Environmentally induced, occupational diseases with emphasis on chronic kidney disease of multifactorial origin affecting tropical countries

Abstract

Background: Environmentally induced, occupational diseases are increasing worldwide, especially in rural agricultural communities. Poverty-associated malnutrition, environmental hazards and pollution, and lack of access to clean water, safe sanitation, and modern healthcare facilities are often associated with these chronic illnesses.

Method: The authors systematically reviewed occupational public health issues that have been related to the environment. General interpretations of results were included as per the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Pertinent publications from research databases were reviewed on (A) the risk-benefits, (B) the prevalence of risk factors for various diseases, (C) the benefits of not ignoring the risk factors (i.e., broader evidence), and (D) the risks, effects, and outcomes of different types of interventions. The authors used chronic kidney disease of multifactorial origin (CKDmfo) as an example to explore the theme. Emphasis was given to the regions with emerging economies and developing countries located in the vicinity of the equator.

Findings: Geographical, socio-economic and aetiological similarities exist for many chronic non-communicable diseases that are affecting tropical countries around the equator. The authors identified manufacturing, mining, and agriculture as the biggest polluters of the environment. In addition, deforestation and associated soil erosion, overuse of agrochemicals, and irresponsible factory discharge (e.g., chemicals and paint, from rubber and textile factories, etc.), all contribute to pollution. To decrease the escalating incidences of environmentally induced diseases, governments should work proactively to protect the environment, especially watersheds, and take steps to minimise harmful occupational exposures and strictly enforce environmental regulations.

Conclusion: Creating public awareness of environmental issues and their relationship to public health is essential. This includes regular monitoring and periodic publication of the quality of water, air and soil; preventing deforestation and man-made soil erosion, increasing forest and ground cover, preventing occupational injuries, judicious and safe use of agrochemicals, sustainable agriculture and development programs, and implementing legislation to protect and conserve water heriage and the environment. These actions are essential both for a healthier environment and for the health of the people who live in that environment. Such measures would also decrease public health threats from such, including global-warming-related erratic environmental changes and the occurrence and the spread of non-communicable diseases, such as CKDmfo.

Keywords: Agribusiness; Agriculture; Agrochemicals; Contamination; Human diseases; Kidney disease; Occupational hazards; Policies; Pollution; Premature death; Prevention; Water.

Fig. 1

The common factors contributing to water pollution. Also shown are the interactions and interconnectedness of the factors leading to water pollution and adverse human health and the role of socioeconomics, behaviour, and occupational and environmental components in the genesis of CKDmfo

Fig. 2

Hypothetical interactions and interrelationships of excessive and irresponsible use of agrochemicals and the development of CKDmfo, a hypothesis that has not been fully tested or proven

Fig. 3

An example of productivity, showing the yield output curve in response to the increasing use of fertiliser in rice, potato, and vegetable cultivations. Crop output increases with increasing amounts of right fertiliser mixture, but at a certain point [MC = M × R], it starts to plateau and may even decline. Thus, more is not always better (adapted from Wimalawansa et al., [51, 66])

Fig. 4

Global distribution of CKDu/CKDmfo. All affected countries are located close to the equator and have agriculture-based economies. Red circles indicate that the causes for CKDu/CKDmfo are unknown; yellow circles indicate countries in which some of the potential causes are understood. Some commonalities, especially the proximity to the equator of affected countries, are highlighted. The map is from the public domain, modified to indicate locations