Ergonomic Risk Assessment during an Informal Hand-Made Cookware Operation: Extending an Existing Model.

The work conducted in the informal sector is highly variable within and between days. Characterizing ergonomic exposures remains a challenge because of unstructured work settings and schedules. The existing ergonomic risk assessment tools have been widely used in formal work settings with a narrow range of exposure, and for predefined tasks that primarily constitute a daily routine. There is limited information in the literature on how they have been applied in informal workplaces. The aim of this study was to extend an existing risk assessment tool and to evaluate the applicability of the extended tool by assessing ergonomic exposure related to hand-made cookware operations. Eighteen hand-made cookware makers were recruited from six sites. A walkthrough risk assessment questionnaire was used to collect information on workers, tasks, work stations and workplace structures. The Rapid Upper Limb Assessment (RULA) screening tool was extended by including duration and vibration. An action priority matrix was used to guide intervention. According to the RULA action levels, the workers required investigation and changes soon, and immediate investigation and changes. The use of an action priority matrix was appropriate, and indicated that all the workers assessed were within the high to very high exposure domain and required immediate corrective measures. The methodology used proved to be an effective and reliable strategy for identifying ergonomic exposure among hand-made cookware makers.

Occupational Exposure to Fine Particulate Matter (PM4 and PM2.5) during Hand-Made Cookware Operation: Personal, Indoor and Outdoor Levels.

(1) Exposure of informal artisanal cookware makers to fine particles has not yet been characterized. The aim of this study was to characterize occupational exposure to fine particulate matter (PM4 and PM2.5) levels and fine particulate matter (PM2.5) elemental components; (2) Artisanal cookware makers were recruited from five cookware making sites. Exposure to fine particulate matter was measured for 17 male participants. SidePak personal aerosol monitors (AM520) were used to measure personal exposure to PM4, while a DustTrak monitor and an E-sampler were used to assess indoor and outdoor PM2.5 levels, respectively. A questionnaire was administered to capture information on demographic characteristics. The chemical characterization of indoor and outdoor PM2.5 filter mass was conducted using Wavelength Dispersive X-ray Fluorescence. Time series record of 15-min averages for indoor and outdoor PM2.5 levels were assessed; (3) The median (range) was 124 µg/m3 (23-100,000), 64 µg/m3 (1-6097) and 12 µg/m3 (4-1178), respectively, for personal PM4, indoor and outdoor PM2.5. The highest levels for many of the elemental components of PM2.5 were found in the outdoor PM2.5 filter mass and (4). The information generated during this study may assist in extending occupational health and safety strategies to artisanal cookware makers and developing targeted prevention initiatives.

Exposure to lead and other toxic metals from informal foundries producing cookware from scrap metal.

Metal exposure remains a significant public health problem, particularly in the informal sector. The rise in informal foundries to cast scrap metal into artisanal cookware is widespread in low- and middle-income countries. The main aim of this study was to characterize metal exposure in artisanal cookware makers working in informal foundries in South Africa by measuring lead (Pb) in blood as well as sample metal concentrations on hands before and after work. The blood Pb distribution of the artisanal pot makers ranged from 1.1 to 4.6 µg/dl with the median blood Pb level being 2.1 µg/dl (IQR 1.7-2.5). The median blood Pb level in artisanal pot makers was 1.0 µg/dl higher compared with the non-exposed community members (p < 0.0001). Before-and-after handwipe sampling revealed a median increase in all 22 elements. Pre and post aluminum (Al) load on the handwipes revealed a 7.3 factor increase (0.53 and 3.9 mg Al/handwipe respectively) (p = 0.003). Hand Pb load before and after pot making revealed a 3.5-fold increase (median increase of 6.2 µg Pb/handwipe). An increase in backyard informal foundries may be linked to increased exposure to toxic metals for workers, family members and communities.

Indoor Temperatures in Patient Waiting Rooms in Eight Rural Primary Health Care Centers in Northern South Africa and the Related Potential Risks to Human Health and Wellbeing.

Increased temperatures affect human health and vulnerable groups including infants, children, the elderly and people with pre-existing diseases. In the southern African region climate models predict increases in ambient temperature twice that of the global average temperature increase. Poor ventilation and lack of air conditioning in primary health care clinics, where duration of waiting time may be as long as several hours, pose a possible threat to patients seeking primary health care. Drawing on information measured by temperature loggers installed in eight clinics in Giyani, Limpopo Province of South Africa, we were able to determine indoor temperatures of waiting rooms in eight rural primary health care facilities. Mean monthly temperature measurements inside the clinics were warmer during the summer months of December, January and February, and cooler during the autumn months of March, April and May. The highest mean monthly temperature of 31.4 ± 2.7 °C was recorded in one clinic during February 2016. Maximum daily indoor clinic temperatures exceeded 38 °C in some clinics. Indoor temperatures were compared to ambient (outdoor) temperatures and the mean difference between the two showed clinic waiting room temperatures were higher by 2-4 °C on average. Apparent temperature (AT) incorporating relative humidity readings made in the clinics showed 'realfeel' temperatures were >4 °C higher than measured indoor temperature, suggesting a feeling of 'stuffiness' and discomfort may have been experienced in the waiting room areas. During typical clinic operational hours of 8h00 to 16h00, mean ATs fell into temperature ranges associated with heat-health impact warning categories of 'caution' and 'extreme caution'.

Experiences of homosexual patients' access to primary health care services in Umlazi, KwaZulu-Natal.

BACKGROUND: Homosexual patients are affected by social factors in their environment, and as a result may not have easy access to existing health care services. Prejudice against homosexuality and homosexual patients remains a barrier to them seeking appropriate healthcare. The concern is that lesbians and gays might delay or avoid seeking health care when they need it because of past discrimination or perceived homophobia within the health care thereby putting their health at risk. AIM OF THE STUDY: The aim of the study was to explore and describe the experiences of homosexual patients utilising primary health care (PHC) services in Umlazi in the province ofKwaZulu-Natal (KZN). METHOD: A qualitative, exploratory, descriptive study was conducted which was contextual innature. Semi-structured interviews were conducted with 12 participants. The findings of this study were analysed using content analysis. RESULTS: Two major themes emerged from the data analysis, namely, prejudice against homosexual patients by health care providers and other patients at the primary health care facilities, and, homophobic behaviour from primary health care personnel. CONCLUSION: Participants experienced prejudice and homophobic behaviour in the course of utilising PHC clinics in Umlazi, which created a barrier to their utilisation of health services located there. Nursing education institutions, in collaboration with the National Department of Health, should introduce homosexuality and anti-homophobia education programmes during the pre-service and in-service education period. Such programmes will help to familiarise health care providers with the health care needs of homosexual patients and may decrease homophobic attitudes.