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Introduction, section snippets, references (104), cited by (53), recommended articles (6).
Journal of Cleaner Production
Review a systematic literature analysis of the nature and regional distribution of water pollution sources in nigeria.
Water quality monitoring and assessment helps to determine the purity of water and how safe it is for use. This also guides environmental engineers in identifying the pollution sources and developing appropriate strategies in mitigating them. The aim of this study was to systematically analyse published literature to identify the interaction of the nature and regional distribution of pollution sources in Nigeria in the domain of surface water, groundwater, and rainwater quality. The scope of the analysis was on published literature on the subject in the last two decades. Regional distribution was observed to affect pollution sources for surface water, groundwater and rainwater in Nigeria as differences were observed in each geopolitical zone. Several research questions were raised which became the focus of the literature analysis. The major sources of surface water, groundwater and rainwater pollution in Nigeria were identified as industrial effluent (18% of research output), hydrogeology (25% of research output), and roof type (31%) respectively. Some 13% of surface water sources, 17% of groundwater sources and 8% of rainwater sources were adjudged to be clean based on World Health Organisation guidelines. The onus still falls on government related stakeholders, policy makers and industry based decision makers to instigate, develop and actualise sustainable waste management and water treatment approaches in the mitigation of water pollution in the country. The current study provides key information that could influence such decisions especially in view of the choice of process type for cleaner production that would cater for the specific needs of the various geopolitical zones.
Water is essential for the sustenance of life on earth and is needed in the day-to-day activities of man (Krishna et al. 2020). Accessibility to clean water and treatment facilities are the fundamental measures for preventing diverse waterborne diseases (Forstinus et al. 2016). According to the World Health Organisation (WHO), it was projected that 5.2 billion people use safely treated drinking water service (Ravindra et al. 2019). About 1 billion people worldwide do not have access to safe drinking water (Ekere et al. 2019). Globally, there are about 2.2 million deaths annually in developing countries due to water borne disease (Olukanni et al. 2014).
Standard water quality is a major problem faced by many countries particularly in a developing country like Nigeria (Seiyaboh et al. 2017b). Easy access to safe potable water is one of the challenges for the water systems regardless of the obsolete infrastructure, reduced source water, and tensed finances (Ur Rehman et al. 2020). Various locations across the country have been impacted by recent cases of reduced water quality which has greatly pose a harmful effect to the health of the populace (Allaire et al. 2018). Such health issues include cardiovascular disease, abdominal pain, diabetes, black foot disease, hypertension, severe diarrhoea, nausea and vomiting (Jadoon et al. 2019). When the quality of such natural water sources is compromised, it becomes more expensive to provide clean water for the population (Ullah et al. 2019).
Most of the wastewater in Nigeria is directed to water management plants but a fewer percentage of the entire population has a proper sewage plant connected to the treatment plants (Kanu and Achi, 2011). This means that the final effluent release into the environment is usually polluted (Ighalo et al. 2020b). Farm run-off containing fertiliser, insecticides and pesticides from the farm also affects the water quality (Brooks et al. 2020). Between leaving a management plant and getting to the municipals, treated water may become contaminated while travelling in the delivery channel on the way to consumers through a range of processes (Spellman et al., 2013). Microbial water quality can wane in networks due to regrowth or trap in of untreated water through impaired pipes, causing serious health hazards to consumers (Heibati et al. 2017).
Water quality monitoring and assessment is important for a variety of reasons. It helps to determine how safe the water sources are for drinking (Ighalo et al. 2020a). Researchers can furthermore isolate the specific parameter that are below regulatory threshold. This also guides environmental engineers in identifying the pollution sources and developing appropriate strategies in mitigating them (Ighalo et al. 2020c). For the achievement of the sustainable development goals, the availability of clean water in both the urban and rural scenarios cannot be overemphasised.
Various studies have been conducted in water quality assessment and monitoring in Nigeria over the past two decades (Izah and Srivastav, 2015). The study has come in the direction of surface water, groundwater and rainwater sources (Ighalo and Adeniyi, 2020a). In order to guide other researchers in contributing to this area of research, it is important to understand the scope of work done.
The nature and regional distribution of water pollution sources in Nigeria is currently unknown. This knowledge is needed to help environmental engineers and scientist develop proper mitigation strategies for different locations in the country. This is the gap in knowledge that the current investigation intends to fill. This paper furthermore makes specific scientific contribution to the pursuit of sustainable water management in developing countries. This is in line with recent effort towards environmental sustainability in various industries and sectors (Ighalo and Adeniyi, 2020b).
The aim of this study was to systematically analyse published literature to identify the interaction of the nature and regional distribution of pollution sources in Nigeria in the domain of surface water, groundwater, and rainwater quality. The study focused on the spatial distribution and location of the investigations. The reason for the study is to determine the extent of progress in the research area. This would help indigenous researchers identify knowledge gaps and areas requiring more research investigations. The broad scope of the study is such that some general questions on the subject which were previously unknown would be addressed which would be of great relevance to researchers, students, other stakeholders, policymakers and the general public.
For this study, all papers published in water quality monitoring and assessment in Nigeria in the last two decades (2000–2020) was sourced from google scholar. Google Scholar is a search engine for all types of research output and scholarly literature. The scope was quite broad as both papers on surface water, groundwater and rainwater quality were sourced. The keywords were ‘water quality’ and ‘Nigeria’. This dataset (in the supplementary material Tables S1-S3was the framework for the study.
General summary of research output
In this section, the overall research output in the domain of the study is discussed. Research output here does not refer to the total number of studies. This is because some papers have a far larger scope than others leading to a greater contribution to research output. A careful observation of the supplementary material Tables S1-S3will show that several papers appear on multiple lines and in multiple tables. This applies to papers where two or more of surface water, groundwater and rainwater
In this study, the interaction of the nature and regional distribution of pollution sources in Nigeria in the domain of surface water, groundwater, and rainwater quality was identified by a systematic analysis of published literature. Regional distribution was a factor that affects pollution sources for surface water, groundwater and rainwater in Nigeria as differences were observed in each region. Specific research questions in line with the subject matter of the literature analysis were
Author credits
Joshua O. Ighalo : Conceptualization; Data curation; Formal analysis; Investigation; Methodology; Validation; Roles/Writing - original draft; Writing - review & editing.
Adewale George Adeniyi : Supervision; Validation; Visualization; Writing - review & editing.
Jamiu A. Adeniran : Investigation; Data curation; Formal analysis; Roles/Writing - original draft.
Samuel Ogunniyi : Investigation; Data curation; Formal analysis; Roles/Writing - original draft.
Declaration of competing interest
The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
Potentially harmful elements contamination in water and sediment: evaluation for risk assessment and provenance in the northern Sulaiman fold belt, Baluchistan, Pakistan
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southwestern nigeria, j. min. geol., effect of discharges from re-channeled rivers and municipal runoff on water quality of opa reservoir, ile-ife, southwest nigeria, afr. j. environ. sci. technol., ecological and human health risks associated with metals in water from anka artisanal gold mining area, nigeria, hum. ecol. risk assess., assessment of oil and grease, total petroleum hydrocarbons and some heavy metals in surface and groundwater within the vicinity of nnpc oil depot in apata, ibadan metropolis, nigeria, int. j. res. rev. appl. sci., impacts of anthropogenic activities on heavy metal levels in surface water of nun river around gbarantoru and tombia towns, bayelsa state, nigeria, annals of ecology and environmental science, impact of pit latrines on groundwater quality of fokoslum, ibadan, southwestern nigeria, br. j. appl. sci. technol., organic and heavy metal assessment of groundwater sources around nigeria national petroleum cooperation oil depot aba, south-eastern 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assessment of epie creek in yenagoa metropolis, bayelsa state, nigeria, traditional water harvesting structures and sustainable water management in india: a socio-hydrological review, int. lett. nat. sci., water sources and water uses—now and in the future, quality assessment of direct harvested rainwater in parts of anambra state, nigeria, int. j. agric. biosci., effects of gas flaring and oil spillage on rainwater collected for drinking in okpai and beneku, delta state, nigeria, global j. hum. soc. sci., physico-chemical properties of rainwater collected from some industrial areas of lagos state, nigeria, eur. j. sci. res., quality assessment of vegetable oil effluent discharged into a southeastern nigeria river, african journal of environment and natural science research, hydrochemistry and water quality index of groundwater resources in enugu north district, enugu, nigeria, environ. monit. assess., phytoremediation of petroleum hydrocarbons in polluted waters using pistia 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journal of tropical diseases and health, assessment of the quality of water from hand dug wells and boreholes at federal low: cost housing estate bauchi, bauchi state, nigeria, biosorption of indigo carmine from aqueous solution by terminalia catappa shell, journal of environmental chemical engineering, iarc monographs on the evaluation of carcinogenic risks to humans, no. 100c. asbestos (chrysotile, amosite, crocidolite, tremolite vol 1. vol iarc working group on the evaluation of carcinogenic risk to humans, bacteriological analysis of borehole water in uli, nigeria, african journal of applied zoology and environmental biology, attrition resistance, a sporadically studied factor in aqueous adsorption: status quo and research outlook towards creating better adsorbents.
Attrition resistance in an adsorbent is one measure of its mechanical strength. It quantifies its ability to resist the impact of frictional forces generated in a milieu where hydrodynamic agitation exists. However, attrition resistance has been only sporadically examined in adsorbents used to remove aqueous adsorbates. Since attrition is relevant in aqueous adsorption process design, this review discusses the quantification of attrition resistance, variability in loss due to attrition across adsorbents, and the implications of attrition on adsorption systems. Finally, some key research opportunities that could be explored for a better understanding of attrition in real-scale water purification are presented. It is inferred that substantial research and development still needs to be accomplished to better understand the attrition resistance-adsorbent behavior within real-scale aqueous adsorption environments. The results can be harnessed to design and produce more robust, efficient and cost-effective adsorbents.
Analysis and study of the migration pattern of microplastic particles in saturated porous media pavement
This work aims to establish an analytical and comparative model of pavement stormwater runoff and determine how to solve water pollution in saturated porous media pavements. Heavy metal element particles in the stormwater runoff due to the rainfall will cause inevitable environmental pollution. First, the pavement runoff and materials of saturated porous media are analyzed. Besides, particle migration laws and separation effects of different materials are compared. Based on this, microplastics are selected as the primary material for pavement filling. Then, the adsorption effect of microplastics and the parameters of rainwater infiltration rate and infiltration ratio are analyzed to propose a multi-level ecological integrated treatment system for pavement runoff. Specifically, the environmental resource pollution and saturated porous media materials are analyzed. In addition, the adsorption effect of microplastic particles is analyzed to establish a model to study the selection process of the optimal adsorption material. The main contribution of the research is to analyze the migration process of metal particles in the soil in combination with the internal particle migration rules of plastic granular materials. The research results demonstrate that the rain runoff coefficient gradually increases with the expansion of the permeable area of the pavement. The rain runoff coefficient reaches the maximum value under the pavement of 120 square meters. In addition, a comparative analysis of three street pavements is conducted on the residential street pavement (RSP), commercial street pavement (CSP), and active street pavement (ASP). When comparing the two sets of data, the overall average permeability of the RSP is better than CSP and ASP. The research materials are compared under isothermal conditions. The particle adsorption effect of the same material at 50 °C is significantly better than that at 30 °C. Therefore, it is feasible to resolve the pavement runoff water pollution through technical schemes.
New outlook on hazardous pollutants in the wastewater environment: Occurrence, risk assessment and elimination by electrodeionization technologies
Over the decades, water contamination has increased substantially and has become a severe global issue. Degradation of natural resources is taking place at an alarming rate as a result of the use of chemicals like dyes, heavy metals, fertilizers, pesticides, and many more, necessitating the development of long-term pollution remediation methods/technologies. As a new development in the field of environmental engineering, electrodeionization incorporates both traditional ion exchange and electrodialysis. This communication provides an overview of hazardous contaminants such as dyes, heavy metals, fertilizers, and pesticides, as well as their converted forms, which are present in water. It highlights the risks of water pollutants to public health and the environment. Various electrochemical methods with a focus on electrodeionization for the treatment of wastewater and removal of hazardous contaminants are outlined in this review. Additionally, this review discusses the challenges and the future outlook for the development in this field of research.
China's improving total environmental quality and environment-economy coordination since 2000: Progress towards sustainable development goals
Improving China's total environmental quality is an important means to implement the United Nations 2030 Agenda for Sustainable Development. How to quantify the environmental quality evolution progress scientifically, and ensure realizing the goals of fresh air, clean water, soil safety, good ecology, and fine human settlement environment in China is an urgent and significant issue. Here, according to Sustainable Development Goals (SDGs) and China's development characteristics, we construct an integrated environmental quality evaluation index system, comprising 5 dimensions—air environmental quality, water environmental quality, soil environmental quality, ecological environmental quality, and human settlement environmental quality—to measure the progress in achieving the SDGs over the past 20 years. Findings show China has made substantial improvements in environmental quality, with an average growth rate of 2.4% annually, presenting high in southeast and low in northwest. Human settlement environmental quality improved to the largest extent, 6.5% annually, followed by ecological, water, soil, and air environmental quality, with an annual rate of 2.46, 2.45,1.83, and 0.84%, respectively. All regions present an increasing trend in total environment. However, large gaps still existed between diverse regions across China. Furthermore, coordination development level between environment and economy rose constantly across China, and 23 provinces have reached the primary coordination development status. Targeted practical measures are proposed to promote environmental quality improvement. It will provide a policy-related assessment tool to help develop sound development strategies and balance national and local capacities for sustainable development.
Multi-objective pity beetle algorithm based optimal control of wastewater treatment process
Water is a critically scarce resource for industrial production and social life. The discharge of untreated wastewater into natural waters can pose a serious risk to human health. Most of urban wastewater treatment plants use biochemical methods, the most common of which is the biological reaction through activated sludge to degrade pollutants. Considering the public environmental protection and socio-economic needs, this paper establishes a wastewater treatment process (WWTP) optimization model considering the trade-off between effluent quality (EQ) and energy consumption (EC), and designs an dynamic optimal control framework based on a novel multi-objective evolutionary algorithm (MOEA) to track and control the key variables in the WWTP. The numerical experiments of multi-objective test functions show that the proposed MOEA has good convergence and distributivity. Simulation results based on the BSM1 platform show that the constructed framework can accurately adjust the set-points of controllers in time to improve the performance, which has broad application prospects in practical applications.
Occurrence, health risk, and removal efficiency assessment of volatile organic compounds in drinking water treatment plants (DWTPs): An investigation of seven major river basins across China
The presence of volatile organic compounds (VOCs) in drinking water has the potential to harm human health and undermine public confidence. Hence, this is the first study to comprehensively investigate concentrations of 25 VOCs in the 146 drinking water treatment plants (DWTPs) in 24 cities across seven major river basins (including the Yangtze River, Yellow River, Haihe River, Songhua River, Liaohe River, Pearl River, and Huaihe River), China. The occurrence, human health, and olfactory risks, as well as removal efficiency of VOCs in DWTPs, were evaluated. The findings revealed that 21 VOCs were detected, with concentrations ranging from not detected to 99.10 μg/L (trichloromethane). The maximum concentrations of trichloroacetaldehyde (54.90 μg/L) and trichloromethane (99.10 μg/L) exceeded China's regulated values (GB 5749–2006/2022). The concentrations of VOCs and water quality parameters showed a strong positive correlation. Human health and olfactory risks assessment indicated that drinking water exposures do not pose carcinogenic (CR < 10 −6 ) and non-carcinogenic (HI < 1) health risks to consumers, nor do olfactory and taste hazards (OHI <1). However, it is worth mentioning that due to the relatively high concentrations of some VOCs (trichloroacetaldehyde, acrolein, and trichloromethane), the health risk posed by them are still a major concern that needs to be addressed. Finally, the removal efficiency of VOCs is low in 146 DWTPs (mean of 12.91%–76.79%). Taken together, adding advanced treatment procedures for the purpose of improving the removal efficiency of pollutants of DWTPs in the future is an urgent priority.
Performance assessment of the automotive heat exchanger with twisted tape for thermoelectric based waste heat recovery
Waste heat recovery in automobiles is a practical technique to reduce emissions and fuel consumption. The extent of waste heat recovery is directly proportional to the efficiency of the heat exchanger. However, the change in internal geometry has become a convenient method to extract the maximum heat from the exhaust heat exchanger while producing a minimum pressure drop. In the current study, the performance of the exhaust heat exchanger with twisted ribs has been studied for the six different operating points of the diesel engine. Three distinct geometric parameters of twisted tape i.e., pitch ratio, twist ratio, and tilt angle have been studied in detail. Experiments were repeated for various geometric parameters to arrive at the best specification of the twisted tape. The results show that the pitch ratio of 8, twist ratio of 4, and the tilt angle of 60° yield the highest power output. The results obtained were compared with the internal flat heat exchanger. It has been observed that the system equipped with a twisted rib produces more net power than the smooth surface system. Moreover, a comparison of fuel consumption with the commonly used alternator has been performed and the proposed system has the potential to improve the BSFC by 0.65%.
Forecast of future yield for printed circuit board resin waste generated from major household electrical and electronic equipment in China
As the biggest generator and consumer of household electrical and electronic equipment (EEE) in the world, China generates a large amount of printed circuit board (PCB) resin waste during the production and scrap disposal processes of household EEE each year, yet the precise estimation of the PCB resin waste generation in China is still to be determined. In this paper, the stock-based model is applied to forecast the future generation and sources of PCB resin waste in China. Eight major types of EEE are included to calculate the generation of PCB resin waste from 1998 to 2035. Results show that there will be more than 19.67 billion EEE scrapped during the research period, and about 12.97–13.43 million tonnes of PCB resin waste will generated from the production and scrap disposal processes of EEE. Waste air conditioner, TV set, and washing machine are the major contributors of PCB resin waste. At least 568.27 thousand tonnes of PCB resin waste will be produced in 2035, accompanied by over 231.09 thousand tonnes copper and 333.55 tonnes gold. It is also found that the generation of PCB resin waste is affected by lifestyle, technological level and population policy. This study provides a reliable tool to predict the generation of PCB resin waste and other waste generated from WEEE, and offers suggestions for policy design on waste management.
Hybridization of rotary absorber tube and magnetic field inducer with nanofluid for performance enhancement of parabolic trough solar collector
A considerable amount of energy is lost in the parabolic trough solar collectors due to the poor capability of working fluid in full absorption of the concentrated solar irradiation across the receiver tube. A new hybrid method is recommended here to cover up such deficiency by simultaneously using a rotary absorber tube and magnetic field inducer with nanofluid. Results showed that the combination effects of the receiver rotation and the magnetic field improve the convection mechanism in the absorber and increase both energetic and exergetic performance of the collector. The study reveals that there is an optimal rotational speed in the each magnetic field intensity for different hydrothermal and thermodynamic parameters. That is, in comparison with the case with no magnetic field and rotational tube employment, the total heat loss in the collector can be saved by 37.4% when a magnetic field of 1000 G and a rotary tube with speed of 0.4 rad/s are employed simultaneously. In this comparison, a maximum improvement of 101% and 24% in the performance evaluation criteria (PEC) and exergy efficiency of the system is achieved by employing the proposed hybrid method, respectively. Results also revealed that there is an optimal rotational speed in the each magnetic field intensity, in which employing a magnetic field at this rotational speed does not increase pressure drop for the sake of improving energetic and exergetic efficiencies of the solar collector.
Using a methodological approach to model causes of food loss and waste in fruit and vegetable supply chains
Food loss and waste occur at all stages of the food supply chain. Since their causes are interconnected and may influence each other, then approaches with holistic supply chain perspectives are useful to map their relationships and guide the selection, design and implementation of the appropriate mitigation strategies. In this paper, 14 causes of food loss and waste in fruit and vegetable supply chains were identified and divided into seven levels of influence, by the Interpretive Structural Modelling methodology, showing that the logistic related causes have a major influence on the others. Furthermore, five root causes were identified by the Matrix Impact of Cross Multiplication Applied to Classification analysis (inadequate transportation systems, inadequate or defective packaging, lack of storage facilities, poor handling and operational performance and lack of coordination and information sharing) and used to discuss the mitigation strategies that should be implemented to reduce food loss and waste.
Take-back regulation policy on closed loop supply chains: Single or double targets?
Many countries have imposed product take-back conditions on their manufacturers, as part of the commitment to the extended product responsibility. This paper explores the feasibility of the take-back regulation operating under a collection target and a reuse target. Two models using different regulation setups are developed to show the effects of a take-back regulation on consumer surplus, the benefits to the supply chain, and social welfare. The results suggest that the optimal strategies of the manufacturer depend on the regulation model applied. Setting higher regulation targets decreases the manufacturer’s profit, but the chain benefits from the reuse target. To achieve a high collection rate and reuse efficiency, policy makers should set a high collection target and a high reuse target. To improve the social welfare, a low collection target and a high reuse target should be set. This study provides some suggestions for the manufacturer to cope with regulation targets and offers some guidelines for policy makers to set and implement the regulation targets.
An analysis of the relation between water pollution and economic growth in China by considering the contemporaneous correlation of water pollutants
The study of the relationship between water pollution and economic growth holds great significance for sustainable development. Under Environmental Kuznets Curve (EKC) hypothesis, this paper focuses attention on a Chinese context and investigates the relationship between water pollution discharge--waste water (WW), chemical oxygen demand (COD) and ammonia nitrogen (NH 4 –N) and economic growth--per capita Gross Domestic Production (GDPPC), based on a comparison of the results from two variable coefficient panel data models–-a Locally Weighted Smoothed Regression Estimator and Smoothing Scatterplots Model (LOWESSM) which is a nonparametric model, and a Semi-parametric Seemingly Unrelated Regression Model (SSURM) which considers the contemporaneous correlation of water pollutants that most previous studies have ignored. The empirical results indicate that there exist differences that can be represented by the characteristics of different EKC types, or different turning points under the same EKC type and that the SSURM may be more conducive to reflecting the real relationship between water pollution and economic growth. The study also finds that there are eight types of EKC which can be categorized as “good EKCs” (negative monotonic shape, inverted N-shape, inverted U-shape and M-shape), “bad EKCs” (positive monotonic shape, N-shape and U-shape) and “transition EKC” (positive monotonic and flat-tailed shape) and the proportion of “good EKCs” in economically developed areas (71.43%) is lower than that in the less economically developed areas (76.47%) in terms of COD discharge. Results suggest that addressing the state of water pollution will not occur automatically as GDPPC increases, but requires the regulatory power of government environmental policies.
- DOI: 10.1016/j.chemosphere.2020.127569
- Corpus ID: 220669885
A comprehensive review of water quality monitoring and assessment in Nigeria.
- Joshua O. Ighalo , A. Adeniyi
- Published 11 July 2020
- Environmental Science
- Chemosphere
82 Citations
A systematic literature analysis of the nature and regional distribution of water pollution sources in nigeria.
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Environmental health situation in Nigeria: current status and future needs
Hyellai titus pona.
a School of Energy and Environmental Engineering, University of Science and Technology Beijing, 30 Xueyuan Road, Haidian District, Beijing, 100083, China
Duan Xiaoli
b School of Energy and Environmental Engineering, University of Science and Technology & Head of Center for Environmental Health Research, China
Olusola O. Ayantobo
c State Key Laboratory of Hydroscience and Engineering, Department of Hydraulic Engineering, Tsinghua University, Beijing, China
d Department of Water Resources Management and Agricultural-Meteorology, Federal University of Agriculture, Abeokuta, Nigeria
Narh Daniel Tetteh
e School of Communication and Information, Beihang University, China
Associated Data
The authors do not have permission to share data.
Environmental health-related risks are becoming a primary concern in Nigeria, with diverse environmental problems such as air pollution, water pollution, oil spillage, deforestation, desertification, erosion, and flooding (due to inadequate drainage systems) caused mostly by anthropogenic activities. This paper reviews the pre-existing and current environmental health problems, proffer future research and needs, policy needs, and recommendations necessary to mitigate Nigeria's environmental health situation. Data from the Institute of Health Metric and Evaluation on Global Burden of Disease (GBD) was used to ascertain the causes of Death and Disability-adjusted Life Years (DALYs) in Nigeria from 2007-2017 and published literatures where reviewed. According to the world health data report, most of the highest-ranked causes of DALYs in Nigeria are related to environmental risk factors. The lower respiratory infection associated with air pollution has advanced from the 4 th in 2007 to the highest ranked cause of death in 2017. Other predominant causes of death associated with environmental risk factors include chronic respiratory diseases, cardiovascular diseases, enteric infections, diarrheal diseases, communicable, maternal, neonatal, and nutritional disease, which has resulted in approximately 800 thousand deaths and 26 million people living with DALYs per annum in Nigeria. Major environmental risk factors include household air pollution, ambient air pollution, water, sanitation, and hygiene (WaSH), which shows a prolonged but progressive decline. In contrast, ambient particulate matter pollution, ambient ozone pollution, and lead exposure show a steady rise associated with death and DALYs in Nigeria, indicating a significant concern in an environmental health-related risk situation. Sustaining a healthy environment is critical in improving the quality of life and the span of a healthy life. Therefore, environmentally sustainable development policies and practices should be essential to the population and policymakers for a healthy life.
1. Introduction
The environment is the total living and non-living surroundings of any organism needed for life and sustainability [ 1 ]. The state of the environment per time has a significant impact on the biotic and abiotic components of the environment, thus essential for health and human living. If the environment is not healthy, then everything in the environment is posed at risk [ 1 ]. Environmental health is the interconnection between people and their environment by which human health and a balanced, nonpolluted environment are sustained or degraded [ 2 ]. Individual, societal, national, and global activities relating to the environment have a complex and dynamic relationship operating simultaneously. Environmental health reciprocates in two ways, which include environmental factors affecting human health and human activities affecting environmental quality.
The environmental, physical, chemical, and biological factors and their related behaviors impact health in one way or another [ 3 ]. These could be a two-way interaction of environmental health as a human activity affecting the environment, likewise the conditions of the environment affecting human health [ 2 ]. Sustaining a healthy environment is critical in improving the quality of life and a healthy life span.
The World health report indicated that globally, 23 percent of death occurrences and 26 percent of children deaths ranging up to 4 million children under five every year are due to environmental factors [ 4 , 5 ]. Also, 85 out of 102 categories of diseases and injuries are influenced by environmental factors [ 6 ]. According to the World Health Organization (WHO), the interactions between humans and the environment affect the quality of life, health disparities, and a healthy life span. Making the environment healthier can prevent about 13 million death yearly and avoid 13%–37% of the world's disease burden, such as 40% of deaths from malaria, 41% of deaths from lower respiratory infections, and 94% of deaths from diarrheal disease [ 2 , 6 ]. Therefore, environmental health involves preventing or controlling disease, disability, and injury associated with interactions between the environment and humans [ 7 ] (see Figure 1 ).
Flow chart showing the Environmental Heath situation in Nigeria.
The state of Nigeria's environment recently has been undergoing drastic changes. Nigeria rapidly turning to oil exploration and industrialization has many manufacturing industries, oil refineries, and factories. Also, Nigeria's fast population growth has caused environmental-related problems [ 8 ]. Due to a lack of development in rural areas, there is high population migration to urban areas leading to more environmental-related problems [ 9 ]. Problems such as air pollution, water pollution, solid waste management, urban poverty, deforestation, desertification, wind erosion, and flooding increase, cause more risk to the environment and the population in highly industrialized cities in Nigeria. Climate change has been evident in almost all parts of Nigeria [ 10 ], such as excess flooding in the south-east and north-central region, a decline in rainfall in the Northeastern and southern region, and temperature increase in all regions of the country ( Figure 2 ).
Map of Nigeria showing different locations and environmental problems.
Globally there has been a significant change in the state of the environment. Climate change and the greenhouse effect have been on the rise leading to so many natural disasters such as ice-melting, floods, tsunami, air pollution, the emergence of infectious and non-communicable diseases leading to various health risks humans [ 11 , 12 ]. There are several health issues in Nigeria as a country, such as control of some disease vectors, maternal mortality, infectious diseases, poor hygiene and sanitation, disease surveillance, and road traffic injuries. Additionally, like many other countries, Nigeria faces environmental health-related problems, including environmental hazards and the insufficiency of basic human necessities. However, the designed programs for addressing health issues in the country have proven inadequate and resulted in a small health status improvement [ 13 ].
Therefore, in line with the above background, our main objective is to identify environmental health-related risks by discussing the current status and the future needs within Nigeria between 2007 and 2017. Specifically, we (i) assessed and relayed Nigeria's current environmental health situation. (ii) presented the causes of death and years lost to disability (DALYs), showing levels of contributions from environmental risks (iii) explained how environmental factors affect health, identifying specific diseases associated with environmental risks. (iv) reviewed literatures and discussed extensively environmental problems, their sources, and associated ill-health (v) propose future research and policy needs to mitigate the situation.
2. Study area, datasets, and methods
2.1. study area.
Nigeria is one of the West African countries that borders the Republic of Benin to the West, Cameroon and Chad to the East, and Niger to the North [ 14 ]. The coast of Nigeria lies on the Gulf of Guinea to the South, while it borders Lake Chad to the Northeast. The country covers a total of 923,768 km 2 (356, 669 sq mi) [ 15 ]. The valleys of river Niger and Benue are the most extensive topographical area, with rugged highland to the southwest [ 16 , 17 ]. It is also found in the tropics, where the climate is very humid and seasonally damp. The country is affected by four types of climates such as tropical monsoon, Sahel, tropical savanna, and Alpine climate. The temperatures can rise to 44 °C (111.2 °F) in some parts, especially at the coast, during dry seasons and ranges 16 °C–25 °C in highland areas with temperate conditions along the Cameroon border [ 18 , 19 ]. The rainfall ranges between 4000 mm (157.5 in) to 2000 mm (118.1 in) per year in Southern parts and totals 1100 mm (43.3 in) in central Nigeria.
Nigeria's population is about 202 million, and the population density is 221 per km 2 (571 people per m 2 ), with about 51.2 percent of the population urbanized, while the median age is 17.9 years [ 15 , 20 ]. The population growth rate of Nigeria is about 2.62 percent, growing faster compared to other similar-sized countries. However, this growth rate is projected to decrease up to 2.04 percent by the year 2050. Nigeria's Gross Domestic Product (GDP) in 2018 was about $444,92 million, which presents a growth of about 1.9 percent compared to the one of 2017(International Monetary Fund, 2018) [ 21 ]. Nigeria agriculture has four components, including crop, livestock, fishing, and forestry [ 15 ]. Estimates from reports show that 22.86% of Nigeria's GDP was contributed by agriculture in 2018. The report also estimated that industries contributed 23.18% of the Nigeria GDP, while services contributed to 53.97% in 2018 [ 18 ], [ 22 ]. However, the Nigerian economy is currently shifting from agriculture to industries such as gas and oil. The primary manufacturing industries include wood, rubber, cement, and textiles among others [ 23 , 24 ].
2.2. Datasets
The data used was acquired from Institute for Health Metrics and Evaluation (IHME). This study's data range is from 2007 to 2017 of the Global burden of diseases, injuries, and risk factor studies (GBD, 2017); the data contains variables of interest, causes of death, and DALYs. Data sources are available online and can be explored in detail at GBD 2017 from the IHME http://ghdx.healthdata.org/gbd-results-tool . Data were extracted for Nigeria on all age groups, both sex, environmental risks, and health-related-risk clusters of environmental-risk factors. This study concentrated mainly on related risk clusters diseases and injuries categorized under environmental risk factors such as cardiovascular diseases, diarrheal diseases, mental disorder, enteric infections, respiratory infections, tuberculosis, lower respiratory infections, chronic obstructive pulmonary disease (COPD), chronic respiratory diseases ischemic heart disease, stroke, communicable, maternal, neonatal, and nutritional diseases.
2.3. Methods
IHME uses three major risk categories to attribute DALYs, Years living with disability (YLDs), and causes of deaths, which are; (i) environmental and occupational risks, (ii) behavioral risks, and (iii) metabolic risks. The different related risks are clustered into these three significant categories. Details of criteria used in assessing risk factors and how it is calculated are explained in details elsewhere [ 25 , 26 , 27 , 28 , 29 ]. DALYs are calculated as the sum of Years of Life Lost (YLLs) and Years Lived with Disability (YLDs) [ 30 ]. GBD calculates these impacts for a country using epidemiological studies, mathematical functions, country's exposure estimates, and data of underlying rates of diseases and deaths that are adjusted to the database of Gridded population of the world (GPW); more details of the methodology can be found in https://www.stateofglobalair.org/resources .
After the acquisition of the data, we performed statistical analysis using excel and python statistical tools similar to previous studies [ 26 , 30 , 31 ] because of python's ability to analyze a large volume of data and create interactive plots, charts, and graphics at a rapid pace [ 32 ]. With these tools, we represented environmental risk factors graphically; air pollution, household air pollution from solid fuels, ambient particulate matter pollution, ambient ozone pollution, lead exposure and unsafe water, sanitation, and handwashing versus all causes of death and DALYs. Lastly, we justified our results by reviewing published papers to ascertain the environmental problems, their sources, and the status of environmental health situations in Nigeria.
3. Health patterns in Nigeria
In this section, Nigeria's health pattern will be discussed while presenting the causes of death and DALYs and showing the contribution levels from environmental risk. Environmental health has proven to be a dynamic and continually evolving situation globally. Nigeria, the same as other countries in the world, is experiencing emerging challenges in environmental health. Some of the common emerging environmental health issues in Nigeria include climate change, which influences infectious disease patterns, air quality, and the severity of natural hazards such as droughts, storms, and floods (WHO). Hazardous wastes and toxic substances are yet to be fully recognized, and research to appreciate how these risk factors impact health is underway [ 33 ]; however, reducing such risk factors continues in Nigeria and other parts of the world [ 13 ]. The majority of Nigeria's populations spend the most time at work, school, or home environments. Some of these environments expose them to indoor pollution, structural issues, electric and fire hazards, lead-based paint hazards, and inadequate sanitation and heating [ 21 ]. These environmental hazards have impacted the health and safety of the population. Therefore, there is a need for maintaining excellent healthy homes and societies to achieve a sustainable environmental health system [ 34 ].
In the scope of Nigeria's demography, this study seeks to analyze and take an overarching analysis of the factors affecting the quality of health; the quality health as mention anchors on environmental activities that causes death and DALYs. Graphical representation of the top 10 risk factors contributing to most death and disability combined in Nigeria is shown in Figure 3 , and Table 1 shows the top 10 causes of death. Figure 4 shows the cause of deaths due to different air pollution, and Figure 5 shows the cause of DALYs due to various air pollution. Causes of death and DALYs due to WaSH and lead exposure is shown in Figure 6 , and Figure 7 shows the number of death due to other environmental risks from 2007-2017.
Top 10 risk factors contributing to most death and disability combined in Nigeria 2007–2017(IHME, 2018) (Note: Red box indicating environmental risk factors).
Top 10 causes of most deaths in Nigeria from 2007-2017 (IHME, 2020) (Note: Arrow shows lower respiratory infection moving from the 4 th rank to 1 st rank).
(a) Causes of deaths due to household air pollution from solid fuels in Nigeria from 2007-2017, (b) Causes of deaths due to air pollution in Nigeria 2007–2017, (c) Causes of deaths due to ambient particulate matter pollution in Nigeria 2007–2017, (d) Causes of death due to ambient ozone pollution in Nigeria 2007–2017 (Institute for Health Metrics and Evaluation, 2017).
(a) Causes of DALYs due to air pollution in Nigeria from 2007-2017, (b) Causes of DALYs due to air ambient particulate matter pollution in Nigeria 2007–2017, (c) Causes of DALYs due to ambient ozone pollution in Nigeria 2007–2017, (d) Causes of DALYs due household air pollution from solid fuels in Nigeria 2007–2017 (Institute for Health Metrics and Evaluation, 2017).
(a) Causes of Disability Adjusted life years (DALYs) due to Unsafe Water, Sanitation, and Handwashing in Nigeria 2007–2017, (b) Causes of death due to Unsafe Water, Sanitation, and Handwashing in Nigeria 2007–2017, (c) Causes of Disability Adjusted life years (DALYs) due to Lead Exposure in Nigeria 2007–2017, (d) Causes of death due to Lead Exposure in Nigeria 2007–2017 (Institute for Health Metrics and Evaluation, 2017).
Number of Deaths and DALYS due to other Environmental Risks from 2007-2017 in Nigeria (Institute for Health Metrics and Evaluation, 2017).
The analysis shows that ambient ozone pollution and lead exposure negatively affect health quality, especially heart conditions; a further look at the pattern shows a gradual and upward trend. Our analytical representation shows that household air pollution from solid fuels, air pollution, ambient particulate matter pollution, ambient ozone pollution, lead exposure, and WaSH affects health quality more. The proportion of deaths for a particular cause relative to deaths from all environmental-related risks is similar to DALYs' ratio for a particular cause relative to DALYs for all environmental-related risks. Most of the high-ranked causes of death and DALYs in Nigeria are associated with environmental risked factors [ 35 , 36 ]. Figure 3 shows malnutrition, unsafe sex, alcohol use, and high blood pressure as attributes of death and DALYs combined in Nigeria. These are mostly behavioral or metabolic risks (IHME, 2020). However, the environmental-related risk WaSH and air pollution spread widely and affect virtually the entire population, especially the vulnerable group in which children, elderly, pregnant women, chronic disease, and poor people.
The most common causes of most premature deaths in Nigeria were malaria, diarrheal diseases, HIV/AIDs, and lower respiratory infection by 2007. However, in 2017, the lower respiratory infection took the lead, followed by neonatal disorder, all associated with environmental interactions. The cause of most death in 2017 was attributed first to lower respiratory infection, ranked 4 th in 2007, as shown in Table 1 [ 20 ]. The lower respiratory infections had a change of about -10.7%, followed by neonatal disorders, -1.5%, while malaria had -35.8% between the years 2007–2017, according to Organization health data- Nigeria in Table 1 [ 20 ]. The environmental risk factors that cause DALYs and death in Nigeria are WaSH, followed by air pollution in 2017 with changes between 2007 to 2017 of WaSH -38.5% and air pollution -14.4%; showing low air quality is one of the most causes of death in Nigeria ( Figure 3 ). This indicates a concern in Nigeria's current environmental health situation [ 1 , 37 ], depicting a healthy environment is vital for increasing a healthy life span [ 38 ], which calls for immediate action from the public and policymakers for healthy lives and the environment's sustainability.
4. Health effects of environmental risk factors in Nigeria
In line with section 3, we will explain how environmental factors affect health and identify specific diseases associated with environmental risks. Nigeria's environmental problems and sources will also be reviewed to justify our findings on the status of environmental health situations. The deterioration of the environment has led to vectors' breeding [ 39 ], thereby reducing human health quality. The WHO identified some environmental factors affecting human health, including polluted air, poor sanitation, polluted water, unhealthy housing, and global environmental change. These factors are associated with acute respiratory infections, diarrheal diseases, malaria, and other vector-borne diseases, injuries and poisoning, mental health conditions, cardiovascular diseases, cancer, and other infections [ 40 , 41 , 42 ]. This made it abundantly clear that improving environmental conditions is very imperative [ 43 ]. The paramount environmental risk factors associated with Nigeria's health patterns from our results are discussed as follows:
4.1. Air pollution
Air pollution is the discharge of any harmful substance into the air, which can cause minor health problems, including burning eyes and nose, itchy irritated throat, and breathing problems to significant health problems including chronic respiratory diseases or mortality [ 44 ]. Air pollution includes household air pollution, particulate matter pollution, ozone pollution, etc. It is mainly categorized into two based on exposure: ambient pollution in outdoor exposure and indoor pollution in an enclosed air pollution exposure [ 45 ].
In Nigeria, air pollution is associated with different health risks such as cardiovascular diseases, respiratory infections, tuberculosis, lower respiratory infections, COPD, chronic respiratory diseases, ischemic heart disease, stroke, communicable, maternal, neonatal, and nutritional diseases [ 20 ]. Nigeria is ranked amongst the world's first five and the largest country in Africa, with the top-most level of premature death associated with air pollution [ 20 , 46 , 47 ]. Globally, air pollution is estimated to cause about 29% of lung cancer deaths, 43% of COPD deaths, 25% of ischemic heart disease deaths, and 24% of stroke deaths [ 48 ].
4.1.1. Ambient air pollution
Ambient air pollutants, including particulate matter, ozone, SO 2 , and NO 2 , are related to several respiratory problems, such as bronchitis, emphysema asthma [ 49 ], heart failure hospitalizations, and mortality [ 13 , 50 ]. Figure 4 (a, b, c, and d) show different classifications of air pollution and health risk leading to most causes of death in Nigeria. Respiratory infections, tuberculosis, lower respiratory infections, and communicable diseases are estimated to have caused over 350 thousand deaths and 10 million people living with DALYs yearly, related to air pollution (Figures 4 b, b,5a), 5 a), and ambient particulate matter air pollution (Figures 4c, 5 b) compared to other health risk associated to air pollution from 2007-2017. Ambient ozone air pollution at ground level is associated with almost two thousand deaths and over 35 thousand DALYs per annum caused by COPD and chronic respiratory disease, which has been steadily increasing since 2007–2017 in Nigeria (Figures 4d, 5 c). This result indicates a significant concern [ 51 , 52 ] observing ambient particulate matter pollution had a sharp shoot of associated deaths in 2012 ( Figure 4 d) and DALYs in 2015 ( Figure 5 c), both with minimal changes till 2017. Ambient air pollution is a top risk factor responsible for reducing longevity in global GBD ranking [ 20 , 53 ], likewise in Nigeria. Studies showed an increase in the outdoor air pollution level in Nigeria, mainly from anthropogenic sources in the urban cities, summing up to more exposure to the population in such urban areas [ 53 , 54 ]. Global average life expectancy is between 60-70years; however, in Nigeria, it is reported to be 54.4yers according to WHO [ 55 ].
The primary sources of outdoor gaseous emissions in Nigeria are from industries, automobile exhaust, electrical generating plant exhaust at homes and business centers due to an irregular power supply, emissions from the incineration of wastes, and gaseous emissions from dumpsites [ 33 , 56 , 57 ]. Nigerian industries' high emissions include exhausts from internal combustion engines and particulates from milling activities, cement production, and quarrying sites. Peculiar to Nigeria is the mass importation of second-hand motor vehicles, which can be used for a prolonged period, usually exceeding 30 years. Some old vehicles are still found on the road presently, usually tagged 'smoking' vehicles due to the thick exhaust emissions visible. Second-hand used cars usually have high gaseous emissions due to incomplete combustion of oil and fuel impurities that could be hazardous to public health. Motorcycles and tricycles are classified into these categories [ 56 , 58 , 59 , 60 ]. Illegal importation of e-waste to dumpsites in the south-western part of Nigeria has been a significant problem to air pollution because scavengers go to the dumpsites and burn down the e-waste to get some vital part of it to sell. The incomplete burning of this e-waste leads to air pollution and soothes in the atmosphere [ 1 ].
Exploring crude oil, refining, and gas flaring are predominant in the southern part of Nigeria ( Figure 2 ) [ 61 ].Residents in most states across the country burn most household wastes due to a lack of central dumpsites. The use of petrol or diesel generator as a source of electricity for both residents and industries due to lack of stable electric power is high. This has led to emissions of carbon monoxide (CO), carbon dioxide (CO 2 ), nitrogen oxides (NOx), sulphur dioxide (SO 2 ), and particulate matter in the atmosphere thereby increasing air pollution and lower air quality [ 62 ]. Many of Nigeria's population suffer from cardiovascular diseases, physiological and mental health problems, respiratory system-related issues, acid rain, and destruction of vegetation resulting from air pollution.
These anthropogenic activities and occupational exposures have led to air pollution-related risk health problems [ 1 , 63 ]. There is also a high potential exposure to unknown hazards due to increasing industrialization in the country. For example, the increasing number of industries, especially in Nigeria's urban areas, has introduced new chemicals into the atmosphere [ 64 , 65 ]. The presumption is that some of such chemicals have or will present unexpected problems to public health and need to be treated before their release [ 66 , 67 ].
4.1.2. Household air pollution
More than 50% of domestic energy used in developing countries is generated through biomass burning [ 68 ]. Studies have shown that 76% of the global particulate matter air pollution emissions in the developing world are indoor with a peak concentration often exceeding 2000 μg/m 3 [ 69 ]. For instance, in Nigeria, over 70% of the population are still using biomass for fuel woods with a poorly ventilated kitchen [ 70 , 71 ]. Examples of sources in small settlements and villages are fuelwood, charcoal, and agro-waste (e.g., palm fruit fiber, palm kernel shell); in bigger towns; fuelwood, charcoal, and kerosene in some instances, plastic wastes; in cities; sources are fuelwood (usually at restaurants), charcoal, and gas [ 57 , 72 ]. These fuel sources usually undergo incomplete combustion, leading to hazardous gases and particulate matter, which causes harm to human health.
Indoor air pollution from household fuel use has been ranked the second high-risk factor responsible for adverse human health, with the potential of resulting in respiratory and cardiovascular mortality [ 73 ]. It may also lead to low birthweights and neurodevelopmental impairment [ 74 ]. Household air pollution from the use of solid fuels in Nigeria causes lower respiratory infections, respiratory infections, and communicable diseases resulting in over 180 thousand deaths ( Fig 4 a) and 12 million people with DALYs ( Figure 5 d) per annum in Nigeria from 2007-2017 showing a steady decline with yearly progression This studies in line with previous studies have shown that increasing air pollution levels are associated with adverse health effects, hospitalization, and early death among the exposed groups.
4.2. Water, sanitation and hygiene (WaSH)
Unsafe water, poor sanitation, and hygiene have led to an annual death of about 1.7 million people [ 6 ], including over 70 thousand children under the age of 5 [ 75 ], [ 76 ] due to high vulnerability to water-borne diseases. Unsafe water, sanitation, and handwashing have been associated with enteric infections, diarrheal diseases, respiratory infections, tuberculosis, lower respiratory infections, communicable, neonatal, and nutritional diseases in humans [ 20 ]. Figure 6 (a,b) shows a high number of deaths greater than 300 thousand and more than 3 million DALYs lost in Nigeria yearly associated with unsafe water and sanitation with enteric infections, diarrheal diseases, communicable, maternal, neonatal, and nutritional disease as the leading causes from 2007-2017 with yearly progressive steady decline.
Population growth has led to an increase in demand for high-quality water and sanitation facilities. As domestic and economic activities increase, the value of water increases, making water pollution more detrimental to human health. Domestic water pollution, industrial water pollution, agriculturally based water pollution, and oil spill water pollution are the primary sources of water contamination in Nigeria. The World Bank report on Nigeria also indicates a deficit of 43 healthy years of life per 1000 due to diarrhea [ 77 , 78 ]. Studies also reported that Nigeria had progressed in access to water and improved sanitation from 1990. However, the pace of progress slowed down, resulting in 56 million without water access and another 130 million without access to improved sanitation as of 2015 [ 79 ], with over 45 million people in Nigeria practicing open defecation [ 77 ].
Unhygienic disposal of waste in waterways blocks the waterways resulting in flooding during the rainy season, increasing water contamination, breeding of mosquitoes, emergence, and fast spread of water-borne disease; accumulated waste is usually a breeding ground for various diseases and disease vectors [ 1 ]. Many states in Nigeria do not have a central sewage collection center or central dumpsites and have poor sanitary infrastructural management [ 80 ]. Studies show that untreated sewage at Lagos' and Abuja's open solid-waste dumpsites [ 81 , 82 ] have contaminated water systems, leading to health risks caused by poor hygiene such as diarrhea-related disorders, bilharzia among others [ 71 ]. People living close to these waste sites, especially in urban areas, end up eating food or drinking water with high nitrate and other harmful chemicals. During the rainy season in Nigeria, rain mixed with waste can contaminate clean surface water and percolate through the soil into underground water.
Health issues have been increasing due to oil spills and illegal industrial waste in the Niger Delta regions because many industries in oil exploration, transportation, import, and export have little consideration of environmental issues. Within 1976–2009 there has been a report of about 9583 accidents and disasters resulting from oil exploration activities, including oil spills on either rivers and or coastal waters posing the communities' health at risk [ 83 , 84 ]. UN study in 2011 on the effect of oil spillage in the Niger Delta reported that the majority of the people living in oil-producing areas suffer from chronic diseases all their lives due to drinking water contaminated with high levels of hydrocarbon [ 37 ]. Also, the benzene level in the Niger Delta is 900 times higher than the WHO standard, and at a depth of 5 m, oil was found [ 37 ]. Industrial waste, which contains chemicals and heavy metals usually deposited in water, has resulted in most aquatic animals' death due to oxygen depletion and ingestion of heavy metals [ 85 ]; thus, affecting the health of people who consume aquatic animals.
Arsenic and heavy metals deposited in water from industrial waste usually infiltrate into underground water and wells, resulting in physical, muscular, neurological degenerative processes that cause brain disorder and nervous system diseases [ 86 ] to people. Polluted water from the mining site can affect the population's health who use it as a drinking water source. Waste from textile industries, sugar industries, pulp and paper industries, petroleum, and many other industries in Nigeria are usually improperly disposed of on land or waterways, becoming an urban environmental problem. Improper disposition of toxic and non-toxic waste degrades land also makes surface and underground water unhygienic and unsafe for humans or agricultural use [ 9 ].
4.3. Lead exposure
Blood lead levels are another concern of the currently rapid industrializing countries [ 87 ]. This blood lead exposure affects children's cognitive function. Since there is no safe blood lead level identified for a child, any exposure must be handled remarkably [ 35 ]. Besides, lead exposure generally occurs without common symptoms or signs; hence it is rarely recognized [ 4 , 87 , 88 ]. GBD health data has associated lead exposure with having a causative effect on various diseases such as cardiovascular disease, ischemic heart disease, mental disorder, and stroke [ 20 ]. Figure 6 (c and d) shows the cause of over 2,500 deaths and about 600 thousand DALYs lost yearly due to lead exposure in Nigeria between 2007-2017, with cardiovascular disease and ischemic heart disease on a steady rise. There is a need for concerned organizations and institutions to eliminate childhood exposures to lead to reduce the risk of lead exposure and promote public health in general.
The lead dust is usually dispersed into the environment during the extraction of gold, thus exposing the public to health defects when the lead is inhaled through the air or ingested in unsafe water [ 4 , 88 ]. Studies reported that most lead in Nigeria had been exposed to the environment through unsafe mining practices by the community [ 34 , 89 , 90 ]. Most miners do not wear protective equipment while mining, hence returning home with lead dust on their clothes and rocks containing gold with high lead levels [ 88 , 91 ]. Investigations in Zamfara reveal widespread lead-poison, with thousands of children living with dangerous levels of blood lead and hundreds of death and animals due to this lead risk [ 92 ]. Some environmental health reports for surveys and research conducted in Nigeria over the previous years show lead metal at unsafe levels has gotten in homes, especially in Northern Nigeria [ 13 , 93 ]. The water from the village's wells in Zamfara shows high levels of this heavy metal, and children in this community have blood lead in dangerous levels [ 4 , 64 , 82 ].
4.4. Other environmental risks
Nigeria faces a wide array of other environmental problems, including deforestation, desertification, wind erosion, flooding, and climate change. Some have seemingly minor risks at an individual level, while in synergy, they contribute significantly to more deaths and DALYs combined. Figure 7 shows the number of deaths and DALYs due to other environmental risks from 2007-2017 in Nigeria; the number of DALYs caused by the cardiovascular disease has been steadily rising as the year progresses, with an estimate of 60 thousand population affected each year. This can contribute to the rise of respiratory disease from 4 th rank to 1 st rank ( Table 1 ) between 2007-2017. Stroke, ischemic heart disease, and mental disorder show little changes maintaining a range between 22,000 to 26,000 DALYs yearly from 2007-2017 in Nigeria. Approximately 1000 deaths are attributed to ischemic heart disease and stroke respectively per annum, while an estimated 2000 deaths are attributed to cardiovascular diseases per annum. An estimate of 140 thousand deaths is attributed to other environmental risks yearly.
More than 70% of Nigeria's forest land has been cut down due to settlements, increase in urbanization [ 94 ], construction of roads, use of biomass as a significant source of cooking fuel, and wood as raw material for different constructions and much industrial use [ 60 , 95 ]. All these results in deforestation, loss of wildlife, and change in the micro-climate. Deforestation in the Northern part of Nigeria ( Figure 2 ), especially the Sahel-savannah region, has led to more desert encroachment and sand storm, another source of air pollution and respiratory health problem.
Climate change, desert encroachment, and deforestation have led to the blowing away of the land surface in Nigeria's Northern part [ 9 ], while heavy rainfalls often flood and wash away a large portion of plain lands. This is usually due to low topography, lack of proper drainage, and disposition of waste in waterways by people [ 96 , 97 ]. This has resulted in the loss of cultivations, fertile soils, homes are washed away by floods, and disease outbreaks carried by dirty water. Diarrhea and breading of disease vectors are paramount in flooded areas causing various health effects [ 98 ].
5. Summary, research needs, and recommendation
Environmental health has become a significant concern in Nigeria. This paper reviews the current status and existing environmental health situations in Nigeria. Leading studies have been reviewed in this paper, and the key findings are as follows:
- • Nigeria is faced with environmental problems such as air pollution, water pollution, lead exposures, poor waste management, deforestation, desertification, wind erosion, and flooding, which has harmed the population.
- • In Nigeria, lower respiratory infection associated with the environmental risk factor is the highest-ranked cause of death in 2017.
- • Environmental factors such as ambient air pollution, household air pollution, unsafe water, sanitation, hand washing, and lead poisoning are associated with most health-related causes of death in Nigeria from 2007-2017
- • Air pollution, household air pollution, and WaSH showed a prolonged but progressive decline while ambient particulate matter pollution, ambient ozone pollution. Lead exposure shows a steady rise in association to death and DALYs in Nigeria, proving a significant concern in an environmental health-related risk situation.
- • Other high causes of death associated with environmental risk factors include COPD, chronic respiratory diseases, cardiovascular diseases, enteric infections, diarrheal diseases, communicable, maternal, neonatal, and nutritional disease, which has led to approximately over 800 thousand deaths and 26 million people living with DALYs yearly in Nigeria
In Nigeria, there is a need to appropriately implement environmental health policies and enact other pertinent policies to mitigate the environmental health situation. Also, there is a need to have a directorate of environmental health to ensure all concerned activities are well-coordinated [ 93 , 99 ].
5.1. Research needs
There is a need to create a framework for coordinating research activities with considerable inputs from the Health, Policy, Systems, Research, and Analysis (HPSR + A). Need for incorporating HPSR + A training and research at students' early training stage [ 100 , 101 ]. Capacity building of all departments offers environmental health research in terms of human resources to identify unknown environmental hazards from chemicals in the environment. Policymakers need to take advantage of pre-existing financial and administrative governance approaches [ 102 ] to establish organizational, staff, and course advancement in environmental health research and training. The future environmental health practitioners and policymaker's engagement should consider building capacity researchers in HPSR + A, especially in advocacy skills to determine the community's needs effectively.
There is also a need for prior determined, pre-existing communication channels of research findings on dissemination workshops, briefing notes, and technical meetings, harnessed with advocacy as an approach to strengthening engagements and linkages between practitioners and policymakers. There is an urgent need to establish further and develop frameworks to facilitate networking and research activities in academic institutions and significantly in policy institutions, emphasizing socio-cultural similarities such as information management and bureaucracy. Most importantly, forming systems to coordinate government, research organizations, and donors in environmental health policy research structures.
5.2. Recommendations
The state of Nigeria's environment is at a critical stage, which can have more health risks that can affect an extended period beyond the present condition if not mitigated. Thus, the need to implement immediate actions for a healthy environment and increase life expectancy in Nigeria. Below are some recommendations;
- • Second-hand vehicle exhaust is a significant source of air pollution [ 103 ]; likewise demonstrates the improper disposition and burning of e-waste [ 104 ]. The incomplete combustion of hydrocarbons produces soot into the atmosphere. The Nigerian customs service should put more crackdowns and severe punishment for the illegal importation of second-hand vehicles and e-waste. There should be more vehicle inspections to ensure vehicle owners service their cars regularly and old vehicles are flagged off the roads to reduce air pollutants' emissions. Through such, only good condition vehicles can move on the road.
- • Inadequate infrastructure such as uninterrupted electric power supply had been a significant challenge in Nigeria for a while [ 33 ]. The population keeps using generators associated with air pollution and respiratory-related health risk [ 59 ]. Constant electric power supply will reduce the use of diesel generators by residents, offices, and organizations, which will lead to cleaner air.
- • The percentage of families using biomass fuelwood is high. This has led to respiratory health effects on vulnerable groups, mostly women and children [ 70 , 105 , 106 ]. Clean energy improved stoves at an affordable price can reduce over 70% of Nigerian homes' dependence on biomass as cooking fuel. Biogas and other renewable energies such as solar power and wind energy can be used as alternative energy sources to reduce petroleum products' dependency.
- • Increased industrialization has led to high potential exposure to air pollution, and most industries do not adhere to the federal government's air quality emission standard. The gas flaring policy for the complete halting of gas flaring in Nigeria has not been adhered to by industries [ 83 ]. This has led to thick soothe covering over cities, respiratory problems to the population, and acid rain. Policymakers and inspectors should make industries adhere strictly to the sets standard of treatments and proper discharge of industrial waste, either liquid, solid, or gaseous.
- • The rate of illegal mining has been on the rise in the north-central region [ 107 ]. Improper mining carried out, such as non-use of protective equipment and abandonment of mining sites without proper closure after mining, has led to water contamination during the rainy season [ 89 , 107 ]. Poor drainage aids the flooding of contaminated water to water bodies used by the nearby communities. This has resulted in increasing lead poisoning and many heavy metal-related diseases. There is a need for a crackdown on illegal mining and constant surveillance of mining or potential mining sites by the environmental protection agencies and law enforcement agencies. This will ensure legal mining sites adhere strictly to mining regulations on proper disposal of mining waste, landfilling, and appropriate closure of mined areas when mining is over. This will reduce hazards caused by flooding and contamination of land and water to communities around mining sites.
- • Most houses in Nigeria were built without proper town planning or allocation for sewage and other waste disposal capacity [ 104 ], thus; becoming a peril to adequate waste management. A central sewage system, government-built dumpsites, and garbage sorting as part of proper waste management will help keep a sanitary environment, reduce water contamination, recycle and reuse some recyclable waste. Waste management legislation, adequate policy, and a planning framework for waste management are needed.
- • Basic sanitation infrastructural amenities such as public toilets are inadequate or completely lacking in various regions of Nigeria [ 108 ], resulting in open defecation practices by the population. Nigeria's adopted Community-Led Total Sanitation (CLTS) in 2008 had made progress in portable water availability [ 77 ]. However, there is a need to build more public toilets in communities, major cities, and market places. This will reduce open defecation, which has resulted in the emergence and transfer of infectious diseases such as cholera.
6. Conclusion
The situation of the state of the environment in Nigeria is rapidly degenerating. The environment affected by humans' activities shows the negative environmental health issues being on the rise. The environmental health situation is usually an interconnection between human activities and the environment. Nigeria faces emerging challenges in environmental health, such as climate change, low air quality, water contamination, and natural hazards like floods, storms, and drought. All of these negatively affect human health. Nigeria being a significant oil producer, has problems associated with exploration, such as oil spillage on water and land and gas flaring leading to air pollution. Most of the highest-ranked risk factors causing the most death and disability combine in Nigeria are environmental-related.
Environmental health policy is necessary to contain the surging rise of environmental problems. The need for environmental health legislation and inspection to ensure the public and industries adhere to regulations set is vital. This will reduce environmental health risks and more gain in healthy life span in Nigeria. A healthy environment will lead to a healthy life.
Declarations
Author contribution statement.
All authors listed have significantly contributed to the investigation, development and writing of this article.
Funding statement
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Data availability statement
Declaration of interests statement.
The authors declare no conflict of interest.
Additional information
No additional information is available for this paper.
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Annals of Science and Technology
Review of Drinking Water Quality in Nigeria: Towards Attaining the Sustainable Development Goal Six
Obinna c. nwinyi , obinna c. nwinyi , osariyekemwen uyi , osariyekemwen uyi , emmanuel j. awosanya , emmanuel j. awosanya , ifeoluwa t. oyeyemi , ifeoluwa t. oyeyemi , anthony m. ugbenyen , anthony m. ugbenyen , aliyu muhammad , aliyu muhammad , okunola a. alabi , okunola a. alabi , obinna i. ekwunife , obinna i. ekwunife , charles o. adetunji and charles o. adetunji and iyekhoetin m. omoruyi iyekhoetin m. omoruyi, published online : 24 nov 2020, volume & issue : volume 5 (2020) - issue 2 (december 2020), page range: 58 - 77, received : 02 aug 2020, accepted : 05 oct 2020, pdf preview, recent articles, journal & issue details.
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Review article, effects of water pollution on human health and disease heterogeneity: a review.
- 1 Research Center for Economy of Upper Reaches of the Yangtse River/School of Economics, Chongqing Technology and Business University, Chongqing, China
- 2 School of Economics and Management, Huzhou University, Huzhou, China
Background: More than 80% of sewage generated by human activities is discharged into rivers and oceans without any treatment, which results in environmental pollution and more than 50 diseases. 80% of diseases and 50% of child deaths worldwide are related to poor water quality.
Methods: This paper selected 85 relevant papers finally based on the keywords of water pollution, water quality, health, cancer, and so on.
Results: The impact of water pollution on human health is significant, although there may be regional, age, gender, and other differences in degree. The most common disease caused by water pollution is diarrhea, which is mainly transmitted by enteroviruses in the aquatic environment.
Discussion: Governments should strengthen water intervention management and carry out intervention measures to improve water quality and reduce water pollution’s impact on human health.
Introduction
Water is an essential resource for human survival. According to the 2021 World Water Development Report released by UNESCO, the global use of freshwater has increased six-fold in the past 100 years and has been growing by about 1% per year since the 1980s. With the increase of water consumption, water quality is facing severe challenges. Industrialization, agricultural production, and urban life have resulted in the degradation and pollution of the environment, adversely affecting the water bodies (rivers and oceans) necessary for life, ultimately affecting human health and sustainable social development ( Xu et al., 2022a ). Globally, an estimated 80% of industrial and municipal wastewater is discharged into the environment without any prior treatment, with adverse effects on human health and ecosystems. This proportion is higher in the least developed countries, where sanitation and wastewater treatment facilities are severely lacking.
Sources of Water Pollution
Water pollution are mainly concentrated in industrialization, agricultural activities, natural factors, and insufficient water supply and sewage treatment facilities. First, industry is the main cause of water pollution, these industries include distillery industry, tannery industry, pulp and paper industry, textile industry, food industry, iron and steel industry, nuclear industry and so on. Various toxic chemicals, organic and inorganic substances, toxic solvents and volatile organic chemicals may be released in industrial production. If these wastes are released into aquatic ecosystems without adequate treatment, they will cause water pollution ( Chowdhary et al., 2020 ). Arsenic, cadmium, and chromium are vital pollutants discharged in wastewater, and the industrial sector is a significant contributor to harmful pollutants ( Chen et al., 2019 ). With the acceleration of urbanization, wastewater from industrial production has gradually increased. ( Wu et al., 2020 ). In addition, water pollution caused by industrialization is also greatly affected by foreign direct investment. Industrial water pollution in less developed countries is positively correlated with foreign direct investment ( Jorgenson, 2009 ). Second, water pollution is closely related to agriculture. Pesticides, nitrogen fertilizers and organic farm wastes from agriculture are significant causes of water pollution (RCEP, 1979). Agricultural activities will contaminate the water with nitrates, phosphorus, pesticides, soil sediments, salts and pathogens ( Parris, 2011 ). Furthermore, agriculture has severely damaged all freshwater systems in their pristine state ( Moss, 2008 ). Untreated or partially treated wastewater is widely used for irrigation in water-scarce regions of developing countries, including China and India, and the presence of pollutants in sewage poses risks to the environment and health. Taking China as an example, the imbalance in the quantity and quality of surface water resources has led to the long-term use of wastewater irrigation in some areas in developing countries to meet the water demand of agricultural production, resulting in serious agricultural land and food pollution, pesticide residues and heavy metal pollution threatening food safety and Human Health ( Lu et al., 2015 ). Pesticides have an adverse impact on health through drinking water. Comparing pesticide use with health life Expectancy Longitudinal Survey data, it was found that a 10% increase in pesticide use resulted in a 1% increase in the medical disability index over 65 years of age ( Lai, 2017 ). The case of the Musi River in India shows a higher incidence of morbidity in wastewater-irrigated villages than normal-water households. Third, water pollution is related to natural factors. Taking Child Loess Plateau as an example, the concentration of trace elements in water quality is higher than the average world level, and trace elements come from natural weathering and manufacture causes. Poor river water quality is associated with high sodium and salinity hazards ( Xiao et al., 2019 ). The most typical water pollution in the middle part of the loess Plateau is hexavalent chromium pollution, which is caused by the natural environment and human activities. Loess and mudstone are the main sources, and groundwater with high concentrations of hexavalent chromium is also an important factor in surface water pollution (He et al., 2020). Finally, water supply and sewage treatment facilities are also important factors affecting drinking water quality, especially in developing countries. In parallel with China rapid economic growth, industrialization and urbanization, underinvestment in basic water supply and treatment facilities has led to water pollution, increased incidence of infectious and parasitic diseases, and increased exposure to industrial chemicals, heavy metals and algal toxins ( Wu et al., 1999 ). An econometric model predicts the impact of water purification equipment on water quality and therefore human health. When the proportion of household water treated with water purification equipment is reduced from 100% to 90%, the expected health benefits are reduced by up to 96%.. When the risk of pretreatment water quality is high, the decline is even more significant ( Brown and Clasen, 2012 ).
To sum up, water pollution results from both human and natural factors. Various human activities will directly affect water quality, including urbanization, population growth, industrial production, climate change, and other factors ( Halder and Islam, 2015 ) and religious activities ( Dwivedi et al., 2018 ). Improper disposal of solid waste, sand, and gravel is also one reason for decreasing water quality ( Ustaoğlua et al., 2020 ).
Impact of Water Pollution on Human Health
Unsafe water has severe implications for human health. According to UNESCO 2021 World Water Development Report , about 829,000 people die each year from diarrhea caused by unsafe drinking water, sanitation, and hand hygiene, including nearly 300,000 children under the age of five, representing 5.3 percent of all deaths in this age group. Data from Palestine suggest that people who drink municipal water directly are more likely to suffer from diseases such as diarrhea than those who use desalinated and household-filtered drinking water ( Yassin et al., 2006 ). In a comparative study of tap water, purified water, and bottled water, tap water was an essential source of gastrointestinal disease ( Payment et al., 1997 ). Lack of water and sanitation services also increases the incidence of diseases such as cholera, trachoma, schistosomiasis, and helminthiasis. Data from studies in developing countries show a clear relationship between cholera and contaminated water, and household water treatment and storage can reduce cholera ( Gundry et al., 2004 ). In addition to disease, unsafe drinking water, and poor environmental hygiene can lead to gastrointestinal illness, inhibiting nutrient absorption and malnutrition. These effects are especially pronounced for children.
Purpose of This Paper
More than two million people worldwide die each year from diarrhoeal diseases, with poor sanitation and unsafe drinking water being the leading cause of nearly 90% of deaths and affecting children the most (United Nations, 2016). More than 50 kinds of diseases are caused by poor drinking water quality, and 80% of diseases and 50% of child deaths are related to poor drinking water quality in the world. However, water pollution causes diarrhea, skin diseases, malnutrition, and even cancer and other diseases related to water pollution. Therefore, it is necessary to study the impact of water pollution on human health, especially disease heterogeneity, and clarify the importance of clean drinking water, which has important theoretical and practical significance for realizing sustainable development goals. Unfortunately, although many kinds of literature focus on water pollution and a particular disease, there is still a lack of research results that systematically analyze the impact of water pollution on human health and the heterogeneity of diseases. Based on the above background and discussion, this paper focuses on the effect of water pollution on human health and its disease heterogeneity.
Materials and Methods
Search process.
This article uses keywords such as “water,” “water pollution,” “water quality,” “health,” “diarrhea,” “skin disease,” “cancer” and “children” to search Web of Science and Google Scholar include SCI and SSCI indexed papers, research reports, and works from 1990 to 2021.
Inclusion-Exclusion Criteria and Data Extraction Process
The existing literature shows that water pollution and human health are important research topics in health economics, and scholars have conducted in-depth research. As of 30 December 2021, 104 related literatures were searched, including research papers, reviews and conference papers. Then, according to the content relevancy, 19 papers were eliminated, and 85 papers remained. The purpose of this review is to summarize the impact of water pollution on human health and its disease heterogeneity and to explore how to improve human health by improving water pollution control measures.
Information extracted from all included papers included: author, publication date, sample country, study methodology, study purpose, and key findings. All analysis results will be analyzed according to the process in Figure 1 .
FIGURE 1 . Data extraction process (PRISMA).
The relevant information of the paper is exported to the Excel database through Endnote, and the duplicates are deleted. The results were initially extracted by one researcher and then cross-checked by another researcher to ensure that all data had been filtered and reviewed. If two researchers have different opinions, the two researchers will review together until a final agreement is reached.
Quality Assessment of the Literature
The JBI Critical Appraisal Checklist was used to evaluate the quality of each paper. The JBI (Joanna Briggs Institute) key assessment tool was developed by the JBI Scientific Committee after extensive peer review and is designed for system review. All features of the study that meet the following eight criteria are included in the final summary:1) clear purpose; 2) Complete information of sample variables; 3) Data basis; 4) the validity of data sorting; 5) ethical norms; (6); 7) Effective results; 8) Apply appropriate quantitative methods and state the results clearly. Method quality is evaluated by the Yes/No questions listed in the JBI Key Assessment List. Each analysis paper received 6 out of 8.
The quality of drinking water is an essential factor affecting human health. Poor drinking water quality has led to the occurrence of water-borne diseases. According to the World Health Organization (WHO) survey, 80% of the world’s diseases and 50% of the world’s child deaths are related to poor drinking water quality, and there are more than 50 diseases caused by poor drinking water quality. The quality of drinking water in developing countries is worrying. The negative health effects of water pollution remain the leading cause of morbidity and mortality in developing countries. Different from the existing literature review, this paper mainly studies the impact of water pollution on human health according to the heterogeneity of diseases. We focuses on diarrhea, skin diseases, cancer, child health, etc., and sorts out the main effects of water pollution on human health ( Table 1 ).
TABLE 1 . Major studies on the relationship between water pollution and health.
Water Pollution and Diarrhea
Diarrhea is a common symptom of gastrointestinal diseases and the most common disease caused by water pollution. Diarrhea is a leading cause of illness and death in young children in low-income countries. Diarrhoeal diseases account for 21% of annual deaths among children under 5 years of age in developing countries ( Waddington et al., 2009 ). Many infectious agents associated with diarrhea are directly related to contaminated water ( Ahmed and Ismail, 2018 ). Parasitic worms present in non-purifying drinking water when is consumed by human beings causes diseases ( Ansari and Akhmatov., 2020 ) . It was found that treated water from water treatment facilities was associated with a lower risk of diarrhea than untreated water for all ages ( Clasen et al., 2015 ). For example, in the southern region of Brazil, a study found that factors significantly associated with an increased risk of mortality from diarrhoea included lack of plumbed water, lack of flush toilets, poor housing conditions, and overcrowded households. Households without access to piped water had a 4.8 times higher risk of infant death from diarrhea than households with access to piped water ( Victora et al., 1988 )
Enteroviruses exist in the aquatic environment. More than 100 pathogenic viruses are excreted in human and animal excreta and spread in the environment through groundwater, estuarine water, seawater, rivers, sewage treatment plants, insufficiently treated water, drinking water, and private wells ( Fong and Lipp., 2005 ). A study in Pakistan showed that coliform contamination was found in some water sources. Improper disposal of sewage and solid waste, excessive use of pesticides and fertilizers, and deteriorating pipeline networks are the main causes of drinking water pollution. The main source of water-borne diseases such as gastroenteritis, dysentery, diarrhea, and viral hepatitis in this area is the water pollution of coliform bacteria ( Khan et al., 2013 ). Therefore, the most important role of water and sanitation health interventions is to hinder the transmission of diarrheal pathogens from the environment to humans ( Waddington et al., 2009 ).
Meta-analyses are the most commonly used method for water quality and diarrhea studies. It was found that improving water supply and sanitation reduced the overall incidence of diarrhea by 26%. Among Malaysian infants, having clean water and sanitation was associated with an 82% reduction in infant mortality, especially among infants who were not breastfed ( Esrey et al., 1991 ). All water quality and sanitation interventions significantly reduced the risk of diarrhoeal disease, and water quality interventions were found to be more effective than previously thought. Multiple interventions (including water, sanitation, and sanitation measures) were not more effective than single-focus interventions ( Fewtrell and Colford., 2005 ). Water quality interventions reduced the risk of diarrhoea in children and reduced the risk of E. coli contamination of stored water ( Arnold and Colford., 2007 ). Interventions to improve water quality are generally effective in preventing diarrhoea in children of all ages and under 5. However, some trials showed significant heterogeneity, which may be due to the research methods and their conditions ( Clasen et al., 2007 ).
Water Pollution and Skin Diseases
Contrary to common sense that swimming is good for health, studies as early as the 1950s found that the overall disease incidence in the swimming group was significantly higher than that in the non-swimming group. The survey shows that the incidence of the disease in people under the age of 10 is about 100% higher than that of people over 10 years old. Skin diseases account for a certain proportion ( Stevenson, 1953 ). A prospective epidemiological study of beach water pollution was conducted in Hong Kong in the summer of 1986–1987. The study found that swimmers on Hong Kong’s coastal beaches were more likely than non-swimmers to complain of systemic ailments such as skin and eyes. And swimming in more polluted beach waters has a much higher risk of contracting skin diseases and other diseases. Swimming-related disease symptom rates correlated with beach cleanliness ( Cheung et al., 1990 ).
A study of arsenic-affected villages in the southern Sindh province of Pakistan emphasized that skin diseases were caused by excessive water quality. By studying the relationship between excessive arsenic in drinking water caused by water pollution and skin diseases (mainly melanosis and keratosis), it was found that compared with people who consumed urban low-arsenic drinking water, the hair of people who consumed high-arsenic drinking water arsenic concentration increased significantly. The level of arsenic in drinking water directly affects the health of local residents, and skin disease is the most common clinical complication of arsenic poisoning. There is a correlation between arsenic concentrations in biological samples (hair and blood) from patients with skin diseases and intake of arsenic-contaminated drinking water ( Kazi et al., 2009 ). Another Bangladesh study showed that many people suffer from scabies due to river pollution ( Hanif et al., 2020 ). Not only that, but water pollution from industry can also cause skin cancer ( Arif et al., 2020 ).
Studies using meta-analysis have shown that exposure to polluted Marine recreational waters can have adverse consequences, including frequent skin discomfort (such as rash or itching). Skin diseases in swimmers may be caused by a variety of pathogenic microorganisms ( Yau et al., 2009 ). People (swimmers and non-swimmers) exposed to waters above threshold levels of bacteria had a higher relative risk of developing skin disease, and levels of bacteria in seawater were highly correlated with skin symptoms.
Studies have also suggested that swimmers are 3.5 times more likely to report skin diseases than non-swimmers. This difference may be a “risk perception bias” at work on swimmers, who are generally aware that such exposure may lead to health effects and are more likely to detect and report skin disorders. It is also possible that swimmers exaggerated their symptoms, reporting conditions that others would not classify as true skin disorders ( Fleisher and Kay. 2006 ).
Water Pollution and Cancer
According to WHO statistics, the number of cancer patients diagnosed in 2020 reached 19.3 million, while the number of deaths from cancer increased to 10 million. Currently, one-fifth of all global fevers will develop cancer during their lifetime. The types and amounts of carcinogens present in drinking water will vary depending on where they enter: contamination of the water source, water treatment processes, or when the water is delivered to users ( Morris, 1995 ).
From the perspective of water sources, arsenic, nitrate, chromium, etc. are highly associated with cancer. Ingestion of arsenic from drinking water can cause skin cancer and kidney and bladder cancer ( Marmot et al., 2007 ). The risk of cancer in the population from arsenic in the United States water supply may be comparable to the risk from tobacco smoke and radon in the home environment. However, individual susceptibility to the carcinogenic effects of arsenic varies ( Smith et al., 1992 ). A high association of arsenic in drinking water with lung cancer was demonstrated in a northern Chilean controlled study involving patients diagnosed with lung cancer and a frequency-matched hospital between 1994 and 1996. Studies have also shown a synergistic effect of smoking and arsenic intake in drinking water in causing lung cancer ( Ferreccio et al., 2000 ). Exposure to high arsenic levels in drinking water was also associated with the development of liver cancer, but this effect was not significant at exposure levels below 0.64 mg/L ( Lin et al., 2013 ).
Nitrates are a broader contaminant that is more closely associated with human cancers, especially colorectal cancer. A study in East Azerbaijan confirmed a significant association between colorectal cancer and nitrate in men, but not in women (Maleki et al., 2021). The carcinogenic risk of nitrates is concentration-dependent. The risk increases significantly when drinking water levels exceed 3.87 mg/L, well below the current drinking water standard of 50 mg/L. Drinking water with nitrate concentrations lower than current drinking water standards also increases the risk of colorectal cancer ( Schullehner et al., 2018 ).
Drinking water with high chromium content will bring high carcinogenicity caused by hexavalent chromium to residents. Drinking water intake of hexavalent chromium experiments showed that hexavalent chromium has the potential to cause human respiratory cancer. ( Zhitkovich, 2011 ). A case from Changhua County, Taiwan also showed that high levels of chromium pollution were associated with gastric cancer incidence ( Tseng et al., 2018 ).
There is a correlation between trihalomethane (THM) levels in drinking water and cancer mortality. Bladder and brain cancers in both men and women and non-Hodgkin’s lymphoma and kidney cancer in men were positively correlated with THM levels, and bladder cancer mortality had the strongest and most consistent association with THM exposure index ( Cantor et al., 1978 ).
From the perspective of water treatment process, carcinogens may be introduced during chlorine treatment, and drinking water is associated with all cancers, urinary cancers and gastrointestinal cancers ( Page et al., 1976 ). Chlorinated byproducts from the use of chlorine in water treatment are associated with an increased risk of bladder and rectal cancer, with perhaps 5,000 cases of bladder and 8,000 cases of rectal cancer occurring each year in the United States (Morris, 1995).
The impact of drinking water pollutants on cancer is complex. Epidemiological studies have shown that drinking water contaminants, such as chlorinated by-products, nitrates, arsenic, and radionuclides, are associated with cancer in humans ( Cantor, 1997 ). Pb, U, F- and no3- are the main groundwater pollutants and one of the potential causes of cancer ( Kaur et al., 2021 ). In addition, many other water pollutants are also considered carcinogenic, including herbicides and pesticides, and fertilizers that contain and release nitrates ( Marmot et al., 2007 ). A case from Hebei, China showed that the contamination of nitrogen compounds in well water was closely related to the use of nitrogen fertilizers in agriculture, and the levels of three nitrogen compounds in well water were significantly positively correlated with esophageal cancer mortality ( Zhang et al., 2003 ).
In addition, due to the time-lag effect, the impact of watershed water pollution on cancer is spatially heterogeneous. The mortality rate of esophageal cancer caused by water pollution is significantly higher downstream than in other regions due to the impact of historical water pollution ( Xu et al., 2019 ). A study based on changes in water quality in the watershed showed that a grade 6 deterioration in water quality resulted in a 9.3% increase in deaths from digestive cancer. ( Ebenstein, 2012 ).
Water Pollution and Child Health
Diarrhea is a common disease in children. Diarrhoeal diseases (including cholera) kill 1.8 million people each year, 90 per cent of them children under the age of five, mostly in developing countries. 88% of diarrhoeal diseases are caused by inadequate water supply, sanitation and hygiene (Team, 2004). A large proportion of these are caused by exposure to microbially infected water and food, and diarrhea in infants and young children can lead to malnutrition and reduced immune resistance, thereby increasing the likelihood of prolonged and recurrent diarrhea ( Marino, 2007 ). Pollution exposure experienced by children during critical periods of development is associated with height loss in adulthood ( Zaveri et al., 2020 ). Diseases directly related to water and sanitation, combined with malnutrition, also lead to other causes of death, such as measles and pneumonia. Child malnutrition and stunting due to inadequate water and sanitation will continue to affect more than one-third of children in the world ( Bartlett, 2003 ). A study from rural India showed that children living in households with tap water had significantly lower disease prevalence and duration ( Jalan and Ravallion, 2003 ).
In conclusion, water pollution is a significant cause of childhood diseases. Air, water, and soil pollution together killed 940,000 children worldwide in 2016, two-thirds of whom were under the age of 5, and the vast majority occurred in low- and middle-income countries ( Landrigan et al., 2018 ). The intensity of industrial organic water pollution is positively correlated with infant mortality and child mortality in less developed countries, and industrial water pollution is an important cause of infant and child mortality in less developed countries ( Jorgenson, 2009 ). In addition, arsenic in drinking water is a potential carcinogenic risk in children (García-Rico et al., 2018). Nitrate contamination in drinking water may cause goiter in children ( Vladeva et al.., 2000 ).
Discussions
This paper reviews the environmental science, health, and medical literature, with a particular focus on epidemiological studies linking water quality, water pollution, and human disease, as well as studies on water-related disease morbidity and mortality. At the same time, special attention is paid to publications from the United Nations and the World Health Organization on water and sanitation health research. The purpose of this paper is to clarify the relationship between water pollution and human health, including: The relationship between water pollution and diarrhea, the mechanism of action, and the research situation of meta-analysis; The relationship between water pollution and skin diseases, pathogenic factors, and meta-analysis research; The relationship between water pollution and cancer, carcinogenic factors, and types of cancer; The relationship between water pollution and Child health, and the major childhood diseases caused.
A study of more than 100 literatures found that although factors such as country, region, age, and gender may have different influences, in general, water pollution has a huge impact on human health. Water pollution is the cause of many human diseases, mainly diarrhoea, skin diseases, cancer and various childhood diseases. The impact of water pollution on different diseases is mainly reflected in the following aspects. Firstly, diarrhea is the most easily caused disease by water pollution, mainly transmitted by enterovirus existing in the aquatic environment. The transmission environment of enterovirus depends on includes groundwater, river, seawater, sewage, drinking water, etc. Therefore, it is necessary to prevent the transmission of enterovirus from the environment to people through drinking water intervention. Secondly, exposure to or use of heavily polluted water is associated with a risk of skin diseases. Excessive bacteria in seawater and heavy metals in drinking water are the main pathogenic factors of skin diseases. Thirdly, water pollution can pose health risks to humans through any of the three links: the source of water, the treatment of water, and the delivery of water. Arsenic, nitrate, chromium, and trihalomethane are major carcinogens in water sources. Carcinogens may be introduced during chlorine treatment from water treatment. The effects of drinking water pollution on cancer are complex, including chlorinated by-products, heavy metals, radionuclides, herbicides and pesticides left in water, etc., Finally, water pollution is an important cause of children’s diseases. Contact with microbiologically infected water can cause diarrhoeal disease in children. Malnutrition and weakened immunity from diarrhoeal diseases can lead to other diseases.
This study systematically analyzed the impact of water pollution on human health and the heterogeneity of diseases from the perspective of different diseases, focusing on a detailed review of the relationship, mechanism and influencing factors of water pollution and diseases. From the point of view of limitations, this paper mainly focuses on the research of environmental science and environmental management, and the research on pathology is less involved. Based on this, future research can strengthen research at medical and pathological levels.
In response to the above research conclusions, countries, especially developing countries, need to adopt corresponding water management policies to reduce the harm caused by water pollution to human health. Firstly, there is a focus on water quality at the point of use, with interventions to improve water quality, including chlorination and safe storage ( Gundry et al., 2004 ), and provision of treated and clean water ( Khan et al., 2013 ). Secondly, in order to reduce the impact of water pollution on skin diseases, countries should conduct epidemiological studies on their own in order to formulate health-friendly bathing water quality standards suitable for their specific conditions ( Cheung et al., 1990 ). Thirdly, in order to reduce the cancer caused by water pollution, the whole-process supervision of water quality should be strengthened, that is, the purity of water sources, the scientific nature of water treatment and the effectiveness of drinking water monitoring. Fourthly, each society should prevent and control source pollution from production, consumption, and transportation ( Landrigan et al., 2018 ). Fifthly, health education is widely carried out. Introduce environmental education, educate residents on sanitary water through newspapers, magazines, television, Internet and other media, and enhance public health awareness. Train farmers to avoid overuse of agricultural chemicals that contaminate drinking water.
Author Contributions
Conceptualization, XX|; methodology, LL; data curation, HY; writing and editing, LL; project administration, XX|.
This article is a phased achievement of The National Social Science Fund of China: Research on the blocking mechanism of the critical poor households returning to poverty due to illness, No: 20BJY057.
Conflict of Interest
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Publisher’s Note
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Keywords: water pollution, human health, disease heterogeneity, water intervention, health cost
Citation: Lin L, Yang H and Xu X (2022) Effects of Water Pollution on Human Health and Disease Heterogeneity: A Review. Front. Environ. Sci. 10:880246. doi: 10.3389/fenvs.2022.880246
Received: 21 February 2022; Accepted: 09 June 2022; Published: 30 June 2022.
Reviewed by:
Copyright © 2022 Lin, Yang and Xu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Xiaocang Xu, [email protected]
This article is part of the Research Topic
Bioaerosol Emission Characteristics and the Epidemiological, Occupational, and Public Health Risk Assessment of Waste and Wastewater Management
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