Skin Problems among Users of the Urine-Based Fertiliser in Ouagadougou Periurban Areas, Burkina Faso: A Prospective Study

Joseph M. Makaya^1*, Serge Aho², Joseph Wethé³, Dayéri Dianou⁴, Nicolas Barro¹, Alfred S. Traoré¹

¹Research Center for Biological, Food and Nutritional Sciences, Research and Training Unit, Life and Earth Sciences, University of Ouagadougou, Ouagadougou, Burkina Faso.
²Epidemiology and Infection Control Unit, Public Hospital of Dijon, Dijon, France.
³Pan African Agency, Water and Sanitation for Africa, Ouagadougou, Burkina Faso.
⁴National Center for Scientific and Technological Researches, Institute for Health Sciences Research, Ouagadougou, Burkina Faso.

DOI: 10.4236/ojsst.2014.44019                

Abstract

The great challenge for the sustainable use of excreta (urine, faeces) in agriculture is to increase the benefits of these products as resources and decrease the negative effects on human health. The risk of gastrointestinal diseases associated with the use of human excreta as natural fertilisers is well established, while information on skin problems remains largely anecdotal. The objective of this study was to evaluate the prevalence of skin problems among people involved in the handling of the urine used as fertiliser along a productive sanitation system in Ouagadougou periurban areas. A questionnaire was used for each targeted worker to collect data on sociodemographic characteristics, conditions of work and reported health symptoms such as skin burning, itching, eye irritation and paronychia. The exposure measurements were essentially based on field observations. A total of 435 people were interviewed, including 45 workers in urine storage sites, 209 farmers using urine-based fertiliser and 181 control farmers. More than 35% of site workers reported skin symptoms. For farmers using urine-based fertiliser and their controls, 17.2% and 26.0% reported skin symptoms, respectively. Overall, the associations between skin symptoms and the handling of urine used as fertiliser were almost significant (P < 0.06). Also, the study showed that these skin symptoms reported by the urine handlers are associated with conditions of work. Effective preventive measures such as wearing suitable protective equipment and practicing good personal hygiene should be emphasized. This topic needs to be further examined using longitudinal studies.

Keywords

Human Urine, Fertiliser, Exposure, Hazardous Agents, Skin Problems

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Mnkeni, P.N.S., Kutu, F.R., Muchaonyerwa, P. and Austin, L.M. (2008) Evaluation of Human Urine as a Source of Nutrients for Selected Vegetables and Maize under Tunnel House Conditions in the Eastern Cape, South Africa. Waste Management & Research, 26, 132-139. http://dx.doi.org/10.1177/0734242X07079179
[2]	Richert, A., Gensch, R., Jönsson, H., Dagerskog, L., Stenström, T. and Bonzi, M. (2010) Food Security and Productivesanitation: Practical Guideline on the Use of Urine in Crop Production. Sustainable Sanitation Practice, 3, 31-33.
[3]	Makaya, J.M., Savadogo, A., Somda, M.K., Bour, J.B., Barro, N. and Traoré, A.S. (2014) Quality of Human Urine Used as Fertilizer: Case of an Ecological Sanitation System in Ouagadougou Peri-Urban Areas—Burkina Faso. Journal of Environmental Protection, 5, 467-474. http://dx.doi.org/10.4236/jep.2014.56049
[4]	Dagerskog, L. and Bonzi, M. (2010) Opening Minds and Closing Loops—Productive Sanitation Initiatives in Burkina Faso and Niger. Sustainable Sanitation Practice, 3, 4-11.
[5]	World Health Organization (WHO) (2006) Guidelines for the Safe Use of Wastewater, Excreta and Greywater, Vol. 4, Wastewater Use in Agriculture. World Health Organization, Geneva, 196.
[6]	Paulsen, E., Skov, P.S. and Andersen, K.E. (1998) Immediate Skin and Mucosal Symptoms from Pot Plants and Vegetables in Gardeners and Greenhouse Workers. Contact Dermatitis, 39, 166-170. http://dx.doi.org/10.1111/j.1600-0536.1998.tb05888.x
[7]	Douwes, J., Mannetje, A. and Heederik, D. (2000) Work-Related Symptoms in Sewage Treatment Workers. Annals of Agricultural and Environmental Medicine, 8, 39-45.
[8]	Trang, D.T., van der Hoek, W., Tuan, N.D., Cam, P.D., Viet, V.H., Luu, D.D., Konradsen, F. and Dalsgaard, A. (2007) Skin Disease among Farmers Using Wastewater in Rice Cultivation in Nam Dinh, Vietnam. Tropical Medicine and International Health, 12, 51-58. http://dx.doi.org/10.1111/j.1365-3156.2007.01941.x
[9]	van der Hoek, W., Anh, V.T., Cam, P.D., Vicheth, C. and Dalsgaard, A. (2005) Skin Diseases among People Using Urban Wastewater in Phnom Penh. UA Magazine, 14, 30-31.
[10]	Schenker, M.B., Orenstein, M.R. and Samuels, S.J. (2002) Use of Protective Equipment among California Farmers. American Journal of Industrial Medicine, 42, 455-464. http://dx.doi.org/10.1002/ajim.10134
[11]	Mahe, A., Cissé, I.A., Faye, O., N’Diaye, H.T. and Niamba, P. (1998) Skin Diseases in Bamako (Mali). International Journal of Dermatology, 37, 673-676. http://dx.doi.org/10.1046/j.1365-4362.1998.00454.x
[12]	Lorette, G., Beaulieu, P.H., Guihard, W., Lemaître, M., Jarlier, N., Bismuth, R., Duru, G. and Janin, N. (2003) Skin Infections in Communities: Bacteria Involved and Sensibility to Antibiotics. Annales de Dermatologie et de Venereologie, 130, 723-731.
[13]	Guo, Y.L., Wang, B.J., Lee, C.C. and Wang, J.D. (1996) Prevalence of Dermatoses and Skin Sensitisation Associated with Use of Pesticides in Fruit Farmers of Southern Taiwan. Occupational Environ Medicine, 53, 427-431. http://dx.doi.org/10.1136/oem.53.6.427
[14]	Vallejos, Q.M., Schulz, M.R., Quandt, S.A., Feldman, S.R., Galvan, L., Verma, A., Fleischer, A.B., Rapp, S.R. and Arcury, T.A. (2008) Self Report of Skin Problems among Farmworkers in North Carolina. American Journal of Industrial Medicine, 51, 204-212. http://dx.doi.org/10.1002/ajim.20550
[15]	Horiuchi, N., Oguchi, S., Nagami, H. and Nishigaki, Y. (2008) Pesticide-Related Dermatitis in Saku Districk, Japan, 1975-2000. International Journal of Occupational and Environmental Health, 14, 25-34. http://dx.doi.org/10.1179/oeh.2008.14.1.25
[16]	Pedersen, L.K., Johansen, J.D., Held, E. and Agner, T. (2004) Augmentation of Skin Response by Exposure to a Combination of Allergens and Irritants—A Review. Contact Dermatitis, 50, 265-273. http://dx.doi.org/10.1111/j.0105-1873.2004.00342.x
[17]	Lynde, C.B., Obadia, M., Liss, G.M., Ribeiro, M., Holness, D.L. and Tarlo, S.M. (2009) Cutaneous and Respiratory Symptoms among Professional Cleaners. Occupational Medicine, 59, 249-254. http://dx.doi.org/10.1093/occmed/kqp051
[18]	Suskind, R.R. (1977) Environment and the Skin. Environmental Health Perspectives, 20, 27-37. http://dx.doi.org/10.1289/ehp.772027
[19]	Thyssen, J.P., Johansen, J.D., Linneberg, A. and Menné, T. (2010) The Epidemiology of Hand Eczema in the General Population-Prevalence and Main Findings. Contact Dermatitis, 62, 75-87. http://dx.doi.org/10.1111/j.1600-0536.2009.01669.x
[20]	Smedley, J., Williams, S., Peel, P. and Pedersen, K. (2012) Management of Occupational Dermatitis in Healthcare Work- ers: A Systematic Review. Occupational and Environmental Medicine, 69, 276-279. http://dx.doi.org/10.1136/oemed-2011-100315
[21]	Larson, E.L., Hughe, C.A. and Pyrek, J.D. (1998) Changes in Bacterial Flora Associated with Skin Damage on Hands of Healthcare Personnel. American Journal of Infection Control, 26, 513-521. http://dx.doi.org/10.1016/S0196-6553(98)70025-2
[22]	Gong, J.Q., Lin, L. and Lin, T. (2006) Skin Colonization by Staphylococcus aureus in Patients with Eczema and Atopic Dermatitis and Relevant Combined Topical Therapy: A Double Blind Multicentre Randomized Controlled Trial. British Journal of Dermatology, 155, 680-687. http://dx.doi.org/10.1111/j.1365-2133.2006.07410.x
[23]	Harbarth, S., Liassine, N., Dharan, S., Herrault, P., Auckenthaler, R. and Pittet, D. (2000) Risk Factors for Persistent Car- riage of Methicillin-Resistant Staphylococcus aureus. Clinical Infectious Diseases, 3, 1380-1385. http://dx.doi.org/10.1086/317484
[24]	Wertheim, H.F.L., Melles, D.C., Vos, M.C., van Leeuwen, W., van Belkum, A. and Verbrugh, H.A. (2005) The Role of Nasal Carriage in Staphylococcus aureus Infections. The Lancet Infectious Diseases, 5, 751-762. http://dx.doi.org/10.1016/S1473-3099(05)70295-4
[25]	Sou, Y.M. (2009) Recycling Wastewater for Irrigation: Fertilizing Potential, Health Risks and Impacts on Soil Quality. Ph.D. Dissertation, EPF Lausanne, Lausanne.
[26]	Dianou, D., Savadogo, B., Zongo, D., Zougouri, T., Poda, J.N., Bado, H. and Rosillon, F. (2011) Surface Waters Quality of the Sourou Valley: The Case of Mouhoun, Sourou, Debe and Gana Rivers in Burkina Faso. International Journal of Biological and Chemical Sciences, 5, 1571-1589.
[27]	Nitiema, L.W., Savadogo, B., Zongo, D., Kaboré, A., Poda, J.N., Traoré, A.S. and Dianou, D. (2013) Microbial Quality of Wastewater Used in Urban Truck Farming and Health Risks Issues in Developing Countries: Case Study of Ouagadougou in Burkina Faso. Journal of Environmental Protection, 4, 575-584. http://dx.doi.org/10.4236/jep.2013.46067
[28]	Bassolé, D. and Ouédraogo, L. (2007) Problem of the Use of Pesticides in Crop Conservation and Truck Farming in Urban and Peri-Urban Areas, Burkina Faso. International Fertilizer Development Center, IFDC, 51 p.
[29]	Agency for Toxic Substances and Disease Registry, ATSDR (2004) Toxicological Profiles for Ammonia. US Department of Health and Human Services, Public Health Services, Atlanta. http://www.atsdr.cdc.gov/toxpro2.html
[30]	Blanco, L.E., Aragon, A., Lundberg, I. and Lidén, C. (2005) Determinants of Dermal Exposure among Nicaraguan Subsistence Farmers during Pesticide Applications with Backpack Sprayers. Annals of Occupational Hygiene, 49, 17-24.
[31]	Beare, J.D., Wilson, R.S. and Marsh, R.J. (1988) Ammonia Burns of the Eye: Old Weapon in New Hands. British Medicine Journal, 296, 590. http://dx.doi.org/10.1136/bmj.296.6622.590
[32]	Jonsson, H. and Vinneras, B. (2007) Experiences and Suggestions for Collection Systems for Source-Separated Urine and Faeces. Water Science and Technology, 56, 71-76. http://dx.doi.org/10.2166/wst.2007.558
[33]	Strong, L.L., Thompson, B., Coronado, G.D., Griffith, W.C., Vigoren, E.M. and Islas, I. (2004) Health Symptoms and Exposure to Organophosphate Pesticides in Farmworkers. American Journal of Industrial Medicine, 46, 599-606. http://dx.doi.org/10.1002/ajim.20095
[34]	Shrutakirthi, S.D., Suraj, D., Sugandhi, R., Girija, R. and Sreekumaran, N. (2005) Dermatoses among Paddy Field Workers—A Descriptive, Cross-Sectional Pilot Study. Indian Journal of Dermatology, Venereology and Leprology, 71, 254-258. http://dx.doi.org/10.4103/0378-6323.16617
[35]	Cissé, G. (1997) Health Impact of Wastewater Utilization in Urban Agriculture: Case of Truck Farming in Ouagadougou. Ph.D. Dissertation, EPF Lausanne, Lausanne.
[36]	Géraut, C. and Frimat, P. (1993) Dermatoses in Cement Users. Archives des Maladies Professionnelles, 54, 312-314.
[37]	Susitaival, P., Flyvholm, M.A. and Meding, B. (2003) Nordic Occupational Skin Questionnaire (NOSQ-2002): A New Tool for Surveying Occupational Skin Diseases and Exposure. Contact Dermatitis, 49, 70-76. http://dx.doi.org/10.1111/j.0105-1873.2003.00159.x