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A critical analysis of the current South African occupational health law and hearing loss.

ABSTRACT: BACKGROUND:Occupational health laws must recognise the constitutional requirement of substantive equality, and its role in 'the progressive realisation' of the rights provided by Section 27. OBJECTIVES:Our main aim is to review current South African occupational health law (vis-à-vis workers' constitutional rights) in relation to hearing loss. We focus on gaps in the law regarding occupational hearing loss in South Africa. METHOD:Our review of legal texts relies on experience as a methodological device augmented by the use of a critical science. Guided by literature or evidence synthesis methodologies, South African primary and secondary laws were reviewed along with unpublished (non-peer-reviewed) grey literature. An established six-step framework guided our thematic analysis. A semantic approach aided the critical interpretation of data using the Bill of Rights as a core analytical framework. RESULTS:Four themes are discussed: (1) separate and unequal regulatory frameworks; (2) monologic foregrounding of noise; (3) minimisation of vestibular disorders; and (4) dilution of ototoxic agents. The highly divided legal framework of occupational health and safety in South Africa perpetuates a monologic 'excessive noise-hearing loss' paradigm that has implications for the rights of all workers to equal protections and benefits. There is a need to harmonise occupational health and safety law, and expand the scope of hearing-protection legislation to include the full range of established ototoxic hazards. CONCLUSION:Occupational audiology is dominated by efforts to address noise-induced hearing loss. A 'noise' despite the reality of workers' exposures to a range of ototoxic stressors that act synergistically on the ear, resulting in audio-vestibular disorders.

SUBMITTER: Manning WG

PROVIDER: S-EPMC7136813 | biostudies-literature | 2020 Mar

REPOSITORIES: biostudies-literature

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A critical analysis of the current South African occupational health law and hearing loss.

Manning Warren G WG Pillay Mershen M

The South African journal of communication disorders = Die Suid-Afrikaanse tydskrif vir Kommunikasieafwykings 20200324 2

<h4>Background</h4>Occupational health laws must recognise the constitutional requirement of substantive equality, and its role in 'the progressive realisation' of the rights provided by Section 27.<h4>Objectives</h4>Our main aim is to review current South African occupational health law (vis-à-vis workers' constitutional rights) in relation to hearing loss. We focus on gaps in the law regarding occupational hearing loss in South Africa.<h4>Method</h4>Our review of legal texts relies on experien ...[more]

PMID: 32242441

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Project description:BACKGROUND:Occupational noise-induced hearing loss (ONIHL) is a complex, but preventable, health problem for South African miners. Meticulously collected data should be made use of to design interventions to address this health issue. OBJECTIVES:A single mine's electronic data were reviewed in a secondary data review to determine, from the records, factors that hearing conservation practitioners deemed useful for identifying 'at risk' miners and to establish factors that would pave the way for the integration of the 2014 hearing conservation programme (HCP) milestones into the mine's current proactive data management system (PDMS). The objectives of this article were to establish how miners with published risk factors associated with ONIHL were managed by the mine's hearing conservation practitioners as part of the HCP; to determine if the mine's hearing conservation practitioners could estimate miners' risk of ONIHL using baseline percentage loss of hearing (PLH) as a hearing conservation measure; and to estimate the contribution of noise exposure to ONIHL risk. METHOD:In a secondary data review design, records in a platinum mine's two electronic data sets were reviewed: the first contained diagnostic audiometry records (N = 1938) and the second comprised a subset of miners diagnosed with ONIHL (n = 73). Data were available for the period 2014-2017 and included demographic, occupational, audiometry and ONIHL diagnosis data. Miners' risk factors associated with ONIHL were identified using the functional risk management structure. A logistic regression model was used for the baseline PLH margins of 0% - 40% (in 5% increments) to estimate the adjusted predictions for miners at risk of developing ONIHL. The contribution of noise exposure as a risk for ONIHL was estimated using a two-way sample proportion test. RESULTS:The mean age of the miners (all male candidates) was 47 ± 8.5 years; more than 80% had worked for longer than 10 years. Valid baseline audiometry records were available for only 34% (n = 669) of the miners. Miners with a 0% baseline PLH had a 20% predicted risk of ONIHL, and a 45% predicted risk if they had a 40% baseline PLH - these employees were referred. The noise exposure risk rankings revealed that 64.9% (n = 1250) of the miners were exposed to 91 dBA - 105 dBA noise exposure levels and that 59 (80.8%) diagnosed with ONIHL were exposed to noise levels of up to 104 dBA. CONCLUSION:These findings indicate significant gaps in the mine's PDMS, requiring attention. Nonetheless, the mine's current data capturing may be used to identify miners at risk of developing ONIHL. The PLH referral cut-off point (?2.5%) used by the mine's hearing conservation practitioners, when used in conjunction with baseline PLH shifts, was the major factor in early identification of ONIHL in miners exposed to ?85 dBA noise. An inclusive integrative data management programme that includes the medical surveillance data set of the miners' noise exposure levels, occupations, ages and medical treatments for tuberculosis and human immunodeficiency syndrome is recommended, as these are important risk indicators for developing ONIHL, particularly within the South African context.

Project description:ObjectiveMost of the Chinese occupational population are becoming at risk of noise-induced hearing loss (NIHL). However, there is a limited number of literature reviews on occupational NIHL in China. This study aimed to analyse the prevalence and characteristics of occupational NIHL in the Chinese population using data from relevant studies.DesignSystematic review and meta-analysis.MethodsFrom December 2019 to February 2020, we searched the literature through databases, including Web of Science, PubMed, MEDLINE, Scopus, the China National Knowledge Internet, Chinese Sci-Tech Journal Database (weip.com), WanFang Database and China United Library Database, for studies on NIHL in China published in 1993-2019 and analysed the correlation between NIHL and occupational exposure to noise, including exposure to complex noise and coexposure to noise and chemicals.ResultsA total of 71 865 workers aged 33.5±8.7 years were occupationally exposed to 98.6±7.2 dB(A) (A-weighted decibels) noise for a duration of 9.9±8.4 years in the transportation, mining and typical manufacturing industries. The prevalence of occupational NIHL in China was 21.3%, of which 30.2% was related to high-frequency NIHL (HFNIHL), 9.0% to speech-frequency NIHL and 5.8% to noise-induced deafness. Among manufacturing workers, complex noise contributed to greater HFNIHL than Gaussian noise (overall weighted OR (OR)=1.95). Coexposure to noise and chemicals such as organic solvents, welding fumes, carbon monoxide and hydrogen sulfide led to greater HFNIHL than noise exposure alone (overall weighted OR=2.36). Male workers were more likely to experience HFNIHL than female workers (overall weighted OR=2.26). Age, noise level and exposure duration were also risk factors for HFNIHL (overall weighted OR=1.35, 5.63 and 1.75, respectively).ConclusionsThe high prevalence of occupational NIHL in China was related to the wide distribution of noise in different industries as well as high-level and long-term noise exposure. The prevalence was further aggravated by exposure to complex noise or coexposure to noise and specific chemicals. Additional efforts are needed to reduce occupational noise exposure in China.

Project description:BACKGROUND:South Africa's quadruple burden of disease, coupled with health system challenges and other factors, predicts a high burden of disability within the population. Human Resources for Health policy and planning need to take account of this challenge. Occupational therapists are part of the health rehabilitation team, and their supply and status in the workforce need to be better understood. METHODS:The study was a retrospective record-based review of the Health Professions Council of South Africa database from 2002 to 2018. The data obtained from the Health Professions Council of South Africa was analysed for the following variables: geographical location, population groups, age, practice type and sex. Data was entered on a Microsoft Excel spreadsheet and analysed using the Statistical Package for the Social Sciences (SPSS version 22.0). RESULTS:In 2018, there were 5180 occupational therapists registered with the Health Professions Council of South Africa with a ratio of 0.9 occupational therapists per 10 000 population. There has been an average annual increase of 7.1% over the time period of 2002-2018. The majority of occupational therapists are located in the more densely populated and urbanised provinces, namely Gauteng, Western Cape and KwaZulu-Natal. Most of the registered occupational therapists are under the age of 40?years (67.7%). The majority (66%) are classified as white followed by those classified as black and coloured. Females make up 95% of the registered occupational therapists. Nationally, 74.8% of occupational therapists are deployed in the private sector catering for 16% of the population while approximately 25.2% are employed in the public sector catering for 84% of the population. CONCLUSIONS:Under-resourcing and disparities in the profile and distribution of occupational therapy human resources remain an abiding concern which negatively impacts on rehabilitation service provision and equitable health and rehabilitation outcomes.

Dataset Information

A critical analysis of the current South African occupational health law and hearing loss.

Publications

A critical analysis of the current South African occupational health law and hearing loss.

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