The social value of place-based creative wellbeing: A rapid review and evidence synthesis.

Creative well-being is an increasing field of interest to which biomedical and social sciences have made uneven contributions. The instrumental value of culture and its subsequential public investment is grounded in the interplay of social, cultural and economic capital to attain and preserve wellbeing and health and foster social mobility. The current evidence addresses the effectiveness of arts interventions in improving illnesses. Little attention has been paid to the social value of creative wellbeing for the general population. This paper is a rapid review and evidence synthesis that aims to answer the question, 'What is the social value of place-based arts and culture interventions at individual (wellbeing) and community (social inequalities) levels in the UK and Europe?'. After a systematic search of five databases, search engines, and a call for evidence in August 2022, 14 out of 974 sources met the inclusion criteria. Studies were organised into three themes (Community, Events, Museums), and outcomes were analysed considering the indicators and dimensions of wellbeing (Office for National Statistics). The review evidenced that creative wellbeing leads to improvements in wellbeing outcomes and can contribute to alleviating social determinants of health. However, considering their impact on the underlying causes of structural social inequalities requires caution.

New global indicator for workers' health: mortality rate from diseases attributable to selected occupational risk factors.

Through sustainable development goals 3 and 8 and other policies, countries have committed to protect and promote workers' health by reducing the work-related burden of disease. To monitor progress on these commitments, indicators that capture the work-related burden of disease should be available for monitoring workers' health and sustainable development. The World Health Organization and the International Labour Organization estimate that only 363 283 (19%) of 1 879 890 work-related deaths globally in 2016 were due to injuries, whereas 1 516 607 (81%) deaths were due to diseases. Most monitoring systems focusing on workers' health or sustainable development, such as the global indicator framework for the sustainable development goals, include an indicator on the burden of occupational injuries. Few such systems, however, have an indicator on the burden of work-related diseases. To address this gap, we present a new global indicator: mortality rate from diseases attributable to selected occupational risk factors, by disease, risk factor, sex and age group. We outline the policy rationale of the indicator, describe its data sources and methods of calculation, and report and analyse the official indicator for 183 countries. We also provide examples of the use of the indicator in national workers' health monitoring systems and highlight the indicator's strengths and limitations. We conclude that integrating the new indicator into monitoring systems will provide more comprehensive and accurate surveillance of workers' health, and allow harmonization across global, regional and national monitoring systems. Inequalities in workers' health can be analysed and the evidence base can be improved towards more effective policy and systems on workers' health.

Par le biais des objectifs de développement durable 3 et 8 ainsi que d'autres mesures, plusieurs pays se sont engagés à protéger et promouvoir la santé des travailleurs en réduisant l'impact des maladies liées au travail. Mais pour évaluer leurs progrès en la matière, il convient de mettre en place des indicateurs estimant l'impact des maladies liées au travail afin de placer le développement durable et la santé des travailleurs sous surveillance. D'après l'Organisation mondiale de la Santé et l'Organisation internationale du Travail, seulement 363 283 (19%) des 1 879 890 décès liés au travail dans le monde en 2016 découlaient de blessures, tandis que 1 516 607 (81%) d'entre eux étaient causés par des maladies. La plupart des systèmes de surveillance qui s'intéressent à la santé des travailleurs ou au développement durable, comme le cadre mondial d'indicateurs pour les objectifs de développement durable, comportent un indicateur relatif à l'impact des accidents de travail. Cependant, rares sont ceux qui possèdent un indicateur concernant l'impact des maladies professionnelles. Pour combler cette lacune, nous dévoilons un nouvel indicateur mondial: le taux de mortalité dû aux maladies attribuables à certains facteurs de risque professionnels classé par maladie, facteur de risque, sexe et catégorie d'âge. Nous exposons le motif politique de l'indicateur, décrivons l'origine des données et les méthodes de calcul, et communiquons et analysons l'indicateur officiel pour 183 pays. Nous fournissons également des exemples de la façon dont l'indicateur peut être utilisé dans des systèmes nationaux de surveillance de la santé des travailleurs et soulignons ses forces et faiblesses. Nous concluons en affirmant que l'intégration de ce nouvel indicateur dans les systèmes de surveillance offrira un suivi plus complet et précis de la santé des travailleurs et ouvrira la voie à une harmonisation des systèmes mondiaux, nationaux et régionaux. Il est possible d'analyser les inégalités en matière de santé des travailleurs et d'en améliorer les bases factuelles afin d'établir des politiques et systèmes plus efficaces dans ce domaine.

A través de los objetivos de desarrollo sostenible 3 y 8 y de otras políticas, los países se han comprometido a proteger y promover la salud de los trabajadores reduciendo la carga de morbilidad relacionada con el trabajo. Para supervisar los avances en el cumplimiento de estos compromisos, debería disponerse de indicadores que reflejen la carga de morbilidad relacionada con el trabajo, a fin de controlar la salud de los trabajadores y el desarrollo sostenible. La Organización Mundial de la Salud y la Organización Internacional del Trabajo estiman que solo 363 283 (19%) de las 1 879 890 muertes relacionadas con el trabajo a nivel mundial en 2016 se debieron a lesiones, mientras que 1 516 607 (81%) muertes se debieron a enfermedades. La mayoría de los sistemas de vigilancia centrados en la salud de los trabajadores o el desarrollo sostenible, como el marco de indicadores mundiales para los objetivos de desarrollo sostenible, incluyen un indicador sobre la carga de las lesiones laborales. No obstante, pocos de estos sistemas cuentan con un indicador sobre la carga de las enfermedades relacionadas con el trabajo. Para subsanar esta carencia, presentamos un nuevo indicador mundial: la tasa de mortalidad por enfermedades atribuibles a factores de riesgo laborales seleccionados, por enfermedad, factor de riesgo, sexo y grupo de edad. Describimos la justificación política del indicador, describimos sus fuentes de datos y métodos de cálculo, e informamos y analizamos el indicador oficial para 183 países. También proporcionamos ejemplos del uso del indicador en los sistemas nacionales de vigilancia de la salud de los trabajadores y destacamos las ventajas y las limitaciones del indicador. Concluimos que la integración del nuevo indicador en los sistemas de vigilancia proporcionará una vigilancia más exhaustiva y precisa de la salud de los trabajadores, y permitirá la armonización entre los sistemas de vigilancia mundiales, regionales y nacionales. Se podrán analizar las desigualdades en la salud de los trabajadores y se podrá mejorar la base de evidencias para lograr políticas y sistemas más eficaces en materia de salud de los trabajadores.

Protecting healthcare workers during a pandemic: what can a WHO collaborating centre research partnership contribute?

Objectives: To ascertain whether and how working as a partnership of two World Health Organization collaborating centres (WHOCCs), based respectively in the Global North and Global South, can add insights on "what works to protect healthcare workers (HCWs) during a pandemic, in what contexts, using what mechanism, to achieve what outcome". Methods: A realist synthesis of seven projects in this research program was carried out to characterize context (C) (including researcher positionality), mechanism (M) (including service relationships) and outcome (O) in each project. An assessment was then conducted of the role of the WHOCC partnership in each study and overall. Results: The research found that lower-resourced countries with higher economic disparity, including South Africa, incurred greater occupational health risk and had less acceptable measures to protect HCWs at the onset of the COVID-19 pandemic than higher-income more-equal counterpart countries. It showed that rigorously adopting occupational health measures can indeed protect the healthcare workforce; training and preventive initiatives can reduce workplace stress; information systems are valued; and HCWs most at-risk (including care aides in the Canadian setting) can be readily identified to trigger adoption of protective actions. The C-M-O analysis showed that various ways of working through a WHOCC partnership not only enabled knowledge sharing, but allowed for triangulating results and, ultimately, initiatives for worker protection. Conclusions: The value of an international partnership on a North-South axis especially lies in providing contextualized global evidence regarding protecting HCWs as a pandemic emerges, particularly with bi-directional cross-jurisdiction participation by researchers working with practitioners.

Men and women waste pickers on landfills in Johannesburg, South Africa: divergence in health, and socioeconomic status.

OBJECTIVE: To investigate gender differences in health in informal waste pickers affected by poverty and multiple environmental and work hazards. METHODS: A cross-sectional descriptive study was conducted at two major landfill sites in a large city. Information on health, work hazards and health care access as well as blood pressure, blood glucose, cholesterol and BMI were measured. RESULTS: A total of 361 waste pickers participated in the survey. The women interviewed earned on average 22% less per month than the men waste pickers. The women presented with worse chronic health outcomes (OR 2.69 95% CI 1.51-4.78) and signs of chronic disease (OR 1.73 95% CI 1.02-2.96) compared to men despite showing greater health-seeking behaviours. CONCLUSION: Women waste pickers suffer worse health outcomes, such as lifestyle diseases and HIV. Further research is needed to identify the factors involved. Responsive programs supporting health care, improved working conditions and income for waste pickers may also improve their health.

Usefulness of occupation and industry information in mortality data in South Africa from 2006 to 2015.

BACKGROUND: There is no population based occupational health surveillance system in South Africa, thus mortality data may be a cost effective means of monitoring trends and possible associations with occupation. The aim of this study was to use deaths due to pneumoconiosis (a known occupational disease) to determine if the South African mortality data are a valid data source for occupational health surveillance in South Africa. METHODS: Proportions of complete occupation and industry information for the years 2006-2015 were calculated for working age and retired adults. Deaths due to pneumoconiosis were identified in the data set and mortality odds ratios calculated for specific occupations and industry in reference to those who reported being unemployed using logistic regression. RESULTS: Only 16.1% of death notifications provided a usual occupation despite 43.1% of the population being employed in the year. The MORs for occupation provided significant increased odds of pneumoconiosis for miners (9.04), those involved in manufacturing (4.77), engineers and machinery mechanics (6.85). Along with these jobs the Mining (9.8), Manufacture (2.2) and Maintenance and repair industries (6.0) have significantly increased odds of pneumoconiosis deaths. The data can be said to provide a useful source of occupational disease information for surveillance where active surveillance systems do not exist. CONCLUSION: The findings indicate valid associations were found between occupational disease and expected jobs and industry. The most useful data are from 2013 onwards due to more detailed coding of occupation and industry.

HIV Preexposure Prophylaxis in the U.S. Military Services - 2014-2016.

Human immunodeficiency virus (HIV) infection is a substantial health concern for the U.S. Department of Defense (DoD) and for service members stationed throughout the world. Each year, approximately 350 new HIV infections are diagnosed in members of the U.S. military services, with most infections acquired within the United States (1). The DoD populations most affected by HIV mirror those in the U.S. civilian population; the highest rates of new military diagnoses are in men and blacks or African Americans (blacks) (1). Blacks are disproportionally affected, and most new diagnoses occur among men who have sex with men (MSM). HIV preexposure prophylaxis (PrEP) is approximately 90% effective in preventing HIV infection when used properly (2), and an increasing number of active duty personnel have used HIV prevention services and PrEP in the military health system since the repeal of "Don't Ask, Don't Tell"* in 2011 (3). Military health system and service records were reviewed to describe HIV PrEP use among military personnel, and military health care providers were surveyed to assess HIV PrEP knowledge and attitudes. Among 769 service members prescribed PrEP during February 1, 2014-June 10, 2016, 60% received prescriptions from an infectious disease provider, 19% were black men, and 42% were aged >28 years. Half of surveyed military health care providers self-rated their PrEP knowledge as poor. DoD is developing new policy to address access to care challenges by defining requirements and establishing pathways for universal patient access to PrEP.

Seabird mortality induced by land-based artificial lights.

Artificial lights at night cause high mortality of seabirds, one of the most endangered groups of birds globally. Fledglings of burrow-nesting seabirds, and to a lesser extent adults, are attracted to and then grounded (i.e., forced to land) by lights when they fly at night. We reviewed the current state of knowledge of seabird attraction to light to identify information gaps and propose measures to address the problem. Although species in families such as Alcidae and Anatidae can be grounded by artificial light, the most affected seabirds are petrels and shearwaters (Procellariiformes). At least 56 species of Procellariiformes, more than one-third of them (24) threatened, are subject to grounding by lights. Seabirds grounded by lights have been found worldwide, mainly on oceanic islands but also at some continental locations. Petrel breeding grounds confined to formerly uninhabited islands are particularly at risk from light pollution due to tourism and urban sprawl. Where it is impractical to ban external lights, rescue programs of grounded birds offer the most immediate and employed mitigation to reduce the rate of light-induced mortality and save thousands of birds every year. These programs also provide useful information for seabird management. However, these data are typically fragmentary, biased, and uncertain and can lead to inaccurate impact estimates and poor understanding of the phenomenon of seabird attraction to lights. We believe the most urgently needed actions to mitigate and understand light-induced mortality of seabirds are estimation of mortality and effects on populations; determination of threshold light levels and safe distances from light sources; documentation of the fate of rescued birds; improvement of rescue campaigns, particularly in terms of increasing recovery rates and level of care; and research on seabird-friendly lights to reduce attraction.

Detecting 16S rRNA Methyltransferases in Enterobacteriaceae by Use of Arbekacin.

16S rRNA methyltransferases confer resistance to most aminoglycosides, but discriminating their activity from that of aminoglycoside-modifying enzymes (AMEs) is challenging using phenotypic methods. We demonstrate that arbekacin, an aminoglycoside refractory to most AMEs, can rapidly detect 16S methyltransferase activity in Enterobacteriaceae with high specificity using the standard disk susceptibility test.

Increased time-to-pregnancy is associated with domestic work in South Africa.

BACKGROUND: The effects of female occupational exposures on fecundity have not been evaluated in South Africa. The aim of this study was to assess the effects of three specific occupational groups on time-to-pregnancy (TTP). METHODS: This cross-sectional study collected data, by means of a questionnaire, on 1210 women representative of a South African population, and sought information on: TTP for the most recent pregnancy, time-specific information on maternal factors and occupational exposures, as well as some paternal factors. Occupational exposure groups were determined using employment profile prior to the pregnancy. In the risk analysis, domestic workers and teachers were compared to administrative staff. Accidental and unplanned pregnancies were excluded from the analysis and participants who were never pregnant were censored. Discrete-time Cox regression models were built to estimate fecundability ratios (FR). RESULTS: The median TTP in administrative workers, domestic workers and teachers was 4, 12 and 3 months respectively. After adjusting for a number of potential confounders, TTP was significantly related to occupation at the time of pregnancy attempt. Compared to administrative workers, domestic workers had a significantly lower per-cycle probability of conception (adjusted FR = 0.53; 95 CI 0.32-0.88). The per-cycle probability of conception in teachers compared to administrative workers was not significantly different (adjusted FR = 1.14; 95 CI: 0.75-1.72). CONCLUSION: Domestic work was associated with prolonged TTP. Working as a domestic worker in South Africa may affect fecundity.

Label-free Pb(II) whispering gallery mode sensing using self-assembled glutathione-modified gold nanoparticles on an optical microcavity.

An ultrasensitive assay for the detection of Pb(II) has been developed using whispering gallery mode (WGM) sensing. In this technique a photonic microcavity was decorated with glutathione (GSH)-modified gold nanoparticles (Au NPs). The resonator was functionalized using an aminosilane to promote adhesion of the GSH-modified NPs creating a highly sensitive sensor specific to Pb(II). Upon introduction of Pb(II) solutions via a fluidic cell, Pb(II) ions bind to the GSH-Au NP complex and induce a shift of the resonant wavelength. Using this detection strategy we show that we are able to detect Pb(II) concentrations down to 0.05 nM in the presence of alkaline and heavy metal interferences such as Mg(II), Mn(II), Ca(II), Ni(II), Cd(II), Cr(II), Fe(II), and Hg(II). The signal was found to be proportional to the Pb(II) concentration within the range of 2.40-48.26 nM and was found to have an association constant of 2.15 × 10(5) M(-1) s(-1). The sensitivity obtained shows unparalleled advantages over currently available technology and satisfies the exposure thresholds set out by world organizations such as International Agency for Research on Cancer (IARC) and the Environmental Protection Agency (EPA). We believe that this sensor has the potential to be made portable for applications in environmental monitoring and in-field applications.

Single molecule sensing with solid-state nanopores: novel materials, methods, and applications.

This tutorial review will introduce and explore the fundamental aspects of nanopore (bio)sensing, fabrication, modification, and the emerging technologies and applications that both intrigue and inspire those working in and around the field. Although nanopores can be classified into two categories, solid-state and biological, they are essentially two sides of the same coin. For instance, both garner popularity due to their ability to confine analytes of interest to a nanoscale volume. Due to the vast diversity of nanopore platforms and applications, no single review can cover the entire landscape of published work in the field. Therefore, in this article focus will be placed on recent advancements and developments taking place in the field of solid-state nanopores. It should be stated that the intention of this tutorial review is not to cite all articles relating to solid-state nanopores, but rather to highlight recent, select developments that will hopefully benefit the new and seasoned scientist alike. Initially we begin with the fundamentals of solid-state nanopore sensing. Then the spotlight is shone on the sophisticated fabrication methods that have their origins in the semiconductor industry. One inherent advantage of solid-state nanopores is in the ease of functionalizing the surface with a range of molecules carrying functional groups. Therefore, an entire section is devoted to highlighting various chemical and bio-molecular modifications and explores how these permit the development of novel sensors with specific targets and functions. The review is completed with a discussion on novel detection strategies using nanopores. Although the most popular mode of nanopore sensing is based upon what has come to be known as ionic-current blockade sensing, there is a vast, growing literature based around exploring alternative detection techniques to further expand on the versatility of the sensors. Such techniques include optical, electronic, and force based methods. It is perhaps fair to say that these new frontiers have caused further excitement within the sensing community.

Regional variation in pesticide concentrations in plasma of delivering women residing in rural Indian Ocean coastal regions of South Africa.

Exposure to pesticides places pregnant women and the developing foetus at the highest risk. The objective of this study is to obtain an exposure assessment by investigating levels of pesticides in blood plasma of delivering women. We report on the concentrations of α, ß, γ HCH, endosulfan, HCB and the pyrethroids: cis-permethrin, cyfluthrin, cypermethrin and deltamethrin found in the maternal blood plasma of delivering women (n = 241) in three coastal sites of KwaZulu Natal. γ-HCH and endosulfan 1 and 2 were the most dominant pesticides in all three sites. Significantly, higher levels of γ-HCH and endosulfan were found in site 3 (vicinity of Empangeni) compared to the other two sites (p < 0.05). The GM levels for γ-HCH, endosulfan 1 and 2 were 956, 141 and 21 ng g(-1) lipids in site 3, respectively. The pyrethroid pesticides, HCB, α-HCH and ß-HCH were detected in less than 31% of the samples in all sites. γ-HCH correlated positively and strongly to both endosulfan 1 and 2 (r > 0.47), indicating a common source of exposure. The high levels of γ-HCH and endosulfan in maternal plasma samples in site 3 indicate the current and on-going exposure, which is of great concern for reproductive health and prenatal exposure.

Psychological Distress in South African Healthcare Workers Early in the COVID-19 Pandemic: An Analysis of Associations and Mitigating Factors.

While the global COVID-19 pandemic has been widely acknowledged to affect the mental health of health care workers (HCWs), attention to measures that protect those on the front lines of health outbreak response has been limited. In this cross-sectional study, we examine workplace contextual factors associated with how psychological distress was experienced in a South African setting where a severe first wave was being experienced with the objective of identifying factors that can protect against HCWs experiencing negative impacts. Consistent with mounting literature on mental health effects, we found a high degree of psychological distress (57.4% above the General Health Questionnaire cut-off value) and a strong association between perceived risks associated with the presence of COVID-19 in the healthcare workplace and psychological distress (adjusted OR = 2.35, p < 0.01). Our research indicates that both training (adjusted OR 0.41, 95% CI 0.21−0.81) and the reported presence of supportive workplace relationships (adjusted OR 0.52, 95% CI 0.27−0.97) were associated with positive outcomes. This evidence that workplace resilience can be reinforced to better prepare for the onset of similar outbreaks in the future suggests that pursuit of further research into specific interventions to improve resilience is well merited.

Risk factors for problematic alcohol use among male waste pickers and caddies in Johannesburg, South Africa: a cross-sectional study.

Informal workers may be prone to problematic substance use due to many factors, including adverse working conditions and low income. The aim of this secondary analysis was to investigate problematic alcohol use risk factors among male informal workers in Johannesburg, South Africa. Alcohol use among the two groups of informal workers in the analysis y golf caddies and waste pickers was measured using the World Health Organization (WHO) Alcohol Use Disorder Identification Test (AUDIT) tool. The WHO self-reporting questionnaire (SRQ) for common mental health disorders (CMD) was used to assess mental health. A multivariate logistic regression model was used to explore the predictors of problematic drinking in informal workers. The study consisted of 514 participants, of which 48.4% were golf caddies and 51.6%, waste pickers. Most participants were younger than 40 years (50.9%). Over half of the participants (54.7%) were alcohol consumers and 74.1% were smokers. Over 60% of the participants who were alcohol consumers had a probable drinking problem. Unstratified regression results showed that common mental distress (aOR = 1.06; 95%CI: 1.01-1.09), age: 30-40 years (aOR = 2.17; 95%CI: 1.18-3.97), smoking (aOR = 2.25; 95%CI: 1.34-3.79), and other water sources (aOR = 0.2; 95%CI: 0.04-0.99) were associated with a probable alcohol problem. Waste pickers (aOR = 0.33; 95%CI: 0.20-0.70) were less likely to be problematic drinkers compared to golf caddies. Problematic drinking in this study was common in both caddies and waste pickers along with smoking. Problematic alcohol use was associated with caddying, mental distress, age, and smoking. Measures such as providing counseling services to informal workers and improvement of working conditions may help change the behaviors of these vulnerable groups.

COVID-19 cases among medical laboratory services staff in South Africa, 2020-2021: A cohort study.

Medical laboratory workers may have an increased risk of COVID-19 due to their interaction with biological samples received for testing and contamination of documents. Records of COVID-19 laboratory-confirmed positive cases within the medical laboratory service were routinely collected in the company's Occupational Health and Safety Information System (OHASIS). Surveillance data from the OHASIS system were extracted from 1 April 2020 to 31 March 2021. An epidemic curve was plotted and compared to that for the country, along with prevalence proportions and incidence rates. The odds of COVID-19 infection were categorised by job and compared to the US Occupational Risk Scores. A logistic regression model assessed the risk of COVID-19 infection per occupational group. A total of 2091 (26% of staff) COVID-19 positive cases were reported. The number of COVID-19 cases was higher in the first wave at 46% (967/2091) of cases, than in the second wave 40% (846/2091) of cases. There was no significant difference in COVID-19 prevalence between male and female employees. The job categories with the most increased risk were laboratory managers [AOR 3.2 (95%CI 1.9-5.1)] and laboratory support clerks [AOR 3.2 (95%CI 1.9-5.2)]. Our study confirms that some categories of medical laboratory staff are at increased risk for COVID-19; this is a complex interaction between workplace risk factors, community interaction, socioeconomic status, personal habits, and behaviour. Targeted interventions are recommended for high-risk groups. OHASIS has the potential to generate data for surveillance of health care workers and contribute towards a South African risk profile.

Respirator fit of a medium mask on a group of South Africans: a cross-sectional study.

BACKGROUND: In South Africa, respiratory protective equipment is often the primary control method used to protect workers. This preliminary study investigated how well a common disposable P2 respirator fitted persons with a range of facial dimensions. METHODS: Quantitative respirator fit tests were performed on 29 volunteers from different racial, gender and face size groups. Two facial dimensions width (bizygomatic) and length (menton-sellion) were measured for all participants. RESULTS: In this study 13.8% of the participants demonstrated a successful fit with the medium sized mask. These included participants from three different racial and both gender groups. The large percentage of failed fit tests (86%) indicates that reliance on off-the-shelf respirators could be problematic in South Africa. CONCLUSIONS: The limitations of this preliminary study notwithstanding, respirator fit appear to be associated with individual facial characteristics and are not specific to racial/ethnic or gender characteristics.

Impact of level five lockdown on the incidence of COVID-19: lessons learned from South Africa.

INTRODUCTION: the level five (L5) lockdown was a very stringent social distancing measure taken to reduce the spread of COVID-19 infections. This study assessed the impact of the L5 lockdown and its association with the incidence of COVID-19 cases in South Africa (SA). METHODS: data was obtained from the National Department of Health (NDoH) from the 5th March to the 30th April 2020. A basic reproductive number (R0) and a serial interval were used to calculate estimated cases (EC). A double exponential smoothing model was used to forecast the number of cases during the L5 lockdown period. A Poisson regression model was fitted to describe the association between L5 lockdown status and incident cases. RESULTS: a total of 5,737 laboratory-confirmed cases (LCC) were reported by 30th April 2020, 4,785 (83%) occurred during L5 lockdown. Our model forecasted 30,629 cases of COVID-19 assuming L5 lockdown was not imposed. High incidence rates of COVID-19 were recorded in KwaZulu-Natal and Mpumalanga Provinces during the L5 lockdown compared to the other provinces. Nationally, the incident rate of COVID-19 was 68.00% higher in L5 lockdown than pre-lockdown for LCC. CONCLUSION: the L5 lockdown was very effective in reducing the incidence of COVID-19 cases. However, the incident rates of LCC and EC were higher nationally, and in some provinces during the L5 lockdown.

Time-to-pregnancy and pregnancy outcomes in a South African population.

BACKGROUND: Time-to-pregnancy (TTP) has never been studied in an African setting and there are no data on the rates of adverse pregnancy outcomes in South Africa. The study objectives were to measure TTP and the rates of adverse pregnancy outcomes in South Africa, and to determine the reliability of the questionnaire tool. METHODS: The study was cross-sectional and applied systematic stratified sampling to obtain a representative sample of reproductive age women for a South African population. Data on socio-demographic, work, health and reproductive variables were collected on 1121 women using a standardized questionnaire. A small number (n = 73) of randomly selected questionnaires was repeated to determine reliability of the questionnaire. Data was described using simple summary statistics while Kappa and intra-class correlation statistics were calculated for reliability. RESULTS: Of the 1121 women, 47 (4.2%) had never been pregnant. Mean gravidity was 2.3 while mean parity was 2.0 There were a total of 2467 pregnancies; most (87%) resulted in live births, 9.5% in spontaneous abortion and 2.2% in still births. The proportion of planned pregnancies was 39% and the median TTP was 6 months. The reliability of the questionnaire for TTP data was good; 63% for all participants and 97% when censored at 14 months. Overall reliability of reporting adverse pregnancy outcomes was very high, ranging from 90 - 98% for most outcomes. CONCLUSION: This is the first comprehensive population-based reproductive health study in South Africa, to describe the biologic fertility of the population, and provides rates for planned pregnancies and adverse pregnancy outcomes. The reliability of the study questionnaire was substantial, with most outcomes within 70 - 100% reliability index. The study provides important public information for health practitioners and researchers in reproductive health. It also highlights the need for public health intervention programmes and epidemiological research on biologic fertility and adverse pregnancy outcomes in the population.

Excess Mortality Due to External Causes in Women in the South African Mining Industry: 2013-2015.

Mining is a recognized high-risk industry with a relatively high occurrence of occupational injuries and disease. In this study, we looked at the differences in mortality between male and female miners in South Africa. Data from Statistics South Africa regarding occupation and cause of death in the combined years 2013-2015 were analyzed. Proportional mortality ratios (PMRs) were calculated to investigate excess mortality due to external causes of death by sex in miners and in manufacturing laborers. Results: Women miners died at a significantly younger age on average (44 years) than all women (60 years), women manufacturers (53 years), and male miners (55 yrs). There was a significantly increased proportion of deaths due to external causes in women miners (12.4%) compared to all women (4.8%) and women manufacturers (4.6%). Significantly increased PMRs were seen in car occupant accidents (467, 95% confidence interval (CI) 151-1447), firearm discharge (464, 95% CI 220-974), and contact with blunt objects (2220 95% CI 833-5915). Conclusion: This descriptive study showed excess deaths in women miners due to external causes. Road accidents, firearm discharge, and contact with blunt objects PMRs were significantly increased. Further research is required to confirm the underlying reasons for external causes of death and to develop recommendations to protect women miners.