Pesticides are among the most pervasive environmental contaminants and they are an important potential risk for human health. Agricultural workers are constantly exposed to pesticide spray, drift and residues in the soil and foliage. Many agricultural pesticides are readily absorbed by the body, through contact with the skin, the respiratory track, the eyes, and the gastrointestinal system. Multiple studies have reported a strong association between pesticide exposure and various health outcomes including cancer. Oxidative stress and DNA damage have been proposed as mechanisms linking pesticide exposure to health effects and neurological diseases. The focus of the present translational study is to examine the relationship between human exposure to the organophosphate pesticide azinphos methyl (AZM) and oxidative stress by measuring biomarkers of oxidative stress in biological fluids (i.e., urine, serum) and peripheral blood lymphocytes (PBLs) of agricultural workers. The findings from these field studies will be validated in vitro by examining cultures of human lymphocytes treated with AZM for similar biomarkers of oxidative stress. Since the collection of PBLs from study participants is highly invasive and not suitable for studies involving younger subjects, we also examined buccal cells for biomarkers of oxidative stress (i.e., DNA damage) as a more universal source of human tissue to assess oxidative stress in pesticide exposed individuals. We demonstrated in this study that AZM induces oxidative stress and causes DNA damage in human tissues. Agricultural workers who had been exposed to AZM showed elevated serum levels of lipid peroxides, increased urinary levels of 8-OH-dG, and lymphocytes from these individuals showed increased DNA damage and associated changes in oxidative DNA repair enzymes. Biomarkers of oxidative stress were also elevated in human lymphocytes treated with physiologically relevant concentrations of AZM. In cultures of human lymphocytes, AZM caused a concentration-dependent loss of viability and associated increases in ROS and a reduction in intracellular GSH. We also demonstrated that viable leukocytes from the oral cavity can be readily obtained from humans and these buccal cells can be used to assess DNA damage following exposure to occupational and environmental genotoxicants. We also noted that oral leukocytes are especially sensitive to cryopreservation with DMSO and thus, these cells must be cryoprotected with 5% DMSO to preserve the viability of these cells for subsequent biochemical studies. In summary, these in vivo and in vitro studies demonstrated that AZM induces oxidative stress in a dose-dependent matter and that oral lymphocytes are a good source of human tissue for assessing DNA damage and possibly other biochemical changes. The possible health implications of the variations in these biomarkers of oxidative stress and DNA damage are undetermined. Yet the findings from these studies have provided a strong foundation for determining the mechanism by which pesticide induce oxidative stress, to explore the putative relationship between pesticide-induced oxidative stress and disease (e.g. cancer, neurodegenerative disorders) and determine whether tissue damage in humans is brought about by direct or by indirect action of organophosphate pesticides. / Graduation date: 2010

Farm workers are viewed as a neglected segment in the South African society. This qualitative research study focused on exploring and describing the social needs of farm workers in the Central Koup from the perspectives of samples comprising of farm workers and farm owners and/or managers. The aim was to contribute in finding solutions to address the identified needs through employee assistance programmes (EAPs) as one of the areas that an occupational social worker focuses on. The qualitative data was collected through focus group discussions and semi-structured interviews, and the findings were verified with literature. Tesch’s framework for data analysis (in Creswell, 2003) was employed, and data verification was conducted through Guba’s model (in Krefting, 1991:214-222). The findings indicated that the social needs of farm workers could be addressed through typical EAP-related focus areas such as working- and interpersonal relationships, substance abuse, spiritual well-being, recreation, financial management, conflict management, child care and parenting skills, trauma counselling, and practical assistance regarding transport, housing and accessibility of resources. This research endeavour resulted in recommendations regarding the use of EAPs to address the social needs of farm workers. / M. Soc. Sc.

This mixed methods research was conducted in the fall of 2014 to understand the perceptions and experiences of health risks and health outcomes due to pesticide exposure among community members (n=13) - concerned community members, agriculture workers and teachers- that live in the Central California agriculture counties of Monterey, Santa Cruz, Tulare, Fresno and Madera. This research explored: 1) The crops growing in participants’ communities, and how exposure to pesticides used in these crops pose potential health risks to participants and their communities 2) How pesticide exposure is impacting Hispanic/Latino communities in Central California, particularly those that are most vulnerable including school children, agriculture workers, and community members 3) The major public health concerns of impacted communities 4) Feelings of empowered to advocate for community health and environment and 5) What impacted communities wish to see on behalf of government and agribusiness to protect public health from pesticide exposure and toxins.

MPH / Department of Public Health / Hearing Conservation Programme (HCP) has been reported to be effective in protecting the hearing of South African workers who are exposed to occupational noise. In order to reduce Noise Induced Hearing Loss (NIHL) among these workers, a team work that includes an Occupational Audiologist in the proper implementation of hearing conservation programme is needed. The aim of this study was to assess the implementation of hearing conservation programme amongst farm workers in Vhembe District, Limpopo Province in South Africa.A quantitative research approach using cross sectional survey design was used to assess the implementation of the programme among farm workers in Vhembe District, Limpopo Province in South Africa. A self administered questionnaire with both open and closed ended questions was administered to both males and female respondents aged between 19 and 50 years. A total population of 260 farm workers were systematically selected and a sample size of 76 respondents were randomly selected and participated in the study. Permission to conduct the study was obtained from the Ethics Committee of the University of Venda and the office in charge of royal macadamia. The data collected was analyzed using the Statistical package of Social Sciences (SPSS) version 23,0 software. A test-retest method was used to ensure reliability and findings of the study and formed the basis of recommendations. The results of the study indicate that 82,9% of the workers who were exposed to noise for more than 14hours were not using hearing protection devices even though they were supplied. The training on the effects of noise on hearing was received by a quarter (25%) of the farm workers leaving out a large portion of 75% of workers not knowledgeable about the hearing conservation programme. A very small percentage of 3,9% indicated that they had a documented hearing loss against a large number of 96,1%. The findings show that only engineering noise controls are available and there were no provision of noise maps as part of monitoring hearing conservation programme.The farm workers need to be motivated to wear hearing protection devices in order to conserve their hearing. The management of the farm may organize an in-service training regarding the proper implementation of hearing conservation programme.Dermacation of noise zones would remind workers to put on their ear protectors before entering the noise area as part of monitoring the hearing conservation programme.

MPH / Department of Public Health / See the attached abstract below

Thesis (MComm)--Stellenbosch University, 2002. / ENGLISH ABSTRACT: Historically health care in South Africa has been an area of great inequity. Health care was inequitable, inadequate and racially based. In order to redress the gap in the delivery of health care services, created by the previous dispensation of separate development, the National Department of Health has adopted a Primary Health Care (PHC) approach as the guiding principle for the reconstruction of the health system in South Africa. One of the pillars of this approach is the empowerment of communities to participate, thus moving from facility based- to community based health care. The aim of the National Health System (NRS) is to promote health and health knowledge, to provide an equitable, accessible, and appropriate health service, and to empower people to take greater responsibility for their own health. It is constructed around the belief that health for all cannot be achieved simply by improving the formal health system, but that a holistic and multi-sectoral approach is required. This thesis explores the community health worker (CRW) as a possible cost-effective and efficient supplementary service, to the current formal health system, to bridge the gap in the formal health system through the provision of PHC services in a rural setting. This was done through the economic evaluation of a CHW programme operating in the Winelands are of the Western Cape. The aim of this study was to evaluate and analyse the nature, performance, and costs of the programme and place it in context by comparison to other similar programmes. This comparison focused on physical characteristics, goals, and cost structures. It also aims to measure the direct and indirect impact of this type of intervention on the agribusiness sector as well as the local health authorities. The evaluation proceeded from the premise that the CHW programme, if implemented correctly with proper and appropriate training, and adequate post training support, will be a cost-effective and efficient model for the provision ofPHC services in this rural/farming area. The economic evaluation of this CHW programme required it to be viewed from two perspectives. The first component viewed the implementation of the programme from the perspective of the agribusiness sector. This aspect of the study included both a qualitative as well as a quantitative VIew of the costs, benefits (perceived or otherwise), and perceptions of the CHW intervention. The second component assessed the CHW programme within the context of a resource constrained public sector health budget. Since the implementation of this programme implies certain expenditures on the part of the local health authorities, these cost had to be identified and quantified to gauge the effectiveness of that expenditure. / AFRIKAANSE OPSOMMING: Geskikte en doeltreffende gesondheidsdienste in Suid-Afrika se onlangse geskiedenis was nog gereserveer vir 'n uitgesoekte groep mense. Die gesondheidstelsel was ontoereikend, onvoldoende en gebaseer op ras. Daar het 'n gaping ontstaan tussen die dienste wat gelewer is en die werklike behoeftes van die mense wat dit moes gebruik. Ten einde hierdie gaping aan te spreek het die Nasionale Departement van Gesondheid besluit om 'n Primêre Gesondheidsorg (PRe) benadering te volg wat klem plaas op die bemagtiging van plaaslike gemeenskappe deur deelname. Dit was 'n duidelike skuifvanaffasiliteit- na gemeenskap gebaseerde gesondheidsdienste. Die oorkoepelende doel van hierdie verskuiwing in fokus was om voorheen benadeelde gemeenskappe voldoende toegang te gee tot gesondheidsdienste en ook om hierdie dienste aan te pas by die behoeftes van sodanige gemeenskappe. Hierdie tesis ondersoek die Wynland distriksraad se Gemeenskap Gesondheidswerker Program as 'n moontlike koste-effektiewe stelsel vir die lewering van toepaslike primêre gesondheidsdienste in landelike areas. Die doel van die studie was die sistematiese ontleding van die werking en omvang van, en die kostes verbonde aan die implementering en onderhoud van hierdie program. Die studie poog om die impak van hierdie program op die formele landbou sektor asook die plaaslike gesondheidsowerhede te identifiseer en, waar moontlik en prakties wenslik, te kwantifiseer. Die ondersoek sluit in die stelselmatige ontleding van kostes en voordele vir die formele landbou sektor sowel as die plaaslike gesondheidsowerhede. Die kostes asook die kliniese uitkomste geassosieer met die implementasie van die Gesondheidswerker program sal dan in konteks geplaas word deur dit te vergelyk met ander soortgelyke programme wat in die verlede aangepak is. Die vergelyking sal fokus op die fisiese eienskappe, koste struktuur, bronne van ondersteuning en die primêre doel van die intervensie.

Farm workers in South Africa have limited access to health care and health-related information. In this qualitative study, the implementation of a workplace HIV/AIDS policy was evaluated using data gathered through interviews and observation. It was found that, although the farm workers were knowledgeable about HIV and AIDS, this knowledge was insufficient. It was found that the lives of farm workers are deeply affected by HIV and AIDS. It is also suggested that the agricultural sector is not yet able to deal effectively with HIV and AIDS and that, in this regard, urgent planning is needed in respect of HIV and AIDS policies and interventions / Social Work / M.A. (Social Behaviour Studies in HIV/AIDS)

Farm workers in South Africa have limited access to health care and health-related information. In this qualitative study, the implementation of a workplace HIV/AIDS policy was evaluated using data gathered through interviews and observation. It was found that, although the farm workers were knowledgeable about HIV and AIDS, this knowledge was insufficient. It was found that the lives of farm workers are deeply affected by HIV and AIDS. It is also suggested that the agricultural sector is not yet able to deal effectively with HIV and AIDS and that, in this regard, urgent planning is needed in respect of HIV and AIDS policies and interventions / Social Work / M.A. (Social Behaviour Studies in HIV/AIDS)

Purpose This research project was an attempt to determine situational aspects of HIV and AIDS among the designated farming communities in the Vhembe and Mopani districts of Limpopo Province. Questions arising from the pilot project were premised on the capacity of farmers in these areas to adequately address the daunting reality and prevalence of HIV and AIDS in their communities. Research Design and Methodology The research was designed to facilitate the integration of both qualitative and quantitative approaches. A sample of 228 respondents was involved in a triangulated participatory action research method. To the extent that the data collection techniques were triangulated in both nature and focus, HIV/AIDS-related data and information within the designated farming communities was attained with a maximum degree of validity. The data collection techniques used in this regard were: questionnaires, which were distributed to 228 respondents; participant observation; exploratory investigation; unstructured interviews; naturalistic observation; focus group interviews and discussion; and review of documents. The reviewed documents include (primary) sources on HIV/AIDS by the Department of Health and (secondary) sources of literature by various authors presenting a range of perspectives on HIV/AIDS in farming areas. Findings The results of the study revealed the absence of a coordinated policy on HIV/AIDS in particular, and health in general; and a vacuous prevalence of basic HIV/AIDS-related information. For instance, knowledge on condom usage as a prevention strategy was ostensibly scant. Currently, primary healthcare services in the area are not available. The sampled farm workers themselves unanimously corroborated that there was no HIV/AIDS policy on the SAFM farms. Conclusion Based on the main findings established above, it has become indispensable that comprehensive and multidisciplinary HIV/AIDS policy interventions be initiated by all the relevant stakeholders. Local and provincial healthcare authorities need to provide policy guidelines for the development of such policy, taking the particular needs and circumstances of farm workers. The pervasive degree of insufficient HIV/AIDS knowledge among this group necessitates that such a policy should integrate both a labour perspective and healthcare orientation, rather than perpetuating a separation of the two paradigms. This form of integration ensures that the observance of a human rights dimension becomes a sacrosanct component of the prevention of HIV/AIDS among farm workers, as well as their education concerning their healthcare-related rights as farm employees. Furthermore, the prevalence of a national HIV and AIDS policy is mainly aimed at facilitating broad guidelines, not addressing the specific contexts of every public, corporate and rural employment sector (DoH, 2007: 11-12; Muhlemann, et al., 1992: 479). In order that the education, prevention and treatment initiatives in the Vhembe and Mopani farming communities are achieved, the most important parameters of the policy should indicate: ,,X The systematic institutionalisation of local, provincial, and national HIV and AIDS programmes, notwithstanding the provision of healthcare facilities such as clinics; ,,X The promotion of basic healthcare education in general, and HIV/AIDS awareness and prevention among farm workers in particular; ,,X The development of HIV/AIDS work place policy by SAFM as employer; ,,X The systematic involvement and formation of partnerships between policy makers, local and international funders, HIV/AIDS healthcare workers and practitioners, NGOs and SAFM. As a critical factor and unit of analysis in the study, SAFM is expected to fulfil a developmental function among its employees, their families, and the local communities. This function could be enhanced further with the collaboration between SAFM and other farmers in the distribution of basic information regarding HIV/AIDS and other sexually transmitted diseases at the workplace, as well as extensive healthcare education and training for their farming personnel. Trained personnel, especially managers, are a salient factor in the implementation of organisational health and safety requirements (DoH, 2007: 6, 8; Muhlemann, et al., 1992: 478-479). / Health Studies / D. Litt. et Phil. (Health Studies)

Purpose This research project was an attempt to determine situational aspects of HIV and AIDS among the designated farming communities in the Vhembe and Mopani districts of Limpopo Province. Questions arising from the pilot project were premised on the capacity of farmers in these areas to adequately address the daunting reality and prevalence of HIV and AIDS in their communities. Research Design and Methodology The research was designed to facilitate the integration of both qualitative and quantitative approaches. A sample of 228 respondents was involved in a triangulated participatory action research method. To the extent that the data collection techniques were triangulated in both nature and focus, HIV/AIDS-related data and information within the designated farming communities was attained with a maximum degree of validity. The data collection techniques used in this regard were: questionnaires, which were distributed to 228 respondents; participant observation; exploratory investigation; unstructured interviews; naturalistic observation; focus group interviews and discussion; and review of documents. The reviewed documents include (primary) sources on HIV/AIDS by the Department of Health and (secondary) sources of literature by various authors presenting a range of perspectives on HIV/AIDS in farming areas. Findings The results of the study revealed the absence of a coordinated policy on HIV/AIDS in particular, and health in general; and a vacuous prevalence of basic HIV/AIDS-related information. For instance, knowledge on condom usage as a prevention strategy was ostensibly scant. Currently, primary healthcare services in the area are not available. The sampled farm workers themselves unanimously corroborated that there was no HIV/AIDS policy on the SAFM farms. Conclusion Based on the main findings established above, it has become indispensable that comprehensive and multidisciplinary HIV/AIDS policy interventions be initiated by all the relevant stakeholders. Local and provincial healthcare authorities need to provide policy guidelines for the development of such policy, taking the particular needs and circumstances of farm workers. The pervasive degree of insufficient HIV/AIDS knowledge among this group necessitates that such a policy should integrate both a labour perspective and healthcare orientation, rather than perpetuating a separation of the two paradigms. This form of integration ensures that the observance of a human rights dimension becomes a sacrosanct component of the prevention of HIV/AIDS among farm workers, as well as their education concerning their healthcare-related rights as farm employees. Furthermore, the prevalence of a national HIV and AIDS policy is mainly aimed at facilitating broad guidelines, not addressing the specific contexts of every public, corporate and rural employment sector (DoH, 2007: 11-12; Muhlemann, et al., 1992: 479). In order that the education, prevention and treatment initiatives in the Vhembe and Mopani farming communities are achieved, the most important parameters of the policy should indicate: ,,X The systematic institutionalisation of local, provincial, and national HIV and AIDS programmes, notwithstanding the provision of healthcare facilities such as clinics; ,,X The promotion of basic healthcare education in general, and HIV/AIDS awareness and prevention among farm workers in particular; ,,X The development of HIV/AIDS work place policy by SAFM as employer; ,,X The systematic involvement and formation of partnerships between policy makers, local and international funders, HIV/AIDS healthcare workers and practitioners, NGOs and SAFM. As a critical factor and unit of analysis in the study, SAFM is expected to fulfil a developmental function among its employees, their families, and the local communities. This function could be enhanced further with the collaboration between SAFM and other farmers in the distribution of basic information regarding HIV/AIDS and other sexually transmitted diseases at the workplace, as well as extensive healthcare education and training for their farming personnel. Trained personnel, especially managers, are a salient factor in the implementation of organisational health and safety requirements (DoH, 2007: 6, 8; Muhlemann, et al., 1992: 478-479). / Health Studies / D. Litt. et Phil. (Health Studies)