Occupational Health and Safety Statistics as an Indicator of Worker Physical Health in South African Industry

Advancing noise management in aviation: Strategic approaches for preventing noise-induced hearing loss

As urbanization and population growth escalate, the challenge of noise pollution intensifies, particularly within the aviation industry. This review examines current insights into noise-induced hearing loss (NIHL) in aviation, highlighting the risks to pilots, cabin crew, aircraft maintenance engineers, and ground staff from continuous exposure to high-level noise. It evaluates existing noise management and hearing conservation strategies, identifying key obstacles and exploring new technological solutions. While progress in developing protective devices and noise control technologies is evident, gaps in their widespread implementation persist. The study underscores the need for an integrated strategy combining regulatory compliance, technological advances, and targeted educational efforts. It advocates for global collaboration and policy development to safeguard the auditory health of aviation workers and proposes a strategic framework to enhance hearing conservation practices within the unique challenges of the aviation sector.

Medical and legal diagnoses comparison of the occupational diseases: A nationwide study in Turkey

OBJECTIVES

The underreporting of occupational diseases in many countries significantly hampers the development of intervention programs, posing a significant public health problem. Our study aimed to contribute to the occupational diseases surveillance by examining the data of hospitals authorized to issue reports throughout Turkey.

MATERIAL AND METHODS

This cross-sectional study was conducted using medical diagnoses of occupational diseases reported to the General Directorate of Public Health from 81 provinces in Turkey between 1 January 2018 and 31 December 2022. The study evaluated hospitals that made medical diagnoses of occupational diseases and compared age groups, genders, occupational disease diagnosis groups and provinces of work regarding legal and medical diagnoses.

RESULTS

The top three disease groups in terms of medical diagnosis are musculoskeletal disorders with 38.8%, respiratory diseases with 14.4% and hearing defects with 10.9%. Regarding legal diagnoses, respiratory system diseases ranked first with 26.4%, followed by musculoskeletal disorders with 8.2% and hearing defects with 5.5%. While the provinces where most cases of medical occupational diseases are diagnosed share similarities, the majority of affected individuals in Karabük and Batman have not received a legal recognition of the occupational disease. Two-thirds of Turkey's medical occupational disease diagnoses were made in two hospitals.

CONCLUSION

This study is reflecting national data in Turkey and is the country's first nationwide study. The number of occupational diseases in Turkey is lower than expected. It would be more accurate to express the data in a way that includes medical diagnoses instead of using the number of compensated files corresponding to legal diagnoses.

Noise risk assessment practices of four South African manufacturing and utilities companies

BACKGROUND

 The South African Noise Induced Hearing Loss (NIHL) Regulations, mandates employers to conduct a noise risk assessment, which records specific variables for determining the status of exposure and the need for implementation of control measures.

OBJECTIVES

 The study evaluated company noise risk assessment practices for alignment with legal requirements and specific risk assessment guidelines.

METHOD

 Convenience sampling was used to select the four manufacturing and utilities companies that participated in the study. The participating companies submitted latest noise risk assessment records for evaluation through the READ approach.

RESULTS

 The noise risk assessment records of three of the four companies omitted the recording of factors such as the reasonable deterioration in or failure of control measures, adequate control and formalisation of hearing conservation programmes (HCPs). When evaluated against the South African National Standard 31000 Risk Assessment guidelines, the risk assessment processes of the respective companies were lacking in addressing aspects related to establishing communication and consultation, evaluation, adapting, continually improving, leadership and commitment, and integration.

CONCLUSION

 The recorded information on the noise risk assessment reports from the four participating companies were incomplete, negatively affecting subsequent HCP management processes and decision-making. Future studies should investigate other aspects such as the implementation status of recommended noise controls as well as their effectiveness as recorded in the noise risk assessment records.Contribution: This study provided firsthand insights of company noise risk assessment practices, specifically identifying functional and technical areas requiring improvement to enhance current efforts directed towards the minimisation of NIHL within HCPs. The study highlighted that the current practices on recording noise risk assessment information remain incomplete, adversely diminishing the impact of the assessment as an important decision-making tool. The identified technical issues specifically, when addressed, will increase trust on the decisions derived from noise risk assessments.

"Asthma is a very bully disease" - patient experiences of living with chronic respiratory diseases in Cape Town, South Africa

BACKGROUND

Chronic respiratory diseases are common in Cape Town, South Africa. Yet the experiences of how adults with these conditions, such as asthma or COPD (chronic obstructive pulmonary disease), negotiate the health system are poorly understood. Qualitative methodology lends itself to investigate this question.

AIM OF STUDY

To explore the "emic" experiences of adults with CRDs in Cape Town when they were negotiating the health system using semi-structured interviews.

METHODS

Interviews were conducted following informed consent with purposively sampled adults who had attended public hospitals in Cape Town with chronic respiratory disease flare-ups. This work was nested in the quantitative "Diagnosing Airways Disease" study. The topic guide explored patients' experiences of accessing healthcare including receiving and interpretations of the diagnosis and management, and impacts on daily life. Interviews were conducted in Afrikaans, isiXhosa, or English; transcribed, and translated into English and thematically analysed until saturation.

RESULTS

Thirty-two interviews (16 in Afrikaans, 8 in isiXhosa, 8 in English) were completed in 2022. 17 women and 15 men participated. Most participants were older than 50 years (25/32), and most were unemployed (13/32) or retired (11/32). The identified themes were: Perceived causes of illness; experiences of healthcare; perceived risks and barriers when accessing healthcare; and impact on earnings. The perceived causes of their illness and risks were structural, and included air pollution, poor quality housing, occupational exposures, limited healthcare services, and fear of violence. These factors led to self-treatment, sharing of medicines, and delay in receiving a diagnosis. Many paid privately for treatments or services to overcome identified shortcomings of the public healthcare system, and many reported additional significant indirect costs. Being ill had a profound impact on income. The identified themes were explored through the lens of "structural violence", where "social structures stop individuals … from reaching their full potential" (Galtung, 1969).

CONCLUSION

In Cape Town structural elements such as stretched healthcare professionals, insufficiently enforced policies on e.g., housing or work-place exposures, poverty and crime made it difficult for participants to successfully navigate their illness experience. It forced some to pay out of pocket to receive perceived better healthcare privately.

Hearing Conservation Programme Costs at Selected South African Companies

The Occupational Health and Safety Act 1993 and its attending Regulations in South Africa, require employers to conduct cost analysis studies to inform decision-making related to exposure control for occupational health hazard such as noise. Cost analysis, as per South African National Standard/ISO 31000 risk assessment guideline, is an important input for the decision-making process of the risk management process. The costs of administrating a hearing conservation programme intended to minimise noise-induced hearing loss is an example of a cost analysis. This study enrolled four companies from the South African manufacturing and utilities sectors with the aim of establishing whether cost analysis is included during the noise risk assessment process; and determining administration costs of HCP administration. A HCP cost questionnaire was completed by each company's occupational hygiene professionals and risk officers. None of the companies in the study included cost analysis in their respective risk assessment processes. The overall costs, derived from the HCP cost item questionnaire, was much greater for Company A (4 290 014 Rands) than all of the other companies combined (970 685 Rands). Hearing protection device expenditures across the four companies were the greatest expense, while audiometry was the smallest expense owing to service internalisation. The HCP expenditures are incurred on periodic basis, yearly or biennial, and are internalised in companies as direct costs. Cost analysis can enhance the noise risk assessment process by providing additional input to support the decision-making process related to noise control. This challenges the occupational hygiene profession to pursue new frontiers and decision-making models in the scope of noise risk management, beyond noise measurements and hearing protection device use recommendation.

The Effect of Noise Exposure on High-Frequency Hearing Loss among Chinese Workers: A Meta-Analysis

The purpose of this study was to determine the burden of high frequency noise-induced hearing loss (HFNIHL) in Chinese workers exposed to hazardous noise through meta-analysis, to evaluate the major risk factors of HFNIHL in Chinese workers, and to provide evidence for reducing the risk of HFNIHL. We searched for relevant studies on HFNIHL published between January 1990 and June 2022. Inclusion and exclusion criteria were established to screen the literature, and the quality of the studies was assessed. Meta-analysis was performed using the software Stata 17.0. A total of 39 studies involving 50,526 workers in different industries were included in this study. The incidence of HFNIHL in the noise-exposed group (36.6%) was higher than that in the control group (12.5%), with a pooled odds ratio (OR) of 5.16 and a 95% confidence interval (CI) of 4.10-6.49. Sensitivity analysis showed that the results of this meta-analysis were stable. Funnel plots and Egger's test showed no publication bias. Subgroup analysis showed heterogeneity among the results of different studies, which was related to gender, publication year, age, length of work, and type of industry. The dose-response analysis showed that cumulative noise exposure (CNE) and length of work were the main risk factors for HFNIHL. This study suggests that the detection rate of HFNIHL is high in Chinese workers, the risk of HFNIHL increases rapidly when CNE reaches 90 dB(A)·year, and the first 15 years of exposure to noise is a period of increasing risk. Therefore, reasonable measures for preventing hearing loss should be taken to reduce the risk of occupational HFNIHL.