Includes bibliographical references (leaves 62-68). / Introduction: This study examined the patterns and the prevalence of obstructive lung disease (asthma and COPD) and associated risk factors (age, gender, atopy, smoking history, allergic history, previous history of lung disease, occupational exposures, seafood intake) in a working population of seafood processing workers along the West coast of the Western Cape of South Africa. Materials and method: A cross-sectional study was conducted 643 currently employed workers in two fish processing plants working fish canning and fishmeal processing. A modified version of the European Community Respiratory Health Survey (ECRHS) questionnaire was used. Skin prick tests (SPT) used extracts of common airborne allergen. Lung function spirometry and methacholine challenge tests (tidal breathing method) conducted using Vitallograph S-model bellows volume-time spirometers according to ATS guidelines. Serum omega-3 and omega-6 fatty acid levels also analysed to examine the association between dietary fatty acids and asthma outcomes. Multivariate regression models were developed for asthma outcomes after adjusting for age, gender, sex and atopic status whilst the models were adjusted for age, gender and smoking history for COPD outcomes.

Includes bibliographical references (leaves 55-65). / Includes abstract. / This study investigates the prevalence of silicosis in the South African gold mining industry. Gold mining is an important industry in South Africa, yet has been blighted by silicosis and tuberculosis in miners since its inception in 1887. There have been two previous studies conducted in black in-service miners using modern epidemiologic methods that found high prevalences of silicosis .The objectives of our study were three-fold. Firstly, to determine silicosis prevalence stratified by certain variables. Secondly, to compare silicosis prevalences to these two previous studies conducted in order to determine whether any secular trends are present. Thirdly, to report on any variation in silicosis between mining shaft, mining company or mining region, and to generate hypotheses for any variation found.

Includes bibliographical references. / Various studies have demonstrated an association between exposure to pesticides and adverse respiratory health outcomes including non-specific respiratory symptoms, rhinitis and asthma. Few studies have investigated the relationship between pesticide metabolites and asthma outcomes and only a limited number have explored mechanisms for allergic and non-allergic airway inflammation in individuals exposed to pesticides. A previous sub-study of this group reported an association between allergic airway inflammation as determined by fractional exhaled nitric oxide (FeNO) and low levels of whole blood cholinesterase among women farm workers. The main objective of this study was to investigate the relationship between exposure to different pesticides (ascertained through pesticide metabolites concentrations in urine) and asthma phenotypes (based on respiratory symptoms, cytokine patterns and exhaled nitric oxide profiles) among rural women in the Western Cape Province.

Includes bibliographical references. / Occupational skin disease is common in seafood processing workers. While previous studies have reported an increased prevalence of symptoms (as high as 50%) and protein contact dermatitis (3-11%), the prevalence and patterns of type IV allergic contact dermatitis have not been well characterised in epidemiological studies. The aim of this study was to identify host and environmental risk factors for symptoms, clinical eczema, positive patch tests, possible and probable allergic contact dermatitis in seafood processing workers. A cross-sectional study of 594 seafood processing workers was conducted in two seafood processing plants in the Western Cape Province of South Africa. The study used an interviewer administered questionnaire to collect information on demographic characteristics, occupational history, work practices and skin symptoms in the preceding 12 months. A subgroup of symptomatic workers (n=120) were investigated further and compared to a group of randomly selected asymptomatic workers (n=134). Both groups underwent clinical examination by experienced dermatologists and patch testing with a battery of standard allergens (adapted British Contact Dermatitis Group Standard Series) supplemented by various seafood products and additives used in the factory. Data of skin prick tests to common aeroallergens and seafood products, and serum omega-3 fatty acid (Eicosopentaenoic acid) collected in a previously reported study were also used.

Aim: To assess the health impact of an intervention in supermarket bakeries using fractional exhaled nitric oxide and other clinical endpoints for baker’s allergy and asthma after a one-year follow-up period. Methods: A field randomised controlled trial of 31 bakeries initially assigned to one of two intervention groups (bakery mixer lid and training) (n=244) and a control group (n=93). Health data prior to and after the intervention included a modified ECRHS questionnaire; Phadiatop ® and serum specific IgE to cereal flours (wheat, rye, alpha-amylase); and FeNO performed during the work shift using NIOX MINO®. The data of the two intervention groups was combined into one intervention group for the analysis. Data was analysed using STATA (version 12). Results: The two groups were comparable with regard to age (32-33 years), proportion of females (55%-57%) and smoking status (38%-40%). The intervention group had a significantly higher prevalence of workers with atopy (42%, p=0.025), work-related chest symptoms (25%, p=0.044) and sensitisation to cereal flour allergens (35%, p=0.042) at baseline than the control group (25%, 15%, 23% respectively). At one year of follow-up, the incidence and level of decline of work-related ocular-nasal and chest symptoms, sensitisation status and elevated FeNO (FeNO >25ppb) was similar in the two groups. The mean difference in FeNO was similar across the two groups (2.2ppb vs 1.7ppb, p=0.860). However, when stratifying according to baseline FeNO >25ppb, the FeNO decline was greater in the intervention group (16.9 ppb) than in the control group (7.7ppb), although not statistically significant (p=0.237). Multivariate logistic regression models (adjusting for smoking, baseline sensitisation to cereal flour, baseline FeNO >25ppb) did not demonstrate an appreciable decline in FeNO (>10%) in the intervention compared to the control group. However, stratification according to the presence of work related ocular-nasal symptoms at baseline demonstrated a significant decline (>10%) in FeNO in the intervention group compared to the control group (OR=3.73, CI: 1.22-11.42). Conclusion: This study demonstrates some evidence of an intervention effect on exhaled nitric oxide (FeNO) one year after the intervention, particularly among bakers reporting work-related ocular-nasal symptoms at baseline. The lack of a demonstrably stronger effect on other clinical endpoints can be attributable to the short follow-up period.

Background Occupational TB is the most frequently reported occupational disease in health care workers (HCWs) in South Africa. With the emergence of drug resistant strains and their associated health risks, and the associated increased risk for contracting these strains for HCWs, it becomes increasingly important to ensure that the worker’s compensation system is functioning properly for this disease. Whilst many studies have captured the poor functioning of the compensation system for workers in general in South Africa, the closest proxy examining the compensation of HCWs compensation for occupational TB is a study reviewing practices of occupational health nurses responsible for these cases. Whilst examining occupational injuries, workers, in general, report negative experiences with workers’ compensation processes. This study aimed to investigate the experience of health care workers whose cases of occupational TB were reported via the Western Cape Government Health department (WCG:H) to the Compensation Fund of the Department of Labour for compensation claim purposes. Methods This study was a case series with retrospective description, with a qualitative component. Simple random sampling was done on a subset of the population of cases of occupational TB recorded on a database held by the WCG:H administrative office responsible for submitting claims on behalf of WCG:H employees to the Compensation Fund. The study aimed to interview at least 100 HCWs who had reported their occupational TB as per the above mentioned database. In anticipation of a low expected response rate, 300 cases were sampled. Claim status for this sample were evaluated. Utilising general details obtained, an attempt was made to contact each HCW for a telephonic interview consisting of both open and close-ended (qualitative) questions. Fifty-one interviewers were completed. Interviews comprised of a structured telephonic interview carried out by one of three interviewers. The questionnaire consisted of three main sections examining (a) the experience of benefits available for people getting an occupational disease; (b) the experience of the process of reporting a case of an occupational disease to the Compensation Fund and (c) the process of having developed occupational TB as a HCW. Results Nearly half of the 300 cases from the provincial database had no record found on claim status check on the Compensation Fund website (n = 131, 46%). For claims without resolution with either acceptance or repudiation, the median waiting period from date of submission to 31 Dec 2017 was 5.8 years (IQR 3.2 - 9.2). 51 of the 144 cases for which contact attempt was made, gave consent (35% consent rate). Just under one third (n = 15, 31%) of the interviewees did not access occupational leave for their TB. Three quarters (n = 39; 75%) of employees incurred medical costs either personally or by their personal medical aid in relation to their diagnosis and treatment of TB. 21 (42%) of the participants reported ongoing medical problems and one reported being compensated for this. HCWs’ experience of contracting TB was marked by the experiences of stigma, surprise in contracting TB and financial stress as a result of their diagnosis. In addition, the experience of reporting their cases for compensation purposes was marred by poor administration and communication from all parties involved in the process. Conclusion The workers’ compensation system, i.e. the whole process from reporting through to benefit provision, has again been found to have many deficiencies. In this instance, HCWs are not receiving compensation benefits rightfully due to them for occupational TB. The experiences of HCWs contracting TB have been described as mostly being negative. In these negative experiences remedies to the system can be sought. The administrative components of submitting a claim, both by the claimant and by WCG:H to the Compensation Fund, have been found in this study to have a number of obstacles and gaps. Reform in communication, record keeping and timeously checking of claim status and payment of relevant compensation are required from the provincial level. Dedicated occupational health services were recommended by participants as these were expected to improve the service to potential claimants, as well as provide a source of information about the diagnosis and compensation aspects.

Objective: The aim of the study was to determine the risk factors associated with allergic sensitisation and various asthma phenotypes in poultry workers. Methods: A cross-sectional study of 230 currently employed poultry workers used a modified ECRHS questionnaire, spirometry, fractional exhaled nitric oxide, Phadiatop and ImmunoCAP for specific IgE to poultry farming associated allergens (chicken meat, feathers, serum protein, droppings, sunflower seeds, storage mite) and mould mix to investigate workrelated asthma. Results: The mean dust particulate concentration (geometric mean (GM) =11.04mg/m³) was highest in the rearing department while mean (1-3)-ß-D-glucan (GM=148 ng/ m³) and endotoxin levels (GM=2298 EU/m³) were highest in the catching department. Worker's mean age was 37±9 years, 68% were male, 43% current smokers, 34% atopic and 5% casual workers. The prevalence of non-atopic asthma (NAA=10%) was higher than atopic asthma (AA=6%) or probable occupational asthma (OA=5%). Sensitisation to at least one poultry work related allergen was 24%, with sunflower seed and storage mite sensitisation being the most prevalent (13%). In multivariate adjusted models, workers sensitised to chicken specific allergens were more likely to be atopic (OR=20.9, 95% CI: 4.7-93.2) or have casual job status (OR=6.0, 95% CI: 1.1-35.9). Workers with work-related chest symptoms were more likely to work in the rearing department (OR=3.2, 95% CI: 1.2-8.3) and to report episodes of high gas/dust/fume exposures causing asthma symptoms (OR=4.8, 95%CI: 2.4-9.6). Reversible obstructive airway obstruction was more strongly associated with employment in small broiler farms (OR=11.6, 95% CI: 1.0-129.0) as well as casual work (OR=6.4, 95% CI: 1.4-28.0). Furthermore, NAA was strongly associated with casual work (OR=5.0, 95% CI: 1.3-19.0) as well as working in the automated egg laying system (OR=8.0, 95% CI: 1.0-68.6). Further analysis revealed that the proportion of workers sensitised to at least one poultry work related allergen declined with increasing years of service (chi-square trend p=0.023), with workers having <2 years employment demonstrating a higher risk compared to those with >6 years employment (OR=4.0, 95% CI: 1.2-13.8). Conclusion: Non-atopic asthma is the most common asthma phenotype among poultry workers with work in the rearing department demonstrating an increased respiratory risk. The increased risk of reversible airway obstruction among workers in small broiler farms and the declining prevalence of sensitisation with increasing employment duration suggests a healthy worker effect. Preventive measures, including appropriate training, are recommended to reduce respiratory health risks, particularly in novice workers.

Includes bibliographical references. / The peak in production of the three forms of asbestos that were commercially mined in South Africa occurred in the years between 1970 and 1977. Given the latency period of 20-40 years, we should expect to observe a rise in the incidence of mesothelioma throughout this decade. However, all we may ever observe is just the surface of what may be an immeasurable burden of disease due to amongst other reasons, the lack of representative data and the nature of mesothelioma itself. As a result of the obstacles that impeded earlier research, South African studies that have been conducted since Wagner et al. first established the association between asbestos and mesothelioma in 1960, have reported under estimated measures of occurrence of the disease, especially amongst black examiners. It also due to the exploitation and injustice to former miners throughout the asbestos mining history that we remain with an unknown burden and epidemiology of disease as well as heavy costs towards healthcare and rehabilitation of mine dumps. The author sought to review the medical information of claimants registered on an asbestos compensation database hosting the largest number of black asbestos ex-miners of all case series published in South Africa to date. The aim was to describe the demography and the epidemiology of the disease amongst those who had been diagnosed with mesothelioma between 2003 and 2010. The protocol (PART A) describes a brief background of the two Trusts on which this study was based, and the methodology of the study. The literature review (PART B) illustrates the conditions that prevailed in the asbestos mining industry and how these have distorted the epidemiology of mesothelioma in South Africa. The manuscript of the article (PART C) illustrates the data analysis, the results, as well as the discussion of the results. The objective was to describe the proportions of mesothelioma cases within the database by various characteristics. We also described by race the investigations that the claimants underwent to reach the diagnosis. The results showed that out of the 15 461 claimants registered on the database, 295 (1.91%) had mesothelioma. Of these, 54.24 % were black, 7.80% coloured and 37.97% white. There were more men (76.69%) than women (23.39%).

Thesis (PH. D.)--University of Chicago, 1916. / Pub. also as an official report under the direction of the Ohio State Board of Health with title: A survey of industrial health-hazards and occupational diseases in Ohio. Includes bibliographical references and index. Also available on the Internet.

<p>Syfte och frågeställningar: Den här uppsatsens syfte var att ta reda på personalens upplevda hälsa och fysisk arbetskapacitet, fysiska krav i arbetet, samt motionsvanor inom Stockholms Stadsmission. Frågeställningarna var: Hur kan olika individers upplevda hälsa och fysiska krav i arbetet se ut inom skilda yrkesområden på ett och samma företag? Kan den fysiska arbetskapaciteten inom olika yrkesområden påverkas av motionsvanor? Kan rökning vara en faktor som påverkar upplevd hälsa och motionsvanor?</p><p>Metod: Datainsamlingen bestod av enkätundersökning, stegmätning samt steptest för beräkning av syreupptagningsförmågan. Undersökningen omfattade 48 personer från tre arbetsområden: administration, butik och restaurang. De utgjordes av 31 kvinnor och 17 män i åldrarna 19 till 63 år med en medelålder på 38 ± 14 år. På stegmätningen blev det ett bortfall på fem personer, och på steptestet ett totalt bortfall på 11 personer.</p><p>Resultat: Flertalet av deltagarna uppgav att de upplevde ett högt mått av glädje/lycka, kontroll/inflytande och meningsfullhet i sitt arbete. Upplevd hälsa skattades som ganska tillfredsställande eller högre. Upplevd fysik och hur den uppfyller kraven i arbetet skattades relativt högt och jämnt fördelat inom samtliga arbetsområden. Inom administration var arbetet mest stillasittande. Arbetet inom butik och restaurang var mer rörligt vilket bekräftades av resultaten från stegmätningen, och innebar även mer lyft. En arbetsställning där nacke/rygg var framåtböjd/sned el vriden var vanlig inom samtliga områden. Sju personer uppgav att de hade besvär i rygg/höfter och 12 personer att de hade besvär i nacke/axlar dagligen. Totalt svarade 12 personer att de rökte, varav åtta arbetade inom butik. Medelvärden på syreupptagningsförmågan från 37 genomförda steptest blev 39 ± 5 ml/kg/min, för butik 40 ± 5 ml/kg/min och för restaurang 42 ± 6 ml/kg/min.</p><p>Slutsats: Upplevd hälsa och fysik skattades relativt lika inom de tre arbetsområdena, trots stora skillnader i arbetsförhållanden. Den existerande besvärsförekomsten kunde inte kopplas specifikt till något arbetsområde. Det kan dock finnas en risk för framtida uppkomst och ökade besvär framför allt i nacke/axlar och rygg/höfter inom butik och restaurang. Trots att stegmätningen visade att butik och restaurang går nästan dubbelt så mycket på arbetet som administration, verkar inte syreupptagningsförmågan påverkas nämnvärt av att ha ett mer rörligt arbete. Det krävs sannolikt regelbunden fysisk aktivitet av högre ansträngningsgrad för att få positiva effekter på konditionen. Denna studies submaximala konditionstest ger inte en tillförlitlig uppfattning om studiedeltagarnas konditionsstatus, då de var få till antalet. Denna undersökning kunde se ett tydligt samband mellan rökning och lågt utövande av fysisk aktivitet.</p> / <p>Aim and questions: The aim of this survey was to study how the employees experienced their health, their work capacity, frequencies of injuries as well as exercise habits. The questions in the research were: How do different individuals experience health and working conditions in different professional areas within the same company? Could factors like exercise habits affect the physical work capacity within different professional areas?</p><p>Could smoking be a factor influencing how we experience health and exercise habits?</p><p>Method: The collection of data was performed by questionnaires, pedometer measuring and a step test for calculation of oxygen consumption. The survey included 48 persons from three different areas of work: administration, shop and restaurant. The group consisted of 31 women and 17 men between the ages of 19 to 63 years; the average age was 38 ± 14 years. In the pedometer testing there was a loss of five persons and in the step test there was a total loss of 11 persons.</p><p>Results: The participants declared that they experienced an important amount of joy/happiness, control/influence, and meaningfulness in their work. They valued their experienced health as fairly satisfactory or greater. Experienced physical performance and meeting the job requirements were relatively high estimated within all three areas of work. Within the administrative department the job was mostly sedentary. Test persons in the shop and the restaurant were more active which was confirmed by the pedometer testing and their work involved more lifting of things. The body bent forward or the back/neck twisted or flexed during work positions was occurring in all the studied areas. Seven persons described symptoms from back/hips and 12 persons described symptoms from neck/shoulders on a daily basis. On a total 12 persons said they were smokers, out of those, eight persons worked in the shop. The average test result of oxygen consumption during 37 step tests performed was 40 ± 6 ml/kg/min for women and 40 ± 5 ml/kg/min for men.</p><p>Conclusion: Within the three areas of work the test persons experienced a rather similar degree of health and physical capacity in spite of large differences in work conditions.</p><p>The prevalence of symptoms could not specifically be connected to any area of work.</p><p>Nevertheless there is a risk that the test persons working in the shop and the restaurant will show symptoms in the future predominantly from neck/ shoulders and back/hips.</p><p>Notwithstanding the fact that the pedometer measuring showed that people working in the shop and the restaurant walk almost twice as much as those within administration, the oxygen consumption is barely affected by a more active work situation. There is a probability that it requires a regular and higher level of physical activity in order to receive positive effects on a person's fitness status. The submaximal fitness test in this study does not provide a reliable conception of fitness status of the tested persons since they were too few. This study showed an obvious connection between smoking and low physical activity</p>