How does garbage in impact patient outcomes

A good example is given by the findings of the study in Lagos by Olubukola which reported the similarity in waste data and HCW management practices in two General hospitals, characterized by a lack of waste minimization or waste reduction strategies, poor waste segregation practices, lack of instructive posters on waste segregation and disposal of HCW with general waste Olubukola, The mismanagement of healthcare waste poses health risks to people and the environment by contaminating the air, soil and water resources.

Hospitals and healthcare units are supposed to safeguard the health of the community. However, healthcare wastes if not properly managed can pose an even greater threat than the original diseases themselves PATH, A study of Health Care Waste management in Jos Metropolis, Nigeria has demonstrated that the waste management options in the hospitals did not meet the standard practices Ngwuluka et al.

Waste management with safe and environmentally sound methods cannot be over-emphasized. The hospital management board and the hospitals should make a conscious and deliberate effort to ensure they do not contribute to the present and future threats to human health and the environment by poor waste management practices. In order to execute standard waste management, an understudy of a healthcare establishment with standard waste management practices in or outside the country may be the first practical step to undertake Ngwuluka et al.

A waste management team should be constituted which will prepare waste management plan, policy documents and technical guidelines and in addition supervise waste management activities Ngwuluka et al.

In another study in Port-Harcourt metropolis, Nigeria carried out to assess hospitals waste management practice Ogbonna, The study enquired into waste generation rates and various waste disposal options by different categories of hospital. It was further evident in this study that hospital waste management issues and problems are not peculiar to Port Harcourt metropolis alone.

Solid waste disposal methods indicated that open dump sites is most preferred while incineration was non existent in the hospitals, clinics. Most other hospitals do not segregate wastes into marked or colour coded containers for the different waste streams neither do they keep records of waste generation and disposal Ogbonna, In addition, the survey revealed that both hospital waste generators and handlers treat hospital wastes as a usual domestic waste Ogbonna, Therefore disposal of ashes containing toxic metals from Hospital waste incineration can be done through solidification-stabilization of fly and bottom ash with cement because it appears to be the best method to render ash less toxic.

Similarly, the concentration of toxic heavy metals in the ash of hospital waste incinerator can be avoided to some extent through segregation of the waste prior to incineration. Lack of relevant training and protective equipment for waste handlers was a common feature in the survey. Generally, Port Harcourt, as a fast growing city in Nigeria, like most developing countries, lacked the infrastructure, as well as institutional capacity necessary to effectively manage medical wastes as part of the effort to enhance protection of human life and the environment from health hazards arising from improper management of hazardous waste Ogbonna, It was further observed that open dump sites are not even engineered or treated, thus expose the entire public to risks of infection.

Ogbonna reported that except for the oil company clinics such as the SPDC, all the other hospitals sampled do not have any unit or department responsible for waste management. Knowledge, attitude and practices towards environmental issues are relatively low among the various actors in the tasks of hospital waste management.

The following groups of persons are at the risk of health care waste Medical staff: doctors, nurses, sanitary staff and hospital maintenance personnel; In and out-patients receiving treatment in healthcare facilities as well as their visitors. Workers in support services linked to healthcare facilities such as laundries, waste handling and transportation services; Workers in waste disposal facilities and the general public.

Presence of various microorganisms such as pathogenic viruses and bacteria have been investigated by both cultivation and by RT -PCR assays. A number of opportunistic pathogenic bacteria, including Pseudomonas spp. In addition, pathogenic viruses such as noroviruses and hepatitis B virus have been also detected in human tissue wastes. Commonly identified bacterial and viral pathogens such as Pseudomonas spp. Medical waste should be carefully controlled and monitored to prevent nosocomial infection associated with the exposure to these wastes Nascimento et al.

Health service waste gives rise to controversy regarding its importance for human, animal and environmental health Nascimento et al. Occurrences of clinically relevant bacteria in piles of health service waste in a sanitary landfill and their antimicrobial susceptibility profile have been previously studied by Nascimento et al. Nascimento et al. Bacterial resistance to all the antimicrobials tested was observed in all microbial groups, including resistance to more than one drug.

This makes it possible to suggest that viable bacteria in health service waste represent risks to human and animal health. Furthermore, occurrences of multi-resistant strains support the hypothesis that health service waste acts as a reservoir for resistance markers, with an environmental impact.

The lack of regional legislation concerning segregation, treatment and final disposal of waste may expose different populations to risks of transmission of infectious diseases associated with multi-resistant microorganisms. Microbial diseases associated with health care waste Akter, Transmission of disease through infectious waste is the greatest and most immediate threat from healthcare waste. If waste is not treated in a way that destroys the pathogenic organisms, dangerous quantities of microscopic disease-causing agents—viruses, bacteria, parasites or fungi—will be present in the waste.

These agents can enter the body through punctures and other breaks in the skin, mucous membranes in the mouth, by being inhaled into the lungs, being swallowed, or being transmitted by a vector organism World Health Organization, People who come in direct contact with the waste are at greatest risk. Although sharps pose an inherent physical hazard of cuts and punctures, the much greater threat comes from sharps that are also infectious waste.

These infections may be fatal Johannessen, Contamination of water supply from untreated healthcare waste can also have devastating effects. If infectious stools or bodily fluids are not treated before being disposed of, they can create and extend epidemics, since sewage treatment in Africa is almost nonexistent.

For example, the absence of proper sterilization procedures is believed to have increased the severity and size of cholera epidemics in most parts of Africa during the last decade. Chemical and toxic threats. Chemical and pharmaceutical wastes, especially large quantities, can be health and environmental threats. If burned, they may explode or produce toxic fumes. Some pharmaceuticals are toxic as well Johannessen, When chemical and pharmaceutical waste is disposed of in unlined landfills, especially unlined pits, these wastes may contaminate ground and surface water—particularly when large quantities are disposed of.

This can threaten people who use the water for drinking, bathing and cooking, and damaging plants and animals in the local ecosystem. Burning or incinerating healthcare waste, while often a better option than disposal in an unlined pit, may create additional problems. Burning or incineration of healthcare waste may produce toxic air pollutants such as Nitrogen Oxides NOx , particulates, dioxins and heavy metals and distribute them over a wide area. Dioxins believed to be potent cancer-causing agents, do not biodegrade, and accumulate in progressively higher concentrations as they move up the food chain WHO, Disposable pressurized containers pose another hazard for incineration, as they can explode if burned.

In fact, disposal of large quantities of hazardous chemicals and pharmaceuticals is a serious problem. Improvised incinerator at UCH, Ibadan. Antibiotic resistance spread in the Environment through improperly disposed Health Care Wastes. Antimicrobial resistance AMR is resistance of a microorganism to an antimicrobial medicine to which it was previously sensitive.

Resistant organisms they include bacteria, viruses and some parasites are able to withstand attack by antimicrobial medicines, such as antibiotics, antivirals, and anti-malarials, so that standard treatments become ineffective and infections persist and may spread to others.

AMR is a consequence of the use, particularly the misuse, of antimicrobial medicines and develops when a microorganism mutates or acquires a resistance gene WHO, In places like Nigeria most families become financially distressed after hospitalization of members of their families.

Many infectious diseases risk becoming uncontrollable and could derail the progress made towards reaching the targets of the health-related United Nations Millennium Development Goals set for When infections become resistant to first-line medicines, more expensive therapies must be used. The longer duration of illness and treatment, often in hospitals, increases health-care costs and the financial burden to families and societies WHO, Multidrug resistance is described as a phenomenon where a microbial pathogen resists at least three groups of antibiotics CDC, Healthcare liquid wastes are the reservoirs of harmful infectious agents such as the pathogens and multiple drug resistant microorganisms Sharma et al.

Potential infectious risks include the spread of infectious diseases and microbial resistance from health-care establishments into the environment and thereby posing risks of getting infections and antibiotic resistance in the communities Sharma et al.

Therefore, even if the hospitals are discharging their healthcare liquid waste into Sewage system, it is mixed with the sewage and gets in surface water without proper treatment. If the hospital effluents are not treated, concentrated forms of infectious agents and antibiotic resistant microbes are shed into communities resulting in water borne diseases such as cholera, typhoid fever, dysentery and gastroenteritis.

Antibiotics, disinfectants and bacteria resistant to them have been detected in the environmental compartments such as waste water, surface water, ground water, sediments and soils Kummerer, Studies have discovered trace level concentrations of antibiotics in waste water treatment plant effluents and surface waters Kolpin et al, Long term exposure of microorganisms to low concentrations of antibiotics in wastewater and surface water has the potential for the development of antibiotic resistance in these organisms Smith et al.

The concerns about antimicrobial resistance are increasing. In a report by the United Kingdom, House of Lords, it is stated that the resistance to antibiotics and other anti-infective agents constitutes a major threat to public health and ought to be recognized HLSCST, Input of resistant bacteria as well as of antibiotics can disturb the established well balanced and important interdependencies Hiraishi, The input of resistant bacteria into the environment seems to be an important source of resistance in the environment.

Therefore, the development of antibiotic resistance in bacteria and their dissemination in the environment is of serious public health concern because an individual patient can develop an antibiotic resistant infection by contacting a resistant organism and spread in the communities.

Hospitals and public health care units must safeguard the health of the community. However, the waste produced by the health care centres if disposed of improperly, can pose an even greater threat than the original diseases themselves due to the presence of concentrated forms of numerous risks including pathogenic and antibiotic resistant microorganisms Sharma et al.

In Nepal, where several thousand die due to infectious diseases and several more, losing quality of lives, untreated hospital liquid waste discharge into surface water directly or indirectly must have been adding more problems. It is our common observation that majority of the healthcare facilities do not practice safe healthcare liquid waste treatment and disposal.

Basel convention. This convention is a global agreement, ratified by some member countries to address the problems and challenges posed by hazardous waste. Nigeria is a signatory to this convention. It facilitates the implementation of the Convention and related agreements. It also provides assistance and guidelines on legal and technical issues and conducts training on the proper management of hazardous waste.

It was adopted in More recently the work of the Convention has emphasized full implementation of treaty commitments, promotion of the environmentally sound management of hazardous wastes, a lifecycle approach, and minimization of hazardous waste, generation.

The Convention entered into force 5 May HCWC, The Basel Convention Article 4 requires each Party to minimize waste generation and to ensure, to the extent possible, the availability of disposal facilities within its own territory. The Conference of the. Parties at its sixth meeting in December adopted a Strategic Plan for the implementation of the Basel Declaration to building on and using the framework of the Ministerial Basel Declaration on Environmentally Sound Management.

Hazardous wastes are those wastes that are: explosive, flammable, poisonous, infectious, corrosive, toxic, or ecotoxic. The Stockholm convention on persistent organic pollutants. This Convention is a global treaty to protect human health and the environment from persistent organic pollutants POPs.

POPs are chemicals that remain intact in the environment for long periods, become widely distributed geographically, accumulate in the fatty tissue of living organisms and are toxic to humans and wildlife. In implementing the Convention, Governments will take measures to eliminate or reduce the release of POPs into the environment.

The Stockholm Convention was adopted in POPs are chemicals that are highly toxic, persistent, bio-accumulate and move long distance in the environment. The Convention seeks the elimination or restriction of production and use of all intentionally produced POPs i. It also seeks the continuing minimization and, where feasible, ultimate elimination of the release of unintentionally produced POPs such as dioxins and furans.

The Rotterdam convention. The Rotterdam Convention was adopted in The Convention replaces this arrangement with a mandatory PIC procedure and information exchange mechanism on hazardous chemicals and pesticides. The Convention entered into force 24 February The Rotterdam Convention Article 5 , obliges Parties to notify the secretariat of final regulatory actions taken in respect of banned or severely restricted chemicals, for the information of other Parties and possible listing under the Convention.

Developing countries and countries with economies in transition may also propose the listing of severely hazardous pesticide formulations Article 6. The Rotterdam Convention apply to any chemical that is banned or severely restricted by a Party. The Prior Informed Consent procedure applies to the following 28 hazardous pesticides: 2,4,5-T, aldrin, binapacryl, captafol, chlordane, chlordimeform, chlorobenzilate, DDT, 1,2- dibromoethane EDB , dieldrin, dinoseb, DNOC and its salts, ethylene dichloride, ethylene oxide, fluoroacetamide, HCH, heptachlor, hexachlorobenzene, lindane, mercury compounds, monocrotophos, parathion, pentachlorophenol and toxaphene, plus certain formulations of methamidophos, methyl-parathion, monocrotophos, parathion, phosphamidon and a combination of benomyl, carbofuran and thiram.

It also covers 11 industrial chemicals: asbestos actinolite, anthophyllite, amosite, crocidolite, tremolite , polybrominated biphenyls PBBs , polychlorinatedbiphenyls PCBs , polychlorinated terphenyls PCTs , tris 2,3 dibromopropyl phosphate and tetraethyl lead TEL and tetramethyl lead TML.

World conventions and Principles of Health Care Waste management. This principle stipulates that any organisation that generates waste has a duty to dispose of the waste safely.

Therefore it is the HCF that has ultimate responsibility for how waste is containerized, handled on-site and off-site and finally disposed of.

According to this principle all waste producers are legally and financially responsible for the safe handling and environmentally sound disposal of the waste they produce. In case of an accidental pollution, the organisation is liable for the costs of cleaning it up. Therefore if pollution results from poor management of health-care waste then the HCF is responsible.

However, if the pollution results because of poor standards at the treatment facility then the HCF is likely to be held jointly accountable for the pollution with the treatment facility. Likewise this could happen with the service provider. The fact that the polluters should pay for the costs they impose on the environment is seen as an efficient incentive to produce less and segregate well.

Following this principle one must always assume that waste is hazardous until shown to be safe. This means that where it is unknown what the hazard may be, it is important to take all the necessary precautions. This principle recommends that treatment and disposal of hazardous waste take place at the closest possible location to its source in order to minimize the risks involved in its transport.

According to a similar principle, any community should recycle or dispose of the waste it produces, inside its own territorial limits.

It is a bed tertiary care general hospital, situated at Minbhawan, Kathmandu. The annual outpatient flow at the hospital is , and inpatient flow is 35, This was a pre- and post-test interventional study to determine the impact of healthcare waste management HCWM practices, including its collection, segregation, transportation, treatment and ultimate disposal procedure. Regular visits to gynaecology, obstetrics, paediatrics, medicine and orthopaedics wards were performed twice daily by the researchers to monitor how HCWM was practiced.

The first visit was from to in the morning and the second visit from to in the afternoon. These wards were chosen as model wards to explore the feasibility and sustainability of waste management program throughout hospital in the later stage.

Data were collected on a daily basis regarding where waste generation, collection, segregation, storage, transportation, and treatment, both on- and off-site. Information was also collected from the nurses, physicians and waste handlers in the gynaecology, obstetrics, paediatrics, medicine and orthopaedics wards. The healthcare waste management committee HCWMC was formed under the leadership of the executive director of the hospital.

The director was responsible for the overall activities of the committee, including managing annual budget allocation for HCWM activities, and equipment purchasing from internal sources of the hospital. The members of the committee were representatives from all departments and units of the hospital, which were responsible for waste generation.

The committee forwarded them to the director and he finally approved them. The HCWM policy was one aspect of the hospital infection prevention and control policy. The hospital had been following the government rules and regulations, but had not developed its own policy and SOP prior to this. Roles and responsibilities of the committee members were assigned in the policy. The member-secretary of the committee was selected as the focal person, for reporting and disseminating HCWM related issues and arranging meeting of the committee every month.

The committee also assigned a waste management officer for day-to-day internal monitoring of waste management practices. Training program, related to HCWM, was conducted for physicians, nurses and waste handlers. The program included orientation to HCW and its management, standard operating procedure and legal provisions for the safe waste management, segregation, collection and handling techniques of various waste, as well as occupational health and safety issues, safe injection practices [ 9 ].

The committee appointed a focal nurse from respective wards, each month. Focal nurse would be responsible for counseling and recording HCWM related activities. She would be selected by the HCWM meeting, on rotation basis. She was given HCWM related written job description of counseling caregivers of patient about the objectives, procedures, systems and benefits of proper HCWM, with demonstration. The HCWM brochure was developed by the committee, and was provided by the focal nurse to the caregivers at the time of admission of the patient.

The brochure contained complete information about waste management protocol of the hospital. General buckets, used prior to the intervention, were replaced by the WHO- recommended polypropylene coloured buckets. Pictorial text was placed above the bucket. The waste collected was transported to the designated storage area, by two separate and dedicated trolleys- one for the risk waste and other for the non-risk waste.

This was performed on each shift by the well-trained waste handlers, who were trained in handling, transporting, transportation schedule and route, importance of wearing personal protective equipment. They were vaccinated against hepatitis B and tetanus. They were also serologically screened for seroconversion. The first shift, of onsite waste transportation, was from 7 to 8 AM, and the second shift was from 6 to 7 PM. The contents of the bins were poured out for autoclaving or incineration.

The bin was cleaned and disinfected with 0. Sharps collected were disposed daily on sharp pit. The waste, collected at red bucket, was incinerated, twice weekly. The height of the chimney of the incinerator was 20 meter. The ash produced after incineration was land filled. The average score of 40 respondents was processed, for final data analysis.

The observation, during the assessment visit, and questionnaire filled after the assessment by the researchers, were subjected in the IRAT form. Then the IRAT automatically computed a final score. The higher the final score, the better was the HCWM system of the hospital. The score was converted into percentage. The pre-intervention and post-intervention scores were verified by the HCWM committee, as a means of quality assurance of the intervention, and to determine the sustainability of the improvements in the future.

The pre-intervention evaluation showed that the hospital had not allocated budget for proper waste management practices. The hospital had incinerator in a location accessible to the waste handlers, but not to the public. The hospital did not have HCWM Committee, policy, standard operating procedure SOP and proper color coding system for waste segregation, collection, transportation and storage, as well as the specific well-trained waste handlers.

The post-intervention evaluation showed that waste water was still not treated by the hospital. The HCWM policy and SOP were developed, after interventions, and they were consistent with the national and international laws and regulations. Health professionals, such as doctors, nurses and waste handlers, were provided training on HCWM practices. The training programs included segregation, collection and handling, transportation, treatment and disposal of the waste, as well as occupational health and safety issues.

The pre-intervention evaluation showed the poor status of waste management practices. The committee adopted the practice of collecting and storing all healthcare wastes in a temporary waste storage area, within the premises, until they were transported to the waste treatment area [ 1 , 5 ].

The treatment area consisted of waste segregation area, separate incinerator area, cytotoxic waste collection area, autoclave area, and mercury collection house. The committee organized training programs for nurses, and committee members regarding the impact of mercury and importance of its safe disposal. The used needles were cut by the needle cutter, attached with the procedure trolley. The cut portions of needle, and other sharp wastes, were kept in a bucket, half filled with 0.

Then they were collected in sharp pit, near waste treatment area. The committee also developed instructive posters regarding proper waste management technique to make the public aware of the effective segregation of waste. These were inexpensive, but impressive methods of gaining public support for waste management activities, and could be achieved within short period, with the limited resources available [ 15 ]. The committee adopted the system of segregation of waste at source, into suitable colour-coded high density polyethylene bags and bins, for the easy identification and segregation of infectious and non-infectious wastes.

In addition, if the waste disposals are illegal they are likely to contain highly hazardous compounds resulting from industrial activities e. Hazardous waste has been shown to influence the likelihood of developing lung, brain cancer, bladder and lung cancer Loredana and Maria A United Nations Report August noted with regret that while developing countries are improving access to clean drinking water they are falling behind on sanitation goals.

The report also noted that bad sanitation — decaying or non-existent sewage system and toilets- fuels the spread of diseases like cholera and basic illness like diarrhea, which kills a child every 21 s. The hardest hit by bad sanitation is rural poor and residents of slum areas in fast-growing cities, mostly in Africa and Asia Napoleon et al. The importance of waste collection, transfer and disposal cannot be overemphasized.

Apart from the issue of esthetics, uncollected wastes constitute a health risk, which can be a serious consideration in low income residential areas. Leachate from uncollected and decomposed garbage waste can contaminate groundwater and this could have enormous health implications in low-income communities where the use of well-water for drinking is common UNCHS Environment health conditions are hampered through the pollution of ground and surface water by leachates from dump sites.

Air pollution is often caused by open burning at dumps leading to foul odors and wind-blown litters. In dump sites, Methane is an important greenhouse gas, which is a by-product of the anaerobic decomposition of organic wastes Amuda et al. Numerous research studies has shown that environmental governance is at the lower ebb in Nigeria. This definitely has consequential implications and impacts on the public health of the people.

Olukanni and Akinyinka , Napoleon et al. In addition, Olukanni and Akinyinka join other researchers to conclude that there are potential risks to the environment and human health from improper handling of solid wastes. Direct health risks concern mainly the workers in this field, who need to be protected, as far as possible, from contact with wastes.

This further reveals other epidemiological studies that shows that a high percentage of workers who handle refuse, and of individuals who live near or on disposal sites, are infected with gastrointestinal parasites, worms and related organisms.

Disease transmission by houseflies is greatest where inadequate refuse storage, collection and disposal is accompanied by inadequate sanitation Olukanni and Akinyinka, The mountainous heaps of solid wastes that deface Nigerian cities and the continuous discharges of industrial contaminants into streams and rivers without treatment motivated the federal government of Nigeria to promulgate Decree 58 for the establishment of a Federal Environmental Protection Agency FEPA in Nevertheless, research studies since has generally revealed the bankruptcy of the FEPA establishment and how largely Nigeria communities have suffered from poor environmental governance and the subsequent public health challenges which has constituted great threats to the population health.

This paper therefore emanates from the need to address improper disposal and management of MSW in Bodija and Agbowo communities in particular.

Implications of the waste management methods and environmental characteristics of Agbowo and Bodija communities on health conditions of the residents were investigated.

The city of Ibadan, with an heterogeneous population, is located approximately on longitude 3 0 5 1 East of the Greenwich Meridian and latitude 7 0 23 1 North of the Equator at a distance some km worth east of Lagos.

Ibadan is directly connected to many towns in Nigeria, as its rural hinterland by a system of roads, railways and air routes. The physical setting of the city consists of ridges of hills that run approximately in northwest — southeast direction. There are 11 Local government areas across Ibadan- part of which include Ibadan North local government. The two most popular towns in Ibadan North local government include Agbowo and Bodija towns. Ibadan North Local government Area has a household population of 76, Tomori Agbowo is located at the heart of the historic city, Ibadan, while Bodija faces it in the Northward direction and Ojo to its West.

Agbowo and Bodija communities are densely populated with students of the University of Ibadan and The Polytechnic, Ibadan. Agbowo has many features of an urban slum: overcrowding, unplanned housing, and lack of basic social amenities such as piped water Akinremi and Samuel Municipal waste management methods was poor as we observed open drainages and sewers poorly constructed were available and totally absent in most households.

Residents of Agbowo and Bodija were fond of indiscriminate disposal of both liquid and solid municipal wastes. Evidence to this was dominance of open dumpsites, mountainous heaps of solid waste and refuse packs dumped openly along the streets. Inadequate toilet facilities were observed among the households in Agbowo. This makes the residents to openly dispose solid waste, including feces, into drainages. More dominant, too, is the presence of open dumpsites at backyards or closer to houses.

In this investigative study, a comparative cross- sectional design was employed which involved the use of semi- structured interviewer-questionnaire to randomly selected household respondents. Socio-demographic characteristics, environmental characteristics and waste disposal and management methods were compared between the two study areas.

Community participation in MSW management and its effects on population health were compared between the two areas. Our study population included household residents of Agbowo and Bodija who are matured enough to participate in waste disposal and its management. A representative in each household was randomly chosen to participate in the survey. The total sampling techniques i. Multi-stage sampling technique was used to collect the data involving a two - stage design procedure.

Stage1: The division of the study areas into four stratum to represent primary selection units which denote the strata from where the data were collected. Stage 2: Simple random selection of household respondents in each of the locations in each stratum. Further details of sampling procedures are summarized in Table 1. This adopted sampling method help us to collect data that will truly represent the household population estimates at both study areas. A semi-structured interviewer administered questionnaire was used to obtain information on environmental characteristics, waste management practice methods and environmentally related health symptoms and conditions among our respondents.

Each questionnaire was carefully reviewed for completeness and appropriateness of responses. Data were analyzed using descriptive statistics, One Sample T test- to find any significant difference in environmental characteristics between Agbowo and Bodija, significance difference in waste disposal methods between Agbowo and Bodija; Correlation analysis was done to find out any relationship between environmental characteristics and health conditions of our respondents in both study areas.

The socio-demographic characteristics of household respondents as collected during our field survey is presented in Table 2 below. In Agbowo 24 Also from Table 2 : it was clear from the data that Married respondents are higher in our study population: From our analysis, the number of respondents that have both Primary and Secondary education stood as 47 Professionals that responded in Agbowo were 13 6.

Business owners that participated in the survey in Agbowo were 18 8. The analysis shows that the highest household size at both Agbowo 16—20 people and Bodija 20 above was 75 Household size 1—5 people was 9 4. Household size 6—10 in Agbowo was 17 8. Household size 11—15 stood at 45 In our survey, data collected reveals that the most dependable source of portable water in our study areas is Sachet water. Agbowo, 83 This is followed by Borehole; 67 Very few of our respondents have access to Tap water in Bodija, 9 4.

In Agbowo there was no evidence of Tap water at all. Agbowo community, in the face of its overcrowded houses and unplanned housing settlement is characterized with boreholes and well water. In addition, 12 5. Respondents also said that they make use of bush to dispose their feces Agbowo: 26 At our two study areas, different MSW disposal and management practices is very common from one household to the other, especially at Agbowo where MSW and environmental management is not been regulated.

In Bodija the most common means of waste management is open dumping. The number of households that practice open dumping is 87 Only 2 0. In Agbowo just 14 6. From our survey at both study areas- Agbowo and Bodija communities, our result clearly reveals the major environmental characteristics of both communities and the level of environmental sanitation.

However, when asked how frequently waste collectors patrol the community to collect waste; 61 In Bodija waste collectors never visited 54 However, 49 Figure 1 below typically shows the rate of infestation of selected disease carrying organisms found in Agbowo and Bodija households. Rate of infestation of disease carrying organism at our study areas. Source : Field Survey July, From the above graph; the rate of infestation of rats is medium in Bodija and heavy in Agbowo; mosquitoes appear to heavily infest both Agbowo and Bodija communities; cockroah infestation rate seems to be relatively populated in both communities while Bedbugs infestation is medium in both areas.

Flies heavily infest Bodija community compare to its rate in Agbowo. When asked how often does environmental health officers visit each household for environmental inspection, data collected indicated that: 23 In Agbowo 58 In Agbowo 17 8.

However, 87 Very few of the respondents; 6 2. To determine if there is any significant difference in the environmental characteristics between the two study areas, data collected through response from our household respondents were further analyzed using the Student t-test tool of IBM SPSS statistical package version Results from our t-test analysis were presented in Tables 3 and 4 below:. Result of the analysis shown in Table 3 reveals that there is a significant difference between the environmental characteristics of Agbowo and Bodija.

Result of the analysis shown in Table 4 reveals that there is a significant difference between the waste disposal methods and management between Agbowo and Bodija. The Bodija has the highest mean score Results from our field survey states that environmental characteristcis of both Agbowo and Bodija are significantly different and in fact clearly indicate the possibility of threats to population health.