BackgroundThe Sustainable Development Goals include commitments to end poverty, and promote education for all, gender equality, the availability of water and decent work for all. An important constraint is the fact that each day, many millions of women and children, and much less frequently men, carry their household’s water home from off-plot sources. The burden of fetching water exacerbates gender inequality by keeping women out of education and paid employment. Despite speculation about the potential health impacts of fetching water, there is very little empirical evidence. We report the first large study of the health impacts of carrying water on women and children.MethodsA cross-sectional survey was conducted in South Africa, Ghana and Vietnam during 2012. It investigated water carrying methods and health status. Because areas of self-reported pain were correlated we undertook factor analysis of sites of reported pain, to interpret patterns of pain reporting. Regression analysis using Generalised Estimating Equations (GEE) investigated water carrying as a risk factor for general health and self-reported pain.ResultsPeople who previously carried water had increased relative risk of reporting pain in the hands (risk ratio RR 3.62, 95% confidence interval CI 1.34 to 9.75) and upper back (RR 2.27, 95% CI 1.17 to 4.40), as did people who currently carry water (RR hand pain 3.11, 95% CI 1.34 to 7.23; RR upper back pain 2.16, 95% CI 1.25 to 3.73). The factor analysis results indicate that factor 1, ‘axial compression’, which is correlated with pain in the head and upper back, chest/ribs, hands, feet and abdomen/stomach, is associated with currently (0.30, 95% CI 0.17 to 0.43) or previously (0.21, 95% CI 0.01 to 0.42) carrying water. Factor 2, ‘soft tissue strain’, which is correlated with pain in the neck, shoulders/arms, lower back and hips/pelvis or legs, is marginally negatively associated with currently (-0.18, 95% CI -0.32 to -0.04) carrying water. The factor ‘axial compression’ was more strongly associated with carrying water containers on the head.ConclusionsParticipants who reported a history of current or past water carrying more frequently reported pain in locations most likely to be associated with sustained spinal axial compression in the cervical region. Given the fact that cervical spinal conditions are globally one of the more common causes of disability, our findings suggest that water carrying, especially by head loading is a major contributing factor in musculoskeletal disease burden in low income countries. Our findings support the proposed indicator for monitoring SDG6.1: “Percentage of population using safely managed drinking water services at home.”

Particulate matter (PM) is a key indicator of air pollution and a significant risk factor for adverse health outcomes in humans. PM is not a self-contained pollutant but a mixture of different compounds including chemical and biological fractions. While several reviews have focused on the chemical components of PM and associated health effects, there is a dearth of review studies that holistically examine the role of biological and chemical components of inhalable and respirable PM in disease causation. A literature search using various search engines and (or) keywords was done. Articles selected for review were chosen following predefined criteria, to extract and analyze data. The results show that the biological and chemical components of inhalable and respirable PM play a significant role in the burden of health effects attributed to PM. These health outcomes include low birth weight, emergency room visit, hospital admission, respiratory and pulmonary diseases, cardiovascular disease, cancer, non-communicable diseases, and premature death, among others. This review justifies the importance of each or synergistic effects of the biological and chemical constituents of PM on health. It also provides information that informs policy on the establishment of exposure limits for PM composition metrics rather than the existing exposure limits of the total mass of PM. This will allow for more effective management strategies for improving outdoor air quality.

ObjectiveTo assess the health risks associated with exposure to particulate matter (PM10), sulphur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO) and ozone (O3).DesignThe study is an ecological study that used the year 2014 hourly ambient pollution data.SettingThe study was conducted in an industrial area located in Pretoria West, South Africa. The area accommodates a coal-fired power station, metallurgical industries such as a coke plant and a manganese smelter.Data and methodEstimate of possible health risks from exposure to airborne PM10, SO2, NO2, CO and O3 was performed using the US Environmental Protection Agency human health risk assessment framework. A scenario-assessment approach where normal (average exposure) and worst-case (continuous exposure) scenarios were developed for intermediate (24-hour) and chronic (annual) exposure periods for different exposure groups (infants, children, adults). The normal acute (1-hour) exposure to these pollutants was also determined.Outcome measuresPresence or absence of adverse health effects from exposure to airborne pollutants.ResultsAverage annual ambient concentration of PM10, NO2 and SO2 recorded was 48.3±43.4, 11.50±11.6 and 18.68±25.4 µg/m3, respectively, whereas the South African National Ambient Air Quality recommended 40, 40 and 50 µg/m3 for PM10, NO2 and SO2, respectively. Exposure to an hour's concentration of NO2, SO2, CO and O3, an 8-hour concentration of CO and O3, and a 24-hour concentration of PM10, NO2 and SO2 will not likely produce adverse effects to sensitive exposed groups. However, infants and children, rather than adults, are more likely to be affected. Moreover, for chronic annual exposure, PM10, NO2 and SO2 posed a health risk to sensitive individuals, with the severity of risk varying across exposed groups.ConclusionsLong-term chronic exposure to airborne PM10, NO2 and SO2 pollutants may result in health risks among the study population.

Air pollution poses a serious threat to human health and the general ecosystem both in South Africa and globally. This is mostly caused by the mining and combustion of fossil fuels, such as coal. There are some known pollutants associated with coal mining and combustion that are emitted into the air, resulting in various health implications that affect children the most as they are the most vulnerable. In this study, the levels of certain air pollutants in schools in the vicinities of coal mines were assessed. A cross-sectional study design was adopted. Five schools were purposively selected for this study. Air samples were collected inside and outside the classrooms of each school. Radiello V R passive air samplers were used to measure the levels of sulphur dioxide, nitrogen dioxide and ozone while filter pumps were employed for lead (Pb). Standard laboratory analytical methods were employed for the analysis. Estimates of the possible health risks resulting from exposure to airborne sulphur dioxide, nitrogen dioxide and ozone were performed using the United States Environmental Protection Agency Human Health Risk Assessment framework. The non-cancer risk of sulphur dioxide, nitrogen dioxide and ozone was determined using the hazard quotient. The results of this study revealed that sulphur dioxide, nitrogen dioxide and ozone were detected within and outside the classrooms at various levels. For example, the concentration of sulphur dioxide within the classroom ranged from 3.0 to 38 mg/m 3. Outside the classroom, sulphur dioxide levels detected were much higher ranging from 17 to 84 mg/m 3. The results of the non-carcinogenic risks from exposure to nitrogen dioxide, sulphur dioxide and ozone via inhalation route were less than 1.0. The elevated levels of these pollutants in the vicinity of schools investigated should be a cause for concern for all the stakeholders in the education sector. Therefore, appropriate measures need to be taken urgently to safeguard the health of the concerned community.

No abstract