No description available.

Learners at the public schools of North West Province in the Dr Kenneth Kaunda Education region, within the Matlosana Local municipality’s municipal area of jurisdiction, are exposed to unhygienic health hazard conditions due to insufficient toilet facilities used by a large number of learners and poor health conditions resulting out of it, which might cause and spread health related diseases to the users of these toilet facilities. The primary objective of this research was to investigate the nature and extent of the provisioning and maintenance of toilet facilities in the public schools within the Matlosana Local Municipality’s municipal area. A questionnaire was designed and distributed to obtain information from 57 respondents who comprised of the 3 schools principals who constituted 5% of the research population, 18 educators who constituted 32% and 36 learners who constituted 63%, all totalling 100% of the research sample size, at Are-Fadimeheng; Dominion Reefs and Nkagisang public schools. The findings revealed that the majority, which is 85% of the research population (learners and educators) as users of these facilities are affected and were generally unhappy about the prevailing conditions of the school toilet facilities. This they attribute to lack of proper budgeting as the main cause. The most aggravating factor is the absence of a janitor with plumbing skills to look after the schools’ toilet facilities. Findings highlighted that school learners and educators deserve as their human right to live under acceptable health conditions and clean environment. However it is the responsibility of the Government to expand the existing schools toilet structures which are in line with the National Building regulation ratio of 1:25 of users per toilet as recommended by Department of Water Affairs (DWA), to ensure health for all. The results of this study can assist the government to embark on strategic intervention programmes that can improve conditions of public schools toilet facilities in the North West Province, South Africa to meet the Millenium Development Goals (MDG) target in addressing sanitation backlogs by half in 2015. Conclusions for the study were drawn and recommendations were made for the improvement of conditions in the Public Schools Toilet facilities. / Thesis (M. Development and Management)--North-West University, Potchefstroom Campus, 2011.

Learners at the public schools of North West Province in the Dr Kenneth Kaunda Education region, within the Matlosana Local municipality’s municipal area of jurisdiction, are exposed to unhygienic health hazard conditions due to insufficient toilet facilities used by a large number of learners and poor health conditions resulting out of it, which might cause and spread health related diseases to the users of these toilet facilities. The primary objective of this research was to investigate the nature and extent of the provisioning and maintenance of toilet facilities in the public schools within the Matlosana Local Municipality’s municipal area. A questionnaire was designed and distributed to obtain information from 57 respondents who comprised of the 3 schools principals who constituted 5% of the research population, 18 educators who constituted 32% and 36 learners who constituted 63%, all totalling 100% of the research sample size, at Are-Fadimeheng; Dominion Reefs and Nkagisang public schools. The findings revealed that the majority, which is 85% of the research population (learners and educators) as users of these facilities are affected and were generally unhappy about the prevailing conditions of the school toilet facilities. This they attribute to lack of proper budgeting as the main cause. The most aggravating factor is the absence of a janitor with plumbing skills to look after the schools’ toilet facilities. Findings highlighted that school learners and educators deserve as their human right to live under acceptable health conditions and clean environment. However it is the responsibility of the Government to expand the existing schools toilet structures which are in line with the National Building regulation ratio of 1:25 of users per toilet as recommended by Department of Water Affairs (DWA), to ensure health for all. The results of this study can assist the government to embark on strategic intervention programmes that can improve conditions of public schools toilet facilities in the North West Province, South Africa to meet the Millenium Development Goals (MDG) target in addressing sanitation backlogs by half in 2015. Conclusions for the study were drawn and recommendations were made for the improvement of conditions in the Public Schools Toilet facilities. / Thesis (M. Development and Management)--North-West University, Potchefstroom Campus, 2011.

No description available.

No description available.

Globally, investigations into food-borne illnesses show that the majority of cases involve poor hand hygiene of the food handler. The challenge of providing safe food therefore requires new strategies for evaluating cross-contamination of pathogenic micro-organisms on the food handler's hands, which might be detrimental or hazardous to the health of the patient Although food-borne diseases may be multifactorial in aetiology, no standards or evaluation systems, such as an occupational health surveillance programme, are available to monitor and ensure that food is free of pathogens. The formulation and implementation of standards may contribute to ensuring that food handlers comply with hand hygiene practices during food handling. Such practices guarantee that food reaching the patient is safe. The objectives in this research project originated from the occupational health practice and gave direction of the empirical research project. The literature was reviewed to discover what is currently known concerning the food handlers' hand hygiene during food handling and food-borne illnesses and the theoretical framework gave direction and guidance to the survey design of the empirical research, which was quantitative, explorative, descriptive and contextual in nature. The food handlers from the food preparation sections of the four major healthcare services in Potchefstroom, in the North West Province, South Africa, were the target population and the sampling method was all-inclusive (n=110). Eighty (75.47%) food handlers participated in the research project. The design entailed three steps. The first was conducted with a questionnaire, to identify the food handlers' compliance with hand hygiene during food handling. The second step involved determining the prevalence of Escherichia coli and Staphylococcus aureus on the food handlers' hands. The results were used for the formulation of standards for the hand hygiene of food handlers. Finally, recommendations for practice, education and research were made. The implementation of these recommendations could contribute knowledge to the body of nursing and promote good hand hygiene practices in the healthcare service. / Thesis (M.Cur.)--North-West University, Potchefstroom Campus, 2009.

Globally, investigations into food-borne illnesses show that the majority of cases involve poor hand hygiene of the food handler. The challenge of providing safe food therefore requires new strategies for evaluating cross-contamination of pathogenic micro-organisms on the food handler's hands, which might be detrimental or hazardous to the health of the patient Although food-borne diseases may be multifactorial in aetiology, no standards or evaluation systems, such as an occupational health surveillance programme, are available to monitor and ensure that food is free of pathogens. The formulation and implementation of standards may contribute to ensuring that food handlers comply with hand hygiene practices during food handling. Such practices guarantee that food reaching the patient is safe. The objectives in this research project originated from the occupational health practice and gave direction of the empirical research project. The literature was reviewed to discover what is currently known concerning the food handlers' hand hygiene during food handling and food-borne illnesses and the theoretical framework gave direction and guidance to the survey design of the empirical research, which was quantitative, explorative, descriptive and contextual in nature. The food handlers from the food preparation sections of the four major healthcare services in Potchefstroom, in the North West Province, South Africa, were the target population and the sampling method was all-inclusive (n=110). Eighty (75.47%) food handlers participated in the research project. The design entailed three steps. The first was conducted with a questionnaire, to identify the food handlers' compliance with hand hygiene during food handling. The second step involved determining the prevalence of Escherichia coli and Staphylococcus aureus on the food handlers' hands. The results were used for the formulation of standards for the hand hygiene of food handlers. Finally, recommendations for practice, education and research were made. The implementation of these recommendations could contribute knowledge to the body of nursing and promote good hand hygiene practices in the healthcare service. / Thesis (M.Cur.)--North-West University, Potchefstroom Campus, 2009.

Farliga kemikalier kan migrera från leksaker eller andra varor och utgöra en hälsorisk. Eftersom barn är särskilt känsliga för exponering av farliga kemikalier bör de skyddas ytterligare, vilket görs med gällande lagstiftning för leksaker. Kemikalieinspektionens tillsyn visar dock på brister och att kemikalielagstiftningen inte är tillräcklig. Syftet med denna uppsats är därför att undersöka riskuppfattningen och kännedomen kring farliga kemikalier i barns leksaker hos föräldrar med barn i åldern 0-3 år. För att undersöka detta används en kvantitativ metod i form av webbenkät och datamaterialet presenteras med beskrivande statistik.  Resultat ställs i relation med vald teori om riskperception och visar bland annat att en lägre kännedom och tillit till lagstiftning bidrar till en lägre riskuppfattning. Oro, media och historiska händelser där farliga kemikalier visat sig ha en hormonstörande effekt bidrar till en högre riskuppfattning. Vissa skillnader i riskuppfattningen mellan kvinnor och män kan även utläsas. Resultat visar också att det inte finns någon skillnad mellan låg- och höginkomsttagare vad gäller betalningsviljan för en leksak försedd med innehållsförteckning. Det verkar därför inte vara ekonomiska förutsättningar som styr om åtgärder vidtas, utan snarare föräldrars oro för att deras barn exponeras för farliga kemikalier i leksaker.  Slutligen konstateras det i uppsatsen att en åtgärd för att minska barns exponering för farliga kemikalier och därmed även hälsorisker är en minskad konsumtion. / Hazardous chemicals can migrate from toys and other goods and pose a health risk. As children are particularly sensitive to exposure to hazardous chemicals, they should be further protected, as is the case with current toy legislation. However, the Swedish Chemicals Agency's supervision shows shortcomings and that the chemical legislation is not sufficient. The purpose of this essay is therefore to investigate the perception of risk and knowledge about dangerous chemicals in children's toys, for parents with children aged 0-3 years.  Results are set in relation to the chosen theory of risk perception and show, among other things, that a lower knowledge and trust in legislation contributes to a lower perception of risk. Concerns, media and historical events where dangerous chemicals have been shown to have an endocrine disrupting effect contribute to a higher risk perception. There are some differences in the perception of risk between women and men. The result also shows that there is no difference between low- and high-income earners in terms of willingness to pay for a toy provided with a table of content. Therefore it does not seem to be economic conditions that govern whether measures are taken, but rather parents' concerns that their children are exposed to dangerous chemicals in toys.  Finally, the essay states that a measure to reduce children's exposure to hazardous chemicals and thus also health risks is a reduced consumption.

In the United States, over 90 contaminants in community water supplies (CWS) are regulated based on maximum contaminant limits (MCLs) set by the Environmental Protection Agency under the Safe Drinking Water Act. These limits are crucial to the health of over 90% of the US population who rely on CWS for their drinking water. Despite advancements in safer water, questions remain about the potential role of prolonged exposures to contaminants at sub-regulatory levels in chronic diseases. Historically, conducting epidemiologic studies of drinking water exposures in the United States has been challenging due to the fragmented availability of CWS service areas and contaminant information, which varies depending on each state’s efforts. This dissertation attempts to overcome some of these barriers by collaborating with long-standing institutes in California to evaluate the relationship between drinking water contaminants (arsenic, uranium, and trihalomethanes) and the risks of cardiovascular disease (CVD) and chronic kidney disease (CKD) in a large prospective cohort. The California Teachers Study (CTS) cohort is comprised of over 130,000 women living across the state and followed for health outcomes, including CVD and CKD, since enrollment (1995-1996). The California Office of Environmental Health Hazard and Assessment (OEHHA) houses some of the most detailed information about CWS available in the United States. With their partnership, we consolidated three decades (1990-2020) worth of yearly contaminant data from CWS. Thanks to a statewide effort that gathered service boundary data from local agencies, we were able to identify CWS serving participants’ residential addresses. Ultimately, these efforts produced new drinking water exposure data available in the CTS cohort, accessible for the analyses of associated health outcomes. Chapter 1 provides an overview of the novel contributions and methods of this dissertation, and background knowledge about the three common drinking water contaminants under study—arsenic, uranium, and trihalomethanes. The three epidemiologic studies included in this dissertation were designed to evaluate the relationship between these contaminants and health outcomes, selected based on previous toxicologic evidence. To this end, we detail current knowledge on the relationships between a) arsenic and CVD, b) uranium and arsenic and CKD, and c) trihalomethanes and CKD. Chapter 2 details our efforts to construct residential histories of CTS participants using address data collected throughout follow-up (1995-2018). Environmental epidemiologic studies using geospatial data often estimate exposure at a participant’s residence upon enrollment, but mobility during the exposure period can lead to misclassification. We aimed to mitigate this issue using address records that have been self-reported and collected from the US Postal Service, LexisNexis, Experian, and California Cancer Registry. We identified records of the same address based on geo-coordinate distance (≤250m) and street name similarity. We consolidated addresses, prioritizing those confirmed by participants during follow-up questionnaires, and estimating the duration lived at each address using dates associated with records (e.g., date-first-seen). During 23-years of follow-up, about half of participants moved (48%, including 14% out-of-state). We observed greater mobility among younger women, Hispanic or Latina women, and those in metropolitan and lower socioeconomic status areas. The cumulative proportion of in-state movers remaining eligible for analysis was 21%, 32%, and 41% at 5-, 10-, and 20-years post-enrollment, respectively. Using self-reported information collected 10 years after enrollment, we correctly identified 94% of self-identified movers and 95% of non-movers as having moved or not moved from their enrollment address. This dataset provides a foundation for estimating long-term exposure to drinking water contaminants evaluated in this dissertation, and supports other epidemiologic studies of diverse environmental exposures and health outcomes in this cohort. Chapter 3 details our first epidemiologic analysis evaluating the relationship between long-term arsenic exposure from CWS and CVD risk in the CTS cohort. Inorganic arsenic in drinking water is linked to atherosclerosis and cardiovascular disease. However, risk is uncertain at lower levels present in CWS, currently regulated at the federal maximum contaminant level of 10µg/L. Using statewide healthcare administrative records from enrollment through follow-up (1995-2018), we identified fatal and nonfatal cases of ischemic heart disease (IHD) and CVD (including stroke). Participants’ residential addresses were linked to a network of CWS boundaries and annual arsenic concentrations (1990-2020). Most participants resided in areas served by a CWS (92%). Exposure was calculated as a time-varying, 10-year moving average up to a participant’s event, death, or end of follow-up. Using multivariable-adjusted Cox models, we estimated hazard ratios (HRs) and 95% confidence intervals (95%CIs) for the risk of IHD or CVD. We evaluated arsenic exposure categorized by concentration thresholds relevant to regulation standards (<1.00, 1.00-2.99, 3.00-4.99, 5.00-9.99, ≥10µg/L) and continuously using a log2-transformation (i.e., per doubling). We also stratified analyses by age, body mass index (BMI), and smoking status. This analysis included 98,250 participants, 6,119 IHD cases and 9,936 CVD cases. The HRs for IHD at concentration thresholds (ref:<1µg/L) were 1.06 (95%CI=1.00-1.12) at 1.00-2.99µg/L, 1.05 (95%CI=0.94-1.17) at 3.00-4.99µg/L, 1.20 (95%CI=1.02-1.41) at 5.00-9.99µg/L, and 1.42 (95%CI=1.10-1.84) at ≥10µg/L. HRs for every doubling of wAs exposure were 1.04 (95%CI=1.02-1.06) for IHD and 1.02 (95%CI=1.01-1.04) for CVD. We observed statistically stronger risk among those ≤55 versus >55 years at enrollment (pinteraction=0.006 and 0.012 for IHD and CVD, respectively). This study demonstrates that long-term arsenic exposure from CWS, at and below the regulatory limit, may increase cardiovascular disease risk, particularly IHD. Chapter 4 details our second epidemiologic analysis evaluating uranium and arsenic from CWS and CKD risk in the CTS cohort. Metals/metalloids in drinking water, including uranium and arsenic, have been linked to adverse kidney effects and may contribute to CKD risk, but few epidemiologic studies exist. Annual average concentrations of uranium and arsenic were obtained for CWS serving participants’ residential address(es). We calculated participant’s average exposure from enrollment in 1995 to 2005. CKD cases were ascertained from inpatient hospitalization records beginning in 2005, once diagnostic coding was adopted, through 2018. Our analysis included 6,185 moderate to end stage CKD cases among 88,185 women. We evaluated exposure categorized by concentration thresholds relevant to regulatory standards, up to ½ the current regulatory limit (uranium=15µg/L; arsenic=5µg/L), and continuously on the log scale per interquartile range (IQR). We used mixed-effect multivariable-adjusted Cox models to estimate HRs and 95%CIs of CKD by uranium or arsenic levels. We also conducted analyses stratified by risk factors and comorbidities. Exposures at the 50th (25th, 75th) percentiles were 3.1 (0.9, 5.6) µg/L for uranium, and 1.0 (0.6, 1.8) µg/L for arsenic. Higher uranium exposure, relative to <2µg/L, was associated with CKD risk, with HRs of 1.20 (95%CI=1.07-1.35) at 2.0-<5.0µg/L, 1.08 (95%CI=0.95-1.22) at 5.0-<10µg/L, 1.33 (95%CI=1.15, 1.54) at 10-<15µg/L, and 1.32 (95%CI=1.09-1.58) at ≥15µg/L (ptrend=0.024). We found no overall association between arsenic and CKD (log IQR; HR=1.02, 95%CI=0.98-1.07). However, risk from arsenic was statistically different by age and comorbidity status, with risk only observed among younger individuals (≤55 years), and those who developed cardiovascular disease or diabetes. Uranium exposure from drinking water below the current regulatory limit may increase CKD risk. Relatively low, chronic exposure to arsenic may affect kidney function among those with comorbidities. Chapter 5 details our third and final epidemiologic analysis evaluating trihalomethanes in residential CWS and CKD risk in the CTS cohort. Disinfection byproducts from water chlorination, including trihalomethanes (THMs), have been associated with bladder cancer and adverse birth outcomes. Despite mechanistic evidence of nephrotoxic effects, especially brominated THMs, no epidemiologic studies to date have evaluated CKD risk. This study included 89,158 women with 6,232 moderate to end stage CKD cases identified from statewide healthcare administrative records (2005-2018). Average concentrations of four THMs, including three brominated THMs, were calculated for CWS serving participants’ residential addresses from 1995-2005. We estimated HRs and 95%CIs using mixed-effect multivariable-adjusted Cox models. A g-computation mixture analysis approach was used to estimate the overall effect and relative contribution of brominated THMs, chloroform (non-brominated THM), as well as uranium and arsenic—other potentially nephrotoxic metals in CWS previously evaluated. Median (25th, 75th, 95th percentiles) were 5.5 (0.5, 24.1, 57.8) µg/L for total THMs and 2.7 (0.6, 11.3, 30.0) µg/L for brominated THMs. In flexible exposure-response models, we observed a positive relationship between total THMs and CKD risk, which was stronger for brominated THMs. The HRs (95%CIs) of CKD risk from brominated THMs at the highest two exposure categories (75th-94th, ≥95th, versus <25th) were 1.23 (1.13-1.33) and 1.43 (1.23-1.66), respectively; ptrend<0.001. Brominated THMs were the largest contributor (53%) to the overall mixture effect on CKD risk, followed by uranium (35%), arsenic (6%), and chloroform (5%). Trihalomethanes in water, in particular brominated trihalomethanes which are not regulated separately, may contribute to CKD development, even at levels below the current US regulatory limit (80µg/L). Chapter 6 concludes this dissertation by summarizing our findings, highlighting the policy implications, relevance to other populations, and discussing future directions. Recently, the US EPA has released a geospatial dataset of CWS boundaries across the country that can be used in conjunction with national contaminant data. This development underscores the growing recognition for more research on drinking water quality and health. We hope that the methods developed and used in our analyses will be informative to future studies, and that there will be opportunities for replication of our findings to better inform policy and protect the health of populations nationwide.