Risk of Mercury exposure during childhood: a review of Sri Lankan situation.

Sri Lanka had ratified the Minamata convention in the year 2017 and is planning to phase out Mercury by 2020. Mercury thermometers and compact fluorescent light bulbs are abundant at hospitals, households and schools. Limitations in safe disposal and containment mechanisms have enhanced the unregulated e-waste collection and extraction. Sri Lanka has plentiful lagoons, fishing bays, and inland irrigation systems. Fish consumption is high, especially around the coastal belt. Mercury can bioaccumulate in humans by the consumption of fish from contaminated sources. Children are at risk of exposure in their living environments and via food. A multicountry study done across three oceans on Mercury threat to women & children revealed, lagoon pollution from industrial Mercury emissions in Sri Lanka, possessing high Mercury among local females who consume fish from that lagoon. The mean hair Mercury level in coastal areas with high fish consumption exceeded the reference dose even among children. Aquatic life and crop studies revealed a mixed picture of Mercury levels which some are lower and some are higher than the permissible levels. Studies on environmental Mercury levels and correlations with health effects among children will help to fill the data gap. Public awareness of the health effects of Mercury and mechanisms of Mercury disposal should be established.

Children's Environmental Health in South and Southeast Asia: Networking for Better Child Health Outcomes.

Children are particularly vulnerable to environmental hazards because they receive higher doses of pollutants in any given environment and often do not have equitable access to social protection mechanisms such as environmental and health care services. The World Health Organization established a global network of collaborating centres that address children's environmental health (CEH). The network developed a focus on low- and middle-income countries (LMICs) and is broadening its reach by conducting regional workshops for CEH.Objective: This paper reports on the outcomes of a workshop held in conjunction with the 17th International Conference (November 2017) of the Pacific Basin Consortium for Environment and Health, focused on the state of CEH in South and Southeast Asia as presented by seven countries from the region (India, Bangladesh, Nepal, Bhutan, Vietnam, Thailand, Sri Lanka).Workshop outcomes: Country reports presented at the meeting show a high degree of similarity with respect to the issues threatening the health of children. The most common problems are outdoor and household air pollution in addition to exposure to heavy metals, industrial chemicals, and pesticides. Many children still do not have adequate access to clean water and improved sanitation while infectious diseases remain a problem, especially for children living in poverty. Child labour is widely prevalent, generally without adequate training or personal protective equipment. The children now face the dual burden of undernutrition and stunting on the one hand and overnutrition and obesity on the other.Conclusion: It is evident that some countries in these regions are doing better than others in varying areas of CEH. By establishing and participating in regional networks, countries can learn from each other and harmonise their efforts to protect CEH so that all can benefit from closer interactions.

Prevention-intervention strategies to reduce exposure to e-waste.

As one of the largest waste streams, electronic waste (e-waste) production continues to grow in response to global demand for consumer electronics. This waste is often shipped to developing countries where it is disassembled and recycled. In many cases, e-waste recycling activities are conducted in informal settings with very few controls or protections in place for workers. These activities involve exposure to hazardous substances such as cadmium, lead, and brominated flame retardants and are frequently performed by women and children. Although recycling practices and exposures vary by scale and geographic region, we present case studies of e-waste recycling scenarios and intervention approaches to reduce or prevent exposures to the hazardous substances in e-waste that may be broadly applicable to diverse situations. Drawing on parallels identified in these cases, we discuss the future prevention and intervention strategies that recognize the difficult economic realities of informal e-waste recycling.

Evaluation of flood preparedness in government healthcare facilities in Eastern Province, Sri Lanka.

BACKGROUND: Sri Lanka is vulnerable to floods and other hydro-meteorological disasters. Climate change is projected to increase the intensity of these events. OBJECTIVE: This study aimed to assess the flood preparedness in healthcare facilities in Eastern Province. DESIGN: This was a cross-sectional, descriptive, mixed methods study conducted in Trincomalee District. Surveys were conducted in 31 government healthcare facilities, using a pre-tested, structured questionnaire covering the last 5 years. Seven in-depth interviews were conducted with randomly selected Medical Officers in Charge or their equivalent, and 3 interviews were conducted with Medical Offices of Health. RESULTS: Two general hospitals, 3 base hospitals, 11 divisional hospitals, and 15 primary care units were included. Six respondents (19.4%) reported flooding in their facility, and 19 (61.3%) reported flooding in their catchment area. For the health workforce, 77.4% of respondents reported not enough staff to perform normal service delivery during disasters, and 25.5% reported staff absenteeism due to flooding. Several respondents expressed a desire for more disaster-specific and general clinical training opportunities for themselves and their staff. Most respondents (80.7%) reported no delays in supply procurement during weather emergencies, but 61.3% reported insufficient supplies to maintain normal service delivery during disasters. Four facilities (12.9%) had disaster preparedness plans, and 4 (12.9%) had any staff trained on disaster preparedness or management within the last year. One quarter (25.8%) of respondents had received any written guidance on disaster preparedness from the regional, provincial, or national level in the last year. CONCLUSIONS: While there is a strong health system operating in Sri Lanka, improvements are needed in localized and appropriate disaster-related training, resources for continuing clinical education, and investments in workforce to strengthen flood and other disaster resilience within the government healthcare system in the study district.

Occupational health issues in small-scale industries in Sri Lanka: An underreported burden.

BACKGROUND: Work-related diseases and occupational accidents affect a significant number of workers globally. The majority of these diseases and accidents are reported from developing countries; and a large percentage of the workforce in developing countries is estimated to be employed in small-scale industries. Sri Lanka is no exception. These workers are exposed to occupational hazards and are at a great risk of developing work- related diseases and injuries. OBJECTIVE: To identify occupational health issues faced by small-scale industry workers in Sri Lanka. METHODS: A cross sectional study was conducted among workers in four selected small-scale industry categories in two districts of Sri Lanka. A small-scale industry was defined as a work setting with less than 20 workers. Cluster sampling using probability proportionate to size of workers was used. Eighty clusters with a cluster size of eight from each district were selected. Data was collected using a pre-tested interviewer administered questionnaire. RESULTS: Our study surveyed 198 industries. Headache (2.2%, 95% CI 1.5-3.1) and eye problems (2.1%, 95% CI 1.4-2.9) were the commonest general health issues detected. Back pain (4.8%, 95% CI 3.8-6.1) was the most prevalent work-related musculoskeletal pain reported. Knee pain was the second highest (4.4%, 95% CI 3.4-5.6). Most of the work-related musculoskeletal pain was either of short duration or long lasting. CONCLUSIONS: Work-related musculoskeletal pain was much more common than the general health issues reported. Health promotional programs at workplaces focusing ergonomics will benefit the workers at small-scale industries inSri Lanka.

E-waste issues in Sri Lanka and the Basel Convention.

E-waste is hazardous, complex and expensive to treat in an environmentally sound manner. The management of e-waste is considered a serious challenge in both developed and developing countries and Sri Lanka is no exception. Due to significant growth in the economy and investments and other reasons the consumption of electronic and electrical equipment in Sri Lanka has increased over the years resulting in significant generation of e-waste. Several initiatives such as introduction of hazardous waste management rules, ratification of the Basel Convention in 1992 and the introduction of a National Corporate E-waste Management Program have been undertaken in Sri Lanka to manage e-waste. Strengthening policy and legislation, introducing methods for upstream reduction of e-waste, building capacity of relevant officers, awareness raising among school children and the general public and development of an e-waste information system are vital. Research on e-waste needs to be developed in Sri Lanka. The health sector could play a leading role in the provision of occupational health and safety for e-waste workers, advocacy, capacity building of relevant staff and raising awareness among the general public about e-waste. Improper e-waste management practices carried out by informal sector workers need to be addressed urgently in Sri Lanka.