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.Additional file 1: Table S1. Prevalence of chronic respiratory symptoms and diseases in relation to independent variables in all 11-study communities located 1-2 km and ≥5 km from mine dumps in Gauteng and North West provinces, South Africa during November-December 2012.Additional file 2: Table S2. Crude odds ratios with 95% confidence intervals of chronic respiratory symptoms and diseases in all 11-study communities located 1-2 km and ≥ 5km from mine dumps in Gauteng and North West provinces, South Africa during November-December 2012.Additional file 3: Table S3. Adjusted odds ratios with 95% confidence intervals of chronic respiratory symptoms and diseases in all 11-study communities located 1-2 km and ≥5 km from mine dumps in Gauteng and North West provinces, South Africa during November-December 2012.The Mine Health Safety Council (MHSC), National Research Fund – Deutscher Akademischer Austausch Dienst (NRF - DAAD) and the University of Pretoria (UP).http://www.ehjournal.netam201

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.The Mine Health Safety Council of South Africa (MHSC) and National Research Fund – Deutscher Akademischer Austausch Dienst (NRF – DAAD).http://www.biomedcentral.com/bmcpublichealtham2017School of Health Systems and Public Health (SHSPH

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.University of Pretoriahttp://www.occhealth.co.zahb201

Association between wheeze and selected air pollution sources in an air pollution priority area in South Africa : a cross-sectional study

BACKGROUND: An association between wheeze (a symptom of asthma) and environmental tobacco smoke (ETS), types of fuel used for residential heating or cooking and the frequency of trucks passing near homes, has been reported mainly in developed countries. Little is known about the strength of such associations in developing countries. This study was conducted in residential areas situated in Ekurhuleni Metropolitan Municipality, namely Tembisa and Kempton Park, which form part of the Highveld region, a priority area in terms of air pollution in South Africa. METHODS: From 3764 eligible school children, aged between 13 and 14 years, from 16 selected high schools in the study area, 3468 completed a modified questionnaire based on the International Study of Asthma and Allergies in Childhood (ISAAC). Data were analysed using multiple logistic regression models. RESULTS: The results are based on data from 3424 children. In the adjusted models, exposure to ETS at school was associated with wheeze ever (OR 1.22 95% CI: 1.03 − 1.45) and current wheeze (OR 1.33 95% CI: 1.08 − 1.64). When gas was most frequently used for residential heating the likelihood of wheeze ever increased by 47% (OR 1.47 95% CI: 1.15 − 1.88). Trucks passing near homes for almost the whole day during weekdays, increased the likelihood of wheeze ever (OR 1.32 95% CI: 1.01 − 1.73), current wheeze (OR 1.61 95% CI: 1.15 − 2.24) and current severe wheeze (OR 2.22 95% CI: 1.28 − 3.77). When data were stratified according to residential area, for children living in Tembisa, ETS exposure at home was associated with current wheeze (OR 1.36 95% CI: 1.06 − 1.77); gas most frequently used for residential heating was associated with wheeze ever (OR 1.68 95% CI: 1.23 − 2.28) and current wheeze (OR 1.61 95% CI: 1.08 − 2.39); paraffin most frequently used for residential heating was associated with current severe wheeze (OR 1.85 95% CI: 1.04 − 3.28). CONCLUSION: It was concluded that children living in one of the air pollution priority areas of South Africa, have an increased risk of wheezing due to exposure to both indoor and outdoor air pollution sources.The University of Pretoria, Tshwane University of Technology, Medical Research Council and the National Research Foundation.http://www.ehjournal.net/content/13/1/32am201

Association between exposure to drinking water disinfection byproducts and adverse pregnancy outcomes in South Africa

Currently, there is contradictory evidence for the risk of adverse pregnancy outcomes associated with maternal exposure to disinfection byproducts (DBPs). We examine the association between maternal exposure to trihalomethanes (THMs) in drinking water and adverse pregnancy outcomes, including premature birth, low birth weight (LBW) and small for gestational age (SGA). In total, 1,167 women older than 18 years were enrolled at public antenatal venues in two geographical districts. For each district, we measured the levels of residential drinking water DBPs (measured in THMs) through regulatory data and routine water sampling. We estimated the individual uptake of water of each woman by combining individual water use and uptake factors. Increased daily internal dose of total THMs during the third trimester of pregnancy significantly increased the risk of delivering premature infants (AOR 3.13, 95% CI 1.36–7.17). The risk of premature birth was also positiviely associated with exposure to total THMs during the whole pregnancy (AOR 2.89, 95% CI 1.25–6.68). The risk of delivering an SGA and LBW infant was not associated with maternal exposure to THMs. Our findings suggest that exposure to THMs is associated with certain negative pregnancy outcomes. The levels of THMs in water should be routinely monitored.This work was supported by the South African National Research Foundation (NRF) (Grant number SFH150625121049).http://www.iwaponline.com/jwh/default.htmam2022School of Health Systems and Public Health (SHSPH

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. OBJECTIVE. 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 + hypertension (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 SAWe thank everybody who participated in the questionnaire interviews, Mr Moses Kebalepile and all the fieldworkers who assisted in data collection, the data technicians for the data capturing, and Statistics South Africa for providing the population sizes of elderly people in each study community.The Mine Health Safety Council, the National Research Fund – Deutscher Akademischer Austausch Dienst and the University of Pretoria.http://www.samj.org.zaam2016School of Health Systems and Public Health (SHSPH