Submitted in fulfillment of the requirements for the Degree of Master of Health Sciences in Nursing, Durban University of Technology. Durban. South Africa, 2017. / Introduction Musculoskeletal disorders (MSDs) are classified as occupational disease. They are described as disorders that affect the musculoskeletal system, and affect the health, productivity and careers of the working population. Dental technicians are at risk of MSDs as much as other members of the dental professionals as a result of their daily activities which involves manual work or they could be labour intensive. The risk factors for MSDs among dental professionals are multifactorial. Problem Statement There are currently no established statistics on the prevalence and risk of musculoskeletal disorders among dental technicians in South Africa. Purpose The purpose of the study was to determine the prevalence and risk of MSDs among dental technicians in South Africa. Research Method A quantitative research approach using a cross sectional correlational survey design was adopted for this study. Using a purposive sampling, the data base of all the dental technicians was obtained from the South African Dental Technician Council (SADTC) and those with valid e-mail addresses and telephone numbers were invited to participate in the study. A modified Nordic musculoskeletal questionnaire was used to collect data, 79 technicians responded with only 72 valid questionnaires available for analysis. Results The twelve month prevalence rate of MSDs among dental technicians in South Africa is 90%. MSDs was reported in all body parts and across all ages and genders. The prevalence for neck, hand/wrist, upper back and low back pain were the highest, having the same prevalence rate of 68.1%. The risk factors for MSDs in at least one body part that were identified in this study are age, prolonged standing and vibration. There was no significant relationship between gender, alcohol intake, smoking, having children and MSDs in any body part. However, a relationship exists between age and MSDs in the wrist/hand, standing and elbow pain, vibration and lower back symptoms. Conclusion The study showed that the prevalence of musculoskeletal disorder is high (90%) among dental technicians in South Africa. The prevalence of MSD is not age or gender related. However, some affected body parts were directly linked to age, standing and vibration. More research needs to be done on the ergonomics and workplace in order to address the high incidence of MSDs. / M

This study aims to ascertain the legal redress available to employees who suffer psychological harm as a result of workplace stress. On a general level, it identifies and assesses some of the available policy options, particularly as they relate to the interaction of statutory workers’ compensation schemes and the common law. On a more specific level, it examines and analyses various issues: the nature and extent of compensable psychiatric harm; the legal duty on employers to protect employees’ health and well being; the role of negligence; requirements specific to the Compensation for Occupational Injuries and Diseases Act 130 of 1993 (COIDA); and the causal nexus necessary to sustain a claim. The conclusion is reached that employees should utilise the workers’ compensation system as the primary vehicle to obtain redress if they suffer from occupational psychiatric harm. However, due to the law’s generally conservative approach to psychiatric harm and intimations that the Department of Labour intends setting strict requirements for claims for psychiatric harm in terms of COIDA, the common law of delict might continue to play an important role in claims for occupational psychiatric harm. The writer recommends that a hybrid system for compensation for stress-related psychiatric harm suffered in the course and scope of employment be adopted, with the statutory compensation scheme providing relatively limited benefits and the common law providing general damages if the claimant can prove negligence on the part of the employer; that the requirement of a recognised psychiatric illness be maintained for both statutory compensation and compensation in terms of the common law; that all parties’ interests are carefully balanced in delineating the employer’s legal duty to employers and that undue weight not be accorded to the terms of the contract of employment; that more attention be paid to factual causation and the development of lternatives/complements to the traditional conditio sine qua non test; that the validity of the circular instruction on post-traumatic stress disorder (PTSD) be tested on administrative-law grounds; and that the stringent prescription requirements set by the circular instruction on PTSD be reviewed.

The present study sought to investigate the effects of a Standard workstation, designed for “average” users, on an anthropometrically diverse sample of computer operators, and to assess whether physical and perceptual responses, as well as performance efficiency were dependent on stature. Further investigation assessed the influence of personalised adjustments to the Standard workstation, based on the anthropometric characteristics of the subjects, as well as the introduction of a custom-designed ‘floating’ wrist support, on subject responses. All subjects (n=30) were tested in each of the three workstations: Standard, Personalised and Wrist Support. For analysis of responses in the Standard workstation, subjects were divided into three groups depending on their stature: Short (<1650mm), Medium (1650mm to 1800mm), Tall (>1800mm). The musculoskeletal responses indicated that Tall subjects were forced to adopt the most awkward general body postures as a result of the low computer screen. However, the low screen allowed for the Short subjects to adopt the most natural general body postures, although levels of muscular activity in the upper trapezius suggest that the muscular load imposed on both Short and Tall subjects was significantly greater than that imposed on the Medium subjects. In addition, the Medium subjects’ perceptions of the Standard workstation dimensions support the fact that this workstation was better suited to users with “average” morphologies. The responses elicited in the Personalised and Wrist Support workstations were improved significantly when compared to the Standard workstation. Joint angles were more natural, upper trapezius EMG was reduced, standard of performance improved and perceptual responses indicated a diminished incidence of body and visual discomfort, as well as greater perceived satisfaction with these workstation dimensions. The improved physical responses suggest a decrease in the risk of developing cumulative trauma disorders. Although subjects were unaccustomed to the wrist support device, this workstation demonstrated a further reduction in the range of wrist angles, as well as a general positive attitude towards the concept.

v anglickém jazyce The dissertation thesis deals with a very substantial and permanent part of the labour law's field and labour law-related and the other connected relationships, i.e. the issue of the work accidents and occupational diseases, mainly from the perspective of that arised reponsability's relationship, resp. the employer's obligations to damages' compensation in relation to employee and his individual rights (claims) to the damages' compensation due to the incurred accidents in the form of a work accident or occupational disease. The author's impetus to the choise of the working accidents and occupational diseases' topic (resp. the employer's responsability for damages caused to emploees due to working accidents and occupational diseases) for the purposes of the dissertation thesis is owed to (permanently) a very substantial importance of the issue in the terms of labour law-related relationships and generally and essentially society-wide relationships, even if in despite of a very substantial importance of the issue the expert's litterature to the issue of the working accidents and occupational diseases is not to be considered as sufficient. The purpose of the dissertation thesis to analyse and evaluate the actual state of the legal regulation regarding the working accidents and...

This dissertation may be read on several different levels. At its most accessible, it is a detailed ethnographic description of how ‘women in mining’ negotiate the daily terrain of caregiving and being exposed to highly contagious and resistant diseases that are associated with mining, which could potentially adversely affect their day-to-day lives, wellbeing and family relations. At its most analytical, it utilises Nixon’s concept of ‘slow violence’ by carefully charting the challenges that a female mineworker faces; having to provide for her family even in the most difficult situations, and sometimes at the expense of her own health. Hence, ‘women in mining’ are situated in a web of connections that exist between working underground and being caregivers in their homes; while at risk of transmitting tuberculosis (TB) and acquiring reproductive health related problems. This dissertation illustrates the tactics and coping strategies that women in mining employ, and argues that they ‘make a plan’ to minimise the negative social consequences of ill health.

No description available.

Occupationally-related airway diseases, including asthma and chronic obstructive lung disease, have emerged as having substantial public health importance. The aim of this study was to identify the predictors of occupational sensitisation to grain dust allergens and changes in lung function among grain mill workers in Cape Town. There were two major objectives of the study. Firstly, to determine which of the following factors determine the distribution of serum ECP (eosinophilic cationic protein): age, gender, grain dust exposure, smoking status, atopy and sensitisation to workplace allergens. Secondly, to investigate the risk factors associated with the following outcomes: i) sensitisation to occupational allergens; ii) diagnosis of occupational asthma; iii) diagnosis of chronic obstructive airways disease; and iv) longitudinal changes in lung function. The risk factors studied included age, gender, smoking habits, occupational exposure, lung function status on baseline survey (1989), and allergic sensitisation assessed at follow up (1996). The methods employed involved a repeat measures cross-sectional design including a cohort followed up at different points over a seven year period. Survey instruments included a questionnaire, spirometry and allergy tests (phadiotop, RAST for wheat, rye, Lepidoglyphus destructor, Tyrophagus putrescentiae and Sitophilus granarius). The results indicated an association of grain dust with pulmonary function and allergic sensitisation to grain dust constituents. After adjusting for known confounders such as age, gender and smoking, significant associations were found between employment duration and both decrements in lung function and sensitisation to wheat grain. A decrement of 278 ml in FEY 1 and 328 ml in FYC was associated with occupational sensitisation to wheat (and rye). Increasing employment duration resulted in annual decrements of 18.3 ml in FEY1 and 23 ml in FYC for every year employed. The odds for developing occupational asthma was only mildly elevated (OR=l.35) with increasing employment duration. Age, however, was found to be protective (OR=0.85). Although we were unable to demonstrate a relationship between across-week changes in lung function, at inception, and rapid longitudinal lung function decline, our findings suggested that longitudinal change was related to the degree of airway obstruction at inception. Sensitisation to grain dust allergens was also found to be an independent predictor for FEY 1 and FYC. The prevalence of sensitisation was the highest for wheat (26.4%), followed by Tyrophagus putrescentiae (22.6%), rye (21.7%), Lepidoglyphus destructor (15.1 %) and Sitophilus granarius (15.1 %). Sensitisation to wheat was highly correlated with sensitisation to rye (r = 0.92) and so were Lepidoglyphus destructor and Tyrophagus putrescentiae (r = 0.85). Although a large proportion of the workforce ( 41.5 % ) were sensitised to occupational allergens, the prevalence of respiratory symptoms was between 15.6% and 23.9%. There were 16.7% of workers with health outcomes which fulfilled our criteria for occupational asthma. Atopic workers in our study had at least a nine-fold increased odds of becoming sensitised to grain dust allergens (OR: 8.9-74.7) and a two-fold increased odds of developing occupational asthma (OR= 1.9-84.9). Furthermore, the study found that smokers had a twofold increased odds of becoming atopic, thereby placing them at greater risk of developing respiratory health problems. The mean ECP in this population was 15.4 ug/1 (SD:2.5). Although 45.3% of the workers were atopic, it was not found to be predictor of elevated ECP levels. We were however able to demonstrate a significant association between ECP and sensitisation to grain allergens. Workers sensitised to wheat (positive RAST) had, on average, 1. 78 ug/1 higher ECP levels. The odds of having an elevated ECP (&gt; 15 ug/1) increased by 2.9 for workers sensitised to wheat grain. In conclusion, the results of the study indicate that selection effects are in operation, demonstrating the health worker effect. The findings also suggest that across week reactions may be less sensitive than the across shift changes in predicting rapid longitudinal decline in lung function. While we were able to characterise the distribution of ECP according to exposure, we were however unable to define the temporal relationship between elevated between exposures, ECP and lung function outcomes due to limitations of the study design.

Diisocyanates (dNCO) such as methylene diphenyl diisocyanate (MDI) are used primarily as cross-linking agents in the production of polyurethane products such as paints, elastomers, coatings and adhesives, and are the most frequently reported cause of chemically induced immunologic sensitization and occupational asthma (OA). Immune mediated hypersensitivity reactions to dNCOs include allergic rhinitis, asthma, hypersensitivity pneumonitis and allergic contact dermatitis. There is currently no simple diagnosis for the identification of dNCO asthma due to the variability of symptoms and uncertainty regarding the underlying mechanisms. Immunological sensitization due to dNCO exposure is traditionally thought to require initial conjugation of the dNCO to endogenous proteins to generate neoantigens, which trigger production of dNCO specific T lymphocytes and ultimately dNCO specific IgE. Testing for dNCO-specific IgE, for diagnosis of dNCO asthma is however, only specific (96-98%) but not sensitive (18-27%). The low prevalence of detectable dNCO specific IgE has been attributed to both assay limitations and a potential IgE-independent dNCO asthma mechanism(s). The identity of the conjugated proteins responsible for the sensitization also remains unknown. It is also not clear whether dNCOs bind to extracellular, cell membrane, or intracellular proteins as a way of triggering non-IgE asthma. Standardization and optimization of immunoassays used to screen for dNCO specific antibodies in sera is important if its utility as a dNCO asthma diagnostic tool is to be achieved. This will potentially improve sensitivity and allow comparison of results across studies. Current studies on assays of dNCO-specific IgE and IgG lack or have limited characterization of the conjugates used. Diisocyanates bound to hemoglobin (Hb), human serum albumin (HSA), and THP-1 proteins were quantified by HPLC with fluorescence detection. Proteomic tandem mass spectrometry (MS) was used to delineate TDI and MDI specific amino acid binding sites on Hb as well as identification of proteins from MDI exposed THP-1 cells. The trinitrobenzene sulfonic acid assay (TNBS) and SDS gel electrophoresis were used to evaluate extent of intra and intermolecular cross-linking in dNCO-HSA conjugates. Binding of monoclonal antibodies (mAbs) to dNCO bound proteins in enzyme-linked immunosorbent assay (ELISA) was used to evaluate antigenicity of dNCO-protein conjugates. The amount of dNCO binding to HSA and Hb increased with the concentration of the dNCO used for conjugation. All the dNCOs reacted with HSA more than with Hb. Eight binding sites were observed with both MDI and TDI on Hb. The N-terminal valines of both the alpha and beta subunits on Hb, lysine 40 of the alpha subunit and lysine 61 of the beta subunit were common binding sites for both TDI and MDI. Lysine 7 of the alpha subunit and lysines 8, 65 and 66 of the beta subunit were unique to MDI. On the other hand, lysines 11, and 16 of the alpha subunit and lysines 17 and 144 of the beta subunit were unique to TDI. Protein bound MDI was detected in a dose-dependent manner in membrane and cytoplasm fractions of MDI exposed THP-1 cells. MDI was also detected in 11 of the 13 cytoplasmic protein bands. The extent of MDI intracellular protein binding was not affected by cytochalasin D, a chemical that binds actin filaments and inhibits active uptake into cells. The extent of cross-linking shown using the TNBS assay was found to increase with amount of dNCO used. Clear bands from both intra and intermolecular cross-linking were observed on all dNCO-Hb/HSA SDS gels. Using ELISA, both TDI-Hb and TDI-HSA conjugates were reactive to monoclonal antibodies produced against TDI conjugated HSA indicating that dNCO-Hb is also antigenic. The best characterization of dNCO-protein conjugates is achieved by the quantitative determination of conjugated dNCO per mole of protein as well as determining the extent of dNCO cross-linking. Although HSA is more reactive to dNCOs than other serum proteins such as Hb, contribution from other serum proteins to development of OA should not be overlooked as dNCO-Hb was found to be reactive to dNCO specific mAbs. dNCO-conjugated proteins identified in the soluble fraction of MDI exposed THP-1 cells were all of intracellular origin suggesting that MDI can cross the cell membrane and react with intracellular proteins. The entry of MDI into live cells is a passive process, as the extent of intracellular binding was not affected by cytochalasin D. The present study support the potential involvement of dNCO-haptenated membrane and intracellular proteins in development of non-IgE dNCO asthma.

No description available.

So, Chun Lung. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2011. / Includes bibliographical references (leaves 178-196). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstract also in Chinese; appendix in Chinese.