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Sub-Saharan Africa (SSA) has a significant proportion of populations living in urban slum conditions, where exposure to multiple environmental stressors and social inequalities is ubiquitous. This commentary synthesizes commonalities in recent environmental health studies from urban cities in East and West Africa, presented during a symposium sponsored by the Africa Chapter of the International Society of Environmental Epidemiology (ISEE) in August 2020. A key takeaway from this symposium is the need for harmonization of epidemiologic and exposure data collection in three domains tailored to the SSA context: (1) improvements in socioeconomic status (SES) measurement through harmonization in the conceptualization and operationalization of SES indicators; (2) improvements in air pollution exposure assessment in resource-constrained contexts by better integration, validation, and harmonization of exposure data of air pollution and mitigating factors; and (3) harmonization in the assessment of health outcomes and biomonitoring of contaminants. Focusing on these three domains would galvanize environmental epidemiologists in SSA around shared data collection instruments and shared data platforms and facilitate the pooling of data across the continent. Fostering this collaborative research will enable researchers and decision-makers to glean new insights and develop robust environmental health interventions and policies for SSA urban slums and for improved population health.

The Lancet Commission on pollution and health reported that pollution was responsible for 9 million premature deaths in 2015, making it the world's largest environmental risk factor for disease and premature death. We have now updated this estimate using data from the Global Burden of Diseases, Injuriaes, and Risk Factors Study 2019. We find that pollution remains responsible for approximately 9 million deaths per year, corresponding to one in six deaths worldwide. Reductions have occurred in the number of deaths attributable to the types of pollution associated with extreme poverty. However, these reductions in deaths from household air pollution and water pollution are offset by increased deaths attributable to ambient air pollution and toxic chemical pollution (ie, lead). Deaths from these modern pollution risk factors, which are the unintended consequence of industrialisation and urbanisation, have risen by 7% since 2015 and by over 66% since 2000. Despite ongoing efforts by UN agencies, committed groups, committed individuals, and some national governments (mostly in high-income countries), little real progress against pollution can be identified overall, particularly in the low-income and middle-income countries, where pollution is most severe. Urgent attention is needed to control pollution and prevent pollution-related disease, with an emphasis on air pollution and lead poisoning, and a stronger focus on hazardous chemical pollution. Pollution, climate change, and biodiversity loss are closely linked. Successful control of these conjoined threats requires a globally supported, formal science-policy interface to inform intervention, influence research, and guide funding. Pollution has typically been viewed as a local issue to be addressed through subnational and national regulation or, occasionally, using regional policy in higher-income countries. Now, however, it is increasingly clear that pollution is a planetary threat, and that its drivers, its dispersion, and its effects on health transcend local boundaries and demand a global response. Global action on all major modern pollutants is needed. Global efforts can synergise with other global environmental policy programmes, especially as a large-scale, rapid transition away from all fossil fuels to clean, renewable energy is an effective strategy for preventing pollution while also slowing down climate change, and thus achieves a double benefit for planetary health.

BACKGROUND AND AIM: Clean drinking water and sanitation have been recognized as essential to the realization of all human rights by the United Nations General Assembly on 28 July 2010, through Reso...

BACKGROUND AND AIM: Nigeria with a population of about 200million people is faced with infrastructural deficit. There is a lack of environmental monitoring stations and research funding for non-com...

Human health and wellbeing and the health of the biosphere are inextricably linked. The state of Earth’s life-support systems, including freshwater, oceans, land, biodiversity, atmosphere, and climate, affect human health. At the same time, human activities are adversely affecting natural systems. This review paper is the outcome of an interdisciplinary workshop under the auspices of the Future Earth Health Knowledge Action Network (Health KAN). It outlines a research agenda to address cross-cutting knowledge gaps to further understanding and management of the health risks of these global environmental changes through an expert consultation and review process. The research agenda has four main themes: (1) risk identification and management (including related to water, hygiene, sanitation, and waste management); food production and consumption; oceans; and extreme weather events and climate change. (2) Strengthening climate-resilient health systems; (3) Monitoring, surveillance, and evaluation; and (4) risk communication. Research approaches need to be transdisciplinary, multi-scalar, inclusive, equitable, and broadly communicated. Promoting resilient and sustainable development are critical for achieving human and planetary health.

Continuing carbon emissions and the associated consequent rise of mean global temperatures from the combustion of fossil fuels has had and will continue to have profoundly worsening implications in...

The most complex and largest Turnaround Maintenance (TAM) in the history of the Shell Nigeria Exploration and Production Company's Bonga asset was completed in April 2017. Strategic value drivers were Statutory/Regulatory, Asset Integrity, Relief Valve(RV) Recertifications, Vessel Cleaning and Upgrades. Often, Turnaround management has huge impact and directly contributes to the company's bottom line profits. However, controlling turnaround costs and duration represent a definite challenge. This paper presents the structured process of managing the TAM project and key lessons learnt on integration with its attendant impact on project delivery. The turnaround comprises over three hundred Operations, Maintenance and Project scopes. Over ten in-field vessels were deployed, including a 600-bed Floating accommodation vessel, and over 50 Nigerian contractors and sub-contractor companies were involved while over 2,000 material deliveries were required. The workforce was over 1,000 people that cuts across 10 Functions, several Disciplines, diverse culture and mixed genders; and spread across locations. Team effectiveness and integration were identified as key elements for the team to complete the scope safely, within budget and on schedule. Overall, several challenges were encountered during the TAM; and interventions were implemented to deepen end-to-end thinking, make performance on integrated key performance indicators visible and rally the teams to get critical steps right. This paper shares learnings on how the team was orchestrated to develop shared goals, common understanding of processes and appropriate behaviours and work effectively across organizational boundaries as ONE team. The critical scopes were delivered on schedule and below budget. The TAM therefore resulted in increased asset reliability, continued production integrity, and significantly reduced the risk of unscheduled outages or production deferments.

The dependence of human health and well-being on nature is well recognized. A delicate balance between this human relationship and the external environment requires that biodiversity be safeguarded...

Setting Warri and environs in the Niger Delta, in the Southern region of Nigeria. Objective To investigate the burden of respiratory illness in children in the Niger Delta. Design A cross-sectional survey of 1397 schoolchildren aged 7-14 years in areas of low socio-economic status (SES), using written questionnaires in English based on the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire, with explanation of symptoms. Results The prevalence of doctor-diagnosed asthma was 0.9% (95%CI 0.4-1.3), and wheeze in the last 12 months was 5.4% (95%CI 4.3-6.6). The prevalence of other respiratory symptoms was high, in particular night cough 23.3% (95%CI 21.1-25.5), rhinitis 19.2% (95%CI 17.1-21.3) and phlegm production 16.6% (95%CI 14.7-18.6). Risk of wheeze in the younger age groups was twice (OR 2.09, 95%CI 1.29-3.39) that of older ages after controlling for sex and geographical area. Risk of asthma in urban children was reduced (OR 0.15, 95%CI 0.05-0.50) compared to rural children after controlling for age and sex. Urban children also had a lower risk of rhinitis, exercise limitations and absenteeism due to respiratory illness than rural children. Conclusion The prevalence of symptoms of allergic disease was lower than in the African centres in the ISAAC surveys conducted in urban centres. Doctor-diagnosed asthma is likely to be a poor indicator of asthma in low SES areas of developing countries due to health care access issues.

Health, Safety and Environment (HSE) reporting is defined as the recording of all unwanted or unplanned events/occurrences whether or not they resulted in injuries to people, damage to assets, harm to environment or have the potential to do so. In Nigeria, recording and reporting of accidents and ill health at work is a legal requirement under the Mineral Oil Safety Regulations (MOSR) 1997 and internationally, under the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations (RIDDOR) 2013. In HSE reporting, there are leading (proactive) and lagging (reactive) indicators. "Leading" indicators are preferred because they record performance before the top event and therefore helps create a safer work place, reduce lost time, increase productivity and improve company reputation. Identification of situations/actions that can lead to actual incidents /accidents in the work place and removing them ahead of time is key; It also helps to identify weak links and provide focus areas and efficient channelling of resources and creates learning opportunities in the workplace and proactively prevents actual incidents from occurring. These leading indicators include Unsafe Acts (UA), Unsafe Conditions (UC) and Near Misses (NM. This paper will discuss contributions of proactive reporting in relation to good HSE performance and learnings, over a couple of years in Oil & Gas Company. It will also demonstrate how application of LEAN methodology (an efficiency minded and quality-oriented process) helped to overcome the challenges with reporting and hence improved the quantity, quality and learning from past incidents. The outcome of this project, has been critical in creating a culture of pro active safety management and reduction in significant safety incidents

The weak structure of the health system in Nigeria, its lack of vertical and horizontal integration, slow deployment of evidence-based decisions to impact health outcomes and weak synergy between government and other stakeholders, has led to minimal innovations in health care services. The introduction of community-based health insurance scheme (CHIS) at Obio Cottage Hospital changed the processes of service. The increased number of clients led to opportunities for innovation across the spectrum of health care. This included the ‘Green hospital energy’ initiative which reduced cost of power from an average of $300 - $1500/month to $180 – $500/month, increased facility utilization to an average of 340 patients /day. LEAN process led to a 51% reduction in patient transit time from mean of 3.8hours to 1.7 hours. There was also a 53% improved process efficiency through a cut down in process steps from 72 to 35 and introduction of the aired-oven which reduced specimen processing from 2hours 25mins to 13 minutes. CHIEASY reduced the lengthy registration process including curtailing the manual handling of client records. It provided an electronic and authentication system to track enrolment and financial accountability thus improving quality of care. Remote health through Vsee saved lives and cut cost of 10 patients diagnosed through video and audio report. These innovations brought about general clients' satisfaction and increased demand in health care in the facility. Healthcare innovations to clients have multiplier effects in the provision of safe, timely, sustainable and quality-assured health care services and can be delivered at minimal costs. This analysis aimed to examine the use of innovative methods in improving efficiency in service delivery in a resource limited setting

Objectives/Scope The vast majority of 170 million Nigerians have no access to affordable and quality assured health care. The government provided medical facilities are mostly over-stretched and most Nigerians pay out of pocket for basic health care. The Shell Petroleum Development Company of Nigeria Limited embraced the concept of Public Private Partnership as a strategic approach to Corporate Social Responsibility in the health sector. In 2010, SPDC in collaboration with the Rivers State government upgraded the Obio health center to a cottage hospital and worked with the local community to catalyse the Obio Community Health Insurance Scheme. The partners in the CHIS agreed an annual premium of N7,200 [about$36] per participant for access to essential primary and secondary health care, with special focus on maternal and child health. Methods, Procedures, Process As the insurance package covers more than 95% of community health care needs, patients seen daily increased from 20 to 147 per day. Patients spent long hours on visits leading to dissatisfaction. In 2012, Lean methodology was deployed to address this problem. The outpatient transit time starts from the time the patient reports to the reception, goes through the medical records, vital signs, consultations, laboratory investigation (if necessary), and pharmacy, till discharge. With the use of Lean tools such as value stream mapping, lack of standardisation of key activities at transit points was found to be causing proportionate delay in patients waiting time. 5S exercise was carried out, Standard Operating Procedures and visual measures were developed and deployed with onsite trainings. Results, Observations, Conclusions These led to 78% reduction in transit time, hospital handling more patient flow per day and improved customer satisfaction. Novel/Additive Information Lessons learnt include using leadership Gemba visits and inculcating Lean thinking among hospital staff to improve operational efficiency and bring about a culture change.

The 1992 United Nations Conference on Environment and Development (the Earth Summit) recognized the need for businesses to invest in environmental stewardship beyond regulatory requirements. In response to this, the International Standard Organization (ISO) a non-governmental organization that formulates technical and management standards, introduced the ISO 14001 environmental standards in 1995. As at 2013, ISO had 164 members, each representing a country with about 22% from Africa. The ISO 14001 standard requires participants to establish Environmental Management System (EMS) that is verifiable externally. Participants are required to pass an initial certification audit and subsequent annual recertification audits conducted by approved and accredited third-party organizations. In 1996, Shell committed to external certification of its EMS, initially with EC EMAS (Eco-Management and Audit Scheme) and later with ISO 14001 EMS. Shell in Nigeria developed a phased approach to ISO 14001 certification of its operations, starting with the Alakiri Gas and Oil production facilities in 1997, with the goal to maintain transparency, demonstrate visibility and leadership commitment to continuous improvement in environmental performance. This paper reviews the value added and lessons learnt from ISO 14001 implementation in Shell Nigeria. It assesses the company environmental performance prior to certification and 15years after, and the overall impact on Health Safety and Environment (HSE) management. Also, it takes a look at how ISO 14001 impacts management of HSE across the industry in Africa and discusses the challenges and opportunities offered by voluntary environmental governance vis-à-vis effectiveness of traditional style of government regulation and compliance driven approach.

Local and global headwinds such as shrinking conventional oil reserves, environmental challenges, complex commercial frameworks; stricter regulations, higher production costs and drop in oil price continue to prevail in the oil and gas industry in recent times. In response to these challenges, the industry players (National and International E&P companies, Marginal Field Operators, Service Providers etc.) are constantly seeking ways to optimize operations and cash flow. This thus presents opportunities for the deployment of Continuous Improvement (CI) methodologies such as Lean, Six-Sigma as well as the recent development in the last few years that combines Lean and Six-Sigma to create “Lean Six Sigma”, to remove “wastes” (non-value adding activities) from processes and improve overall performance in business delivery. While Lean focuses on removing non-value adding activity, aligning production with customer requirements and thus streamlining and optimizing process efficiency, Six-Sigma focuses on reducing process variation by delivering products at lower cost with improved quality and reduced cycle time. The application of the “Lean Six Sigma” is increasingly becoming a panacea for maintaining efficiency at all levels and driving operational efficiency in the industry. Continuous improvement not only makes good business sense but also improves job satisfaction. This presentation will share what “wastes” look like in the oil and gas business, proffer ways we can spend less for more and share lessons learnt from deployment of continuous improvement in Shell Nigeria.

African countries are particularly vulnerable to climate change because of their dependence on rain-fed agriculture, high levels of poverty, and poor infrastructure. Rain-fed agriculture accounts f...

Target populations for research in developing countries often lack an understanding of the research, have limited or no access to basic health care, and are politically powerless. The commentary to...

The literature has been mostly consistent about public health benefits of mitigating indoor and outdoor air pollution from industrial, traffic, housing, household and other domestic sources. Severa...

Shell companies and its Joint Venture partners spend millions of dollars per year on social investments in host communities as commitment to corporate social responsibility. Lack of community ownership and participation in identifying developmental needs and delivery process were seen as gaps in realizing full benefits of the social investments. A participatory interface management and development model– The Global Memorandum of Understanding (GMoU) with host communities was introduced to address these gaps. In the GMoU model, the communities take charge and drive developmental initiatives, Shell and its Joint Venture partners provide funding/capacity building while government oversees process governance. However, the quality of most GMoU infrastructure projects has been a source of concern among stakeholders. To address these concerns, improvement opportunities were identified in the infrastructure projects' delivery process. For example, in one instance, over 488 infrastructure project designs were generated by 244 GMoU communities in one year with each community, developing different designs for similar infrastructure. This process requires communities to spend significant amount of development fund to pay for projects design. Similarly quality-checking and approving designs become burdensome for supervising engineers often leading to frustration, erosion of work-life balance and design flaws going undetected. A Lean methodology that involves elimination of wastes through utilization of the knowledge of the people who do the job to deliver value to customers was therefore deployed to improve the GMoU Infrastructure Projects Delivery process. Stakeholders jointly produced results that eliminate wastes in the process, reduce approval cycle time, improve project quality and save cost. This paper will share this experience with learnings for cross industry collaboration in infrastructure projects design for betterment of the host communities.

Population and economy are two key factors considered in global energy demand projections. With rapidly growing world population, energy security is a global concern. The 2011 World Energy Outlook projected that from the 2010 levels, global oil demand will grow by 14% while gas use will rise by more than 50% as well as account for over 25% of world energy demand by 2035. With hydrocarbons no longer easily accessible, success in the future of oil and gas will require meeting various challenges, including ensuring that both discovered and new resources can be produced in economically and environmentally sound manner to offset the natural field decline. Also, shareholders, non-government organizations and local communities are seeking for more value and demonstration of social responsibilities from the industry. Additionally, governments and policymakers are imposing stricter regulations that impact reserve maturation and production. One of the ways stakeholders' expectations can be addressed is by making the most use of resources to lower costs and improve operational efficiency. Lean is a business improvement technique with a collection of tools to eliminate ‘'waste" in an operation and reduce cycle time. Cost reduction is achieved by improving the flow of material and information through the system and continuously finding ways to reduce the amount of work by taking out unnecessary or "waste" steps in processes. Originally developed by the Japanese automobile company, Toyota and widely employed in the manufacturing industry, more industries are adopting the Lean concept. This presentation will showcase Lean application in hydrocarbon development and production. Case studies will be provided to demonstrate how Lean implementation has helped and can be used to eliminate wastes in processes and bring about a culture change. Business results are faster hydrocarbon maturation, enhanced production, sustainable cost reduction and stakeholders reaching mutual agreement faster on sustainable development/environmental issues.

Environmental epidemiology, a well-established subspecialty of epidemiology, is of vital importance in the identification and prevention of environmentally linked morbidity and premature mortality. Perhaps more than most other applied sciences, the discipline of environmental epidemiology faces significant ethical challenges because of the involvement of powerful stakeholders whose influence may affect all levels of research and policy formulation. Although findings of environmental epidemiologic studies play a critical role in arguing for evidenced-based policies aimed at protecting the public from harms, they can also have direct effects on industry profits, political careers, academic funding, and professional advancement. Conflicting interests among various stakeholders create ethically challenging situations that may threaten the core tenets of the discipline, which focus on maintaining, enhancing, and promoting health in communities worldwide. The International Society for Environmental Epidemiology (ISEE) Ethics and Philosophy (E & P) Committee is one of the earliest, active, and enduring ethics committees in the field of epidemiology. Since its inception in 1991, the committee has taken an active role in supporting ethical conduct and formulating ethics guidelines for the profession of environmental epidemiology, publishing its first set of Ethics Guidelines in 1996 (Soskolne and Light 1996) and formally adopting the guidelines in 1999. These guidelines addressed the four major categories of ethical conduct: obligations to subjects of research, obligations to society, obligations regarding funders/sponsors and employers, and obligations to colleagues. Our profession functions within a social and political context in which laws, technology, economic pressures, and social norms are evolving. Thus, it behooves the custodians of guidelines to revisit their guidelines from time to time to reflect on new ethical challenges and on the current context in which they are to be applied. We recognize that guidelines cannot be enforced; they serve rather as a reference and pathway for ethically conscious professionals in our field who are seeking to improve the integrity of their research or to resolve ethical challenges that they face in their work. At the 2009 ISEE annual meeting in Dublin, Ireland—10 years after the Ethics Guidelines were adopted—a subcommittee of the ISEE E & P committee was formed to review and update the guidelines. Certain trends and growing research challenges served as an impetus for the project, including A sharp increase in reports of conflicting interests (> 7,000 references in a 2011 PubMed search) An increase in industry-funded research at academic institutions (and a concomitant increase in the proportion of academic faculty supported by or funded by industry) Research with an a priori agenda and expected results Industry and economic stakeholder influence on government policies Environmental (in)justice Imbalances in allocation of research funding and priorities Purposes of environmental epidemiologic research Public input into public health research processes and policies Data access and ownership of public health information Nature of informed consent Control and use of biospecimens Maintenance of confidentiality Fair attribution for research contributions and protection of intellectual property Influence of ghost-written scientific articles on law making and on international bodies whose mission is to protect the public interest Challenging unacceptable behavior and protecting whistleblowers Major expansion of the field of environmental epidemiology The globalization of public health issues that require collaborative professional efforts to address them. The goals of the subcommittee focused on including current and evolving ethical and philosophical challenges, re-crafting recommendations and providing guidance for professional conduct, and providing case studies to enhance the relevance of the guidelines and to stimulate discussion about solutions (still pending). A core writing group (S.K., C.L.S., B.A.M., and W.K.A.D.) took primary responsibility for conducting the review and developing revisions, with input invited from members of the E & P committee at large. Over a 2-year period, and through an iterative process, suggested revisions and updates were evaluated and incorporated by consensus of the core writing group and the E & P committee. Once the draft guidelines were accepted by majority vote of the E & P committee, they were submitted to the Governing Council of the ISEE for comment and review. Members of the Governing Council submitted additional comments and suggested changes, leading to further refinement by the core writing group. The finalized version of the Ethics Guidelines for Environmental Epidemiologists was accepted and adopted by the Governing Council of the ISEE on 25 April 2012 [ISEE 2012; see also Supplemental Material (http://dx.doi.org/10.1289/ehp.1205562)]. This is the first time that the guidelines (first published in 1996) have been revised.

Heads of governments at the 1996 World Food Summit reaffirmed “the right of everyone to have access to safe and nutritious food, consistent with the right to adequate food and fundamental right of ...