World Health Organization Commission Research Articles

Association Between Social Determinants of Health and Traumatic Brain Injury: A Scoping Review.

Traumatic brain injury (TBI) is a leading cause of death and disability worldwide. Disparities exist in the populations that acquire TBIs, however, with a greater burden and poorer outcomes associated with communities of color and lower socioeconomic status. To combat health inequities such as these, institutions have begun to target social determinants of health (SDoH), which are environmental factors that affect health outcomes and risks. The SDoH may play a role in sustaining a TBI and provide modifiable targets for action to reduce the risk of TBI, especially in high-risk communities. In this study, we describe the existing literature regarding SDoH and their association with sustaining a TBI. We performed a scoping review with a comprehensive search of the Ovid MEDLINE/Embase databases. To summarize the literature, this review adapts the World Health Organization's Commission on SDoH's conceptual framework. Fifty-nine full-text articles, including five focusing on lower and middle-income countries, met our study criteria. Results of the scoping review indicate that several structural determinants of health were associated with TBI risk. Lower educational attainment and income levels were associated with higher odds of TBI. In addition, multiple studies highlight that minority populations were identified as having higher odds of TBI than their White counterparts. Literature highlighting intermediate determinants of health examined in this review describes associations between sustaining a TBI and rurality, work environment, medical conditions, medication/substance use, and adversity. Recommended exploration into lesser-researched SDoH is discussed, and the expansion of this review to other aspects of the TBI continuum is warranted.

Antibiotic Resistance Profile of E. coli Isolates from Lettuce, Poultry Manure, Irrigation Water, and Soil in Kumasi, Ghana.

Inputs such as irrigation water and poultry manure used in lettuce cultivation have been found to be associated with antibiotic-resistant pathogens. The study assessed the antibiotic resistance profile of Escherichia coli isolated from lettuce, poultry manure, irrigation water, and soil in Kumasi. One hundred and fifty-six samples of lettuce, irrigation water, soil, and manure were collected from three farms over a seven-week cultivation period (seedlings to harvest stage). E. coli were enumerated using standard methods. 98% of the samples were positive for E. coli. Geometric means for lettuce, irrigation water, and soil ranged from 2.0 × 105 to 1.67 × 107 MPN/100 ml while that of manure ranged from 2.0 × 105 to 1.31 × 107 MPN/100 ml. Generally, the microbial load of all parameters on all farms across the weeks was significant and exceeded World Health Organization (WHO) and International Commission on Microbiological Specifications for Foods (ICMSF) standard recommendations for food. Using the Kirby Bauer method, antibiotic sensitivity testing was performed against 225 biochemically confirmed E. coli with twelve antibiotics. Relatively high resistance was recorded for some members of the beta-lactam class: meropenem: 94.2%, ampicillin: 91.9%, cefuroxime: 95.1%, ceftriaxone: 94.7%, and cefotaxime: 94.2%. Eighty of the isolates were screened for extended spectrum beta lactamase (ESBL) production using cefotaxime (CTX) and cefotaxime/clavulanic acid (CTX/CLA) discs and three showed positive: one each from poultry manure, irrigation water, and soil. Polymerase chain reaction (PCR) confirmed the presence of blaCTX-M gene. The occurrence of antibiotic-resistant E. coli in vegetables and their production environment is alarming and poses serious health threats to the general public. The presence of blaCTX-M gene in E. coli from a vegetable production site recorded for the first time in Ghana requires enforcement by regulatory bodies on the inappropriate use of antibiotics in the country.

A preliminary study on determination of radioactivity levels and estimation of the annual effective dose in dried fruits consumed in Albania.

This work aimed to support Albania's food safety monitoring regime. In this context, the natural and artificial radioactivity was measured in 20 samples of dried fruits collected randomly in different markets of Tirana. The activity concentration of 40K, 226Ra, 232Th and 137Cs was determined by using the high-purity germanium detector. The maximum values of activity concentration in dried fruits were calculated as 517±22Bqkg-1 for 40K, 11.10±0.93Bqkg-1 for 226Ra, 4.38±0.26Bqkg-1 for 232Th and 0.83±0.14Bqkg-1 for 137Cs. The average values of activity concentration of 40K and 226Ra were 269and 6.05Bqkg-1 and the average effective dose to individuals from the intake of the dried fruits was 44μSv y-1. All average values in this study were lower than recommended values by reports United Nations Scientific Committee on the Effect of Atomic Radiation, World Health Organization and International Commission on Radiological Protection for all age groups. Therefore, all dried fruit samples in this study are safe for consumption with acceptable radiological risk and none of them pose any significant radiological impact. The obtained data in this paper and information for levels of radioactivity and ingestion absorbed dose from dried fruits can be used to be the basic data for future comparative analysis of the other studies.

Establishing spirituality as an intermediary determinant of health among 42,843 children from eight countries

The World Health Organization (WHO) Commission on the Social Determinants of Health (CSDH) conceptual framework identifies socio-economic position as a structural determinant of health. Recognized intermediary determinants include biological, behavioural, and psychosocial factors. We examined whether connections afforded by a healthy spirituality potentially act as unrecognized intermediary determinants in adolescent populations, contributing to inequities in mental health. Reports from 42,843 children (21,007 boys, 21,836 girls) from eight countries who participated in the 2017–2018 Health Behaviour in School-aged Children (HBSC) study were used to describe correlations between family affluence and positive levels of mental health, using a cross-sectional design. Based on the CSDH conceptual framework and multivariable regression analyses, we then examined whether these associations were mediated by spiritual health. Connections afforded by a high level of spiritual health were universally correlated with positive mental health status. In three Western European nations (England, Scotland, and Wales) and Canada affluence was correlated with better mental health and this was partially mediated by spiritual health. Among the four Eastern European countries (Latvia, Lithuania, Moldova, Poland), our findings did not support aspects of the CSDH framework that focus on affluence as a direct determinant of health. Spiritual health potentially is an intermediary determinant of children's health in some Western countries, but not in Eastern countries. The universality of social determinants of health models and the measures used in their evaluation require careful assessment across cultures, political contexts, and health outcomes.

BREAST CANCER SCREENING IN ROMANIA: CHALLENGES AND OPPORTUNITIES FOR EARLY DETECTION.

Breast cancer has surpassed lung cancer as the most common type of cancer globally, representing approximately 25% of all cancer cases and leading in cancer-related mortality among women. In Romania, breast cancer accounts for 26.9% of all female cancer diagnoses, with an increasing incidence and significant mortality rate despite one of the lowest incidence rates in Europe. The study highlights the disparities in breast cancer outcomes across Europe, with Romania showing lower survival rates compared to Western European countries. This disparity is partly attributed to the low participation in breast cancer screening programs, where only 9% of eligible Romanian women underwent mammography in 2020, far below the European average of 60%. The World Health Organization (WHO) and European Commission emphasize the importance of organized population-based screening for women aged 50-69, yet many barriers, including low health literacy, lack of awareness, and socio-economic challenges, hinder effective participation, especially among vulnerable populations. This study, conducted over three years at the "Alessandrescu Rusescu " National Institute for Mother and Child Health, involved 1,705 patients and aims to provide insights into improving breast cancer screening participation and outcomes in Romania.

Radon activity and their radiological doses in drinking water of Chitradurga district, Karnataka, India.

In this investigation, radon activity concentration, inhalation and ingestion doses due to intake of radon in drinking water have been estimated in the Chitradurga district drinking water by using radon Emanometry technique. The average radon concentrations vary from 1.81±0.11 to 300.33±4.56Bql-1 with a mean value of 56.01±2.44Bql-1. Most of the radon concentration levels are within the World Health Organization (WHO) and European Union (EU) commission recommended level of 100Bql-1. About 70% of the drinking water had radon concentration level higher than the United States Environmental Protection Agency (USEPA) recommended Maximum Contamination Limit (MCL) of 11.1Bql-1. The annual ingestion dose varies from 0.38 to 63.03μSvy-1 with an average value of 11.75μSvy-1. The estimated annual ingestion dose is well within the WHO recommended reference level of 100μSvy-1.

Spatial distribution of radon concentration and risk evaluation through consumption of groundwater in the District of Kotli, Azad Jammu and Kashmir

Radon (222Rn) is naturally readily water-soluble, posing a cancer risk to the exposed community. Human exposure in the community may occur via 222Rn intake in drinking water. Groundwater is used for drinking and other domestic purposes in the region. Higher concentrations of 222Rn in groundwater have been reported near Kotli district, Azad Jammu, and Kashmir. This investigation aimed to measure 222Rn concentrations in groundwater and evaluate the associated risk assessment for children and adults in the Kotli district. 222Rn concentrations were measured in randomly collected groundwater samples of Kotli (n = 25) and Sehnsa (n = 15) towns in the Kotli district using the portable Radon Detector (RAD7, Durridge Company, United States of America). Among the studied areas, the Sehnsa showed a higher average 222Rn concentration (7.6 ± 0.2 Bq/L) in groundwater compared to Kotli (6.0 ± 1.9 Bq/L). The average concentrations of 222Rn were found within the recommended limit (11.1 Bq/L) of the United States Environmental Protection Agency (USEPA), except for 10% of sampling sites. 222Rn concentrations were used for the calculation of total effective dose for ingestion and inhalation pathways (EwTotal) values for infants (24.5 ± 7.5 and 30.7 ± 0.9 μSv/a), children (18.1 ± 5.5 and 23.5 ± 0.7 μSv/a), and adults (18.1 ± 5.5 and 22.7 ± 0.3 μSv/a) in the Kotli and Sehnsa, respectively. This study noted that EwTotal and estimated lifetime cancer risk (ELCR) values were found within the World Health Organization (WHO) and European Commission (EU) acceptable limits (<100 μ Sv/a and 0.1 × 10−3).

The educational gradient in dental caries experience in Northern- Norway: a cross-sectional study from the seventh survey of the Tromsø study

BackgroundAlthough, studies from Norway indicate a reduction in dental caries experience, in Northern-Norway this non-communicable oral condition is still prevalent. There is conflicting evidence of presence of social inequalities in dental caries in an adult population. Therefore, the aim of this study was to assess an association between educational level and dental caries experience in adults in urban Tromsø municipality, Northern-Norway, using The World Health Organization (WHO) Commission on Social Determinants of Health (CSDH) framework of health determinants.MethodsData from 3752 participants having recorded dental caries status and educational level in the seventh survey of the Tromsø Study: Tromsø7 were included. Dental status was examined clinically as decayed-, missing-, filled-teeth (DMFT score). For statistical analyses DMFT score was grouped into lower (DMFT < 19) and higher (DMFT ≥ 20). Educational level was obtained from a questionnaire and categorized as primary/partly secondary education, upper secondary education, tertiary education, short and tertiary education, long. Data on social and intermediary determinants was also self-reported. Univariable and multivariable binary logistic regression analyses were applied.ResultThis study included 1939 (52%) women and the mean age of the participants was 57.11. The mean DMFT score was 18.03. The odds of having higher DMFT score followed a gradient based on educational level. Participants who reported lower than secondary education had 2.06 -fold increased odds of having higher DMFT score than those with tertiary education, long (OR: 2.06, 95% CI: 1.50–2.83). Those with upper secondary education had 60% higher odds of having higher DMFT score (OR: 1.60, 95% CI: 1.21–2.11), and those with tertiary education, short had 66% higher odds of having higher DMFT score (OR: 1.66, 95% CI: 1.24–2.22).ConclusionThe current cross-sectional study suggested an educational gradient in dental caries experience in an adult population of Northern- Norway. Further studies validating our results and investigating mechanisms of educational inequalities in oral health are warranted.

Surgeon Understanding and Perceptions of Social Determinants of Health

IntroductionSocial determinants of health impact surgical outcomes. Characterization of surgeon understanding of social determinants of health is necessary prior to implementation of interventions to address patient needs. The study objective was to explore understanding, perceived importance, and practices regarding social determinants of health among surgeons. MethodsSurgical residents and attending surgeons at a single academic medical center completed surveys regarding social determinants of health. We conducted semi-structured interviews to further explore understanding and perceived importance. A conceptual framework from the World Health Organization (WHO) Commission on Social Determinants of Health informed the thematic analysis. ResultsSurvey response rate was 47.9% (n = 69, 44 residents [63.8%], 25 attendings [36.2%]). Respondents primarily reported good (n = 29, 42.0%) understanding of social determinants of health and perceived this understanding to be very important (n = 42, 60.9%). Documentation occurred seldom (n = 35, 50.7%), and referrals occurred seldom (n = 26, 37.7%) or never (n = 20, 29.0%). Residents reported a higher rate of prior training than attendings (95.5% versus 56.0%, P < 0.001). Ten interviews were conducted (six residents, four attendings). Residents demonstrated greater understanding of socioeconomic positions and hierarchies shaped by structural mechanisms than attendings. Both residents and attendings demonstrated understanding of intermediary determinants of health status and linked social determinants to impacting patients' health and well-being. Specific knowledge gaps were identified regarding underlying structural mechanisms including the social, economic, and political context that influence an individual's socioeconomic position. ConclusionsSelf-reported understanding and importance of social determinants of health among surgeons were high. Interviews revealed gaps in understanding that may contribute to limited practices.

Health risk assessment of toxic metal(loids) (As, Cd, Pb, Cr, and Co) via consumption of medicinal herbs marketed in Malawi

This study aimed to assess the potential health risks associated with consuming three commonly consumed medicinal herbs in Malawi: Azadirachta indica, Mondia whitei, and Moringa oleifera. The concentrations of five metal(loids) (As, Cd, Pb, Cr, and Co) were determined using inductively coupled plasma mass spectrometry, while their safety was assessed by comparing the measured values with the legislated maximum contaminant levels (MCL)and reported metal(loids) concentrations in other countries. The results indicated significant variations of metal(loids) concentrations amongst the studied medicinal herbs, with Azadirachta indica containing the highest mean As (0.078 ± 0.010 mg kg−1) and Cd (0.049 ± 0.05 mg kg−1) concentrations and Mondia whitei and Moringa oleifera contained the highest mean Co (1.01 ± 0.05 mg kg−1) and Cr (1.42 ± 1.18 mg kg−1) concentrations, respectively. However, the mean concentrations of As, Cd, Pb, Cr, and Co fell below the MCL set by World Health Organization (WHO), Alimentarius Commissions, and European Commission. The estimated daily intake (EDI) for each metal(loid) was less than 1, indicating that the studied medicinal herbs do not pose serious health risks to non-regular consumers. The study also emphasizes the importance of assessing the potential risks associated with consuming medicinal herbs contaminated with heavy metals or metalloids, as it can seriously threaten human health.

Downing the Master's Tools? New Research Strategies to Address Social Determinants of Health Inequalities.

A dramatic increase in the volume of research literature referencing social determinants of health (SDH) since the report of the World Health Organization Commission on the topic in 2008 has not been matched by expansion of policies and interventions to reduce health inequalities by way of SDH. This article argues that familiar hierarchies of evidence that privilege clinical epidemiology as used in evidence-based medicine are inappropriate to address SDH. They misunderstand both the range of relevant evidence and the value-based nature of standards of proof. A richer conceptual armamentarium is available; it includes several applications of the concepts of epidemiological worlds and the lifecourse, which are explained in the article. A more appropriate evidentiary approach to SDH and health inequalities requires "downing the master's tools," to adapt Audre Lorde's phrase, and instead applying a multidisciplinary approach to assessing the evidence that adequately reflects the complexity of the relevant causal pathways. Doing so is made more difficult by the power structures that shape research priorities, yet it is essential.

A Public Health, Whole-of-Government Approach to National Suicide Prevention Strategies

A Public Health, Whole-of-Government Approach to National Suicide Prevention Strategies

Access to health services for chronic disease care during the COVID-19 pandemic in Ecuador: A qualitative analysis using a Social Determinants of Health approach

ABSTRACT This qualitative study aims to explore how the COVID-19 pandemic impacted healthcare access for patients with chronic conditions in Ecuador from the patient’s perspective. We interviewed 19 patients diagnosed with arterial hypertension or type 2 diabetes in rural and urban areas of Ecuador during August and September 2020. We used the Framework Method to analyse the interview transcripts with ATLAS.Ti 8.4 and organised the ideas discussed using categories from the World Health Organization Commission on the Social Determinants of Health conceptual framework. Reorganization of health services during the pandemic meant that patients with arterial hypertension or diabetes could no longer attend face-to-face appointments for disease follow-up. System failures related to medication supply led to increased out-of-pocket payments, which, together with reduced or absent earnings, and in a context with limited social protection policies, meant that patients frequently went for prolonged periods without medication. Rural health initiatives, support from family and use of traditional medicine were reported as ways to manage their chronic condition during this time. Barriers to disease management disproportionately affected individuals with low socioeconomic positions. Stock shortages, lack of protective labour policies and limited reach of anticipatory policies for health emergencies likely worsened pre-existing health inequities in Ecuador.

Linking suicide and social determinants of health in South Korea: An investigation of structural determinants.

Studies have shown that suicide is closely related to various social factors. However, due to the restriction in the data scale, our understanding of these social factors is still limited. We propose a conceptual framework for understanding social determinants of suicide at the national level and investigate the relationships between structural determinants (i.e., gender, employment statuses, and occupation) and suicide outcomes (i.e., types of suicide, places of suicide, suicide methods, and warning signs) in South Korea. We linked a national-level suicide registry from the Korea Psychological Autopsy Center with the Social Determinants of Health framework proposed by the World Health Organization's Commission on Social Determinants of Health. First, male and female suicide victims have clear differences in their typical suicide methods (fire vs. drug overdose), primary warning signs (verbal vs. mood), and places of death (suburb vs. home). Second, employees accounted for the largest proportion of murder-suicides (>30%). The proportion of students was much higher for joint suicides than for individual suicides and murder-suicides. Third, among individuals choosing pesticides as their suicide method, over 50% were primary workers. In terms of drug overdoses, professionals and laborers accounted for the largest percentage; the former also constituted the largest proportion in the method of jumping from heights. A clear connection exists between the investigated structural factors and various suicide outcomes, with gender, social class, and occupation all impacting suicide.

Construction of a digital fetus library for radiation dosimetry.

Accurate estimations of fetal absorbed dose and radiation risks are crucial for radiation protection and important for radiological imaging research owing to the high radiosensitivity of the fetus. Computational anthropomorphic models have been widely used in patient-specific radiation dosimetry calculations. In this work, we aim to build the first digital fetal library for more reliable and accurate radiation dosimetry studies. Computed tomography (CT) images of abdominal and pelvic regions of 46 pregnant females were segmented by experienced medical physicists. The segmented tissues/organs include the body contour, skeleton, uterus, liver, kidney, intestine, stomach, lung, bladder, gall bladder, spleen, and pancreas for maternal body, and placenta, amniotic fluid, fetal body, fetal brain, and fetal skeleton. Nonuniform rational B-spline (NURBS) surfaces of each identified region was constructed manually using 3D modeling software. The Hounsfield unit values of each identified organs were gathered from CT images of pregnant patients and converted to tissue density. Organ volumes were further adjusted according to reference measurements for the developing fetus recommended by the World Health Organization (WHO) and International Commission on Radiological Protection. A series of anatomical parameters, including femur length, humerus length, biparietal diameter, abdominal circumference (FAC), and head circumference, were measured and compared with WHO recommendations. The first fetal patient-specific model library was developed with the anatomical characteristics of each model derived from the corresponding patient whose gestational age varies between 8 and 35 weeks. Voxelized models are represented in the form of MCNP matrix input files representing the three-dimensional model of the fetus. The size distributions of each model are also provided in text files. All data are stored on Zenodo and are publicly accessible on the following link: https://zenodo.org/record/6471884. The constructed fetal models and maternal anatomical characteristics are consistent with the corresponding patients. The resulting computational fetus could be used in radiation dosimetry studies to improve the reliability of fetal dosimetry and radiation risks assessment. The advantages of NURBS surfaces in terms of adapting fetal postures and positions enable us to adequately assess their impact on radiation dosimetry calculations.

Childhood overweight and obesity abatement policies in Europe.

Over the past two decades, a concerted effort to combat the rising tide of childhood overweight and obesity has taken shape. The World Health Organization (WHO) Commission on Ending Childhood Obesity (ECHO) provides recommendations for six priority areas of action, including the promotion of healthy food consumption, promotion of physical activity, preconception and pregnancy care, early childhood diet and physical activity, healthy nutrition and physical activity for school-aged children, and community-based weight management. This paper provides a snapshot of policies and measures aligned to these areas of action within the WHO European Region in order to encourage other countries to make similar efforts. Examples are drawn from Portugal (sugar-sweetened beverage tax, integrated nutrition strategy), the United Kingdom (soft drink levy, active commuting programs, urban design principles), Lithuania (prohibition of energy drinks), Norway (industry and government partnerships to promote healthier foods, nutrition education curriculum for schools), Hungary (tax subsidies to promote healthy diets), the European Union (cross-border marketing regulations, preconception and pregnancy care), Slovenia (food marketing restrictions), Spain (marketing restrictions within educational settings), Poland (investing in sports infrastructure), Russia (increasing sports participation), Estonia (redevelopment of the physical education curriculum), Netherlands (preconception and pregnancy care), Croatia (conditions to support breastfeeding), Austria (perinatal and early childhood nutrition), Czechia (life-course strategy), San Marino (nutrition and physical activity for school-aged children), Ukraine (potable water for schools), Ireland and Italy (community-based weight management approaches). Our findings suggest that a large disparity exists among the type and breadth of policies adopted by Member States, with a mix of single-issue policy responses and more cohesive strategies. The role of data, implementation research, and ongoing surveillance of country-level progress related to childhood overweight and obesity policies are discussed as an essential part of the iterative process of policy development. Additional work to systematically gather context-specific information on policy development, implementation, and reach according to ECHO's six areas of action by WHO European Region countries will inform future policy paradigms within the region.

Advancing Action on Health Equity Through a Sociolegal Model of Health.

In the field of public health, the law and legal systems remain a poorly understood and substantially underutilized tool to address unfair or unjust societal conditions underpinning health inequities. The aim of our article is to demonstrate the value of expanding from a social model of health to a sociolegal model of health and empowering health actors to use the law more strategically in the pursuit of health equity. We propose a modified version of the framework for the social determinants of health (SDoH) equity developed by the 2008 World Health Organization Commission on the Social Determinants of Health by conceptually integrating the functions of the law as identified by the 2019 Lancet-O'Neill Institute Commission on Global Health and Law. Access to justice provides a critical intersection between social models of public health and work in the justice fields. Addressing the inequities produced through the policies and institutions governing society unites the causes of those seeking to enhance access to justice and those seeking to reduce health inequities. Health justice partnerships (HJPs) are an example of a sociolegal model of health in action. Through the resolution of health issues with legal solutions at the individual level, the dismantling of service silos at the institutional level, and policy and law reform at the systemic level, HJPs demonstrate how the law can be used as a tool to reduce social and health inequities. Greater attention to law as a tool for health creates space for increased collaboration among legal and health scholars, practitioners, and advocates, particularly those working in the areas of the social determinants of health and access to justice, and a promising avenue for reducing health inequities.

Data, Social Determinants, and Better Decision-making for Health: the 3-D Commission.

More than a decade after the World Health Organization Commission on the Social Determinants of Health (SDoH), it is becoming widely accepted that social and economic factors, including but not limited to education, energy, income, race, ethnicity, and housing, are important drivers of health in populations. Despite this understanding, in most contexts, social determinants are not central to local, national, or global decision-making. Greater clarity in conceptualizing social determinants, and more specificity in measuring them, can move us forward towards better incorporating social determinants in decision-making for health. In this paper, first, we summarize the evolution of the social framing of health. Second, we describe how the social determinants are conceptualized and contextualized differently at the global, national, and local levels. With this, we seek to demonstrate the importance of analyzing and understanding SDoH relative to the contexts in which they are experienced. Third, we problematize the gap in data across contexts on different dimensions of social determinants and describe data that could be curated to better understand the influence of social determinants at the local and national levels. Fourth, we describe the necessity of using data to understand social determinants and inform decision-making to improve health. Our overall goal is to provide a path for our collective understanding of the foundational causes of health, facilitated by advances in data access and quality, and realized through improved decision-making.

Analyzing the Effect of Radiation on Human beings of Electromagnetic waves from BTS and MS in Kushtia, Bangladesh

Based on Base Transceiver Station (BTS) and Mobile Station (MS) radiation, the residence of Kushtia district in Bangladesh is usually concerned with the potential health effects. Inhabitants, living in this part of Bangladesh are using communication, internet browsing, and other related uses with the help of mobile cellular communication system. The subscriber needed improving radio coverage, excellent communication networks, and quicker speed for internet browsing with the recent developments in mobile cellular communication technologies. To meet this demand, service providers of mobile cellular companies set up several BTS, which emit harmful radiation that has extremely detrimental impact on the human body. Through this paper, the effects of electromagnetic radiation of MS as well as BTS on the human body have been analyzed and Electromagnetic Field (EMF) radiation levels of MSs along with BTSs located in this region have been measured. These measurements have been compared with the measured value provided by the World Health Organization (WHO) and International Commission of Non-Ionizing Radiation Protection (ICNIRP). Finally, a cross-sectional analysis was carried out to evaluate the understanding and self-reported health risks of Electromagnetic waves (EMW) radiation emittedfrom the MS as well as BTS among the inhabitants of this region who are living near and a little away from BTS.

Assessment of selected trace metals in fish feeds, pond water and edible muscles of Oreochromis mossambicus and the evaluation of human health risk associated with its consumption in Vhembe district of Limpopo Province, South Africa.

Fish is a rich source of proteins for humans and is widely consumed in various places in the world. This study assessed the levels of twenty trace metals (B, Al, V, Cr, Mn, Fe, Co, Ni, Cu, Zn, As, Se, Sr, Mo, Cd, Sn, Sb, Ba, Hg and Pb) in fish feeds (n = 2), water (n = 27), and edible muscles of Oreochromis mossambicus (n = 20 from 8 ponds) from fish farms and Luvuvhu River (n = 3 from 1 river site) in Vhembe district of Limpopo Province, South Africa. Physicochemical parameters of water in the study area were analysed. Temperature ranged between 21.4-30.47 °C, pH: 5.59-7.28, electrical conductivity: 608-1216 μS/cm, total dissolved solids: 156-675 mg/l, dissolved oxygen: 0.28 - 0.56 mg/l, turbidity: 3.92-356.7 NTU, respectively. Levels of most trace metals such as Cr (2 μg/l and 1000 μg/kg), Mn (100 μg/l and 500 μg/kg), Fe (10 μg/l and 300 μg/kg), Ni (20 μg/l and 100 μg/kg), As (50 μg/l and 3 μg/kg), Pb (10 μg/l and 300 μg/kg) and Cu (2 μg/l and 2250 μg/kg) in water and O. mossambicus muscles were mostly below the World Health Organization (WHO), Food and Agricultural Organization (FAO)/WHO and European Commission (EC) recommended limit in the collected samples (Tshifulalani site and Duthuni site). However, Cu and Fe recorded concentration above the recommended limit at the control site (Luvuvhu River) in water and O. mossambicus muscles, respectively. Results from the bioaccumulation factor (BF), suggests the presence of metals in the water which can bioaccumulate in the fish muscles. Most of the metals (As, Cd, Hg, Mo, Sr, Sb and Sn) that recorded no possible bioaccumulation also recorded levels that complied with their maximum permissible limit (MPL) of WHO, FAO/WHO and EC guideline values in the fish feeds except for Se and Co. Moderate bioaccumulation was recorded for Cr, Mn, Fe and Zn in some of the sampling sites. Pb and Ni showed extreme bioaccumulation (BF > 5000) in one of the sampling sites and also recorded elevated levels in the fish feeds. Average daily dose (ADD), hazard quotient (HQ) and total hazard quotient (THQ) computed were less than 1. The Cancer risk (CR) evaluated were all below 10-4 except in one site for children (Tshifulanani 2) but the overall average result showed no carcinogenic health risk to the consumers of the O. mossambicus. Therefore, O. mossambicus intake in the study area should be constantly monitored to prevent future health implications.