Health experts are sounding the alarm over the dramatic increase in deaths and illnesses caused by Ghana's worsening air quality due to pollution.

The biggest culprit is Ghana's aging, a highly polluting fleet of vehicles. The transport sector made up of 3.2 million vehicles as of 2022, is the leading producer of air pollution, according to the Ministry of Transport's recently released National Electric Vehicle Policy.

Ghana's vehicle fleet is dominated by old and highly polluting vehicles that make up more than 95 per cent of domestic transport services.

Old vehicles, releasing harmful pollutants, have helped push Ghana's air pollution to levels eleven times above what is recommended by the World Health Organisation.
"This is a wake-up call," says Dr Carl Stephen Osei, Programme Manager, Occupational and Environmental Health Unit of the Ghana Health Service.

"Facilities are recording new induced asthmatic cases. Those with existing conditions are exacerbated due to high exposure. There is enough evidence to show that diesel-powered vehicle fumes have been classified as carcinogenic and cause lung cancers. These gases and particulate matter are killing many people silently.

Air pollution induces illnesses, including pneumonia, acute respiratory failure, asthma, heart failure, stroke and cancer were the leading causes of death in 2022-the last year where data is available.
For four years, hypertension and acute respiratory tract infections have been the leading cause of outpatient cases in Accra, according to data from the Ghana Health Service.

Sensors Show Dangerous Levels on Routes
To assess the level of air pollution commuters in the Greater Accra Metropolitan Area are exposed to, Afri-SET- the air quality sensor evaluation and training facility in the Department of Physics, University of Ghana and the Ghana News Agency, conducted a survey of air pollution in May 2024.

Journalists carried Atmotube Pro low-cost air quality sensors on round trips using commercial minibuses, known as "trotro", sedan cars used as taxis, and in ride-hailing cars, from the major Tema Station, in Accra Central, to and fro 10 routes during morning and evening rush hours.

As an average, the sensors showed levels in the range of "moderate" to "unhealthy for sensitive groups".

However, for many parts of the trips, the pollution levels spiked to the "severely polluted" range, meaning even healthy people can experience adverse symptoms.

Those high levels spikes were observed along the routes: Tema Station to Adentan, Odorkor, Ablekuma, Achimota, Nima, Newtown, Spintex, Amasaman, Kaneshie, Achimota, Kwabenya, Korle-Bu, and Nungua.

The findings alarmed some passengers on the route.

"I am exposed to danger!" exclaims Jonathan Frimpong, an officer at the Ministry of Trade and Industry, after seeing the sensor register 'severely polluted". "I need to check my lungs because I have done this for two years."

All people who commute to work in the Central Business District of Accra and back in trotros and taxis without air conditioning are exposed to high levels of dirty air, especially during rush hours, according to Dr. Allison Hughes, the After analysing the data, he says commuters' exposure is high during the rush hours between 0600 hours and 1000 hours as well as 1600 hours and 1800 hours.

It shows that cyclists, riders, street hawkers and pedestrians are exposed to even higher levels of pollution. Commuters are largely unaware of the serious dangers they face. On a recent morning trip,
Godfred Addo held the door of his trotro, with one hand.

The other was firmly gripping his nose to block his nostrils. But as he attempted to do his job as a conductor - beckoning passengers to the commercial vehicle - he was forced to surrender his grip. At once the dark smoke from the exhaust pipe of another trotro flooded his nose, mouth and eyes.

"Mostly, I catch a cold, or feel dizzy after such incidents," says the 20-year-old who does an average of eight round trips a day from Odorkor to the Tema Station, inhaling soot and toxic chemicals.

When pollution breaks in traffic, you cannot see anything. There is no escape for anyone. Passengers struggle to breathe, covering their noses with handkerchiefs. I know it is dangerous, but there is no option for me, so I don't add it to my worries. Fumes from cars are a pandemic, and it is everywhere on the road.

Among the long queue of workers waiting to board passenger buses one morning at Amasaman bus station was Georgina Awuah.

She tells GNA that it takes about two and a half hours from her home to work and the same on her journey back each day, exposing her to many hours of dangerous emissions.

“By the time I get to work my energy level is reduced for the day's work," Awuah says.
"At 1500 hours or 1600 hours I am thinking of getting back home. The reason is if I delay, I will have to wait for like an hour before catching a bus. Working under such circumstances feels like a punishment."

Long commuting and poor-quality air are contributing to mental health problems too. A study published on JAMA Network, an American-based health platform, found that long-term exposure to multiple air pollutants is associated with an increased risk of depression and anxiety.

"Spending hours in vehicular traffic and being exposed to dirty air has some impacts," says Dr Reginald Quansah, a senior lecturer at the University of Ghana School of Public Health. "Some studies have proposed some mechanisms justifying this. Stress is just one of them."
Economic Burden on Workers and the Nation Workers' constant exposure to dirty air also has a strong economic burden on them and the country.

"In the short and medium term, workers spend money buying cold and cough related drugs, medical tests and suffer loss of man hours if hospitalised. It has an impact on their pocket, especially those low earners," says Dr Elvis Kyere- Gyeabour, the Breathe Cities Portfolio Manager, in Ghana.

For workers under insurance, not all treatments for ischemic heart disease, lung cancer, stroke, as well as pneumonia in children are covered. The costs can add up to the equivalent of twice the annual earnings of some patients.

And the costs also increase in retirement. "There is enough evidence that many workers exposed to high levels of air pollution during their productive years acquire chronic upper respiratory infection and cardiovascular diseases. Some retirees are required to undergo nebulisation every day using their retirement benefits," says Dr Kyere-Gyeabour.

The productivity loss hurts the economy and the National Health Insurance Scheme. The economic cost of air pollution is estimated at US$2.5 Billion or roughly 4.2 per cent of the country's 2017 Gross Domestic Product, according to a World Bank report.
Reducing pollution, promoting quality air

Ghana is looking at phasing out fossil fuel-powered vehicles altogether over the next 21 years, according to a projection in the National Electric Vehicle Policy but the industry says it will need immense government support even for that slow transition.

"We are the largest polluting sector, and we are ready to go electric but the government needs to build the infrastructure and other structures before," says Mr Mark Amoamah, National President of the Chartered Institute of Transport - Ghana.

Reducing emissions from the transport sector before the phase-out will depend on a number of interventions starting with a review of regulations, awareness, and strict enforcement of regulations, according to experts.

"As we speak, a police officer cannot arrest a driver whose car is emitting so much. This is because they do not have any instrument to measure the (emissions) level," says Emmanuel Appoh, Executive Director of Envirofit, an environmental consulting firm and a former Director at the Environmental Protection Agency.

"But this will change when the Motor Traffic Regulation 2024 is passed and people are sensitised, and institutions are strengthened and supported. For instance, every vehicle will need to test for tailpipe emission and get a certificate. With this, a police officer will have the tool to crack down on dirty vehicles."

Dr Daniel Tutu Benefoh, Ghana's Focal Person of the United Nations Framework Convention on Climate Change, also wants to see government services decentralised and moved to different parts of Ghana so workers don't have to commute so long in dirty air.

"The colonial system centralised government services and provided housing for workers," Dr Benefoh notes. "But this failed after independence. The acquired lands where workers lived are being commercialised, while many middle and junior officers live far off and travel hours to work."

Dr Benefoh, who leads Ghana's Mitigation, Greenhouse Gas Inventory and Reporting Programme, suggests that organisations should deploy buses to pick up workers from designated points to reduce the number of vehicles on the road, contributing to pollution.

"Ghana needs an efficient bus system with dedicated line," he emphasises.

While waiting for the many plans to manifest, he advises workers to wear N95 nose masks anytime they are on the road and also avoid rush hours, if possible.