To Speak Up or Not to Speak Up, Organisational and Individual Antecedents That Undergird This Behaviour in Resource Constrained Region.

AIM: To examine the organisational (i.e., perceived organisational support and psychologically safe environment) and individual (i.e., value, belief and norm) antecedents that strengthen healthcare workers' speaking-up behaviour in a developing economy. DESIGN: The study uses a cross-sectional design to gather the same data from healthcare workers within the Ashanti Region of Ghana. METHODS: The data collection happened between 15 June and 30 August 2023. A sample of 380 healthcare workers was selected from 20 facilities in the Ashanti Region of Ghana. A configurational approach, a fussy-set qualitative comparative analysis, was used to identify the configurations that caused high and low speaking-up behaviour among the study sample. RESULTS: The study results reveal that whereas four configurations generate high speaking-up behaviour, three configurations, by contrast, produce low speaking-up behaviour among healthcare workers. CONCLUSION: Results suggest that in so far as organisational support systems which take the form of a psychologically safe environment and perceived organisational support are vital in relaxing the hierarchical boundaries in a healthcare setting to improve healthcare workers' speaking-up behaviour, the individual value-based factors that take the form of values, beliefs and norms are indispensable as it provides the healthcare workers with the necessary inner drive to regard speaking-up behaviour on patient safety and care as a moral duty. IMPACT: Healthcare workers' speaking-up behaviour is better achieved when organisational support systems complement the individual norms, values and beliefs of the individual. REPORTING METHOD: Adhered to Strengthening Reporting of Observational Studies in Epidemiology guidelines. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Predicting nurses' safety compliance behaviour in a developing economy, using the theory of planned behaviour: A configurational approach.

AIM: The study's main objective was to use a fuzzy set qualitative comparative analysis to identify the configuration of recipes that predict nurses' safety compliance behaviour. DESIGN: A cross-sectional design. METHODS: A survey was used where questionnaires were collected from 285 nurses across four primary healthcare hospitals within the Ashanti Region, Ghana. The data collection happened between June 1 to August 2, 2022. A fuzzy set qualitative comparative analysis was used to identify the recipes of psychological factors that determine nurses' safety compliance behaviour. RESULTS: Results from the study suggest that the necessary configurations that explained nurses' safety compliance behaviour came from the presence of subjective norm, attitude, perceived behavioural control, perceived organizational support and negation of intention. The result highlights the need for safety protocols to be conscious of the interplay between nurses' assessment of self, social clues and perception of management care and support since such psychological factors must be considered concurrently to achieve the optimal safety compliance behaviour among nurses. CONCLUSION: A health and safety protocol that fails to recognize the importance of psychological antecedents on subordinates' safety compliance behaviour could limit the safety policy's usefulness in bringing the appropriate behavioural change in nurses. IMPACT: To date, no study has combined the antecedents of theory planned behaviour with perceived organizational support and cue to action to assess how they collectively predict nurses' safety compliance behaviour. Findings from the study suggest that nurses in primary health facilities inform their safety compliance behaviour by assessing self-capabilities, social signals from superiors and colleagues and perception of management support. Hospital administrators and nursing managers in sub-Saharan Africa may rely on these psychological forces to persuade nurses to develop positive safety compliance behaviour at the health facility. PATIENT OR PUBLIC CONTRIBUTION: No Patient or Public Contribution.

Perceived Nexus Between Non-Invigilated Summative Assessment and Mental Health Difficulties: A Cross Sectional Studies.

The COVID-19 pandemic rapidly led to changes in the mode of teaching, learning and assessments in most tertiary institutions worldwide. Notably, non-invigilated summative assessments became predominant. These changes heightened anxiety and depression, especially among individuals with less resilient coping mechanism. We explored the perceptions and experiences of mental health difficulties of students in tertiary education regarding non-invigilated alternative assessments in comparison to invigilated assessments. A pragmatic, mixed method cross sectional design was conducted online via Qualtrics. Thematic analysis of text was carried out using NVivo 12. In the quantitative analysis, univariable and multivariable ordinal logistic models were used to examine the potential factors for preference among students in higher education. A total of 380 Nursing and Social Science students responded to the survey. Approximately 77% of students perceived non-invigilated assessments to be less stressful compared to invigilated exams. Age, course of study, stage of studies, and number of units enrolled per semester were identified as significant drivers for students' perceived preference for non-invigilated assessments. There was an inverse relationship between the perception of stress associated with invigilated exams and the age of students. For instance, students aged between 18-24 were 5 times more likely to prefer non-invigilated exams compared to those aged 55 or more. Comparatively, students in early stages of studies had higher preference for non-invigilated assessments. However, there was a preference reversal for students enrolled in 2 or less units per semester. Social sciences students were two times more likely to prefer non-invigilated examinations to invigilated examinations compared to nursing students. The findings reinforce the use of alternative assessments in higher education as a mitigating agency to lessen the mental health burden of tertiary students in post COVID-19 era. Supplementary Information: The online version contains supplementary material available at 10.1007/s10805-023-09472-w.

E-Waste in Africa: A Serious Threat to the Health of Children.

Waste electronic and electrical equipment (e-waste) consists of used and discarded electrical and electronic items ranging from refrigerators to cell phones and printed circuit boards. It is frequently moved from developed countries to developing countries where it is dismantled for valuable metals in informal settings, resulting in significant human exposure to toxic substances. E-waste is a major concern in Africa, with large sites in Ghana and Nigeria where imported e-waste is dismantled under unsafe conditions. However, as in many developing countries, used electronic and electrical devices are imported in large quantities because they are in great demand and are less expensive than new ones. Many of these used products are irreparable and are discarded with other solid waste to local landfills. These items are then often scavenged for the purpose of extracting valuable metals by heating and burning, incubating in acids and other methods. These activities pose significant health risks to workers and residents in communities near recycling sites. E-waste burning and dismantling activities are frequently undertaken at e-waste sites, often in or near homes. As a result, children and people living in the surrounding areas are exposed, even if they are not directly involved in the recycling. While toxic substances are dangerous to individuals at any age, children are more vulnerable as they are going through important developmental processes, and some adverse health impacts may have long-term impacts. We review the e-waste situation in Africa with a focus on threats to children's health.

Estimating the magnitude and risk associated with heat exposure among Ghanaian mining workers.

Many occupational settings located outdoors in direct sun, such as open cut mining, pose a health, safety, and productivity risk to workers because of their increased exposure to heat. This issue is exacerbated by climate change effects, the physical nature of the work, the requirement to work extended shifts and the need to wear protective clothing which restricts evaporative cooling. Though Ghana has a rapidly expanding mining sector with a large workforce, there appears to be no study that has assessed the magnitude and risk of heat exposure on mining workers and its potential impact on this workforce. Questionnaires and temperature data loggers were used to assess the risk and extent of heat exposure in the working and living environments of Ghanaian miners. The variation in heat exposure risk factors across workers' gender, education level, workload, work hours, physical work exertion and proximity to heat sources is significant (p<0.05). Mining workers are vulnerable to the hazards of heat exposure which can endanger their health and safety, productive capacity, social well-being, adaptive capacity and resilience. An evaluation of indoor and outdoor Wet Bulb Globe Temperature (WBGT) in the working and living environment showed that mining workers can be exposed to relatively high thermal load, thus raising their heat stress risk. Adequate adaptation policies and heat exposure management for workers are imperative to reduce heat stress risk, and improve productive capacity and the social health of mining workers.

Human Exposures to Neonicotinoids in Kumasi, Ghana.

Neonicotinoid insecticides (NNIs) are now popular in many agricultural systems across Africa; however, the extent of human exposures to NNIs in African countries is scarcely reported. The present study evaluates neonicotinoid exposures in the consumer population of Kumasi, a cosmopolitan city in Ghana. A total of 75 human urine samples were collected from healthy volunteers (nonfarmers, aged 13-80 yr) and analyzed with a liquid chromatography electrospray ionization tandem mass spectrometry system. Seven NNIs and 3 NNI metabolites were detected in the following pattern (frequency, median concentration, maximum concentration): N-dm-acetamiprid (94.7%, 0.41 µg/L, 8.79 µg/L) > imidacloprid (70.7%, 0.15 µg/L, 211.62 µg/L) > N-(6-chloro-3-pyridylmethyl)-N-ethyl-N'-methylformamidine (62.2%, 0.43 µg/L, 53.85 µg/L) > 2-[N-(6-chloro-3-pyridylmethyl)-N-ethylamino]-2-(methylimino)acetic acid (56.8%, 0.10 µg/L, 3.53 µg/L) > clothianidin (40%, >limit of quantification [LOQ], 0.45 µg/L) > nitenpyram (18.7%, >LOQ, 0.14 µg/L) ≈ thiamethoxam (18.7%, >LOQ, 0.21 µg/L) > dinotefuran (12.0%, >LOQ, 1.01 µg/L) > acetamiprid (2.7%, >LOQ, 0.08 µg/L) ≈ thiacloprid (2.7%, >LOQ, 0.14 µg/L). Approximately 92% of the subjects were found to be exposed to multiple neonicotinoids simultaneously. The mean, median, and maximum imidacloprid equivalent of the relative potency factor of NNIs were found to be 1.6, 0.5, and 22.52, respectively. The median estimated daily intakes of acetamiprid, imidacloprid, and nitenpyram were 0.47, 1.27, and 0.02 µg/kg/d for females and 0.91, 0.66, and 0.08 µg/kg/d for males, respectively. The maximum daily intakes of all the NNIs were <1% of their chronic reference doses (cRfDs), except for imidacloprid and thiacloprid which recorded maximum daily intakes corresponding to 17.97 and 8.28% of cRfDs, respectively. To the best of our knowledge, the present study is the first biomonitoring report on neonicotinoid insecticides in Africa. Environ Toxicol Chem 2021;40:2306-2318. © 2021 SETAC.

Construct validity and invariance assessment of the social impacts of occupational heat stress scale (SIOHSS) among Ghanaian mining workers.

Heat exposure studies over the last decade have shown little attention in assessing and reporting the psychometric properties of the various scales used to measure impacts of occupational heat stress on workers. A descriptive cross-sectional survey including 320 small- and large-scale mining workers was employed to assess the construct validity of the social impacts of occupational heat stress scale (SIOHSS) in the Western Region of Ghana in 2017. A confirmatory factor analysis (CFA) and invariance analysis were carried out using AMOS version 25 and statistical product and service solutions (SPSS) version 26 to examine the model fit and establish consistency correspondingly across multiple groups (gender, age, working hours, type of mining and workplace setting). Empirically, our results depicted that effects on health and safety, behavioural, productivity and social well-being were each found to be reliable, with Cronbach's α of 0.722, 0.807, 0.852 and 0.900 respectively. Though there were issues of insufficient discriminant validity as some average variance extract (AVE) were smaller than the corresponding maximum shared variance (MSV), the CFA showed good model fit indices (CFI = 0.856, GFI = 0.890, TLI = 0.863, SRMR = 0.08, RMSEA = 0.08). Also, the model was variant for all constrained aspects of the structural model indicating a requirement for an adaptation of the instrument across groups. The good to moderate internal consistency and construct validity of the SIOHSS is adequate evidence for the confidence required for its reliability and accuracy in measuring the social impacts of occupational heat stress on workers.

Severe dioxin-like compound (DLC) contamination in e-waste recycling areas: An under-recognized threat to local health.

Electrical and electronic waste (e-waste) burning and recycling activities have become one of the main emission sources of dioxin-like compounds (DLCs). Workers involved in e-waste recycling operations and residents living near e-waste recycling sites (EWRS) are exposed to high levels of DLCs. Epidemiological and experimental in vivo studies have reported a range of interconnected responses in multiple systems with DLC exposure. However, due to the compositional complexity of DLCs and difficulties in assessing mixture effects of the complex mixture of e-waste-related contaminants, there are few studies concerning human health outcomes related to DLC exposure at informal EWRS. In this paper, we have reviewed the environmental levels and body burdens of DLCs at EWRS and compared them with the levels reported to be associated with observable adverse effects to assess the health risks of DLC exposure at EWRS. In general, DLC concentrations at EWRS of many countries have been decreasing in recent years due to stricter regulations on e-waste recycling activities, but the contamination status is still severe. Comparison with available data from industrial sites and well-known highly DLC contaminated areas shows that high levels of DLCs derived from crude e-waste recycling processes lead to elevated body burdens. The DLC levels in human blood and breast milk at EWRS are higher than those reported in some epidemiological studies that are related to various health impacts. The estimated total daily intakes of DLCs for people in EWRS far exceed the WHO recommended total daily intake limit. It can be inferred that people living in EWRS with high DLC contamination have higher health risks. Therefore, more well-designed epidemiological studies are urgently needed to focus on the health effects of DLC pollution in EWRS. Continuous monitoring of the temporal trends of DLC levels in EWRS after actions is of highest importance.

Barriers to occupational heat stress risk adaptation of mining workers in Ghana.

Increasing temperature and climate warming impacts are aggravating the vulnerability of workers to occupational heat stress. Adaptation and social protection strategies have become crucial to enhance workers' health, safety, productive capacity and social lives. However, the effective implementation of work-related heat stress adaptation mechanisms appears to be receiving little attention. This study assessed the barriers to occupational heat stress adaptation and social protection strategies of mining workers in Ghana. Based on a mixed methods approach, focus group discussions and questionnaires were used to elicit data from 320 mining workers. Workers' adaptation strategies (water intake, wearing loose and light-coloured clothing, participating in training programmes, taking regular breaks, use of mechanical equipment, use of cooling systems and housing designs) varied significantly across the type of mining activity (p < .001). Workers' social protection measures were adequate. The disparities in workers' social protection measures significantly differed across the type of mining activity (p < .001). Barriers of workers to the implementation of relevant adaptation strategies (inadequate knowledge of coping and adaptive behaviour, lack of regular training on adaptation measures, lack of specific heat-related policy regulations, lack of management commitment and the lack of access to innovative technology and equipment) also differed across the type of mining activity (p < .001). Adaptation policy options and recommendations centred on overcoming the barriers that constrain the adaptive capacity of workers and employers have the potential to reduce workers' vulnerability to occupational heat stress.

The nexus between social impacts and adaptation strategies of workers to occupational heat stress: a conceptual framework.

Adverse effects of occupational heat stress in the context of the changing climate on working populations are subtle but considerably harmful. However, social dimensions and impacts of climate change-related occupational heat concerns on workers' safety and health, productivity and well-being are often overlooked or relegated as minor issues in social impact analyses of occupational heat exposure due to climate change. This paper offers a conceptual framework based on an appraisal and synthesis of the literature on social impacts of climate change-related occupational heat exposure on workers' safety and health, productivity and social welfare and the quest to localise and achieve sustainable development goals. A sustained global, national, institutional and individual collaborative involvement and financial support for research, improved adaptation and social protection strategies, predominantly in the developing world, where a large number of people work outdoors, can reduce heat exposure and boost the resilience and adaptive capacity of workers to facilitate efforts to achieve sustainable development goals.

Complex Mixtures of Brominated/Chlorinated Diphenyl Ethers and Dibenzofurans in Soils from the Agbogbloshie e-Waste Site (Ghana): Occurrence, Formation, and Exposure Implications.

The distribution and toxic equivalents (TEQs) of brominated and chlorinated dibenzo- p-dioxins/dibenzofurans (PBDD/Fs and PCDD/Fs) in soils from Agbogbloshie e-waste site (Ghana) were investigated. The composition of brominated/chlorinated dibenzofurans (PXDFs) and diphenyl ethers (PBDEs, PCDEs, and PXDEs) was examined using two-dimensional gas chromatography-time-of-flight mass spectrometry to elucidate possible formation pathways of dioxins from e-waste recycling. The highest concentrations of PCDD/Fs and PBDD/Fs were found, respectively, in the open burning (1.3-380 ng/g dry weight) and dismantling areas (11-1000 ng/g dry weight) and were comparable to the highest reported for informal e-waste sites. PXDFs and PXDEs were detected at up to the range of hundreds of nanograms per gram. The homologue profiles suggest that PXDFs were formed mainly from PBDFs through successive Br-to-Cl exchange. However, monobromo-PCDFs were also derived from de-novo-generated PCDFs in open burning areas. PBDFs contributed similar or higher TEQs (7.9-5400 pg/g dry weight) compared with PCDD/Fs (6.8-5200 pg/g dry weight), whereas PXDFs were also substantial TEQ contributors in open burning areas. The high TEQs of PBDFs in the dismantling area (120-5200 pg/g dry weight) indicate the need to consider brominated dioxins besides chlorinated dioxins in future studies on health implications for e-waste workers and local residents.

Perceptions of climate change and occupational heat stress risks and adaptation strategies of mining workers in Ghana.

Heavy physical workload for long hours coupled with increasing workplace heat exposure due to rising temperatures stemming from climate change, especially where there are inadequate prevention and control policies, adversely affect workers' health and safety, productive capacity and social well-being. However, variations in workers' concerns and awareness of occupational heat stress and climate change risks impede the effectiveness of heat stress management. A mixed method approach was used to assess climate change perceptions and occupational heat stress risks and adaptation strategies of Ghanaian mining workers. Questionnaires and focus group discussions were used to collect data from 320 respondents. Quantitative and qualitative approaches were used for data analysis. Workers' climate change risk perception, as confirmed by trends in climate data, was reasonable, but concerns about climate change effects and workplace heat exposure risks varied significantly across types of mining activity (p < 0.001). Workers experienced heat-related morbidities, but the variation in heat-related morbidity experiences across the type of mining activity was not significant. However, the type of heat-related morbidities experienced by workers differed across the type of mining activity (p < 0.001). Workers' awareness of occupational heat stress prevention and control was adequate. The disparities in workers' awareness and use of the prevention and control measures significantly differed across the type of mining activity (p < 0.001). Occupational heat stress prevention activities should focus on workers, and a concerted effort must be made to promote workers' adaptive capacity and inform policy decisions.

Climate change and occupational heat stress risks and adaptation strategies of mining workers: Perspectives of supervisors and other stakeholders in Ghana.

Increasing air temperatures as a result of climate change are worsening the impact of heat exposure on working populations, including mining workers, who are at risk of suffering heat-related illnesses, injury and death. However, inadequate awareness of climate change-related occupational heat stress risks and adaptation strategies have been shown to render occupational heat stress management ineffective. A concurrent mixed-methods approach was used to assess the perceptions of climate change and occupational heat stress risks and adaptation strategies of mining workers among supervisory personnel and other stakeholders in Ghana. Questionnaires and interviews were used to elicit data from 19 respondents. Data were processed and interpreted using descriptive statistics, chi-square and Fisher's exact tests, and thematic analysis. Supervisors' climate change risks perception was adequate, and their concern about workplace heat exposure risks was moderate. Mining workers' occupational heat stress risks experiences were linked to heat-related illness and minor injuries. Mining workers' adaptation strategies included water intake, use of cooling mechanisms, work-break practices, and clothing use. The related differences in job experience in the distribution of climate change risk perception and occupational heat stress risk experiences, and the difference in educational attainment in the distribution of adaptation strategies of occupational heat stress were significant (p < 0.05). Hence, an effective workplace heat management policy requires adequate understanding of occupational heat stress risks and adaptation policies and continued education and training for mining workers.

Social impacts of occupational heat stress and adaptation strategies of workers: A narrative synthesis of the literature.

Dimensions of risks and impacts of occupational heat stress due to climate change on workers' health and safety, productivity, and social well-being are significantly deleterious. Aside from empirical evidence, no systematic review exists for policy development and decision making in managing occupation heat stress impacts and adaptation strategies of workers. This study sought to synthesise evidence on the social impacts of occupational heat stress and adaptation strategies of workers. From a review of existing literature, eight categories were obtained from 25 studies and grouped into three syntheses: (1) awareness of occupational heat stress, (2) social impacts of occupational heat stress and (3) workers' adaptation to occupational heat stress due to changing climate. Awareness of occupational heat stress among workers varied and their social impacts were related to workers' health and safety, productivity and social well-being. Sustainable adaptation to occupation heat stress due to climate change hinges on financial resource availability. Adequate investment and research are required to develop and implement policies to combat the threat of rising temperature and climate change to enhance workers' adaptive capacity, boost resilience and foster sustainable development.

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.

Association between human exposure to heavy metals/metalloid and occurrences of respiratory diseases, lipid peroxidation and DNA damage in Kumasi, Ghana.

Heavy metals and metalloids contamination in soils, water, food and livers of wild rats have been studied in Kumasi, Ghana and despite the estimated risks to residents, there is no epidemiological study to ascertain these projections. In addition, the World Health Organization and International Agency for Research on Cancer have reported an increase in respiratory diseases and cancers, in Ghana. The study's purpose was therefore to explore the potential associations between metal exposure and occurrences of respiratory diseases, lipid peroxidation and/or DNA damage to different age groups and sexes in Kumasi. Human urine was collected from the general population in urban and control sites in Kumasi and nine metals were measured in each sample. Results showed that although Zn was the most abundant total urinary As concentration was higher in 83% of samples compared to reference values. Urinary concentrations of metals, malondialdehyde (MDA) and 8-hydroxy-2-deoxy-guanosine (8-OHdG) were higher in urban sites compared to the control site. Based on the results obtained, there was no significant correlation between urinary metals and age. However, urinary Cd and MDA were highest in age groups 61-85 and 3-20 years, respectively. Significantly higher levels of urinary Co, As and Cd were detected in female participants. The study revealed that exposure to As was significantly associated with increased odds of asthma (odds ratio (OR) = 2.76; CI: 1.11-6.83) and tachycardia (OR = 3.93; CI: 1.01-15.4). Significant association was observed between urinary metals and MDA and 8-OHdG indicating possibility of lipid peroxidation and/or DNA damage in Kumasi residents.

Oxidative stress and respiratory symptoms due to human exposure to polycyclic aromatic hydrocarbons (PAHs) in Kumasi, Ghana.

Studies of polycyclic aromatic hydrocarbons (PAHs) and its metabolites in PM10, soils, rat livers and cattle urine in Kumasi, Ghana, revealed high concentrations and cancer potency. In addition, WHO and IARC have reported an increase in cancer incidence and respiratory diseases in Ghana. Human urine were therefore collected from urban and control sites to: assess the health effects associated with PAHs exposure using malondialdehyde (MDA) and 8-hydroxy-2-deoxyguanosine (8-OHdG); identify any association between OH-PAHs, MDA, 8-OHdG with age and sex; and determine the relationship between PAHs exposure and occurrence of respiratory diseases. From the results, urinary concentrations of the sum of OH-PAHs (∑OHPAHs) were significantly higher from urban sites compared to the control site. Geometric mean concentrations adjusted by specific gravity, GMSG, indicated 2-OHNaphthalene (2-OHNap) (6.01 ± 4.21 ng/mL) as the most abundant OH-PAH, and exposure could be through the use of naphthalene-containing-mothballs in drinking water purification, insect repellent, freshener in clothes and/or "treatment of various ailments". The study revealed that exposure to naphthalene significantly increases the occurrence of persistent cough (OR = 2.68, CI: 1.43-5.05), persistent headache (OR = 1.82, CI: 1.02-3.26), tachycardia (OR = 3.36, CI: 1.39-8.10) and dyspnea (OR = 3.07, CI: 1.27-7.43) in Kumasi residents. Highest level of urinary 2-OHNap (224 ng/mL) was detected in a female, who reported symptoms of persistent cough, headache, tachycardia, nasal congestion and inflammation, all of which are symptoms of naphthalene exposure according to USEPA. The ∑OHPAHs, 2-OHNap, 2-3-OHFluorenes, and -OHPhenanthrenes showed a significantly positive correlation with MDA and 4-OHPhenanthrene with 8-OHdG, indicating possible lipid peroxidation/cell damage or degenerative disease in some participants. MDA and 8-OHdG were highest in age group 21-60. The present study showed a significant sex difference with higher levels of urinary OH-PAHs in females than males.

Occurrence, profiles, and toxic equivalents of chlorinated and brominated polycyclic aromatic hydrocarbons in E-waste open burning soils.

We conducted this study to assess the occurrence, profiles, and toxicity of chlorinated polycyclic aromatic hydrocarbons (Cl-PAHs) and brominated polycyclic aromatic hydrocarbons (Br-PAHs) in e-waste open burning soils (EOBS). In this study, concentrations of 15 PAHs, 26 Cl-PAHs and 14 Br-PAHs were analyzed in EOBS samples. We found that e-waste open burning is an important emission source of Cl-PAHs and Br-PAHs as well as PAHs. Concentrations of total Cl-PAHs and Br-PAHs in e-waste open burning soil samples ranged from 21 to 2800 ng/g and from 5.8 to 520 ng/g, respectively. Compared with previous studies, the mean of total Cl-PAH concentrations of the EOBS samples in this study was higher than that of electronic shredder waste, that of bottom ash, and comparable to fly ash from waste incinerators in Korea and Japan. The mean of total Br-PAH concentrations of the EOBS samples was generally three to four orders of magnitude higher than those in incinerator bottom ash and comparable to incinerator fly ash, although the number of Br-PAH congeners measured differed among studies. We also found that the Cl-PAH and Br-PAH profiles were similar among all e-waste open burning soil samples but differed from those in waste incinerator fly ash. The profiles and principal component analysis results suggested a unique mechanism of Cl-PAH and Br-PAH formation in EOBS. In addition, the Cl-PAHs and Br-PAHs showed high toxicities equivalent to PCDD/Fs measured in same EOBS samples when calculated based on their relative potencies to benzo[a]pyrene. Along with chlorinated and brominated dioxins and PAHs, Cl-PAHs and Br-PAHs are important environmental pollutants to investigate in EOBS.

Health Consequences of Environmental Exposures: Changing Global Patterns of Exposure and Disease.

Environmental pollution is a major cause of disease and death. Exposures in early life are especially dangerous. Patterns of exposure vary greatly across countries. In low-income and lower middle income countries (LMICs), infectious, maternal, neonatal, and nutritional diseases are still major contributors to disease burden. By contrast, in upper middle income and high-income countries noncommunicable diseases predominate. To examine patterns of environmental exposure and disease and to relate these patterns to levels of income and development, we obtained publically available data in 12 countries at different levels of development through a global network of World Health Organization Collaborating Centres in Children's Environmental Health. Pollution exposures in early life contribute to both patterns. Chemical and pesticide pollution are increasing, especially in LMICs. Hazardous wastes, including electronic waste, are accumulating. Pollution-related chronic diseases are becoming epidemic. Future Global Burden of Disease estimates must pay increased attention to the short- and long-term consequences of environmental pollution.

Environmental Pollution: An Under-recognized Threat to Children's Health, Especially in Low- and Middle-Income Countries.

Exposures to environmental pollutants during windows of developmental vulnerability in early life can cause disease and death in infancy and childhood as well as chronic, non-communicable diseases that may manifest at any point across the life span. Patterns of pollution and pollution-related disease change as countries move through economic development. Environmental pollution is now recognized as a major cause of morbidity and mortality in low- and middle-income countries (LMICs). According to the World Health Organization, pollution is responsible for 8.9 million deaths around the world each year; of these, 94% (8.4 million) are in LMICs. Toxic chemical pollution is growing into a major threat to children's health in LMICs. The disease and disability caused by environmental pollution have great economic costs, and these costs can undercut trajectories of national development. To combat pollution, improved programs of public health and environmental protection are needed in countries at every level of development. Pollution control strategies and technologies that have been developed in high-income countries must now be transferred to LMICs to assist these emerging economies to avoid the mistakes of the past. A new international clearinghouse is needed to define and track the health effects of pollution, quantify the economic costs of these effects, and direct much needed attention to environmental pollution as a risk factor for disease.