Modern environmental health hazards: a public health issue of increasing significance in Africa.
OBJECTIVE
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.


METHODS
We reviewed published epidemiologic, exposure, and environmental studies of chemical agents such as heavy metals and pesticides.


RESULTS
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.


CONCLUSIONS
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.
Nweke
Onyemaechi C
OC
Office of Policy, Economics, and Innovation, U.S. Environmental Protection Agency, Washington, DC 20460, USA. nweke.onyemaechi@epa.gov
Sanders
William H
WH
D000349:Africa; D004782:Environmental Health; D015386:Hazardous Substances / Q000032:analysis*; D006801:Humans; D011634:Public Health
D015386:Hazardous Substances