Environment and Health Research Unit

Johannesburg, South Africa

Environment and Health Research Unit

Johannesburg, South Africa
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Mathee A.,Environment and Health Research Unit | Mathee A.,University of Johannesburg | Mathee A.,University of Witwatersrand
NeuroToxicology | Year: 2014

The prevention of lead exposure continues to constitute a major public health challenge in developed countries. In well-resourced countries major lead exposure reduction interventions have resulted in significant improvements in childhood blood lead distributions. In developing countries on the other hand, while lead exposure and poisoning remain serious public health concerns, a range of prevailing factors and circumstances, such as poverty, a large informal sector, competing public health challenges, low levels of awareness of lead hazards and weak capacity to enforce legislation, contribute to an increase in the scale and intensity of the challenge, and limit the prospects of comparable success in the foreseeable future.This paper collates available information to illustrate that despite some progress, a wide range of sources of lead exist in South Africa, and that certain settings and groups continue to be at high risk of lead exposure. Lead exposure in relation to paint, mining, lead melting in subsistence fishing communities, the consumption of Ayurvedic medicines and food production is described, and discussed with regard to the key factors hindering efforts to prevent lead poisoning and exposure in South Africa and many other developing countries. © 2014 The Authors.

Naicker N.,Environment and Health Research Unit | De Jager P.,University of Witwatersrand | Naidoo S.,National Institute for Occupational Health | Mathee A.,University of Johannesburg
PLoS ONE | Year: 2016

Introduction Low and middle income countries bear the majority burden of self-harm, yet there is a paucity of evidence detailing risk-factors for self-harm in these populations. This study aims to identify environmental, socio-economic and demographic household-level risk factors for self-harm in five impoverished urban communities in Johannesburg, South Africa. Methods Annual serial cross-sectional surveys were undertaken in five impoverished urban communities in Johannesburg for the Health, Environment and Development (HEAD) study. Logistic regression analysis using the HEAD study data (2006-2011) was conducted to identify household-level risk factors associated with self-harm (defined as a self-reported case of a fatal or non-fatal suicide attempt) within the household during the preceding year. Stepwise multivariate logistic regression analysis was employed to identify factors associated with self-harm. Results A total of 2 795 household interviews were conducted from 2006 to 2011. There was no significant trend in self-harm over time. Results from the final model showed that self-harm was significantly associated with households exposed to a violent crime during the past year (Adjusted Odds Ratio (AOR) 5.72; 95% CI 1.64-19.97); that have a member suffering from a chronic medical condition (AOR 8.95; 95% 2.39-33.56) and households exposed to indoor smoking (AOR 4.39; CI 95% 1.14-16.47). Conclusion This study provides evidence on household risk factors of self-harm in settings of urban poverty and has highlighted the potential for a more cost-effective approach to identifying those at risk of self-harm based on household level factors. © 2016 Naicker et al.This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Lund C.,University of Cape Town | De Silva M.,London School of Hygiene and Tropical Medicine | Plagerson S.,Environment and Health Research Unit | Cooper S.,University of Cape Town | And 4 more authors.
The Lancet | Year: 2011

Growing international evidence shows that mental ill health and poverty interact in a negative cycle in low-income and middle-income countries. However, little is known about the interventions that are needed to break this cycle. We undertook two systematic reviews to assess the effect of financial poverty alleviation interventions on mental, neurological, and substance misuse disorders and the effect of mental health interventions on individual and family or carer economic status in countries with low and middle incomes. We found that the mental health effect of poverty alleviation interventions was inconclusive, although some conditional cash transfer and asset promotion programmes had mental health benefits. By contrast, mental health interventions were associated with improved economic outcomes in all studies, although the difference was not statistically significant in every study. We recommend several areas for future research, including undertaking of high-quality intervention studies in low-income and middle-income countries, assessment of the macroeconomic consequences of scaling up of mental health care, and assessment of the effect of redistribution and market failures in mental health. This study supports the call to scale up mental health care, not only as a public health and human rights priority, but also as a development priority. © 2011 Elsevier Ltd.

Westaway M.S.,Environment and Health Research Unit | Westaway M.S.,University of Pretoria
Archives of Gerontology and Geriatrics | Year: 2010

This paper examines the impact of chronic disease status on health and well-being of South Africans in early and later old age. A structured questionnaire, comprising demographic characteristics, self-reported chronic disease status, an 18-item health problems scale and the health and well-being sub-scales from the SF-12 was used to collect data from 400 black, 101 Indian, 107 white and 102 colored residents of Greater Pretoria, South Africa. One hundred and ninety (27%) reported no chronic disease, 181 (25%) had hypertension alone, 179 (25%) had hypertension combined with one or more other chronic diseases and 160 (23%) had other chronic diseases without hypertension. There were no significant differences on health and well-being by race, language, gender or marital status. However, there were significant race, age group and gender effects on chronic disease status. Controlling for these factors, the no chronic disease group had significantly better health and well-being than the other three groups; the group with hypertension alone also had better health and well-being than the chronic disease groups with and without hypertension. It was concluded that chronic diseases combined with and without hypertension were more detrimental to health and well-being than no chronic disease or hypertension alone. © 2009 Elsevier Ireland Ltd.

Wright C.Y.,University of Pretoria | Reeder A.I.,University of Otago | Albers P.N.,Environment and Health Research Unit
Health Education Research | Year: 2016

Interventions in primary schools that increase sun-protective behaviours and decrease ultraviolet radiation exposure, sunburn incidence and skin cancer risk can be effective. SunSmart School Accreditation Programmes (SSAP) are recommended. Prior to SSAP implementation in South Africa, we explored the feasibility of obtaining national baseline information and investigated possible associations between strategies regarding sun protection in schools and students' responses to a questionnaire. Principals from randomly selected urban government schools in all nine South African provinces completed a questionnaire and 679 students were surveyed. The mean sun-related knowledge and behaviour scores of students were 4 (range: 1-7) and 3 (range-0-8) out of 9, respectively. The mean school sun protection effort score was 4 out of 14. There were no statistically significant correlations between students' knowledge or behaviour scores and their school score. The World Health Organization recommends an SSAP to address policy, practice and curriculum changes to support sun protection of students. This cross-sectional study demonstrates the feasibility of, and need for, a larger baseline study with longitudinal, multi-variable follow-up which includes other influential factors, such as parent support. Such research could quantify the impact of the SSAP and identify which key factors influence the sun-related knowledge and behaviours of students. © The Author 2016. Published by Oxford University Press.

Nguyen K.A.,University of Cape Town | Nguyen K.A.,Chronic Diseases of Lifestyle Unit | de Villiers A.,Chronic Diseases of Lifestyle Unit | Fourie J.M.,Chronic Diseases of Lifestyle Unit | And 3 more authors.
Public Health Nutrition | Year: 2013

Objective: To explore the perceptions of educators from the Western Cape Province about the feasibility of implementing South African food-based dietary guidelines (FBDG) in the national curriculum of primary schools. Design: Combined quantitative and qualitative methods. We report on the quantitative component. Setting: Twelve public primary schools of different socio-economic status in three education districts of the Western Cape: Metro Central, Metro East and Cape Winelands. Subjects: Educators (n 256) participated in the self-completed questionnaire survey. Results: Educators assessed that FBDG were appropriate to South African schoolchildren (94%), could be used as an education tool (97%) and fill gaps in the current curriculum about healthy dietary habits (91%). Besides Life Orientation, FBDG could be taught in other learning areas from grades 3 to 7 (9-13 years old). Important barriers to implementing FBDG in the curriculum were educators' workload (61%), insufficient time (46%), learners' disadvantaged background (43%) and educators' lack of knowledge (33%). Other approaches to teach children about FBDG included linking these to the National School Nutrition Programme (82%), school tuck shops (79%), parent meetings (75%), school nutrition policy (73%) and school assembly (57%). Educators in high-income schools perceived that learners' lifestyle was significantly worse (P < 0·001) and that tuck shops and the school assembly were the best means to teach pupils about FBDG (P < 0·001 and P < 0·05). Conclusions: Implementing FBDG in the national school curriculum is seen as important together with optimizing the school physical environment. Key factors required for successful implementation in the curriculum are sufficient educational materials, adequate time allocation and appropriate educator training. Copyright © The Authors 2013.

De Wet T.,University of Johannesburg | Plagerson S.,University of Johannesburg | Harpham T.,London South Bank University | Mathee A.,Environment and Health Research Unit
International Journal of Public Health | Year: 2011

Objectives: This study aimed to investigate the relationship between housing, demographic, socio-economic, social factors and health, in poor urban communities in Johannesburg, South Africa. Methods: Data were drawn from a survey of 1,427 households in Johannesburg. The outcome health variable was a composite measure of chronic ill-health. Housing variables included type of housing, tenure and access to services. Multivariate regression analysis assessed the relationship between housing and health, after adjustment for demographic, socio-economic and social factors. Results: The prevalence of chronic health problems was 25.1% (95% CI 22.8-27.6%). Factors independently associated with the risk of chronic ill-health among household heads included older age (OR, 3.06 [2.37-3.95]), female gender (OR, 2.83 [2.01-3.97]), long-term residence (OR, 2.01 [1.10-3.67]), unemployment (OR, 0.49 [0.36-0.67]), and living in formal housing (OR, 0.66 [0.45-0.98]). Conclusions: The health of the household heads residing in informal housing was significantly better than in formal housing. Explanations for this counter-intuitive finding include the fact that the informal housing dwellers were younger and recent migrants (the 'healthy migrant' phenomenon). Policy implications of the results are identified. © 2011 Swiss School of Public Health.

Wright C.Y.,Modelling and Environmental Health Research Group | Albers P.N.,Environment and Health Research Unit
South African Journal of Science | Year: 2013

Exposure to solar ultraviolet (UV) radiation is known to have both adverse and beneficial consequences for human health. Sunburn and skin cancer are probably the most well-known acute and chronic adverse health impacts. These themes have recently been discussed in the media for the general public; consequently interest in sun protection is growing. The promotion of the use of practical personal strategies to reduce adverse health risks, such as healthy sun behaviour, sun protection mechanisms and solar ultraviolet radiation awareness tools, is increasing. One such tool is the personal UV index (UVI) monitor, promoted commercially as a viable tool for sun awareness; however, such instruments have not been scientifically evaluated in a South African context. Here, two different types of personal UVI monitors, commercially available in South Africa, were compared with a research-grade UVB biometer for a continuous 7-h period on 02 March 2012 in Pretoria. One of the two personal UVI monitors showed reasonable agreement with the UVB biometer, whereas the other monitor overestimated UVI by up to 4 UVI units. When comparing two identical products manufactured by the same company, one monitor overestimated UVI twofold, suggesting inter-instrument variability may be a concern. Commercially available, personal UVI monitors should be used with caution as a public health tool for sun awareness in South Africa. © 2013. The Authors.

Street R.A.,Environment and Health Research Unit
South African Medical Journal | Year: 2016

South Africa (SA) has legislation that regulates almost all of its healthcare systems. The Traditional Health Practitoners Act finally provides legitimisation of an overwhelmingly popular indigenous healthcare system. However, as a consequence of the legal acknowledgement of traditional health practitioners, traditional medicine products must now also be brought under regulatory measures. If traditional medicines are to be prescribed, marketed and sold as part of a healthcare system recognised under SA law, they must meet the same stringent standards. © 2016, South African Medical Association. All rights reserved.

PubMed | Biostatistics Unit and Environment and Health Research Unit
Type: Journal Article | Journal: International journal of environmental research and public health | Year: 2017

Increased temperatures affect human health and vulnerable groups including infants, children, the elderly and people with pre-existing diseases. In the southern African region climate models predict increases in ambient temperature twice that of the global average temperature increase. Poor ventilation and lack of air conditioning in primary health care clinics, where duration of waiting time may be as long as several hours, pose a possible threat to patients seeking primary health care. Drawing on information measured by temperature loggers installed in eight clinics in Giyani, Limpopo Province of South Africa, we were able to determine indoor temperatures of waiting rooms in eight rural primary health care facilities. Mean monthly temperature measurements inside the clinics were warmer during the summer months of December, January and February, and cooler during the autumn months of March, April and May. The highest mean monthly temperature of 31.4 2.7 C was recorded in one clinic during February 2016. Maximum daily indoor clinic temperatures exceeded 38 C in some clinics. Indoor temperatures were compared to ambient (outdoor) temperatures and the mean difference between the two showed clinic waiting room temperatures were higher by 2-4 C on average. Apparent temperature (AT) incorporating relative humidity readings made in the clinics showed realfeel temperatures were >4 C higher than measured indoor temperature, suggesting a feeling of stuffiness and discomfort may have been experienced in the waiting room areas. During typical clinic operational hours of 8h00 to 16h00, mean ATs fell into temperature ranges associated with heat-health impact warning categories of caution and extreme caution.

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