Western Nigeria in 2004.ResultsWe found that there was limited awareness of the sources of lead exposure in the domestic environment and participants had little knowledge of the health effects of chronic low-dose lead exposure.ConclusionWe conclude that the findings of this study should be used, in conjunction with others, to develop appropriate health education intervention for lead exposure in the domestic environment.

Evaluation of Naturally Decomposed Solid Wastes from Municipal Dump Sites for Their Manurial Value in Southwest Nigeria

ABSTRACT Ibadan, like other urban centers in Nigeria is characterized by a large number of illegal solid waste dumps. These waste dumps decomposing under the tropical heat pose serious pollution problems to the ecosystems and at the same time are transformed naturally into ‘manure’ or compost over a period of stay and degradation under the tropical sun. Rapid decline in soil fertility under tropical climate coupled with high cost of chemical fertilizers make these manures very attractive for poor peasant farmers as alternate sources of fertilizers or soil conditioners. This study has evaluated the nutrient value of decomposed waste from six different municipal dumpsites of varying age ranging between 6 months and 20 years. A green house experiment was conducted using sand culture to study the effects of application of these manures on the growth and yield of a common green leafy vegetable, Amaranthus caudatus. These manures were also compared against organo-mineral fertilizers (prepared from cow dung and municipal solid wastes amended with mineral nitrogen and without amendment) used normally by the farmers. The results showed that the dumpsite manures are rich in C, N, P, and K, which promoted plant growth comparable to normal compost.