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

Abstract

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’.Supplementary material: Figure S1: Indoor clinic temperatures, Figure S2: Mean indoor temperature experienced at each time point during each month for clinic 1, as an illustration of daily variation in indoor temperatures measurements, Figure S3: Indoor clinic apparent temperature, Figure S4: Differences between indoor clinic ambient apparent temperature and ambient temperature, Figure S5: Mean apparent temperature during clinic open hours of 8h00 to 16h00 compared to mean apparent temperature during all hours of the day, Table S1: Indoor clinic temperature and humidity measurements, Table S2: Ambient (outdoor) mean, minimum and maximum temperature and relative humidity measurements made at the Thohoyandou airport by month, Table S3: Monthly averages were compared for each clinic and the ambient (outdoor) temperature measurements and tested for statistically significant differences, Table S4: Mean apparent temperature (AT) per month for each clinic, with standard deviation and 1st and 99th percentiles.A South African Medical Research Council Flagship Grant, as well as funds from National Treasury under its Economic Competitiveness and Support Package, and a National Research Foundation Y-Rated Researchers grant.http://www.mdpi.com/journal/ijerpham2017Geography, Geoinformatics and Meteorolog