Personal exposure to particulate matter and heart rate variability among informal electronic waste workers at Agbogbloshie: a longitudinal study.

BACKGROUND: Informal electronic waste recycling activities are major contributors to ambient air pollution, yet studies assessing the effects or relationship between direct/continuous exposure of informal e-waste workers to particulate matter and cardiovascular function are rare. METHODS: Repeated measurements of fractions of PM2.5, PM10-2.5, and PM10 in personal air of informal e-waste workers, (n = 142) and a comparable group (n = 65) were taken over a period of 20 months (March 2017 to November, 2018). Concurrently, 5-min resting electrocardiogram was performed on each participant to assess resting heart rate variability indices. Linear mixed-effects models were used to assess the association between PM fractions and cardiac function. RESULTS: SDNN, RMSSD, LF, HF and LH/HF ratio were all associated with PM. Significant associations were observed for PM2.5 and Mean NN (p = 0.039), PM10 and SDNN (p = 0.035) and PM 10-2.5 and LH/HF (p = 0.039). A 10 µg/m3 increase in the concentrations of PM 2.5, PM10-2.5, and PM10 in personal air was associated with reduced HRV indices and increased resting HR. A 10 µg/m3 per interquartile (IQR) increase in PM10-2.5 and PM10, decreased SDNN by 11% [(95% CI: - 0.002- 0.000); (p = 0.187)] and 34% [(95% CI: - 0.002-0.001); (p = 0.035)] respectively. However, PM2.5 increased SDNN by 34% (95% CI: - 1.32-0.64); (p = 0.493). Also, 10 µg/m3 increase in PM2.5, PM10-2.5 and PM10 decreased RMSSD by 27% [(- 1.34-0.79); (p = 0.620)], 11% [(- 1.73, 0.95); (p = 0.846)] and 0.57% [(- 1.56-0.46); (p = 0.255%)]. CONCLUSION: Informal e-waste workers are at increased risk of developing cardiovascular disease from cardiac autonomic dysfunction as seen in reduced HRV and increased heart rate.

A PRELIMINARY ASSESSMENT OF PHYSICAL WORK EXPOSURES AMONG ELECTRONIC WASTE WORKERS AT AGBOGBLOSHIE, ACCRA GHANA.

Occupational exposure associated with unstructured, informal e-waste recycling has received very limited attention. This study aimed to quantify the occupational physical exposures among informal e-waste workers at the largest e-waste site in Africa. A cross-sectional field survey of 163 male e-waste workers was conducted using a self-report occupational physical activity questionnaire, along with direct work observations, and pedometer estimates of walking activity for a subset of workers (n = 42). Results indicated significant differences in self-reported 7-day work exposures among the three main e-waste job categories, namely, collectors (n = 70), dismantlers (n = 73) and burners (n = 20). Prolonged walking, sitting and standing on five or more days in the workweek was frequently reported by collectors (87%), dismantlers (82%) and burners (60%), respectively. Nearly 90% of collectors and burners and 60% of dismantlers reported lifting and carrying on five or more days in the workweek. The exposure combinations identified suggest a risk for musculoskeletal disorders (MSDs). Findings call attention to the need for research examining potential associations between physical exposures and MSDs affecting e-waste workers in Agbogbloshie. The high exposure variability both between and within workers has implications for future exposure assessments conducted in unregulated, informal work settings.

Micronutrient-rich dietary intake is associated with a reduction in the effects of particulate matter on blood pressure among electronic waste recyclers at Agbogbloshie, Ghana.

BACKGROUND: Informal recycling of electronic waste (e-waste) releases particulate matter (PM) into the ambient air. Human exposure to PM has been reported to induce adverse effects on cardiovascular health. However, the impact of PM on the cardiovascular health of e-waste recyclers in Ghana has not been studied. Although intake of micronutrient-rich diet is known to modify these PM-induced adverse health effects, no data are available on the relationship between micronutrient status of e-waste recyclers and the reported high-level exposure to PM. We therefore investigated whether the intake of micronutrient-rich diets ameliorates the adverse effects of ambient exposure to PM2.5 on blood pressure (BP). METHODS: This study was conducted among e-waste and non-e-waste recyclers from March 2017 to October 2018. Dietary micronutrient (Fe, Ca, Mg, Se, Zn, and Cu) intake was assessed using a 2-day 24-h recall. Breathing zone PM2.5 was measured with a real-time monitor. Cardiovascular indices such as systolic BP (SBP), diastolic BP (DBP), and pulse pressure (PP) were measured using a sphygmomanometer. Ordinary least-squares regression models were used to estimate the joint effects of ambient exposure to PM2.5 and dietary micronutrient intake on cardiovascular health outcomes. RESULTS: Fe was consumed in adequate quantities, while Ca, Se, Zn, Mg, and Cu were inadequately consumed among e-waste and non-e-waste recyclers. Dietary Ca, and Fe intake was associated with reduced SBP and PP of e-waste recyclers. Although PM2.5 levels were higher in e-waste recyclers, exposures in the control group also exceeded the WHO 24-h guideline value (25 µg/m3). Exposure to 1 µg/m3 of PM2.5 was associated with an increased heart rate (HR) among e-waste recyclers. Dietary Fe intake was associated with a reduction in systolic blood pressure levels of e-waste recyclers after PM exposure. CONCLUSIONS: Consistent adequate dietary Fe intake was associated with reduced effects of PM2.5 on SBP of e-waste recyclers overtime. Nonetheless, given that all other micronutrients are necessary in ameliorating the adverse effects of PM on cardiovascular health, nutrition-related policy dialogues are required. Such initiatives would help educate informal e-waste recyclers and the general population on specific nutrients of concern and their impact on the exposure to ambient air pollutants.

Knowledge of pregnant women about birth defects.

BACKGROUND: Occurrence of birth defects (BD) remains an important public health issue. Inadequate knowledge about the defects among prospective mothers could result in delayed interventions. The study determined the knowledge of BD among pregnant women in relation to their socio-demographic profile. METHOD: Four hundred and forty-three (443) pregnant women gave their consent to participate in this study. A researcher-administered questionnaire was used to obtain information on socio-demographic characteristics from the participants and their knowledge about BD. The questionnaire was assessed for test re-test reliability before been administered. The possible scores on the knowledge domain of the questionnaire were categorized into three levels: low knowledge (0-4), moderate knowledge (5-8) and high knowledge (9-12) levels. Data were analyzed using percentages while Spearman's rank correlation was used to determine the relationship between the knowledge of BD among the participants and their socio-demographic profile. Alpha level was set at p < 0.05. RESULTS: A greater proportion of the participants, 235(53.0%) were found in the age range 21 to 30 years, and 234(52.8%) attained secondary level of education. Majority of the participants, 205(46.3%) had high knowledge on the risk factors while 213(48.1%) and 224(50.6%) had moderate overall knowledge and specific knowledge about BD respectively. Most of the participants (48.1%) believed that BD were of supernatural origin. The age, level of education, number of antenatal visits and parity of the participants were not significantly correlated (p > 0.05) with their specific and overall knowledge. CONCLUSIONS: Particpants generally had moderate knowledge about BD. However, this had no bearing on their socio-demographic profile. The knowledge base about BD seems to be influenced by traditional belief of the participants. This finding should therefore serve as a guide for health care providers while planning awareness campaign about BD.

Occupational exposures to particulate matter and PM2.5-associated polycyclic aromatic hydrocarbons at the Agbogbloshie waste recycling site in Ghana.

Electronic waste (e-waste) disposal and recycling activities such as burning and smelting can emit particulate matter (PM), polycyclic aromatic hydrocarbons (PAHs), and other pollutants that expose workers and nearby communities. At informal e-waste recycling facilities, both emission controls and protective measures for workers are absent. This study characterizes personal exposures (breathing zone) of PM and PAHs of e-waste workers at the large Agbogbloshie e-waste site in Accra, Ghana. We collected gravimetric and optical measurements of PM2.5 and PM10 using shift samples for workers and for an age- and gender-matched reference population. PM2.5 filters were analyzed for 26 PAHs using gas chromatography/mass spectroscopy. Among e-waste workers, PM2.5 and PM10 concentrations were 99 ± 56 and 218 ± 158 µg/m3 (median ± interquartile range, optical measurements), respectively; these levels were 78 and 57% higher, respectively, than levels measured at a fixed site that was centrally located at the waste site. In the reference community, breathing zone PM2.5 and PM10 levels were lower, 49 ± 20 and 131 ± 108 µg/m3, respectively, and the fraction of coarse PM was larger. We detected all 26 target PAHs, of which naphthalene and phenanthrene were the most abundant. PAH concentrations were weakly correlated to PM levels, but PAH abundances, representing the fraction of PAH mass to the total PM2.5 mass collected, were strongly and inversely correlated to PM levels, suggesting multiple and different sources of PAHs and PM that affected exposures. Both PM and PAH levels were elevated for workers performing burning and dismantling, and both exceeded standards or risk-based guidelines, e.g., lifetime excess cancer risks for several PAHs were in the 10-4 to 10-6 range, indicating the need to reduce emissions as well as provide respiratory protection. The study emphasizes the importance of using personal and shift samples to accurately characterize worker exposure.

Occupational and Environmental Health Effects of Informal Electronic Waste Recycling - A Focus on Agbogbloshie, Ghana.

The unregulated and unorganized structure of informal electronic waste recycling worksites exposes workers to numerous occupational hazards. This context also presents research challenges in collecting exposure data to establish linkages with adverse health effects and development of risk-mitigating strategies. This paper presents some findings from a 5-year multinational and multi-institutional collaboration of academic and government partners, which documented extensive occupational and environmental health conditions at the Agbogbloshie electronic waste site in central Accra, Ghana.

Work-Related Exposures and Musculoskeletal Disorder Symptoms among Informal E-Waste Recyclers at Agbogbloshie, Ghana.

Recycling of electrical and electronic waste (e-waste) in developing countries is mostly conducted in the informal sector consisting of low skilled workers. Informal e-waste recycling predominantly involves the physically demanding work of manually collecting, dismantling and burning of e-waste items to extract reusable components and valuable metals including gold or copper. This cross-sectional study investigated the effects of manual e-waste recycling work on the musculoskeletal health of 176 workers at Agbogbloshie in Accra, Ghana - the largest informal e-waste dumpsites in Africa. Findings indicate significant associations between prolonged walking and weighted MSD symptom scores for the lower extremities, and between manual material handlings tasks and weighted MSD symptom scores for the upper extremities and lower back. The study calls attention to the need for ergonomics research in the informal work sector to promote safer practices and address a range of worker health concerns.

A Systematic Review of the Effects of Temperature on Anopheles Mosquito Development and Survival: Implications for Malaria Control in a Future Warmer Climate.

The rearing temperature of the immature stages can have a significant impact on the life-history traits and the ability of adult mosquitoes to transmit diseases. This review assessed published evidence of the effects of temperature on the immature stages, life-history traits, insecticide susceptibility, and expression of enzymes in the adult Anopheles mosquito. Original articles published through 31 March 2021 were systematically retrieved from Scopus, Google Scholar, Science Direct, PubMed, ProQuest, and Web of Science databases. After applying eligibility criteria, 29 studies were included. The review revealed that immature stages of An. arabiensis were more tolerant (in terms of survival) to a higher temperature than An. funestus and An. quadriannulatus. Higher temperatures resulted in smaller larval sizes and decreased hatching and pupation time. The development rate and survival of An. stephensi was significantly reduced at a higher temperature than a lower temperature. Increasing temperatures decreased the longevity, body size, length of the gonotrophic cycle, and fecundity of Anopheles mosquitoes. Higher rearing temperatures increased pyrethroid resistance in adults of the An. arabiensis SENN DDT strain, and increased pyrethroid tolerance in the An. arabiensis SENN strain. Increasing temperature also significantly increased Nitric Oxide Synthase (NOS) expression and decreased insecticide toxicity. Both extreme low and high temperatures affect Anopheles mosquito development and survival. Climate change could have diverse effects on Anopheles mosquitoes. The sensitivities of Anopeheles mosquitoes to temperature differ from species to species, even among the same complex. Notwithstanding, there seem to be limited studies on the effects of temperature on adult life-history traits of Anopheles mosquitoes, and more studies are needed to clarify this relationship.

Comparison of ergonomic risk factors and work-related musculoskeletal disorders among dismantler and burners of electronic waste in Agbogbloshie, Accra Ghana.

Rudimentary methods for electronic waste (e-waste) recycling employed in developing countries are a source of work-related musculoskeletal disorders (WRMSDs). A summarized comparison of WRMSDs and preliminary exposure assessment among e-waste dismantlers (D) and burners (B) in Agbogbloshie, Ghana is presented. A cross-sectional study was conducted to investigate WRMSDs and associated risk factors using the Cornell Musculoskeletal Discomfort Questionnaire and a newly developed ergonomic assessment tool. Results indicated higher WRMSDs prevalence in the lower back (68% D vs. 52% B; p = 0.172), shoulder (41% D vs. 29% B; p = 0.279) and upper arm (33% D vs 5% B; p = 0.010). Moderate to severe trunk flexion, high force exertion, repetition and vibration were prevalent risk factors among workers and were significantly higher in dismantlers than burners (p ≤ 0.001). Detailed ergonomic studies investigating the relationship between physical exposures and WRMSDs are needed to provide a deeper understanding of WRMSD causation in e-waste workers and more particularly in unstructured, unregulated work.

Musculoskeletal Disorder Symptoms among Workers at an Informal Electronic-Waste Recycling Site in Agbogbloshie, Ghana.

Informal recycling of electrical and electronic waste (e-waste) has myriad environmental and occupational health consequences, though information about the chronic musculoskeletal health effects on workers is limited. The aim of this study was to examine the prevalence and intensity of self-reported musculoskeletal disorder (MSD) symptoms among e-waste workers at Agbogbloshie in Ghana-the largest informal e-waste dumpsite in West Africa-relative to workers not engaged in e-waste recycling. A standardized musculoskeletal discomfort questionnaire was administered to 176 e-waste workers (73 collectors, 82 dismantlers, and 21 burners) and 41 workers in a reference group. The number of body parts with musculoskeletal discomfort were 1.62 and 1.39 times higher for collectors and dismantlers than burners, respectively. A 1-week discomfort prevalence was highest for collectors (91.8%) followed by dismantlers (89%), burners (81%), and the reference group (70.7%). The discomfort prevalence for e-waste workers was highest in the lower back (65.9%), shoulders (37.5%), and knees (37.5%). Whole-body pain scores (mean ± SE) were higher for collectors (83.7 ± 10.6) than dismantlers (45.5 ± 7.6), burners (34.0 ± 9.1), and the reference group (26.4 ± 5.9). Differences in prevalence, location, and intensity of MSD symptoms by the e-waste job category suggest specific work-related morbidity. Symptom prevalence and intensity call attention to the high risk for MSDs and work disability among informal e-waste workers, particularly collectors and dismantlers.

Micronutrient Status of Electronic Waste Recyclers at Agbogbloshie, Ghana.

Growing evidence suggests that micronutrient status is adversely impacted by toxic metals (e.g., cadmium, lead, and arsenic) exposures; however, the micronutrient status of e-waste recyclers who are amongst the highest metal-exposed groups is not known. This study, therefore, assessed the micronutrient status of e-waste recyclers using dietary information (2-day 24-h recall survey) and biomarker data (whole blood and urine) among 151 participants (100 e-waste recyclers at Agbogbloshie and 51 controls at Madina Zongo from the Accra region, Ghana) in March 2017. Biomarker levels of iron (Fe), calcium (Ca), magnesium (Mg), selenium (Se), zinc (Zn) and copper (Cu) were analyzed by the ICP-MS. Linear regression models were used to assess associations ofwork-related factors and sociodemographic characteristics with micronutrient intake, blood, and urine micronutrient levels. The results showed that apart from Fe and Zn, e-waste recyclers at Agbogbloshie did not meet the day-to-day dietary requirements for Ca, Cu, Se, and Mg intake. Except for the low levels of Mg and Fe detected in blood of e-waste recyclers, all other micronutrients measured in both blood and urine of both groups fell within their reference range. Exposure to biomass burning was associated with lower blood levels of Fe, Mg, and Zn among the e-waste recyclers. Further, among e-waste recyclers, significant relationships were found between the number of years spent recycling e-waste and urinary Ca and Cu excretion. Given that, some dietary and blood levels of micronutrients were below their reference ranges, the implementation of evidence-based nutrition strategies remains necessary among e-waste recyclers to reduce their risk of becoming malnourished.

Effect of Particulate Matter Exposure on Respiratory Health of e-Waste Workers at Agbogbloshie, Accra, Ghana.

Background: Direct and continuous exposure to particulate matter (PM), especially in occupational settings is known to impact negatively on respiratory health and lung function. Objective: To determine the association between concentrations of PM (2.5, 2.5-10 and 10 µm) in breathing zone and lung function of informal e-waste workers at Agbogbloshie. Methods: To evaluate lung function responses to PM (2.5, 2.5-10 and 10 µm), we conducted a longitudinal cohort study with three repeated measures among 207 participants comprising 142 healthy e-waste workers from Agbogbloshie scrapyard and 65 control participants from Madina-Zongo in Accra, Ghana from 2017-2018. Lung function parameters (FVC, FEV1, FEV1/FVC, PEF, and FEF 25-75) and PM (2.5, 2.5-10 and 10 µm) concentrations were measured, corresponding to prevailing seasonal variations. Socio-demographic data, respiratory exposures and lifestyle habits were determined using questionnaires. Random effects models were then used to examine the effects of PM (2.5, 2.5-10 and 10 µm) on lung function. Results: The median concentrations of PM (2.5, 2.5-10 and 10 µm) were all consistently above the WHO ambient air standards across the study waves. Small effect estimates per IQR of PM (2.5, 2.5-10 and 10 µm) on lung function parameters were observed even after adjustment for potential confounders. However, a 10 µg increase in PM (2.5, 2.5-10 and 10 µm) was associated with decreases in PEF and FEF 25-75 by 13.3% % [ß = -3.133; 95% CI: -0.243, -0.022) and 26.6% [ß = -0.266; 95% CI: -0.437, 0.094]. E-waste burning and a history of asthma significantly predicted a decrease in PEF by 14.2% [ß = -0.142; 95% CI: -0.278, -0.008) and FEV1 by 35.8% [ß = -0.358; 95% CI: -0.590, 0.125] among e-waste burners. Conclusions: Direct exposure of e-waste workers to PM predisposes to decline in lung function and risk for small airway diseases such as asthma and COPD.

Development of an observation-based tool for ergonomic exposure assessment in informal electronic waste recycling and other unregulated non-repetitive work.

Most existing ergonomic assessment tools are intended for routine work. Time- and cost-efficient observational tools for ergonomic assessment of unregulated work are lacking. This paper presents the development of an observation-based tool designed to investigate ergonomic exposures among informal electronic waste workers that could be applied to other unregulated jobs/tasks. Real time coding of observation is used to estimate the relative duration, intensity, and frequency of exposure to key work postures, forceful exertions, movements, contact stress and vibration. Time spent in manual material handling activities such as carrying, lifting and pushing/pulling of working carts are also estimated. A preliminary study conducted with 6 e-waste workers showed that the tool can easily be used with minimal training and good inter-observer agreement (i.e., 89% to 100%) for most risk factors assessed. This new assessment tool provides effective and flexible options for quantifying ergonomic exposures among workers engaged in unregulated, highly variable work.

Spatiality in Health: The Distribution of Health Conditions Associated with Electronic Waste Processing Activities at Agbogbloshie, Accra.

Background: A walk through the Agbogbloshie e-waste recycling site shows a marked heterogeneity in the spatial distribution of the different e-waste processing activities, which are likely to drive clustering of health conditions associated with the different activity type in each space. Objective of study: To conduct a spatial assessment and analysis of health conditions associated with different e-waste activities at different activity spaces at Agbogbloshie. Methods: A choropleth showing the various activity spaces at the Agbogbloshie e-waste site was produced by mapping boundaries of these spaces using Etrex GPS device and individuals working in each activity spaces were recruited and studied. Upon obtaining consent and agreeing to participate in the study, each subject was physically examined and assessed various health outcomes of interest via direct physical examination while characterizing and enumerating the scars, lacerations, abrasions, skin condition and cuts after which both systolic and diastolic blood pressure values were recorded alongside the administration of open and close ended questionnaires. All individuals working within each activity space and consented to participate were recruited; giving a total of one hundred and twelve (112) subjects in all. Results: A study of the choropleth showed that health conditions associated e-waste processing activities were clustered in a fashion similar to the corresponding distribution of each activity. While a total of 96.2% of all the study subjects had cuts, the dismantlers had higher mix of scars, lacerations and abrasions. Abrasions were observed in 16.3% of the dismantlers. Scars were the most common skin condition and were observed on the skins of 93.6% of the subjects. Prevalence of burns among the study subjects was 23.1%. Developing hypertension was not associated with activity type and while a total of 90.2% of subjects had normal blood pressure and 9.8% of them were hypertensives. Finally, 98.2% of respondents felt the need to have a first aid clinic at the site with 96.4% and 97.3% willing to visit the clinic and pay for services respectively. Conclusion: We conclude that while the observed injuries were random and were due purely to accidents without any role of spatial determinants such as the configuration, slope, topography and other subterranean features of the activity spaces, a strong association between the injuries and activity type was observed.

Processes and Challenges associated with informal electronic waste recycling at Agbogbloshie, a suburb of Accra, Ghana.

Electronic waste (e-waste) is a worldwide problem with regards to its increasing rate in the global waste stream. Its recycling is known to be associated with adverse health outcomes. The recycling site at Agbogbloshie is a major e-waste recycling hub which presents enormous health threats to the residents in this community as a result of exposure to complex mixtures of chemicals associated with the poor work methods employed. This paper describes the processes involved in e-waste recycling at Agbogbloshie and discusses some of the associated health and psychosocial challenges. Direct field observations and in-depth interviews of eight e-waste workers were conducted from November, 2017 to December, 2017. Results from a thematic analysis of obtained data suggest that inappropriate recycling methods, financial constraints, and the high physical demands of e-waste recycling work were associated with adverse musculoskeletal health conditions among the workers. A more systematic ergonomic study is currently being undertaken to quantify the associations between physical work exposures and worker musculoskeletal health among e-waste workers in Agbogbloshie. Further studies are needed that focus on locally adapted ergonomic interventions for effective recycling of e-waste and reducing the health risk to workers.