| Modern Environmental Health Hazards: A Public Health Issue of Increasing Significance in Africa Onyemaechi C. Nweke1 and William H. Sanders III2,* 1Office of Policy, Economics, and Innovation, and 2Office of Children’s Health Protection and Environmental Education, U.S. Environmental Protection Agency, Washington, DC, USA Abstract
Objectives: Traditional hazards such as poor sanitation currently account for most of Africa’s environmentally related disease burden. However, with rapid development absent appropriate safeguards for environment and health, modern environmental health hazards (MEHHs) may emerge as critical contributors to the continent’s disease burden. We review recent evidence of human exposure to and health effects from MEHHs, and their occurrence in environmental media and consumer products. Our purpose is to highlight the growing significance of these hazards as African countries experience urbanization, industrial growth, and development. Data sources: We reviewed published epidemiologic, exposure, and environmental studies of chemical agents such as heavy metals and pesticides. Data synthesis: The body of evidence demonstrates ongoing environmental releases of MEHHs and human exposures sometimes at toxicologically relevant levels. Several sources of MEHHs in environmental media have been identified, including natural resource mining and processing and automobile exhaust. Biomonitoring studies provided direct evidence of human exposure to metals such as mercury and lead and pesticides such as p,p´-dichlorodiphenyltrichloroethane (DDT) and organophosphates. Land and water resource pollution and industrial air toxics are areas of significant data gaps, notwithstanding the presence of several emitting sources. Conclusion: Unmitigated MEHH releases and human exposure have implications for Africa’s disease burden. For Africans encumbered by conditions such as malnutrition that impair resilience to toxicologic challenges, the burden may be higher. A shift in public health policy toward accommodating the emerging diversity in Africa’s environmental health issues is necessary to successfully alleviate the burden of avoidable ill health and premature death for all its communities now and in the future. Key words: Africa, environmental health, hazards. Environ Health Perspect 117:863–870 (2009) . doi:10.1289/ehp.0800126 available via http://dx.doi.org/ [Online 29 January 2009]
Address correspondence to O.C. Nweke, Office of Policy, Economics, and Innovation, U.S. Environmental Protection Agency, MC1809T, 1200 Pennsylvania Ave. NW, Washington, DC 20460 USA. Telephone: (202) 566-2314. Fax: (202) 566-2339. E-mail: nweke.onyemaechi@epa.gov *Current address: National Center for Environmental Research, Office of Research and Development, U.S. Environmental Protection Agency, Washington, DC. Supplemental Material is available online at http://www.ehponline.org/members/2009/0800126/suppl.pdf We thank D. Payne-Sturges, M. Berger, C. Mercurio, and M. Bailey for their assistance with reviewing earlier versions of the manuscript ; and C. Curtis for research assistance at the initial phase of the project. This article reflects the opinions of the authors and does not represent the views of the U.S. Environmental Protection Agency. The authors declare they have no competing financial interests. Received 26 August 2008 ; accepted 28 January 2009.
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