National Institute for Occupational Health NIOH

Johannesburg, South Africa

National Institute for Occupational Health NIOH

Johannesburg, South Africa
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Murray J.,National Institute for Occupational Health NIOH | Murray J.,University of Witwatersrand | Davies T.,University of Witwatersrand | Rees D.,National Institute for Occupational Health NIOH | Rees D.,University of Witwatersrand
Journal of Public Health Policy | Year: 2011

South African miners face an epidemic of occupational lung diseases. Despite a plethora of research on the mining industry, and the gold mining industry in particular, research impact (including disease surveillance) on policy implementation and occupational health systems performance lags. We describe the gold mining environment, and research on silicosis, tuberculosis, HIV and AIDS, and compensation for occupational disease including initiatives to influence policy and thus reduce dust levels and disease. As these have been largely unsuccessful, we identify possible impediments, some common to other low- and middle-income countries, to the translation of research findings and policy initiatives into effective interventions. © 2011 Macmillan Publishers Ltd.


Van Der Walt A.,University of Cape Town | Singh T.,National Institute for Occupational Health NIOH | Singh T.,University of Witwatersrand | Baatjies R.,University of Cape Town | And 4 more authors.
Occupational and Environmental Medicine | Year: 2013

Objective The aim of the study was to determine the prevalence and risk factors for allergic respiratory disease in spice mill workers. Methods A cross-sectional study of 150 workers used European Community Respiratory Health Survey questionnaires, Phadiatop, serum specific IgE (garlic, chili pepper), spirometry and fractional exhaled nitric oxide (FeNO). Personal air samples (n=62) collected from eight-hour shifts were analysed for inhalable particulate mass. Novel immunological assays quantified airborne garlic and chili pepper allergen concentrations. Results Mean dust particulate mass (geometric mean (GM)=2.06 mg/m3), chili pepper (GM=0.44 mg/m3) and garlic allergen (GM=0.24 mg/m3) were highest in blending and were highly correlated. Workers' mean age was 33 years, 71% were men, 46% current smokers and 45% atopic. Spice-dust-related asthma-like symptoms (17%) were common, as was garlic sensitisation (19%), with 13% being monosensitised and 6% cosensitised to chili pepper. Airflow reversibility and FeNO>50 ppb was present in 4% and 8% of workers respectively. Spice-dust-related ocular-nasal (OR 2.40, CI 1.09 to 5.27) and asthma-like (OR 4.15, CI 1.09 to 15.72) symptoms were strongly associated with airborne garlic in the highly exposed (>0.235 μg/m3) workers. Workers monosensitised to garlic were more likely to be exposed to higher airborne chili pepper (>0.92 μg/m3) (OR 11.52, CI 1.17 to 113.11) than garlic allergens (OR 5.08, CI 1.17 to 22.08) in this mill. Probable asthma was also more strongly associated with chili pepper than with garlic sensitisation. Conclusions Exposure to inhalable spice dust (GM >2.06 mg/m3) containing garlic (GM>0.24 μg/m3) and chili pepper (GM >0.44 μg/m3) allergens increase the risk of allergic respiratory disease and asthma.


Singh T.,National Institute for Occupational Health NIOH | Singh T.,University of Witwatersrand | Bello B.,National Institute for Occupational Health NIOH | Jeebhay M.F.,University of Cape Town
American Journal of Industrial Medicine | Year: 2013

Background: Exposure in the dental environment can increase the risk of respiratory disease in dental healthcare workers (HCWs). This study investigated the prevalence of asthma phenotypes in dental HCWs and associated risk factors. Methods: A cross-sectional study of 454 dental HCWs in five dental institutions in South Africa was conducted. A self-administered questionnaire elicited the health and employment history of subjects. Sera was analyzed for atopic status and latex sensitization. Pre- and post-bronchodilator spirometry was performed. Results: The prevalence of atopic asthma was 6.9%, non-atopic asthma 5.9% and work-exacerbated asthma (WEA) 4.0%. Atopy and work-related ocular-nasal symptoms were strong predictors of WEA (OR: 3.4; 95% CI: 1.07-10.8; OR: 6.7, 95% CI: 2.4-19.1), respectively. Regular use of personal protective equipment (PPE) was associated with a protective affect (OR: 0.23, 95% CI: 0.1-0.7) among non-atopic asthmatics, while glove use and respiratory protection was protective among atopic asthmatics (OR: 0.39, 95% CI: 0.17-0.89). Conclusion: Identification of risk factors associated with specific asthma phenotypes in dental HCWs can be used to focus preventive strategies for asthmatics. © 2012 Wiley Periodicals, Inc.


Vetten M.A.,National Institute for Occupational Health NIOH | Vetten M.A.,University of Witwatersrand | Tlotleng N.,National Institute for Occupational Health NIOH | Tlotleng N.,University of Witwatersrand | And 10 more authors.
Particle and Fibre Toxicology | Year: 2013

Background: Reliable in vitro toxicity testing is needed prior to the commencement of in vivo testing necessary for hazard identification and risk assessment of nanoparticles. In this study, the cytotoxicity and uptake of 14 nm and 20 nm citrate stabilised gold nanoparticles (AuNPs) in the bronchial epithelial cell line BEAS-2B, the Chinese hamster ovary cell line CHO, and the human embryonic kidney cell line HEK 293 were investigated.Methods: Cytotoxicity of the AuNPs was assessed via traditional XTT-, LDH-, and ATP-based assays, followed by cell impedance studies. Dark-field imaging and hyperspectral imaging were used to confirm the uptake of AuNPs into the cells.Results: Interference of the AuNPs with the XTT- and ATP-based assays was overcome through the use of cell impedance technology. AuNPs were shown to be relatively non-toxic using this methodology; nevertheless CHO cells were the most sensitive cell type with 20 nm AuNPs having the highest toxicity. Uptake of both 14 nm and 20 nm AuNPs was observed in all cell lines in a time- and cell type-dependent manner.Conclusions: Using the cell impedance and dark-field hyperspectral imaging technologies, it was possible to study the toxicity of AuNPs in different cell lines and show that these cells could internalize AuNPs with their subsequent intracellular aggregation. It was also possible to show that this toxicity would not correlate with the level of uptake but it would correlate with cell-type and the size of the AuNPs. Therefore, these two label-free methodologies used in this study are suitable for in vitro studies on the effects of AuNPs, and could present themselves as appropriate and valuable methodologies for future nanoparticle toxicity and uptake studies. © 2013 Vetten et al.; licensee BioMed Central Ltd.


Van der Walt A.,University of Cape Town | Baatjies R.,University of Cape Town | Baatjies R.,Cape Peninsula University of Technology | Singh T.,National Institute for Occupational Health NIOH | And 2 more authors.
Occupational and Environmental Medicine | Year: 2016

Background This study evaluated the determinants of high fractional exhaled nitric oxide (FeNO; >50 ppb) and serial changes in FeNO over a 24-hour period in spice mill workers at risk of work-related allergic respiratory disease and asthma. Methods A cross-sectional study of 150 workers used European Community Respiratory Health Survey (ECRHS) questionnaires, Phadiatop, serum-specific IgE (garlic, chilli pepper, wheat; Phadia, ImmunoCAP), spirometry and FeNO. A hand-held portable nitric oxide sampling device (NIOX MINO, Aerocrine AB) measured FeNO before and after the 8-hour shift and after 24 hours from baseline. Results The mean age of workers was 33 years; 71% were male, 46% current smokers and 45% atopic. Among workers with garlic sensitisation, 13% were monosensitised and 6% were co-sensitised to chilli pepper. Baseline preshift FeNO geometric mean (GM=14.9 ppb) was similar to the mean change across shift (GM=15.4 ppb) and across the 24-hour period (GM=15.8 ppb). In multivariate linear models, smoking (ß=-0.507) and atopy (ß=0.433) were strongly associated with FeNO. High FeNO (>50 ppb) was significantly associated with asthma-like symptoms due to spice dust (OR=5.38, CI 1.01 to 28.95). Sensitisation to chilli pepper was more strongly correlated with FeNO (r=0.32) and FeNO>50 ppb (OR=17.04, p=0.005) than garlic. FeNO increase (>12%) across 24 hours demonstrated a strong association with elevated exposures to spice dust particulate (OR=3.77, CI 1.01 to 14.24). Conclusions This study suggests that chilli pepper sensitisation is associated with high FeNO (>50 ppb), more strongly compared with garlic, despite the low prevalence of sensitisation to chilli. Elevated inhalant spice dust particulate is associated with a delayed elevation of FeNO across the 24-hour period. © 2016 by the BMJ Publishing Group Ltd.


Yassi A.,University of British Columbia | Zungu M.,National Institute for Occupational Health NIOH | Zungu M.,University of Pretoria | Spiegel J.M.,University of British Columbia | And 7 more authors.
Globalization and Health | Year: 2016

Background: Health workers are at high risk of acquiring infectious diseases at work, especially in low and middle-income countries (LMIC) with critical health human resource deficiencies and limited implementation of occupational health and infection control measures. Amidst increasing interest in international partnerships to address such issues, how best to develop such collaborations is being actively debated. In 2006, a partnership developed between occupational health and infection control experts in Canada and institutions in South Africa (including an institute with a national mandate to conduct research and provide guidance to protect health workers from infectious diseases and promote improved working conditions). This article describes the collaboration, analyzes the determinants of success and shares lessons learned. Methods: Synthesizing participant-observer experience from over 9 years of collaboration and 10 studies already published from this work, we applied a realist review analysis to describe the various achievements at global, national, provincial and hospital levels. Expectations of the various parties on developing new insights, providing training, and addressing service needs were examined through a micro-meso-macro lens, focusing on how each main partner organization contributed to and benefitted from working together. Results: A state-of-the-art occupational health and safety surveillance program was established in South Africa following successful technology transfer from a similar undertaking in Canada and training was conducted that synergistically benefitted Northern as well as Southern trainees. Integrated policies combining infection control and occupational health to prevent and control infectious disease transmission among health workers were also launched. Having a national (South-South) network reinforced by the international (North-south) partnership was pivotal in mitigating the challenges that emerged. Conclusions: High-income country partnerships with experience in health system strengthening - particularly in much needed areas such as occupational health and infection control - can effectively work through strong collaborators in the Global South to build capacity. Partnerships are particularly well positioned to sustainably reinforce efforts at national and sub-national LMIC levels when they adopt a "communities of practice" model, characterized by multi-directional learning. The principles of effective collaboration learned in this "partnership of partnerships" to improve working conditions for health workers can be applied to other areas where health system strengthening is needed. © 2016 Yassi et al.


Channa K.,University of Tromsø | Channa K.,National Institute for Occupational Health NIOH | Odland J.T.,University of Tromsø | Kootbodien T.,Medical Research Council MRC | And 6 more authors.
Science of the Total Environment | Year: 2013

Mercury is a persistent environmental pollutant that has the potential to adversely affect human health, particularly, foetal neurodevelopment. The purpose of the study was to investigate prenatal mercury (Hg) exposure in the population in three sites along the South Africa coast. Study subjects included women (n. =. 350) who were admitted for delivery at the local hospitals. Maternal and cord blood samples were collected to measure total mercury and each participant was required to answer a questionnaire. The 90th percentile of mercury levels in maternal and cord blood of the total population was 1.15. μg/l and 1.67. μg/l, respectively. Site 1 (Manguzi) participants had the highest maternal geometric mean (GM) values of 0.93. μg/l, which was significantly different from Site 2 (Port Shepstone) (0.49. μg/l) and Site 3 (Empangeni) (0.56. μg/l) (ANOVA test, p<. 0.001). Umbilical cord blood GM Hg level for Site 1 (1.45. μg/l) was more than double the GM Hg level in Site 2 (0.70. μg/l) and Site 3 (0.73. μg/l). Univariate analysis indicated that the following maternal characteristics were positive predictors for elevated umbilical cord Hg levels: maternal blood Hg levels, living with a partner, residing in Site 1, living in informal housing, using wood and gas for cooking, borehole water as a drinking source, and a member of the household being involved in fishing. Maternal dietary predictors of elevated Hg levels in umbilical cord blood included consuming fresh fish, tinned fish, fruit or dairy products, daily. This study provides baseline data and reveals that 2% of the study population were above the EPA's reference value (5.8. μg/l) suggesting low level exposure to mercury in pregnant women and the developing foetus in South Africa. Further research is required to explore the sources of elevated Hg levels in Site 1. © 2013 Elsevier B.V.


PubMed | University of British Columbia, University of the Free State, Vancouver General Hospital VGH, Compensation Commissioner and National Institute for Occupational Health NIOH
Type: | Journal: Globalization and health | Year: 2016

Health workers are at high risk of acquiring infectious diseases at work, especially in low and middle-income countries (LMIC) with critical health human resource deficiencies and limited implementation of occupational health and infection control measures. Amidst increasing interest in international partnerships to address such issues, how best to develop such collaborations is being actively debated. In 2006, a partnership developed between occupational health and infection control experts in Canada and institutions in South Africa (including an institute with a national mandate to conduct research and provide guidance to protect health workers from infectious diseases and promote improved working conditions). This article describes the collaboration, analyzes the determinants of success and shares lessons learned.Synthesizing participant-observer experience from over 9 years of collaboration and 10 studies already published from this work, we applied a realist review analysis to describe the various achievements at global, national, provincial and hospital levels. Expectations of the various parties on developing new insights, providing training, and addressing service needs were examined through a micro-meso-macro lens, focusing on how each main partner organization contributed to and benefitted from working together.A state-of-the-art occupational health and safety surveillance program was established in South Africa following successful technology transfer from a similar undertaking in Canada and training was conducted that synergistically benefitted Northern as well as Southern trainees. Integrated policies combining infection control and occupational health to prevent and control infectious disease transmission among health workers were also launched. Having a national (South-South) network reinforced by the international (North-south) partnership was pivotal in mitigating the challenges that emerged.High-income country partnerships with experience in health system strengthening - particularly in much needed areas such as occupational health and infection control - can effectively work through strong collaborators in the Global South to build capacity. Partnerships are particularly well positioned to sustainably reinforce efforts at national and sub-national LMIC levels when they adopt a communities of practice model, characterized by multi-directional learning. The principles of effective collaboration learned in this partnership of partnerships to improve working conditions for health workers can be applied to other areas where health system strengthening is needed.


Yah C.S.,National Institute for Occupational Health NIOH
Biomedical Research (India) | Year: 2013

The rapid emergence of gold nanoparticles (AuNPs) technology holds great promise for future applications due to their large volume specific surface areas with high diverse surface activities than bulk gold. These properties have made AuNPs of great importance in the development of excellent nanoelectronic chips, promising vehicle for a wide range of biomedical and environmental applications. However, the huge impact arising from the physiochemical properties has given rise to new concerns for future health status. Currently, there is dearth information on AuNPs health effects and no regulatory safety and guidelines relating their properties to toxicities. This review, therefore, focuses on the potential toxicological aspect of AuNPs experienced so far and their interactions with biological systems. These can be applied as measures to improve their biomedical applications and risk assessment. However, assessing the safety issues of nanoparticles is quite challenging, because of the vast physiochemical properties that confound their biomedical and toxicological profiles. Therefore more research with standardized NPs physicochemical properties is needed based on the different types of AuNPs to establish both in vitro and in vivo nanotoxicities. The establishment of each size with specific ligand properties will update the complex conflicting ideas emanating from the different AuNPs safety studies thereof.


PubMed | National Institute for Occupational Health NIOH
Type: | Journal: Particle and fibre toxicology | Year: 2013

Reliable in vitro toxicity testing is needed prior to the commencement of in vivo testing necessary for hazard identification and risk assessment of nanoparticles. In this study, the cytotoxicity and uptake of 14 nm and 20 nm citrate stabilised gold nanoparticles (AuNPs) in the bronchial epithelial cell line BEAS-2B, the Chinese hamster ovary cell line CHO, and the human embryonic kidney cell line HEK 293 were investigated.Cytotoxicity of the AuNPs was assessed via traditional XTT-, LDH-, and ATP-based assays, followed by cell impedance studies. Dark-field imaging and hyperspectral imaging were used to confirm the uptake of AuNPs into the cells.Interference of the AuNPs with the XTT- and ATP-based assays was overcome through the use of cell impedance technology. AuNPs were shown to be relatively non-toxic using this methodology; nevertheless CHO cells were the most sensitive cell type with 20 nm AuNPs having the highest toxicity. Uptake of both 14 nm and 20 nm AuNPs was observed in all cell lines in a time- and cell type-dependent manner.Using the cell impedance and dark-field hyperspectral imaging technologies, it was possible to study the toxicity of AuNPs in different cell lines and show that these cells could internalize AuNPs with their subsequent intracellular aggregation. It was also possible to show that this toxicity would not correlate with the level of uptake but it would correlate with cell-type and the size of the AuNPs. Therefore, these two label-free methodologies used in this study are suitable for in vitro studies on the effects of AuNPs, and could present themselves as appropriate and valuable methodologies for future nanoparticle toxicity and uptake studies.

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