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Health impacts of a randomized biomass cookstove intervention in northern Ghana
Background
Household air pollution (HAP) from cooking with solid fuels has adverse health effects. REACCTING (Research on Emissions, Air quality, Climate, and Cooking Technologies in Northern Ghana) was a randomized cookstove intervention study that aimed to determine the effects of two types of “improved” biomass cookstoves on health using self-reported health symptoms and biomarkers of systemic inflammation from dried blood spots for female adult cooks and children, and anthropometric growth measures for children only.
Methods
Two hundred rural households were randomized into four different cookstove groups. Surveys and health measurements were conducted at four time points over a two-year period. Chi-square tests were conducted to determine differences in self-reported health outcomes. Linear mixed models were used to assess the effect of the stoves on inflammation biomarkers in adults and children, and to assess the z-score deviance for the anthropometric data for children.
Results
We find some evidence that two biomarkers of oxidative stress and inflammation, serum amyloid A and C-reactive protein, decreased among adult primary cooks in the intervention groups relative to the control group. We do not find detectable impacts for any of the anthropometry variables or self-reported health.
Conclusions
Overall, we conclude that the REACCTING intervention did not substantially improve the health outcomes examined here, likely due to continued use of traditional stoves, lack of evidence of particulate matter emissions reductions from “improved” stoves, and mixed results for HAP exposure reductions.
Clinical trial registry
ClinicalTrials.gov
(National Institutes of Health); Trial Registration Number:
NCT04633135
; Date of Registration: 11 November 2020 – Retrospectively registered.
URL:
https://clinicaltrials.gov/ct2/show/NCT04633135?term=NCT04633135&draw=2&rank=1
Journal Article
A cluster randomised trial of cookstove interventions to improve infant health in Ghana
IntroductionHousehold air pollution from solid fuel combustion for cooking and heating is a leading cause of childhood morbidity and mortality worldwide. We hypothesised that clean cooking interventions delivered during pregnancy would improve child health.MethodsWe conducted a cluster randomised trial in rural Ghana to test whether providing pregnant women liquefied petroleum gas (LPG) cookstoves or improved biomass cookstoves would reduce personal carbon monoxide and fine particulate pollution exposure, increase birth weight and reduce physician-assessed severe pneumonia in the first 12 months of life, compared with control participants who continued to cook with traditional stoves. Primary analyses were intention-to-treat. The trial was registered with ClinicalTrials.gov and follow-up is complete.ResultsEnrolment began on 14 April 2014, and ended on 20 August 2015. We enrolled 1414 pregnant women; 361 in the LPG arm, 527 in the improved biomass cookstove arm and 526 controls. We saw no improvement in birth weight (the difference in mean birth weight for LPG arm births was 29 g lighter (95% CI −113 to 56, p=0.51) and for improved biomass arm births was 9 g heavier (95% CI −64 to 82, p=0.81), compared with control newborns) nor severe child pneumonia (the rate ratio for pneumonia in the LPG arm was 0.98 (95% CI 0.58 to 1.70; p=0.95) and for the improved biomass arm was 1.21 (95% CI 0.78 to 1.90; p=0.52), compared with the control arm). Air pollution exposures in the LPG arm remained above WHO health-based targets (LPG median particulate matter less than 2.5 microns in diameter (PM2.5) 45 µg/m³; IQR 32–65 vs control median PM2.5 67 µg/m³, IQR 46–97).ConclusionsNeither prenatally-introduced LPG nor improved biomass cookstoves improved birth weight or reduced severe pneumonia risk in the first 12 months of life. We hypothesise that this is due to lower-than-expected exposure reductions in the intervention arms.Trial registration numberNCT01335490.
Journal Article
The effect of clean cooking interventions on mother and child personal exposure to air pollution: results from the Ghana Randomized Air Pollution and Health Study (GRAPHS)
BackgroundClean cooking interventions to reduce air pollution exposure from burning biomass for daily cooking and heating needs have the potential to reduce a large burden of disease globally.ObjectiveThe objective of this study is to evaluate the air pollution exposure impacts of a fan-assisted efficient biomass-burning cookstove and a liquefied petroleum gas (LPG) stove intervention in rural Ghana.MethodsWe randomized 1414 households in rural Ghana with pregnant mothers into a control arm (N = 526) or one of two clean cooking intervention arms: a fan-assisted efficient biomass-burning cookstove (N = 527) or an LPG stove and cylinder refills as needed (N = 361). We monitored personal maternal carbon monoxide (CO) at baseline and six times after intervention and fine particulate matter (PM2.5) exposure twice after intervention. Children received three CO exposure monitoring sessions.ResultsWe obtained 5655 48-h maternal CO exposure estimates and 1903 for children, as well as 1379 maternal PM2.5 exposure estimates. Median baseline CO exposures in the control, improved biomass, and LPG arms were 1.17, 1.17, and 1.30 ppm, respectively. Based on a differences-in-differences approach, the LPG arm showed a 47% reduction (95% confidence interval: 34–57%) in mean 48-h CO exposure compared to the control arm. Mean maternal PM2.5 exposure in the LPG arm was 32% lower than the control arm during the post-intervention period (52 ± 29 vs. 77 ± 44 μg/m3). The biomass stove did not meaningfully reduce CO or PM2.5 exposure.ConclusionsWe show that LPG interventions lowered air pollution exposure significantly compared to three-stone fires. However, post-intervention exposures still exceeded health-relevant targets.SignificanceIn a large controlled trial of cleaner cooking interventions, an LPG stove and fuel intervention reduced air pollution exposure in a vulnerable population in a low-resource setting.
Journal Article
Ghana randomized air pollution and health study (GRAPHS): study protocol for a randomized controlled trial
Background
Household air pollution exposure is a major health risk, but validated interventions remain elusive.
Methods/Design
The Ghana Randomized Air Pollution and Health Study (GRAPHS) is a cluster-randomized trial that evaluates the efficacy of clean fuels (liquefied petroleum gas, or LPG) and efficient biomass cookstoves in the Brong-Ahafo region of central Ghana. We recruit pregnant women into LPG, efficient cookstove, and control arms and track birth weight and physician-assessed severe pneumonia incidence in the first year of life. A woman is eligible to participate if she is in the first or second trimester of pregnancy and carrying a live singleton fetus, if she is the primary cook, and if she does not smoke. We hypothesize that babies born to intervention mothers will weigh more and will have fewer cases of physician-assessed severe pneumonia in the first year of life. Additionally, an extensive personal air pollution exposure monitoring effort opens the way for exposure-response analyses, which we will present alongside intention-to-treat analyses. Major funding was provided by the National Institute of Environmental Health Sciences, The Thrasher Research Fund, and the Global Alliance for Clean Cookstoves.
Discussion
Household air pollution exposure is a major health risk that requires well-tested interventions. GRAPHS will provide important new evidence on the efficacy of both efficient biomass cookstoves and LPG, and will thus help inform health and energy policies in developing countries.
Trial registration
The trial was registered with clinicaltrials.gov on 13 April 2011 with the identifier
NCT01335490
.
Journal Article
Assessment of Heavy Metal Pollution in the Sediments of the River Pra and Its Tributaries
An investigative study was conducted to determine the heavy metal pollution in the sediment in the Pra Basin of Ghana from 27 sampling points during the dry and wet seasons using the geo-accumulation index (Igeo), enrichment factor (EF), and pollution load index (PLI). Sediments were acid digested and analyzed for the following selected metals: arsenic (As), lead (Pb), cadmium (Cd), zinc (Zn), manganese (Mn), total chromium (Cr), nickel (Ni), and iron (Fe) using the dual atomizer and hydride generator atomic absorption spectrophotometer (model ASC-7000 No A309654, Shimadzu, Japan). The metal concentrations (mg kg−1) in the sediments were as follows: As (0.175) < Cd (3.206) < Ni (79.927) < Zn (118.323) < Cr (216.708) < Mn (234.742) < Pb (335.381) < Fe (1354.513) in the dry season and As (0.002) < Cd (7.279) < Ni (72.663) < Zn (35.622) < Pb (135.863) < Cr (167.604) < Mn (183.904) < Fe (1138.551) for the wet season. The EF which is an indication of whether metal concentrations are due to anthropogenic activities shows enrichment at all site for the metals Cr, Pb, and Cd in the wet seasons. However, only 4 out of the 27 sites showed Ni enrichment in the wet season. Contrary to the wet season, only Pb and Cr recorded enrichment at all sites during the dry season. Fifteen out of the 27 sites recorded Cd enrichment and 24 out of the 27 sites recorded Ni enriched during the dry season. None of the sites were enriched with Fe, As, Zn, and Mn in either the dry or wet seasons. For both dry and wet seasons, the pollution load index for all the sites except one was at the background levels which is a sign of non-deterioration of the sites studied. In the wet season, the calculated Igeo reveals that the study area is not contaminated with respect to As, Zn, Fe, and Mn; uncontaminated to moderately contaminated with Cd; moderately contaminated with Cr; uncontaminated to moderately to heavily contaminated with Ni; and moderately to heavily contaminated with Pb. The dry season Igeo results reveal non-contamination of the study area with respect to As, Fe, and Mn; uncontaminated to moderately contaminated with Zn; moderately contaminated with Cr; uncontaminated to heavily contaminated with Cd; uncontaminated to extremely contaminated with Ni; and moderately to extremely contaminated with Pb. The high levels of Cd, Pb, and Cr in all the sites are due to unregulated illegal mining activities occurring in and around the study area. It is hoped that this study will prompt the basin management board to improve their management strategies in controlling unregulated illegal mining in the basin sediments.
Journal Article
Emerging industry 4.0 and Internet of Things (IoT) technologies in the Ghanaian construction industry: sustainability, implementation challenges, and benefits
Future construction projects will need the implementation of industry 4.0 and Internet-of-Things (IoT) technologies. The construction sector has, however, falling behind other industries in the application of these technologies and is currently facing considerable challenges. One of the industries that lag behind in the use of new innovative technological tools is the construction industry. This study reviews the research work in industry 4.0 and the Internet of Things as they relate to construction and examines key Ghana-based construction professionals and firms to ascertain their level of understanding of these emerging innovative technologies, including the challenges and benefits associated with their implementation. An extensive review of pertinent literature was done to help identify the important paradigms and variables which were cautiously tested. Adopting a quantitative research approach, the attained variables were used to design into a close-ended questionnaire. The sample frame was a survey of people from 154 construction experts and researchers with good standing by using the purposive sampling. Relative importance index (RII) analysis was used to analyzed the data. It was discovered from the findings that smart construction was the most popular industry 4.0 technology in the Ghanaian construction industry. The most important benefit of these technologies is that they will add sustainable policy requirements to tendering, with the most pressing technology being the lack of talent and skills in using industry 4.0 and IoT technologies. The scope of this research is based on the questionnaire survey, proving a sustainable pathway to the construction industry community, which creates its own significance by including key stakeholders and those affected by these technologies.
Journal Article
Heavy metals concentration and pollution index (HPI) in drinking water along the southwest coast of Ghana
The concentration of seven heavy metals in water samples was analyzed along the southwest coast of Ghana in the wet and dry seasons using atomic absorption spectrophotometer. Some physicochemical properties of the water samples were also determined to assess the quality of the water. The ranges of metal concentration in water in the wet season were; As (1.23–7.84 µg/L), Cu (4.10–24.09 µg/L), Pb (4.08–57.98 µg/L), Se (BDL-0.38 µg/L), Zn (2.86–17.75 µg/L) and Hg (0.023–0.068 µg/L), whereas the ranges of metal concentration in the dry season were; As (2.30–5.78 µg/L), Pb (25.47–70.73 µg/L), Se (0.081–0.158 µg/L), Zn (0.79–22.80 µg/L) and Hg (0.004–0.047 µg/L). The results of physicochemical properties of water in the wet season were pH (6.83 to 7.52), EC (291.15–780.64 µS/cm), TDS (195.07–523.02 mg/L), DO (2.98–4.39 mg/L), BOD (3.33 to 6.84 mg/L), salinity (0.01 to 0.30 ppt) and temperature (27.06–30.94 °C), whereas the dry season recorded the ranges of pH (6.84–6.95), EC (516.83 to 660.67 µS/cm), TDS (307.07–442.65 mg/L), DO (1.71–3.04 mg/L), BOD (4.25–13.38 mg/L), salinity (0.22–0.28ppt) and temperature (28.46–30.44 °C). The results showed that the concentration of heavy metals in water was below the WHO standard except Pb which exceeded the limit. The mean heavy metal pollution index (HPI) were 130 and 143 for wet and dry seasons, respectively, indicating that the water HPI was above the critical limit (HPI > 100), hence unfit for drinking. All the physicochemical properties analyzed were within the WHO permissible limits except BOD.
Journal Article
Heavy metal contamination assessment of groundwater quality: a case study of Oti landfill site, Kumasi
Environmentally friendly municipal solid waste management is the biggest problem facing several developing countries, including Ghana. Heavy metals pollution generated by landfill leachate has become increasingly concerned due to its potential impact on human health. This study assessed the pollution level and sources of heavy metal levels in groundwater, as well as evaluated the human health risk effect. The sampling technique and sample treatment were done based on the Standard Methods for the Examination of Water and Wastewater. The results suggested that the mean concentration of Pb, Fe, Cd, and Cr was above the acceptable limits of the World Health Organization for drinking water except for Zn and Cu. The heavy pollution index indicates contamination, while hazard index values at sites BH1 and W4 were greater than one, suggesting adverse health effects. However, the heavy metal pollution index values were less than the critical limit of 100 for drinking water. Multivariate analysis predicted that lithogenic and anthropogenic factors were the possible sources of water pollution of heavy metal in the Oti community. Thus, multivariate statistical techniques could be a beneficial tool for the evaluation of possible sources of heavy metal contamination. The high levels of heavy metals found in the Oti community suggested a considerable pollution of water by leachate percolation from the landfill site. The findings of the study, which can be used in areas under similar environmental conditions, can offer a valuable benchmark for the design of suitable approaches to manage groundwater resources by both local and national policymakers.
Journal Article
Assessing the perceived impact of exploration and production of hydrocarbons on households perspective of environmental regulation in Ghana
This paper seeks to critically study the perceived impacts of the exploration of hydrocarbons in selected coastal communities in the Western region, the oil and gas industry benefits to local communities, and to determine whether hydrocarbon development is a means for sustainable development. The study uses both quantitative and qualitative approaches using a questionnaire survey, key informant interview, and focus group discussion tools to understand the impact of oil and gas exploration and production in selected affected communities along the coast of Ghana. The activities of oil production and exploration impact negatively on communities; it also leads to a sharp increase in food prices thereby increasing their costs of living. The activity has also caused a decline in fish catch levels which happens to be the main economic activity as a result of exclusion zones created by oil companies which limited the extent fishermen can go fishing. In terms of infrastructure, the three communities are lacking, 77% of respondents from Princess Town hold the view that there is no motorable road linking their community in the next town and 60% from Aketakyi also hold the same view. Infrastructure such as roads, schools, water provision, and clinics are woefully provided in these communities.
Journal Article