Smoke Exposure, Hemoglobin Levels, and the Risk of Anemia in Urban Informal Settlement in Southern Ghana

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Abstract Background: Even though there is evidence connecting smoke and its components to anemia, none of these studies were conducted on populations living in urban informal settlements. This study investigated the risks of anemia/HB levels in an informal settlement in Accra, Ghana. Smoke exposure was looked at from a variety of sources, including those in homes, neighborhoods, and places of work. Methods: A questionnaire was administered during an interview to gather data on source of smoke exposure in the household, in the neighbourhood, and the workplace. A phlebotomist collected blood samples from the participants to assess their anaemia status. Results The population (n=329) had a high prevalence of anemia, with 49.1% of people fitting the WHO's definition of anemia, while the average hemoglobin level was 12.6±2.1g/dL. Anemia was associated with the number of different types of waste burntsimultaneously [(1 or 2: prevalence ratio (PR): 95% confidence interval (CI), 1.14, 0.99-1.28: 3+: 1.16, 1.01-1.63, p-for-trend=0.0082)], fuel stacking [(mixed stacking: 1.27, 1.07-1.20: dirty stacking:1.65, 1.19-2.25, p-for-trend=0.0062)], and involvement in fish smoking (1.22, 0.99-1.06). Reduced HB levels were associated with the number of different types of waste burnt simultaneously [(1 or 2: regression coefficient (β): 95% confidence interval (CI), -0.01, -0.97- -0.99: 3+: -0.14, -0.77- -0.05)], current smoker [(yes, almost daily: -1.40, -2.01- -0.79: yes, at least once a month: -1.14, -1.79—0.48)], SHS (yes, almost daily: -0.77, -1.30- -0.21), fuel stacking [(mixed stacking-0.93, -1.33--0.21: dirty stacking-1.04, -1.60- -0.48)], any smoke exposure indicator in the neighbourhood (-0.84, -1.43- -0.25), living close to a major road (-0.62, -1.09- -0.49), and fish smoking (-0.41,-0.93- -0.12). Conclusion Adult populations living in informal settlements may be at risk of anemia following exposure to smoke. Governments in developing nations should put in place pragmatic measures to control smoke emissions in informal settlements to protect human health and well-being.

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