Occupational health and safety in the Southern African Development Community

Pneumoconiosis among artisanal miners in Chunya district, Mbeya, Tanzania

This case series sheds light on the pulmonary diseases afflicting artisanal gold miners in Chunya district, Mbeya, Tanzania. We present 3 cases from a group of 21 miners. The patients, ranging in age and mining exposure, exhibited symptoms of severe pulmonary conditions, including pneumoconiosis, pulmonary hypertension and Cor pulmonale, attributed to prolonged exposure to dust and inadequate protective measures in mining environments. These cases underscore the urgent need for enhanced occupational health standards and preventive strategies in artisanal mining communities.

Occupational survey-based evidence of health status and welfare problems of workers with pneumoconiosis in China

Background

Pneumoconiosis is the most dangerous occupational disease in China. According to unofficial records, nearly million migrant workers were affected by pneumoconiosis in 2011, with the number increasing annually. Among them, a large number of migrant workers suffering from pneumoconiosis were not medically diagnosed. Therefore, fundamental questions remain unanswered: what is the background of workers who receive a diagnosis of pneumoconiosis, and how does pneumoconiosis affect their future and well-being?

Methods

In this study, we identified and surveyed 1,134 workers with pneumoconiosis in seven selected regions in China with substantially high incidences of pneumoconiosis by using a combination of cluster sampling, convenience sampling, and snowball sampling. We used demographic, medical, and rehabilitation conditions and welfare questionnaires to collect the data.

Results

The findings highlighted the socioeconomic status of patients with pneumoconiosis. The majority of workers with pneumoconiosis were adult men who had received no higher education, who lived in rural households, and who were employed in mining or manufacturing industries. Among these workers, 52.8% had been exposed to dust at work for more than 10 years, and 53.1% received a diagnosis of stage II or III pneumoconiosis. More than half of the workers (569 workers, 50.2%) did not receive comprehensive, routine treatment; 33.4% (379 workers) visited a doctor when they experienced physical discomfort, and 6.6% (75 workers) never received treatment. Only 156 workers (13.8%) received rehabilitation services, whereas 978 workers (86.2%) never did. The study results also revealed the severe financial difficulties faced by patients with pneumoconiosis. Only 208 workers (18.3%) had access to work-related injury insurance, with the cost of pneumoconiosis treatment being a substantial burden for 668 workers (60.6%).

Conclusion

In this study, we explored the existing health and welfare problems faced by workers with pneumoconiosis in China and identified the social injustice and health disparities that these workers experience. We also clarified the primary challenges in implementing safety, health, and welfare policies for these workers and those who are exposed to high-risk environments, such as those working in mining.

A Global Review of Implementation of Occupational Safety and Health Management Systems for the Period 1970 to 2020

BACKGROUND

Global awareness on Occupational Safety and Health management systems (OSHMSs) has been increasing exponentially with time over the years. Evidence on the public domain shows that there is still much skepticism and reluctance on implementing OSHMSs, particularly in the least developed and developing countries. The primary objective of the theoretical review was to analyze the available evidence of research gaps on OSHMSs implementation globally over the period 1970 to 2020.

METHODS

The review adopted a descriptive mixed methods design premised on its ability to provide a platform for data triangulation that is paramount in enhancing the authenticity of the review findings.

RESULTS

Many studies conducted on implementation of OSHMSs were bereft of examining the challenges of OSHMSs implementation. The review further exposed some OSHMSs implementation disparities existing between the developed and the developing world, hence a conclusion can be drawn that a 'one size fits all approach' to OSHMS implementation may not ideal for many workplaces.

CONCLUSION

This review recommends contextualization of OSHMSs implementation taking into consideration other differing environmental factors. Ultimately, the review recommends propagation of further research that will exude the challenges associated with implementation of OSHMSs and their causal factors thereby providing the basis for establishment of problem driven solutions to increase uptake of OSHMSs at workplaces.

Assessing the nature of asthma in African epidemiological studies: a scoping review protocol

BACKGROUND

Asthma is one of the most common chronic respiratory conditions in the world and is increasing in prevalence, particularly in Africa and other low-income countries. The disproportionately high numbers of premature deaths and severe or uncontrolled cases in many African countries are indicative of their inability to cope with a costly disease like asthma. Progress has, however, been made in understanding the complex and heterogeneous nature of the disease. The objective of this study will be to summarise the epidemiological literature on the nature of asthma in African countries.

METHODS

We registered a study protocol for a scoping review. The review was designed following the Arksey and O'Malley framework. We will search PubMed/MEDLINE, African Journals Online (AJOL) and relevant grey literature (e.g. Google Scholar, EBSCOhost) from January 1990 onwards. Only primary epidemiological studies of asthma (e.g. frequency, disease mechanisms, associated risk factors and comorbidities) written in English and conducted in Africa will be included. Two reviewers will independently screen all citations, full-text articles and abstract data. Potential conflicts will be resolved through discussion. Findings will be reported using narrative synthesis and tabulation of the summaries.

DISCUSSION

This scoping review will capture the state of the current epidemiological literature on asthma in African countries. Results will be published in a peer-reviewed journal. We anticipate this review will identify gaps and make recommendations for future areas of study.

SCOPING REVIEW REGISTRATION

Open Science Framework http://osf.io/n2p87/.

Accessing Occupational Health Services in the Southern African Development Community Region

Only 15% of the global population has access to occupational safety and health services. In Africa, only 5% of employees working from major establishments have access to occupational health services (OHS). Access to primary health care (PHC) services is addressed in many settings and inclusion of OHS in these facilities might increase efficiency in preventing occupational diseases. A cross-sectional study was conducted in four Southern African Development Community (SADC) countries aiming at assessing the availability of OHS at PHC facilities and the organization of OHS. We conducted a literature review to assess the provision and organization of OHS services. In addition to the review, a total of 23 doctors from Zambia were interviewed using questionnaires in order to determine the availability of OHS and training. Consultations with heads of ministries were done in four SADC countries. Results showed that in the SADC region, OHS are fragmented and lack a comprehensive approach. In addition, out of 23 PHC facilities, only two (13%) provided occupational health and PHC. However, OHS provided at PHC facilities were limited to TB screening and audiometric testing. Our study showed a huge inadequacy of trained occupational health practitioners. This study supports the World Health Organization’s advocacy to integrate OHS at the PHC level.