Gathering the evidence and identifying opportunities for future research in climate, heat and health in South Africa: The role of the South African Medical Research Council.

BACKGROUND: A changing climate is likely to have widespread and varying impacts on ecosystems and human health. South Africa (SA) is particularly vulnerable to the impacts of climate change, given the projected increases in temperature, and changes in the amount and patterns of rainfall. Moreover, SA's vulnerability is exacerbated by extreme inequality and poverty. To prepare for the impacts of climate change and to ensure timeous adaptation, a perspective is given on essential heat and health research in the country. Objectives. To gather studies conducted by the South African Medical Research Council (SAMRC)'s Environment and Health Research Unit (EHRU) to illustrate the range of possible research key areas in the climate, heat and health domain and to present future research priorities. Methods. Studies conducted by the SAMRC's EHRU were gathered and used to illustrate the range of possible research key areas in the climate, heat and health domain. Using national and international published and grey literature, and tapping into institutional research experiences, an overview of research findings to date and future research priorities were developed. Results. Heat and health-related research has focussed on key settings, for example, schools, homes and outdoor work places, and vulnerable groups such as infants and children, the elderly and people with pre-existing diseases. The need to address basic needs and services provision was emphasised as an important priority. Conclusions. High and low temperatures in SA are already associated with mortality annually; these impacts are likely to increase with a changing climate. Critical cross-sectoral research will aid in understanding and preparing for temperature extremes in SA.

Comorbidity of respiratory and cardiovascular diseases among the elderly residing close to mine dumps in South Africa: A cross-sectional study.

BACKGROUND: Pollution arising from mine dumps in South Africa (SA) has been a source of concern to nearby communities. OBJECTIVES: To investigate whether comorbidity of respiratory and cardiovascular diseases among elderly persons (≥55 years) was associated with proximity to mine dumps. METHODS: Elderly persons in communities 1 - 2 km (exposed) and ≥5 km (unexposed) from five preselected mine dumps in Gauteng and North West provinces in SA were included in a cross-sectional study. RESULTS: Exposed elderly persons had a significantly higher prevalence of cardiovascular and respiratory diseases than those who were unexposed. Multiple logistic regression analysis indicated that living close to mine dumps was significantly associated with asthma + hyper- tension (odds ratio (OR) 1.67; 95% confidence interval (CI) 1.22 - 2.28), asthma + pneumonia (OR 1.86; 95% CI 1.14 - 3.04), emphysema + arrhythmia (OR 1.38; 95% CI 1.07 - 1.77), emphysema + myocardial infarction (OR 2.01; 95% CI 1.73 - 2.54), emphysema + pneumonia (OR 3.36; 95% CI 1.41 - 7.98), hypertension + myocardial infarction (OR 1.60; 95% CI 1.04 - 2.44) and hypertension + pneumonia (OR 1.34; 95% CI 1.05 - 1.93). CONCLUSION: Detrimental associations between comorbidity of the health outcomes and proximity to mine dumps were observed among the elderly in SA.

Occupational Noise-Induced Hearing Loss Prevalence and Noise Abatement Techniques in a Steel-Making Plant

Background: A high prevalence of noise-induced hearing loss (NIHL) is observed amongst employees in the steel manufacturing industry.Objective: To determine the prevalence of NIHL and current noise abatement techniques implemented at a steel manufacturing plant.Methods: Structured questionnaires were completed by permanent employees at a steel-manufacturing plant for the purpose of collecting information on occupational and medical histories; noise exposure in and outside the work environment; use of hearing protection devices (HPDs); andcurrent noise abatement procedures. A walk-through survey was also conducted to observe implemented noise abatement techniques using the Noise Induced Hearing Loss Regulations of 2003 as a guideline.Results: A total of 17.9% of workers suffered from NIHL (95% CI 11.8% - 22.5%). Administrative controls; lubrication and mufflers were identified by more than 70% of the respondents as control procedures most often implemented by the company. Most of the respondents (77%) used HPDs always and 97% indicated that they fit their HPDs at the beginning of the shift.Conclusion: NIHL remains a significant health problem in this steel industry despite the implementation of noise abatement techniques and the implementation of a noise conservation programme with all the required elements

Occupational Noise-Induced Hearing Loss Prevalence and Noise Abatement Techniques in a Steel-Making Plant

Background: A high prevalence of noise-induced hearing loss (NIHL) is observed amongst employees in the steel manufacturing industry. Objective: To determine the prevalence of NIHL and current noise abatement techniques implemented at a steel manufacturing plant. Methods: Structured questionnaires were completed by permanent employees at a steel-manufacturing plant for the purpose of collecting information on occupational and medical histories; noise exposure in and outside the work environment; use of hearing protection devices (HPDs); and current noise abatement procedures. A walk-through survey was also conducted to observe implemented noise abatement techniques using the Noise Induced Hearing Loss Regulations of 2003 as a guideline. Results: A total of 17.9% of workers suffered from NIHL (95% CI 11.8% - 22.5%). Administrative controls; lubrication and mufflers were identified by more than 70% of the respondents as control procedures most often implemented by the company. Most of the respondents (77%) used HPDs always and 97% indicated that they fit their HPDs at the beginning of the shift. Conclusion: NIHL remains a significant health problem in this steel industry despite the implementation of noise abatement techniques and the implementation of a noise conservation programme with all the required elements