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Background <p>The rapid rise of non-communicable diseases (NCDs) in sub-Saharan Africa (SSA) coincides with an increasing environmental presence of toxins and toxicants. Chronic human exposure to these agents is recognised as a contributor to NCD risk through pathways including oxidative stress, systemic inflammation, endocrine disruption, organ-directed toxicity, and neurotoxicity. However, region-specific data on exposure levels and population-based studies on the health impacts remain scarce. No population-level studies have been conducted in SSA linking specific environmental exposures to NCD outcomes.</p> Aim <p>To synthesise evidence on the environmental presence and plausible health implications of exposure to heavy metals, agrochemical residues, and mycotoxins (HAMs) in SSA, using Ghana as a detailed case study, to highlight critical data gaps and inform regional research and policy priorities.</p> Methods <p>We conducted a scoping review following PRISMA-ScR guidelines. The primary peer-reviewed literature search covered 2010–2025, in PubMed, Web of Science, Scopus, and African Journals Online. Grey literature including government and NGO reports, and substantive investigative journalism reports were searched up to October 2025. Ninety-five sources reporting the environmental presence of HAMs, human exposure or health-related associations in SSA, focusing on Ghana, were included. The sources were appraised for quality, and data were extracted thematically by exposure class, source and route of exposure, and plausible health-related outcomes.</p> Key findings <p>Human exposure to HAMs is consistently associated in mechanistic, animal model, and occupational studies with cardiometabolic, hepatic, renal, neurological, immunological, and reproductive dysfunction, all of which threaten public health and healthy ageing. The evidence from Ghana shows widespread environmental contamination with HAMs: over 60% of surface water bodies are reported to be polluted by artisanal mining and other anthropogenic activities, four staple foods showing 97–100% mycotoxin contamination (<i>n</i> = 110) with low margins of exposure (≤ 242), and well-documented and common mishandling/misuse of agrochemicals. The literature suggests that this situation is mirrored in other countries in SSA. However, direct epidemiological evidence linking these exposures to disease outcomes in Ghanaian or other SSA populations is almost entirely absent.</p> Gaps and implications <p>There is a critical lack of exposure-response studies, biomonitoring and longitudinal population studies to generate locally relevant data on the exposures. Urgent actions needed include (1) near-term strengthening of environmental and food safety surveillance across SSA, (2) medium-term investment in interdisciplinary exposure-health research, and (3) long-term policies for environmental risk mitigation to safeguard public health and healthy ageing.</p> Conclusion <p>The example from Ghana illustrates a broader regional risk. It is critical to characterise the environmental exposures and their implications for the NCD burden and unhealthy ageing in SSA.</p>

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Adverse environmental exposures in sub-Saharan Africa drive non-communicable disease risk and unhealthy ageing

  • 期刊论文

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  • 发表日期：

    2026年6月23日

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  • Winfred-Peck Dorleku,
  • Florence Akosua Agyemang,
  • Ebenezer Oduro-Mensah,
  • Abigail Aboagyewaa Abrokwah,
  • Victus Gyambiby,
  • Jude Delasi Gbogblogbe,
  • Gifty Harriet Odame,
  • Daniel Oduro-Mensah

摘要

Background

The rapid rise of non-communicable diseases (NCDs) in sub-Saharan Africa (SSA) coincides with an increasing environmental presence of toxins and toxicants. Chronic human exposure to these agents is recognised as a contributor to NCD risk through pathways including oxidative stress, systemic inflammation, endocrine disruption, organ-directed toxicity, and neurotoxicity. However, region-specific data on exposure levels and population-based studies on the health impacts remain scarce. No population-level studies have been conducted in SSA linking specific environmental exposures to NCD outcomes.

Aim

To synthesise evidence on the environmental presence and plausible health implications of exposure to heavy metals, agrochemical residues, and mycotoxins (HAMs) in SSA, using Ghana as a detailed case study, to highlight critical data gaps and inform regional research and policy priorities.

Methods

We conducted a scoping review following PRISMA-ScR guidelines. The primary peer-reviewed literature search covered 2010–2025, in PubMed, Web of Science, Scopus, and African Journals Online. Grey literature including government and NGO reports, and substantive investigative journalism reports were searched up to October 2025. Ninety-five sources reporting the environmental presence of HAMs, human exposure or health-related associations in SSA, focusing on Ghana, were included. The sources were appraised for quality, and data were extracted thematically by exposure class, source and route of exposure, and plausible health-related outcomes.

Key findings

Human exposure to HAMs is consistently associated in mechanistic, animal model, and occupational studies with cardiometabolic, hepatic, renal, neurological, immunological, and reproductive dysfunction, all of which threaten public health and healthy ageing. The evidence from Ghana shows widespread environmental contamination with HAMs: over 60% of surface water bodies are reported to be polluted by artisanal mining and other anthropogenic activities, four staple foods showing 97–100% mycotoxin contamination (n = 110) with low margins of exposure (≤ 242), and well-documented and common mishandling/misuse of agrochemicals. The literature suggests that this situation is mirrored in other countries in SSA. However, direct epidemiological evidence linking these exposures to disease outcomes in Ghanaian or other SSA populations is almost entirely absent.

Gaps and implications

There is a critical lack of exposure-response studies, biomonitoring and longitudinal population studies to generate locally relevant data on the exposures. Urgent actions needed include (1) near-term strengthening of environmental and food safety surveillance across SSA, (2) medium-term investment in interdisciplinary exposure-health research, and (3) long-term policies for environmental risk mitigation to safeguard public health and healthy ageing.

Conclusion

The example from Ghana illustrates a broader regional risk. It is critical to characterise the environmental exposures and their implications for the NCD burden and unhealthy ageing in SSA.