Background: According to WHO, in 2015, over 35% of ischaemic heart disease, the leading cause of death and disability worldwide, and about 42% of strokes, the second largest contributor to global mortality, could have been prevented by reducing or removing exposure to chemical pollutants. Heavy metal and cyanide pollution are prevalent in developing countries, especially in sub-Saharan Africa where the effects of industrial pollutants are more severe, partly due to poor regulation. In Zimbabwe, the mining industry alone contributed to 25% of occupational conditions and injuries in 2020. Therefore, to mitigate these problems, this study seeks to develop a health risk management framework for heavy metals and cyanide pollution in the industrial city of Kwekwe.
Methods: The convergent parallel mixed-method study design will be utilised. Qualitative and quantitative data will be collected, analysed, and merged in order to inform the development of the risk framework. An analytical cross-sectional survey would be used to determine levels of heavy metals in surface water, soil, and vegetables. Free cyanide will be determined in surface water samples only. The phenomenological qualitative inquiry will be used to investigate health events and risks associated with potentially toxic pollutants (heavy metals and cyanide) to describe or interpret participants' lived experiences. The qualitative and quantitative results will be used to develop and validate the framework to manage identified health risks. For data analysis, statistical analysis will be used in the quantitative study, while thematic analysis will be used in the qualitative study. The study was approved by the University of Venda Ethics Committee (Registration Number FHS/22/PH/05/2306) and the Medical Research Council of Zimbabwe (Approval Number MRCZ/A/2944). All ethical principles will be adhered to throughout the study in accordance with the Helsinki Declaration.
Discussion: While existing risk management frameworks have significantly contributed to human and environmental health protection, novel and comprehensive frameworks need to be developed to counter the ever-dynamic and evolving risks associated with chemical pollutants. If the management framework is successfully developed, it could offer an opportunity for the prevention and control of potentially toxic elements.
Keywords: Cancer risk; Delphi technique; Health risk; Kwekwe; Mixed-method study; Potentially toxic metal; Purposive sampling.
In Zimbabwe, just like most developing countries, the problem of environmental pollution continues to threaten and endanger public health. Current pollution management measures seem insufficient in combating the problem to the extent that communities living in or near industrial areas continue to suffer from associated acute and chronic health conditions. Kwekwe city is an industrial and mining area with several abandoned and active mines and processing plants. Artisanal mining is widespread in the area, and many parts of the city's landscape are littered with open mining pits, dumps, and abandoned tailings. Most of these facilities are potential sources of heavy metals and cyanide and pose risks to human health. This study, therefore, seeks to develop a health risk management framework to address problems, which are associated with anthropogenic pollutants such as heavy metals and cyanide. The study will be conducted in two phases, that is, the first phase would involve the collection and analysis of empirical data from environmental samples, residents, and key stakeholders on heavy metal and cyanide pollution and associated health risks. The second phase would utilise findings from the first phase to develop a regulatory framework and to manage identified health risks. The developed framework would be validated through stakeholder and expert participation. The developed health risk management framework could be useful in the prevention and control environmental contamination, hence assisting to improve non-communicable diseases’ outcomes in Kwekwe city.
© 2023. The Author(s).