Objective peripheral neuropathy and protective-equipment use in a farming community in a lead-zinc mining district of south-eastern Nigeria: a cross-sectional study
- 1DAVID UMAHI FEDERAL UNIVERSITY OF HEALTH SCIENCE
Abstract
ObjectivesTo estimate the prevalence of objective peripheral neuropathy, and to test whether self-reported use of personal protective equipment (PPE) is associated with lower neuropathy risk, among adults attending a community hospital in a Nigerian population exposed to both agrochemicals and mining.
DesignClinic-based cross-sectional study (June-November 2025), reported per STROBE.
SettingInfant Jesus Community Hospital, Ishiagu, Ebonyi State, a community combining smallholder farming with granite and lead-zinc mining.
Participants285 adults ([≥]18 years) attending the outpatient screening department; people with known diabetes were excluded.
Main outcome measuresPeripheral neuropathy on the Michigan Neuropathy Screening Instrument (MNSI) examination -- an instrument validated in diabetic populations -- defined a priori as an abnormal 10 g monofilament test or absent/reduced ankle reflexes; three alternative case definitions were pre-specified. PPE use was scored 0-12. Associations were estimated by multivariable logistic regression adjusted for age and sex.
ResultsThe proportion screening positive was 47.0% (95% CI 41.2-52.8) under the primary definition and ranged from 29.8% to 56.8% across definitions. PPE use was near-absent (89.1% never used gloves; 43.2% used none) and showed no detectable protective association (adjusted OR 0.97 per point, 95% CI 0.88-1.06). Men used PPE more than twice as often as women (55.1% vs 24.5%, p<0.001), yet neuropathy did not differ by sex (41.6% vs 49.5%, p=0.27). Only age was associated with neuropathy (adjusted OR 1.02 per year, p=0.02).
ConclusionsNearly half of the adults sampled screened positive for peripheral neuropathy, and protective equipment showed no detectable protective association. Because PPE use was near-absent, the study cannot separate ineffective protection from too little protection to measure, and the cross-sectional design precludes causal inference. The equal burden across sexes despite markedly unequal protective behaviour is consistent with community-wide environmental exposure; reducing the total toxic load is a plausible priority that direct exposure measurement should now test.
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BibTeX
@misc{abanni2026objective,
title = {{Objective peripheral neuropathy and protective-equipment use in a farming community in a lead-zinc mining district of south-eastern Nigeria: a cross-sectional study}},
author = {S. I. Abanni and C. Adache and B. M. Ekure and J. Omotosho},
howpublished = {medRxiv},
year = {2026},
month = sep,
doi = {10.64898/2026.09.21.26363549},
url = {https://www.medrxiv.org/content/10.64898/2026.09.21.26363549v1},
note = {CC BY},
}
RIS
TY - UNPB
TI - Objective peripheral neuropathy and protective-equipment use in a farming community in a lead-zinc mining district of south-eastern Nigeria: a cross-sectional study
AU - S. I. Abanni
AU - C. Adache
AU - B. M. Ekure
AU - J. Omotosho
PY - 2026
DA - 2026/09/21
PB - medRxiv
DO - 10.64898/2026.09.21.26363549
UR - https://www.medrxiv.org/content/10.64898/2026.09.21.26363549v1
AB - ObjectivesTo estimate the prevalence of objective peripheral neuropathy, and to test whether self-reported use of personal protective equipment (PPE) is associated with lower neuropathy risk, among adults attending a community hospital in a Nigerian population exposed to both agrochemicals and mining. DesignClinic-based cross-sectional study (June-November 2025), reported per STROBE. SettingInfant Jesus Community Hospital, Ishiagu, Ebonyi State, a community combining smallholder farming with granite and lead-zinc mining. Participants285 adults ([≥]18 years) attending the outpatient screening department; people with known diabetes were excluded. Main outcome measuresPeripheral neuropathy on the Michigan Neuropathy Screening Instrument (MNSI) examination -- an instrument validated in diabetic populations -- defined a priori as an abnormal 10 g monofilament test or absent/reduced ankle reflexes; three alternative case definitions were pre-specified. PPE use was scored 0-12. Associations were estimated by multivariable logistic regression adjusted for age and sex. ResultsThe proportion screening positive was 47.0% (95% CI 41.2-52.8) under the primary definition and ranged from 29.8% to 56.8% across definitions. PPE use was near-absent (89.1% never used gloves; 43.2% used none) and showed no detectable protective association (adjusted OR 0.97 per point, 95% CI 0.88-1.06). Men used PPE more than twice as often as women (55.1% vs 24.5%, p<0.001), yet neuropathy did not differ by sex (41.6% vs 49.5%, p=0.27). Only age was associated with neuropathy (adjusted OR 1.02 per year, p=0.02). ConclusionsNearly half of the adults sampled screened positive for peripheral neuropathy, and protective equipment showed no detectable protective association. Because PPE use was near-absent, the study cannot separate ineffective protection from too little protection to measure, and the cross-sectional design precludes causal inference. The equal burden across sexes despite markedly unequal protective behaviour is consistent with community-wide environmental exposure; reducing the total toxic load is a plausible priority that direct exposure measurement should now test.
ER -