A thesis submitted to the Faculty of Health Sciences, University of the Witwatersrand, in fulfilment of the requirements for the degree of Doctor of Philosophy / Background Silicosis rates in gold miners in South Africa are very high but there have been no analyses of long term trends. While much research has been conducted on occupational respiratory disease in gold, asbestos and coal miners, little is known about the respiratory health of miners of other commodities, such as diamonds and platinum, two of the most important minerals in South Africa. The ore bodies from which minerals are mined often contain other „incidental‟ minerals and compounds that may cause disease. Aims The aims of this thesis were to conduct the first ever analysis of silicosis trends in black and white gold miners over a 33-year period; to discuss the role of oscillating migration in the high rates of silicosis; and to explore the potential for workers in the diamond and platinum mining sectors to develop occupational respiratory diseases. Methods Gold, diamond and platinum mine workers were identified from the PATHAUT autopsy database at the National Institute for Occupational Health. Trends in silicosis from 1975 to 2007 were calculated separately for black and white gold miners because of differences in exposure, patterns of employment and autopsy referral patterns. The role of oscillating migration in the silicosis epidemic was explored. Diamond mine workers with asbestos-related diseases at autopsy and platinum mine workers with silicosis and/or fibrotic nodules in the lymph nodes were identified. Supplementary data from other sources were reviewed to viii exclude all those who might have been exposed to asbestos or silica, respectively, outside of the mining sector in which they worked. Asbestos lung burdens were calculated for the case series of diamond miners and mine tailings and soil samples were examined for asbestos fibres, using scanning electron microscopy. Findings The proportion of white miners with silicosis increased by 17% (from 18% to 22%) over the 33-year study period. That of black miners increased 10-fold (from 3% to 32%), primarily due to the aging workforce and increasing periods of employment. Adjusted odds ratios for silicosis increased with year of autopsy for black miners. Oscillating migration has also played a major role in the silicosis epidemic. Evidence indicates that diamond mine workers are at risk for developing asbestosrelated diseases and that platinum mine workers are at risk for developing silicosis. Conclusion The gold mines have failed to control silica dust levels adequately and prevent disease in mine workers. The sparsity of available dust measurements and poorly documented work histories are major obstacles to conducting occupational health research in South Africa; attention and legislation needs to be focused urgently on these areas. The PATHAUT database is the only occupational respiratory disease database in South Africa that can be used for disease surveillance, trend analyses and research in all mining sectors.

PhD, Faculty of health Sciences, University of the Witwatersrand, 2000

Thesis (Ph. D.)--University of Hong Kong, 2001. / Includes bibliographical references (leaves 177-225)f.

Thesis (Ph. D.)--Ohio State University, 2003. / Title from first page of PDF file. Document formatted into pages; contains ix, 147 p. Includes bibliographical references (p. 143-147). Available online via OhioLINK's ETD Center

Thesis (MTech (Environmental Health))--Peninsula Technikon, 2004. / Word processed copy. Summary in English. Includes bibliographical references (leaves 122-126). Also available online.

Thesis (doctoral)--Lund University, 1995. / Added t.p. with thesis statement inserted.

Thesis (M.Ost.)--Unitec New Zealand, 2009. / Declaration created by cataloguer. Includes bibliographical references (leaves 87-92).

Thesis (doctoral)--Lund University, 1995. / Added t.p. with thesis statement inserted.

Orientador: Maria Cecilia Cardoso Benatti / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-04T02:45:24Z (GMT). No. of bitstreams: 1 Oliveira_AlexandraPetrilliBavarescoMartinsde_M.pdf: 6586053 bytes, checksum: 18c2526138870573736867a0cdd0519a (MD5) Previous issue date: 2004 / Resumo: A presente pesquisa, de caráter descritivo, teve como finalidade contribuir para o conhecimento da ocorrência de sintomas osteomusculares e qualidade de vida em médicos cirurgiões e clínicos em um hospital universitário da cidade de Campinas, estado de São Paulo. Este trabalho dá continuidade à linha de pesquisa em Saúde do Trabalhador desenvolvida pelo Departamento de Enfermagem da Faculdade de Ciências Médicas da Universidade Estadual de Campinas. Para isto, descreveu-se determinadas características pessoais e ocupacionais, avaliou-se a qualidade de vida e identificou-se a ocorrência dos sintomas osteomusculares nesta população. Foi utilizado um questionário auto-aplicável composto por três partes, contendo questões referentes aos Dados Gerais e Ocupacionais, o questionário genérico de avaliação da Qualidade de Vida (SF-36); e no que se refere aos sintomas osteomusculares foi utilizado a parte geral do Questionário Nórdico. Os aspectos éticos envolvidos no tema, abrangendo o sigilo pessoal e profissional dos entrevistados foi garantido em todas as etapas do trabalho. Participaram da pesquisa 186 médicos sendo, 91 cirurgiões e 95 clínicos, formados predominantemente pelo gênero masculino. A média da idade dos cirurgiões foi de 44,5 anos e dos clínicos de 46 anos. O tempo médio de atuação profissional na instituição pesquisada foi de 14,8 anos para os cirurgiões e 16,1 anos para os clínicos. A carga horária total de trabalho obteve um tempo médio de 51,8 horas/semana entre os cirurgiões e entre os clínicos foi de 44,1 horas/semana. Referiram trabalhar em outros locais desenvolvendo a mesma atividade 87,9% dos cirurgiões e 51,6% dos clínicos. Dentre as situações que mais os incomodavam durante a sua atividade de trabalho a falta de melhores condições de trabalho apresenta-se em primeiro lugar para os dois grupos. Em apenas um domínio do SF-36, "Aspectos Físicos" apresentou diferença estatística significante entre os grupos, sendo este valor menor entre os clínicos. No Questionário Nórdico, referiram apresentar sintomas osteomusculares pelo menos em uma região do corpo, 84,6% dos cirurgiões e 83,1% dos clínicos nos últimos 12 meses e nos últimos sete dias 52,8% dos cirurgiões e 50,5% dos clínicos. Ao comparar os dois grupos quanto ao impedimento de realizar as atividades normais verificou-se que os clínicos são mais prejudicados pelos sintomas nas regiões lombar e quadriVcoxa. Referiram buscar por auxilio a algum profissional da saúde devido a sintomas osteomusculares 43,3% dos cirurgiões e 30,4% dos clínicos. As regiões corporais mais atingidas, entre os participantes, foram a lombar, cervical, ombros e torácica. A procura por auxílio de um profissional da área da saúde e a influência na execução das atividades cotidianas reforçam o fato dos sintomas osteomusculares representarem um problema a estes trabalhadores. Os resultados apresentados confirmam a existência do problema e a necessidade de novas pesquisas / Abstract: Quality of Life Musculoskeletal Symptoms among Physicians at University Hospital This research intends to contribute with information about musculoskeletal symptoms and quality of life among physicians and surgeons at Campinas, São Paulo. This study is part of workers' health research developed by Nursing Department of Campinas State University Medical School. The author described individual and occupational aspects, evaluated quality of life and identified occurrence of musculoskeletal symptoms in this popuIation. A three section self-applied questionnaire was applied, asking general and occupational information, quality of life questions (SF-36) and general part of Nordic Questionnaire. These questionnaires are appropriated to the objectives and the results were subjected to descriptive statistical analysis. The ethical aspects reIated to the interviews, including professional silence were maintained throughout the research. There were 91 surgeons and 96 physicians. Among surgeons, 16 were female and 75 male gender; physicians were 39 female and 56 male. The average age among surgeons was 44.5 years and among physicians 46 years. The average length of work at the institution was 14.8 and 16.1 years for surgeons and physicians respectively and work time was 51.8 hours weekly for surgeons and 44.1 for physicians. 87.9% ofthe surgeons and 51.6% physicians also worked in other hospitaIs with the same activities. Lack of better working conditions was referred by both groups as the most bothering situation. Only in SF-36 "Physical Aspects" there was significant statistical difference between groups, with lower rates among physicians. Nordic Questionnaire showed 84.6% of the surgeons and 83.1% physicians referring musculoskeletal symptoms in at least on part of body during the Iast 12 months and 52.8% of the surgeons and 50.5% physicians in the last week. Comparing both groups according to possibility of performing usual activities, physicians complain more of symptoms in the lumbar and hip and leg regions. 43.3% of the surgeons and 30.4% physicians referred to seek another health professional help because of musculoskeletal symptoms, mainly in lumbar, neck, shoulders and thoracic regions. The search for help from a health professional and the influence to usual daily activities reinforce the importance of musculoskeletal disorders to these people. The obtained results confirm existence of the problem and the need of following researches / Mestrado / Enfermagem e Trabalho / Mestre em Enfermagem

The focus of the present study was on the investigation of the effects of an intervention strategy on an industrial task in situ and a simulation of the same task within a laboratory setting. The task of offloading crates from a truck at a local business was simulated in a laboratory setting for rigorous analysis. The effect of an ergonomically sound intervention on selected physical, physiological and perceptual variables was evaluated in a test - retest experimental set-up using 28 young, healthy male students. Each of the two experimental conditions lasted for 16 minutes. In the pre-intervention task subjects were required to transfer the crates from one point to another by sliding them along the floor. During the execution of the post-intervention task responses to reductions in the stacking height and modifications of the working method were evaluated. Results obtained for spinal kinematics during the simulated industrial task indicated a high biomechanical risk, due to large ranges of motion, high velocities and accelerations in the sagittal and transverse planes. The heavy workload of the task was also evident in elevated physiological responses (HR, RF, VT, VE, VO2, RQ, EE) and perceptual ratings (RPE, Body Discomfort). Assessment of the intervention strategy revealed that the ‘high risk’ industrial task was reduced to ‘moderate acceptable’, with measurements of spinal kinematics, physiological and perceptual variables being significantly reduced. An in situ re-assessment of the workers’ responses to the intervention also elicited reductions in heart rates and perceptual ratings compared to the original task.