A study protocol to evaluate the impact of a personal and domestic hygiene intervention on lead exposure in a community next to a mine dump.

BACKGROUND: Lead has been associated with adverse health effects, especially neurocognitive and behavioural effects, in children. Communities living close to mining land are at risk of elevated exposure to lead. METHODS: This paper outlines a before and after intervention study protocol to evaluate the impact of a personal and domestic hygiene intervention on lead exposure in a community located adjacent to a mine dump. In each participating household, parents or guardians will be interviewed using a structured questionnaire to obtain information on socio-demographic characteristics, living conditions, domestic hygiene practices and potential alternative sources of exposure to lead. A registered nurse will collect hand wipe samples from children aged one to five years, for whom parental consent and where possible child assent has been obtained. Environmental dust samples will be collected from the floors and/or windowsills of children's dwellings for lead content analysis. Soil samples will be collected from yards to determine lead content. An educational intervention will then be applied to the intervention group, including the engagement of households or guardians in an educational discussion on the sources, pathways of exposure, health effects of lead exposure and protective measures, with the aid of a specially designed educational brochure. Data will be analysed for descriptive and inferential statistics using Stata version 16. DISCUSSION: The study will determine whether the intervention led to a reduction in indoor dust lead levels, and if shown to be effective, will inform the development of an awareness campaign to reduce lead exposure in communities located in close proximity to mine dumps. TRIAL REGISTRATION: The study is retrospectively registered on ClinicalTrials.gov Protocol Registration and Results System with registration number NCT05265572 and first release date of 18th February 2022.

Major climate change-induced risks to human health in South Africa.

There are many climatic changes facing South Africa which already have, or are projected to have, a detrimental impact on human health. Here the risks to health due to several alterations in the climate of South Africa are considered in turn. These include an increase in ambient temperature, causing, for example, a significant rise in morbidity and mortality; heavy rainfall leading to changes in the prevalence and occurrence of vector-borne diseases; drought-associated malnutrition; and exposure to dust storms and air pollution leading to the potential exacerbation of respiratory diseases. Existing initiatives and strategies to prevent or reduce these adverse health impacts are outlined, together with suggestions of what might be required in the future to safeguard the health of the nation. Potential roles for the health and non-health sectors as well as preparedness and capacity development with respect to climate change and health adaptation are considered.

Non-allergic rhinitis and associated risk factors among the elderly in communities close to gold mine dumps in Gauteng and North West provinces in South Africa: a cross-sectional study.

PURPOSE: To investigate whether non-allergic rhinitis among the elderly was associated with living close to mine dumps METHODS: Elderly persons (n = 2397) residing in communities 1-2 km (exposed) and ≥ 5 km (unexposed) from five preselected mine dumps in Gauteng and North West provinces in South Africa were included in the cross-sectional study, using a previously validated modified ATS-DLD-78 questionnaire from the British Medical Research Council. RESULTS: The overall prevalence of non-allergic rhinitis in this study was 23.99%. In the unexposed, it was found to be 18.82% and 27.08% exposed communities. Multiple logistic regression analysis indicated that having non-allergic rhinitis was significantly associated with living in exposed communities (OR 1.73; 95% CI 1.37-2.17), being an ex-smoker (OR 1.75; 95 CI 1.35-2.26), being a smoker (OR 1.24; 95% CI 1.02-1.62), history of occupational exposure to dust/chemical fumes (OR 1.58; 1.30-1.93) and use of gas as the main residential heating/cooking fuel type (OR 1.61; 1.01-2.57). CONCLUSION: A high prevalence of non-allergic rhinitis was observed in the elderly living in exposed communities. The adverse association was observed between residing in communities close to mine dumps and non-allergic rhinitis.

Overcrowding and health in two impoverished suburbs of Johannesburg, South Africa.

BACKGROUND: Rapid urbanization, unmatched by an associated supply of housing, has resulted in overcrowding in the cities of many developing countries, including in Johannesburg, South Africa. Household overcrowding has been associated with a range of ill-health outcomes, including acute respiratory infections and diarrhoeal diseases. The aim of this study was to describe the levels of household crowding, and examine associations with respiratory and gastrointestinal symptoms in selected two low-income neighbourhoods in Johannesburg. METHODS: Questionnaire data from a panel study conducted over an 11-year period between 2006 and 2016 were extracted to conduct the analyses. Structured questionnaires, designed to collect information on housing conditions, socio-economic and health status were administered to adult representatives of households occupying the primary dwelling on pre-selected study sites. RESULTS: Over the 11-year study period, levels of overcrowding remained unchanged. Around 57.6% of dwellings in the study neighbourhoods were determined to be overcrowded in relation to international guidelines. Results from the multiple logistic regression analyses indicated that crowded dwellings were associated with elevated levels of acute respiratory and gastrointestinal symptoms, as well as fever/chills. CONCLUSION: Respondent perceptions varied from objective measures of overcrowding. Crowded dwellings were associated with elevated reports of acute respiratory and gastrointestinal symptoms, as well as fever/chills.

Indoor and outdoor PM10 levels at schools located near mine dumps in Gauteng and North West Provinces, South Africa.

BACKGROUND: Few studies in South Africa have investigated the exposure of asthmatic learners to indoor and outdoor air pollution at schools. This study compared outdoor PM10 and SO2 exposure levels in exposed (1-2 km from gold mine dumps) and unexposed schools (5 km or more from gold mine dumps). It also examined exposure of asthmatic children to indoor respirable dust at exposed and unexposed schools. METHODS: The study was conducted between 1 and 31 October 2012 in five schools from exposed and five from unexposed communities. Outdoor PM10 and SO2 levels were measured for 8-h at each school. Ten asthmatic learners were randomly selected from each school for 8-h personal respirable dust sampling during school hours. RESULTS: The level of outdoor PM10 for exposed was 16.42 vs. 11.47 mg.m-3 for the unexposed communities (p < 0.001). The outdoor SO2 for exposed was 0.02 ppb vs. 0.01 ppb for unexposed communities (p < 0.001). Indoor respirable dust in the classroom differed significantly between exposed (0.17 mg.m-3) vs. unexposed (0.01 mg.m-3) children with asthma at each school (p < 0.001). CONCLUSION: The significant differences between exposed and unexposed schools could reveal a serious potential health hazard for school children, although they were within the South African Air Quality Standards' set by the Department of Environmental Affairs. The indoor respirable dust levels in exposed schools could have an impact on children with asthma, as they were significantly higher than the unexposed schools, although there are no published standards for environmental exposure for children with asthma.

Chronic respiratory disease among the elderly in South Africa: any association with proximity to mine dumps?

BACKGROUND: There is increasing evidence that environmental factors such as air pollution from mine dumps, increase the risk of chronic respiratory symptoms and diseases. The aim of this study was to investigate the association between proximity to mine dumps and prevalence of chronic respiratory disease in people aged 55 years and older. METHODS: Elderly persons in communities 1-2 km (exposed) and 5 km (unexposed), from five pre-selected mine dumps in Gauteng and North West Province, in South Africa were included in a cross-sectional study. Structured interviews were conducted with 2397 elderly people, using a previously validated ATS-DLD-78 questionnaire from the British Medical Research Council. RESULTS: Exposed elderly persons had a significantly higher prevalence of chronic respiratory symptoms and diseases than those who were unexposed., Results from the multiple logistic regression analysis indicated that living close to mine dumps was significantly associated with asthma (OR = 1.57; 95% CI: 1.20 - 2.05), chronic bronchitis (OR = 1.74; 95 CI: 1.25 - 2.39), chronic cough (OR = 2.02; 95% CI: 1.58 - 2.57), emphysema (OR = 1.75; 95% CI: 1.11 - 2.77), pneumonia (OR = 1.38; 95% CI: 1.07 - 1.77) and wheeze (OR = 2.01; 95% CI: 1.73 - 2.54). Residing in exposed communities, current smoking, ex-smoking, use of paraffin as main residential cooking/heating fuel and low level of education emerged as independent significant risk factors for chronic respiratory symptoms and diseases. CONCLUSION: This study suggests that there is a high level of chronic respiratory symptoms and diseases among elderly people in communities located near to mine dumps in South Africa.

Mine dumps, wheeze, asthma, and rhinoconjunctivitis among adolescents in South Africa: any association?

The study investigated the association between community proximity to mine dumps, and current wheeze, rhinoconjunctivitis, and asthma among adolescents. This study was conducted during May-November 2012 around five mine dumps in South Africa. Communities in close proximity to mine dumps had an increased likelihood of current wheeze OR 1.38 (95 % CI: 1.10-1.71), rhinoconjunctivitis OR 1.54 (95 % CI: 1.29-1.82), and a protective association with asthma OR 0.29 (95 % CI: 0.23-0.35). Factors associated with health outcomes included other indoor and outdoor pollution sources. Wheeze and rhinoconjunctivitis appear to be a public health problem in these communities. The findings of this study serve as a base for further detailed epidemiological studies for communities in close proximity to the mine dumps e.g. a planned birth cohort study.

Strengthening Urban Informal Trading and Improving the Health of Vendors: An Integrated Management Model.

CONTEXT: Within the urban areas, especially the central business districts, informal trading is growing in large numbers, and the informal vendor's health is also at risk. Despite various frameworks developed for this industry, there are few guidance and implementation strategies on how to accomplish better-managed informal trading, mostly one that entails better occupational settings. OBJECTIVE: The goal of the proposed model is to improve the working conditions for informal vendors in South Africa by redesigning the current informal trading management approach, thus ensuring a healthy workplace. An evidence-based approach was used to inform the development of this model. RESULTS: This paper outlines the current challenges of informal vendors in urban areas as per the quantitative health risk assessment study that was conducted in 16 markets amongst 617 informal food vendors in the inner city of Johannesburg, South Africa. The study investigated the respiratory health caused by air pollution and associated risk factors. Findings revealed a lack of infrastructure and higher exposure to air pollution, resulting in respiratory ill-health amongst outdoor vendors as compared to indoor vendors. The vendors were more exposed to particulate matter pollution in the spring and winter seasons as compared to the autumn and summer seasons. Furthermore, the upper respiratory symptoms were statistically significant to the type of work location (indoor/outdoor), type of cooking fuel, duration of work, frequency of hand hygiene, and wearing of protective equipment. An informal vendors' integrated management model that encompasses a specific informal food vendor's directorate was developed with five main components: the reviewing of informal vendors' legislation, the restructuring of designated vending or trading sites, space allocation and occupancy, vendors' training and skills development, and the sustainability of vending sites and vendors' health. DISCUSSION AND CONCLUSIONS: The status revealed the legislation fragmentation of the informal vendors' activities. The goal of this informal vendors' "healthy workplace management model" is to inform government responses to the current challenges of the informal vendors' sector, as well as to guide policies and actions to reduce ill-health in the industry and to avoid disruptions to informal food supply chains, which are critical in the food sector. This model is explained well and documented for easier implementation in local governments. This paper contributes to the extant literature on street vendors and future management strategies of this trade.

Personal PM2.5 Exposure Monitoring of Informal Cooking Vendors at Indoor and Outdoor Markets in Johannesburg, South Africa.

Air pollutants of concern include particulate matter (PM) in fine size fractions. Thus far, a few studies have been conducted to study the adverse health effects of environmental and occupational air pollutants among informal vendors in big cities in South Africa. Informal vendors in these cities may experience higher exposure to road dust, cooking fumes, and air pollution. This exposure assessment was part of a health risk assessment study of vendors. The objective of this exposure assessment was to determine the differences between outdoor and indoor informal vendors' personal PM2.5 exposures during trading hours. A walkthrough survey was conducted to map the homogeneous exposure groups (HEGs) at vendor markets for sampling purposes, and one market was selected from each of the three identified HEGs. Twenty-five informal cooked food vendors from both indoor (inside buildings) and outdoor (street or roadside vendors) markets in the inner city of Johannesburg, South Africa, participated in the study. HEG-1 were vendors from indoor stalls who used electricity and gas for cooking (10 vendors), HEG-2 was composed of informal outdoor vendors at a fenced site market who used open fire for cooking (10 vendors), and HEG-3 (5 vendors) were roadside vendors who used gas for cooking. Cooking vendors from outdoor markets recorded higher TWA concentrations than indoor market vendors. The vendors' PM2.5 concentrations ranged from <0.01 mg/m3 to 0.77 mg/m3. The mean concentrations of PM2.5 were found to be 0.12 mg/m3, and 0.18 mg/m3 for HEG-2, and HEG-3, respectively. HEG-2 recorded the highest PM2.5 TWA concentrations, followed by HEG-3 and HEG-1. All concentrations were below the South African occupational exposure limit. The findings point to the need for further research into the health risks associated with outdoor cooking vendors, particularly those who utilize open fires.

Health Risk Assessment of Informal Food Vendors: A Comparative Study in Johannesburg, South Africa.

According to the best of our knowledge, there are no critical studies to date about associations between the work environment and prevalence of respiratory diseases and their symptoms among urban informal vendors in South Africa. This study followed a risk assessment methodology to assess the risks associated with the occurrence of respiratory health problems among 617 indoor and outdoor market vendors in the inner city of Johannesburg, South Africa. A walkthrough survey using a checklist was conducted in 16 Markets for identification of respiratory risk factors and description of sanitary conditions. Face-to-face interviews were conducted amongst informal food vendors using a previously validated questionnaire to collect information on demographics and occupational and respiratory health. In addition, a single day area air pollution monitoring of PM2.5, SO2, NO2, CO, and CO2 was conducted in two stalls (indoor and outdoor). The Chi-squared test of association and frequency distribution were used to analyse data. Female vendors aged between 30 to 39 years dominated the trade. The results revealed that a majority of the vendors' work shifts are longer than the recommended eight hours per day (73%), six to seven days per week (90%), and most of them have been working for six to ten years (41%). Poor sanitary conditions were observed in 75% of the markets. The concentrations of air pollutants at the outdoor markets were much greater than those in the indoor markets. All air pollution concentrations were below the recommended national and international standards. The risk of outdoor vendors developing any symptoms were extremely greater than those of indoor vendors, especially cooking vendors. Upper respiratory symptoms were the highest amongst the vendors. The results demonstrated a significant association between work-related risk factors, such as type of work location, duration, type of cooking fuel or heat, vendor training, frequency of hand hygiene practice, and using of a mask, and the upper respiratory symptoms. Based on the findings, there is a need for formalization of the trade, improvement in infrastructure, respiratory health care assessments, and sustainable educational programs.

Environmental exposure to uranium in a population living in close proximity to gold mine tailings in South Africa.

BACKGROUND: Gold mining activities in South Africa resulted in contamination of residential environment with uranium-rich wastes from mine tailings. Health of the people living around the mine tailings could be affected by uranium exposure due to its hazardous chemotoxic and radiological properties. METHODS: We conducted a cross-sectional study to assess i) uranium (U) concentrations in individual hair samples of children and adults living in close proximity to mine tailings in Northeast- Soweto in Johannesburg, South Africa, and ii) the association between U concentrations in hair and various factors, including zone of residence, socio-demographic and housing characteristics. Sampling sites were divided into three zones based on the distance between a dwelling and a cluster of mine tailings (zone 1: <= 500 m, zone 2: 2-3 km away, zone 3: 4-5 km away). U concentrations in hair samples were measured using inductively coupled plasma mass spectrometry. To test the association between U concentrations and selected factors we used robust regression models with log-transformed U concentrations. RESULTS: Among 128 subjects with available U measurements, 63 (49%) were children (ages 7-15 years) of which 38 were girls, the remaining 65 (51%) were adult females. Mean (median) U concentration in hair samples was 143 (92) µg/kg. In the mutually adjusted analyses, only an inverse association between age and U concentration in hair remained statistically significant, with geometric mean in children being 2.1 times higher compared to adults (P < 0.001). There was no evidence of an association between zones and U concentration (P = 0.42). CONCLUSIONS: There was little evidence of association between U concentration in hair and distance from the mine tailings within the 5 km range, but overall concentrations were elevated compared to general population samples in other parts of the world. Children had statistically significantly higher geometric mean of uranium concentration in hair compared to adults. The results are important for improvement of mining waste policies and implementation of health monitoring and protective measures in populations at risk. ARTICLE CATEGORY: Research Article.

Environmental and Occupational Health Exposures and Outcomes of Informal Street Food Vendors in South Africa: A Quasi-Systematic Review.

Introduction: Informal street vending is a form of informal employment, and occupational conditions for people within this group have been proven to be detrimental to their health. Two independent reviewers carried out a systematic evaluation of the existing literature in South Africa on environmental and occupational exposures, as well as the health effects faced by informal street food vendors. Methods: 354 published publications were reviewed and 9 were included, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results: The evidence showed that informal street vendors are exposed to workplace risks that affect their health and wellbeing. Non-enclosed vendor stalls and frequent use of open fires were among the risk concerns. Vendors are vulnerable to gastrointestinal diseases such as salmonellosis and respiratory infections such as influenza and COVID-19 due to inadequate access to water, waste disposal facilities, and basic hygiene awareness and practices. Exposure to air pollutants increased the risk of respiratory and urinary illnesses and an impact on the reproductive health of female street vendors. Conclusions: This investigation demonstrated the difficulties in complying with the requirements of the Regulations Governing General Hygiene Requirements for Food Premises, the Transport of Food, and Related Matters (no. R638 of 22 June 2018) and the Occupational Health and Safety (OHS) Act (no. 85 of 1993). Within South African borders, there is a scarcity of research on occupational exposures and health effects in this occupation. As a result, eliminating or preventing these occupational exposures should be at the top of government and stakeholder agendas. The majority of the research was carried out in KwaZulu Natal and used a quantitative, cross-sectional technique. Other designs, including cohorts, time series, and randomized intervention trials, were underutilized.

Elevated soil and blood lead levels with increasing residential proximity to a mine tailings facility in Soweto, South Africa.

Mining has long been associated with the release of a range of toxic metals including lead, elevated levels of which have been found in land surrounding mine dumps as far afield as Spain, India, Macedonia and Nigeria. Mining has been a key pillar of economic development in South Africa for around a century and a half, and has left a legacy of major environmental contamination, with the poorest experiencing the highest burden of exposure. The current study was undertaken to ascertain the concentrations of lead in soil and in the blood of adults and children residing at increasing distances from a cluster of large tailings facilities (MTFs) in greater Johannesburg, South Africa. Through a cross-sectional survey data on household characteristics were collected through a questionnaire survey, and supplemented with samples of soil from household gardens, together with blood samples from child-adult pairs from all households included in the study. Soil lead concentrations decreased significantly (median = 35.7 mg/kg closest to the mine tailings facility (MTF) and 8.6 mg/kg at the furthest point in the study site) with increasing distance from the MTF. Blood lead levels were highest in both adults (median = 3.0 µg/dL) and children (median = 4.0 µg/dL) who lived closest (≤500 m) to the MTF, and lowest (1.4 µg/dL in adults and 2.5 µg/dL in children) in those who lived furthest away (4-5 km). The study findings point to a need for greater emphasis on the precautionary principle in environmental health and for health impact assessments to inform decisions on planning, especially with regard to the location of human settlements relative to major, polluting development initiatives.

A Study Protocol to Assess the Respiratory Health Risks and Impacts amongst Informal Street Food Vendors in the Inner City of Johannesburg, South Africa.

The overall unemployment rate in South Africa was impacted by the coronavirus (COVID-19) pandemic, which led many people to resort to informal work such as street trading opportunities in big cities. However, this work is located in the same cities where air pollution is of concern. Furthermore, literature has indicated the lack of regulation of the informal trading sector as compared to the formal sector. An analytical cross-sectional study is proposed to be conducted amongst all of the informal food street vendors (indoor/inside buildings and outdoor/street pavements stalls) in the inner city of Johannesburg, South Africa. By adopting a total sampling method of 746 vendor stalls, this study's key focus is on inhalation as an occupational exposure. In addition, the study aims to assess the respiratory risk factors amongst informal food street vendors' stalls and their impact on vendors' respiratory health. The risk factors to be assessed include the five common air pollutants: street vendor's infrastructure; socioeconomic factors; personal behavior such as tobacco smoking and handwashing practices; wearing of respiratory protective equipment; and vendors' exposure duration. The data collection will follow three phases using quantitative methods. In the pre-assessment phase, it will include a pilot study to test the walkthrough survey checklist and the respiratory symptoms and diseases questionnaire. The assessment phase includes a total of eight area samples, which will be taken in a 1-day event over four yearly seasons, as well as thirty personal samples taken in winter over an 8-h work shift. The post-assessment phase will be the development of a risk impact assessment and a risk management model. The study is essential for healthy occupational conditions as indicated in the Occupational Health and Safety (OHS) Act (no. 85 of 1993) and the Regulations governing general hygiene requirements for food premises, the transport of food, and related matters (no. R638 of 22 June 2018).

High blood pressure and exposure to dust from gold mine dumps among the elderly in South Africa: A cross-sectional study.

Objective: To investigate whether high blood pressure was associated with living close to a mine dump among the elderly in South Africa. Study design: This was a cross-sectional study conducted among the elderly in communities 1-2 km (exposed) and 5 km or more (unexposed), from five pre-selected mine dumps in Gauteng and North West provinces of South Africa. Methods: Structured interviews were conducted with 2397 elderly, using a previously validated ATS-DLD-78 questionnaire from the British Medical Research Council. Results: The prevalence of high blood pressure was 57.51% in the exposed and 46.66% in the unexposed communities, respectively. Results from the multiple logistic regression analysis showed that having high blood pressure was significantly associated with living in exposed communities (AOR = 3.04, 95% CI: 2.41-3.83, P < 0.001). Other significant risk factors were being an previous and current tobacco smoker, age group, tertiary level of educational attainment, and having a history of occupational exposure to dust and chemical fumes. Conclusion: The findings of this study suggest that there are high levels of blood pressure among the elderly residing in communities located near mine dumps in South Africa.

Allergy and Household Living Conditions among Adolescents Living near Gold Mine Tailing Dumps in the Gauteng and North West Provinces of South Africa.

This quantitative exploratory baseline study aimed to investigate whether allergy among adolescents was associated with household living conditions, including living near gold mine tailing dumps in South Africa. A questionnaire based on the International Study of Asthma and Allergies was used to collect information on allergy and household risk factors among adolescents (n = 5611). A chi-square test was applied to determine the relationship between community (exposed/unexposed) and confounding variables. Crude and adjusted odds ratios (ORs) and 95% confidence intervals (CI) were calculated using univariate and multiple logistic regression analysis (LRA) to estimate the likelihood of having doctor-diagnosed allergies. The overall prevalence of doctor-diagnosed allergies was 25.5%. The exposed communities had a higher prevalence of doctor-diagnosed allergies (26.97%) compared with the unexposed (22.69%) communities. The study found an association between doctor-diagnosed allergy and having fungus in the house, being female, currently having pets in and around the house, residing in the community for more than three years and living in communities located close to gold mine tailing dumps. Actions to implement buffer zones between gold mine tailing dumps and communities would support Sustainable Development Goals 3 (health) and 11 (sustainable cities and communities), while failing to address the current potential identified risk factors may pose a significant public health challenge. Local policymakers should also apply the precautionary principle to protect the health of children, especially with the location of human settlements relative to air pollution sources.

The Frequency of Fast Food Consumption in Relation to Wheeze and Asthma Among Adolescents in Gauteng and North West Provinces, South Africa.

The prevalence of asthma and allergic diseases have been on the rise, especially in developing countries due to life-style changes. The study aimed to investigate the association between the frequency of fast food consumption with wheeze and asthma among adolescents. A previously validated self-completed questionnaire from the International Study of Asthma and Allergies in Childhood was used to collect information on demographics, socioeconomic status, house characteristics, adolescent respiratory health and diet. The prevalence of wheeze was 38.2% and of asthma was 16.37% among the adolescents. The results from the adjusted regression analyses indicated that eating fast foods three or more times per week was a statistically significant risk factor for wheeze (OR = 1.60; 95% CI: 1.26-2.03) and asthma (OR = 1.37; 95% CI: 1.04-1.91). The study found an association between eating fast foods three or more times per week and wheeze and asthma among adolescents in South Africa. Unhealthy diet plays a crucial role in respiratory health among adolescents; healthy eating habits are encouraged to reduce the burden of respiratory symptoms and diseases.

Platinum Mine Workers' Exposure to Dust Particles Emitted at Mine Waste Rock Crusher Plants in Limpopo, South Africa.

The South African mining industry is one of the largest producers of platinum (Pt) in the world. Workers in this industry are exposed to significant amounts of dust, and this dust consists of particles sizes that can penetrate deep inside the respiratory region. A cross-sectional study was conducted to evaluate dust exposure risk at two Pt mine waste rock crusher plants (Facility A and B) in Limpopo, South Africa. Workers' demographic and occupational information was collected through a structured questionnaire, a walk-through observation on facilities' processes, and static dust sampling for the collection of inhalable and respirable dust particles using the National Institute for Occupational Safety and Health (NIOH) 7602 and the Methods for Determination of Hazardous Substance (MDHS) 14/4 as guidelines. Only 79% of Pt mine workers, used their respiratory protective equipment (RPE), sixty-five percent were exposed to work shifts exceeding the recommended eight hours and 8.8% had been employed for more than ten years. The mean time-weighted average (TWA) dust concentrations between Facility A and B showed a significant difference (p < 0.026). The Pt mine's inhalable concentrations (range 0.03-2.2 mg/m3) were higher than the respirable concentrations (range 0.02-0.7 mg/m3), however were all below the respective international and local occupational exposure limits (OELs). The Pt mine's respirable crystalline silica (SiO2) quartz levels were all found below the detectable limit (<0.01 mg/m3). The Pt miners had increased health risks due to accumulated low levels of dust exposure and lack of usage of RPE. It is recommended that an improved dust control program be put in place which includes, but is not limited to, stockpile enclosures, tire stops with water sprays, and education on the importance of RPE) usage.

Acceptability of Mobile Health Interventions to Increase Diabetic Risk Factor Awareness Among the Commuter Population in Johannesburg: Descriptive Cross-Sectional Study.

BACKGROUND: Developing countries are experiencing a shift from infectious diseases such as HIV and tuberculosis to noncommunicable diseases (NCDs) such as diabetes. Diabetes accounts for more disability-adjusted life years than any other NCD in South Africa, and research has identified a number of preventable risk factors; however, there is not enough evidence from lower resource settings as to how best to disseminate this information to the population. Today, 90% of the world's population lives in mobile phone coverage areas, and this provides a unique opportunity to reach large populations with health information. OBJECTIVE: This study aimed to investigate how potential mobile health (mHealth) platforms should be paired with diabetes risk factor education so that at-risk communities are empowered with information to prevent and manage diabetes. METHODS: A Likert-style survey was distributed to commuters in the City of Johannesburg in July 2018 that explored participants' background characteristics as well as their knowledge and awareness surrounding diabetic risk factors (such as exercise, smoking, and hypertension) and their comfort level with various information delivery methods (such as WhatsApp, short message service, and email). The grouped variables from diabetic risk factors and information delivery methods were described with mean Likert scores and then investigated for relationships with Spearman Rho correlation coefficients. RESULTS: Background characteristics revealed that the self-reported prevalence of diabetes was twice as high in this studied commuter population than the national average. WhatsApp was the most favorable mHealth information delivery method and had a moderate correlation coefficient with diet and nutrition (0.338; P<.001) as well as a weaker correlation with physical activity (0.243; P<.001). Although not as robust as the WhatsApp correlations, each of the other information delivery methods also showed weaker, yet statistically significant, relationships with one or more of the risk factors. CONCLUSIONS: The elevated self-reported diabetes prevalence reinforces the need for diabetes risk factor education in the studied commuter population of Johannesburg. The most feasible mHealth intervention for diabetic risk factor education should focus on WhatsApp messaging while also offering content across other mHealth and traditional platforms to remove barriers to access and enhance the user experience. The content should emphasize diet and nutrition as well as physical activity while also incorporating information on secondary risk factors.

Respiratory Health Symptoms among Schoolchildren in Relation to Possible Food-Related Risk and Protective Factors.

Respiratory health outcomes are among the top five causes of child morbidity and mortality around the world. We aimed to investigate possible food-related risk and protective factors for respiratory health outcomes in children. Structured questionnaires completed by primary caregivers of 10-year old children were used to collect information on demographics, socio-economic status, house characteristics and child respiratory health status. Upper (URIs) and Lower (LRIs) respiratory illnesses comprised hay fever, and wheezing, asthma and bronchitis, respectively. Eight hundred questionnaires were distributed, 648 retrieved and 420 completed in full (52.5% response rate). The hay fever 6-month prevalence was 22.4% and wheezing had the highest 6-month prevalence among the LRIs (13.8%). The majority of children ate vegetables (75.5%), fruit (69.3%) and chicken or fish (81.7%) regularly. Nearly half of the children (45.5%) regularly ate processed food. Eating processed food regularly was statistical significantly associated with wheeze (Adjusted Odds Ratio (OR) = 2.65; 95% CI: 1.38-5.08), hay fever (OR = 1.62; 95% CI: 1.09-2.64) and bronchitis (OR = 1.27; 95% CI: 1.06-2.56). The study found an association between regular consumption of processed foods and wheeze, hay fever and bronchitis among 10 year old children. The regular consumption of processed food plays a role in adverse respiratory health effects among children and healthy eating is emphasized.