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Wright C.Y.,Modelling and Environmental Health Research Group | Wright C.Y.,University of Pretoria | Norval M.,University of Edinburgh | Hertle R.W.,Akron Children’s Hospital
Photochemistry and Photobiology | Year: 2015

Oculocutaneous albinism (OCA) is a genetically inherited autosomal recessive condition. Individuals with OCA lack melanin and therefore are susceptible to the harmful effects of solar ultraviolet radiation, including extreme sun sensitivity, photophobia and skin cancer. OCA is a grave public health issue in sub-Saharan Africa with a prevalence as high as 1 in 1000 in some tribes. This article considers the characteristics and prevalence of OCA in sub-Saharan African countries. Sun-induced adverse health effects in the skin and eyes of OCA individuals are reviewed. Sun exposure behavior and the use of photoprotection for the skin and eyes are discussed to highlight the major challenges experienced by these at-risk individuals and how these might be best resolved. © 2014 The American Society of Photobiology.


Schutte A.E.,North West University South Africa | Wright C.Y.,Modelling and Environmental Health Research Group | Langdon G.,University of Cape Town | Lochner C.,Stellenbosch University | Myers B.,University of Cape Town
South African Journal of Science | Year: 2013

The results of an online survey - the SAYAS Survey of Young Scientists that involved the participation of 1021 postgraduate students and postdoctoral fellows from tertiary institutions in South Africa - were released in a report launched in November 2013. In this commentary we highlight some of the key findings from the report: The Research Experience of Young Scientists in South Africa1. © 2013 The Authors.


Wright C.Y.,Modelling and Environmental Health Research Group | Wright C.Y.,University of Pretoria | Garland R.M.,Modelling and Environmental Health Research Group | Garland R.M.,North West University South Africa | And 2 more authors.
South African Medical Journal | Year: 2014

Climate change is projected to lead to warmer temperatures, especially in southern Africa, where the warming is predicted to be 2°C higher than the global increase. Given the high burden of disease already associated with environmental factors in this region, this temperature increase may lead to grave challenges for human health and quality of life. HIV/AIDS, poverty, food and water insecurity together with inequality and unemployment will further complicate the manner in which we will need to address the challenges of a changing climate. The health impacts are direct, such as increased temperatures leading to heat exhaustion, and indirect, such as likely increases in infectious diseases from contaminated water and changes in the distribution and/or magnitude of vector-borne diseases. The most effective measures for adapting to climate change to ensure healthy populations are to implement basic public health systems and services. These range from a continuous supply of clean water to adequate primary healthcare services. Support for required interventions is required not only from government, but also from healthcare professionals and communities. The need for disease surveillance, data capturing and more focused research is paramount.


Garland R.M.,Modelling and Environmental Health Research Group | Garland R.M.,North West University South Africa
South African Medical Journal | Year: 2014

The South African government has taken several steps in response to climate change and its associated threats to human health. The National Climate Change Response Plan White Paper defines government's vision for effective climate change response and transitioning to a climate-resilient, low-carbon economy. The White Paper identifies potential health challenges for South Africa (SA), including vector- and water-borne diseases and heat stress. The National Climate Change and Health Adaptation Plan (the Plan), prepared by the National Department of Health, expands on these health challenges, raising not only additional ones, but also related socioeconomic risk factors, such as housing and settlements. Community participation was adopted as one of the guiding principles for implementing the Plan, especially as behavioural change is likely to be important for adaptation and coping strategies. Multisectorial co-operation is also imperative, as many of the climate-related health risks involve multiple multidisciplinary stakeholders to implement appropriate interventions. Addressing inequalities and poverty in SA is critical to ensure that the health impacts from climate change are mitigated, particularly as current evidence suggests that the largest health risks are possibly among communities already most impacted by climate-related diseases. More research is needed to determine the impact of climate on health and which communities are the most vulnerable. Tailored monitoring and evaluation systems, linked with climate surveillance, will provide an opportunity to collect health data on key health risks to inform decision-making.


Wright C.Y.,Modelling and Environmental Health Research Group | Brogniez C.,Lille University of Science and Technology | Ncongwane K.P.,South African Weather Service | Ncongwane K.P.,University of KwaZulu - Natal | And 6 more authors.
Photochemistry and Photobiology | Year: 2013

To estimate potential sunburn risk for schoolchildren and outdoor workers, ground-based ambient solar ultraviolet radiation (UVR) measurements were converted into possible child (5% of ambient solar UVR) and outdoor worker (20% of ambient solar UVR) solar UVR exposures by skin type and season for three coastal sites: Durban, Cape Point (South Africa) and Saint Denis (Reunion Island, France). Cumulative daily ambient solar UVR levels were relatively high at all sites, especially during summer, with maximum values of about 67, 57 and 74 Standard Erythemal Dose (SED) (1 SED = 100 J m-2) at Durban, Cape Point and Saint Denis respectively. Sunburn risk was evident for both children and outdoor workers, especially those with skin types I and II (extremely to moderately sensitive) during summer, early autumn and/or late spring at all three sites. Although results need to be verified with real-time, instantaneous and nonintegrated personal solar UVR measurements, this understanding of sunburn risk is useful for initiating the development skin cancer prevention and sun protection awareness campaigns in both countries. Outdoor workers in sunny climates have the potential for high solar ultraviolet radiation (UVR) exposure. Their potential total daily solar UVR exposure may be overlaid with the estimated amount of solar UVR to elicit sunburn by skin type to highlight at-risk groups. Outdoor workers with skin types I, II, III, IV and V were at risk of sunburn on at least one day and in most cases more than several days during the year in all places investigated when applying the weighting of 20% of total daily ambient solar UVR exposure. For at-risk groups, targeted sun protection advice is necessary. © 2013 The American Society of Photobiology.


Makgabutlane M.,South African Weather Service | Makgabutlane M.,University of Pretoria | Wright C.Y.,University of Pretoria | Wright C.Y.,Environment and Health Research Unit | Wright C.Y.,Modelling and Environmental Health Research Group
South African Journal of Science | Year: 2015

The city of Pretoria in South Africa receives considerable solar ultraviolet radiation (UVR) because of its low latitude (22-35°S) and relatively clear skies. Certain meteorological factors affect the amount of solar UVR that reaches the ground; the most dominant factors being stratospheric ozone, cloud cover and solar zenith angle. It is known that overexposure to solar UVR may lead to the development of adverse health conditions, the most significant being skin cancer. Outdoor workers spend a significant amount of time outside and are thus susceptible to this risk. In this case study, we estimated, for the first time, the realtime solar UVR exposure of an outdoor worker in Pretoria. Measurements were made on 27 and 28 May 2013 using a handheld ultraviolet index (UVI) meter calibrated against a science-grade biometer at the South African Weather Service in Pretoria. Personal exposure estimation was used to discern the pattern in diurnal and annual sunburn risk for the outdoor worker. Ambient UVR levels ranged from 0 UVI to 4.66 UVI and the outdoor worker's potential exposure estimates regularly exceeded 80% of these levels depending on the time of day. The risk of sunburn was evident; however, actual incidents would depend on individual skin photosensitivity and melanin content, as well as sun protection used. Further research is needed to determine the personal exposure estimations of outdoor workers in other provinces in which solar UVR levels may be equally high, or higher than those in Pretoria. © 2015. The Author(s).


Wright C.Y.,Modelling and Environmental Health Research Group | Wright C.Y.,University of Pretoria | Reeder A.I.,University of Otago | Gray A.R.,University of Otago | Hammond V.A.,Public Health South
Skin Research and Technology | Year: 2015

Background: Skin color is related to human health outcomes, including the risks of skin cancer and vitamin D insufficiency. Self-perceptions of skin color may influence health behaviours, including the adoption of practices protective against harmful solar ultraviolet radiation levels. Misperception of personal risk may have negative health implications. The aim of this study is to determine whether Munsell® color chart assessments align with child self-reported skin color. Methods: Two-trained investigators, with assessed color acuity, visually classified student inner upper arm constitutive skin color. The Munsell® classifications obtained were converted to Individual Typology Angle (ITA) values and respective Del Bino skin color categories after spectrocolorimeter measurements based on published values/data. As part of a written questionnaire on sun protection knowledge, attitudes, and behaviours, self-completed in class time, students classified their end of winter skin color. Student self-reports were compared with the ITA-based Del Bino classifications. A total of 477 New Zealand primary students attending 27 randomly selected schools from five geographic regions. The main measures were self-reported skin color and visually observed skin color. Results: A monotonic association was observed between the distribution of spectrophotometer ITA scores obtained for Munsell® tiles and child self-reports of skin color, providing some evidence for the validity of self-report among New Zealand primary school children, although the lighter colored ITA defined groups were most numerous in this study sample. Statistically significant differences in ITA scores were found by ethnicity, self-reported skin color, and geographic residence (P < 0.001). Certain Munsell® color tiles were frequently selected as providing a best match to skin color. Conclusion: Assessment using Munsell® color charts was simple, inexpensive, and practical for field use and acceptable to children. The results suggest that this method may prove useful for making comparisons with other studies using visual tools to assess skin color. Alignment between the ITA distribution derived from the Munsell® assessment and child skin color self-reports could probably be improved, particularly with the addition of another 'light'/'white' color category in the self-report instrument. © 2015 John Wiley & Sons A/S.


Albers P.N.,Environment and Health Research Unit | Albers P.N.,University of Pretoria | Wright C.Y.,Environment and Health Research Unit | Wright C.Y.,Modelling and Environmental Health Research Group | And 4 more authors.
South African Medical Journal | Year: 2015

Background. This cross-sectional study examined respiratory health outcomes and associated risk factors in children living in a part of South Africa characterised by high levels of air pollution. Methods. A questionnaire was used to collect self-reported respiratory health and risk factor data from the parents/guardians of children between the ages of 9 and 11 years attending primary schools in the study area. Six government schools were selected based on their location, class size and willingness to participate. Univariate and bivariate analyses as well as logistic regression analysis were performed on the data, using a p-value of 0.25 and biological plausibility. Results. The overall prevalence of respiratory ill-health symptoms was 34.1%. The prevalence of respiratory ill-health conditions was significantly elevated among children from households using non-electrical fuels v. electricity for cooking (43.9% v. 31.6%; adjusted p-value 0.005). The same was noted among those using non-electrical fuels for heating (37.8% v. 29.0%). Conclusion. The elevated prevalence of some respiratory health outcomes among schoolchildren, especially in conjunction with domestic fossil fuel burning, is of concern. The data collected in this study may be used to complement or form a basis for future policy regarding indoor or ambient air quality in the area. © 2015, South African Medical Association. All rights reserved.


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.


PubMed | University of Otago, Modelling and Environmental Health Research Group and Public Health South
Type: Comparative Study | Journal: Skin research and technology : official journal of International Society for Bioengineering and the Skin (ISBS) [and] International Society for Digital Imaging of Skin (ISDIS) [and] International Society for Skin Imaging (ISSI) | Year: 2015

Skin color is related to human health outcomes, including the risks of skin cancer and vitamin D insufficiency. Self-perceptions of skin color may influence health behaviours, including the adoption of practices protective against harmful solar ultraviolet radiation levels. Misperception of personal risk may have negative health implications. The aim of this study is to determine whether Munsell() color chart assessments align with child self-reported skin color.Two-trained investigators, with assessed color acuity, visually classified student inner upper arm constitutive skin color. The Munsell() classifications obtained were converted to Individual Typology Angle (ITA) values and respective Del Bino skin color categories after spectrocolorimeter measurements based on published values/data. As part of a written questionnaire on sun protection knowledge, attitudes, and behaviours, self-completed in class time, students classified their end of winter skin color. Student self-reports were compared with the ITA-based Del Bino classifications. A total of 477 New Zealand primary students attending 27 randomly selected schools from five geographic regions. The main measures were self-reported skin color and visually observed skin color.A monotonic association was observed between the distribution of spectrophotometer ITA scores obtained for Munsell() tiles and child self-reports of skin color, providing some evidence for the validity of self-report among New Zealand primary school children, although the lighter colored ITA defined groups were most numerous in this study sample. Statistically significant differences in ITA scores were found by ethnicity, self-reported skin color, and geographic residence (P < 0.001). Certain Munsell() color tiles were frequently selected as providing a best match to skin color.Assessment using Munsell() color charts was simple, inexpensive, and practical for field use and acceptable to children. The results suggest that this method may prove useful for making comparisons with other studies using visual tools to assess skin color. Alignment between the ITA distribution derived from the Munsell() assessment and child skin color self-reports could probably be improved, particularly with the addition of another light/white color category in the self-report instrument.

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