In low-resource settings, there is a need to develop models that can address contributions of household and outdoor sources to population exposures. The aim of the study was to model indoor PM using household characteristics, activities, and outdoor sources. Households belonging to participants in the Mother and Child in the Environment (MACE) birth cohort, in Durban, South Africa, were randomly selected. A structured walk-through identified variables likely to generate PM . MiniVol samplers were used to monitor PM for a period of 24 hours, followed by a post-activity questionnaire. Factor analysis was used as a variable reduction tool. Levels of PM in the south were higher than in the north of the city (P < .05); crowding and dwelling type, household emissions (incense, candles, cooking), and household smoking practices were factors associated with an increase in PM levels (P < .05), while room magnitude and natural ventilation factors were associated with a decrease in the PM levels (P < .05). A reasonably robust PM predictive model was obtained with model R of 50%. Recognizing the challenges in characterizing exposure in environmental epidemiological studies, particularly in resource-constrained settings, modeling provides an opportunity to reasonably estimate indoor pollutant levels in unmeasured homes.
BackgroundVulnerable population groups in South Africa, especially those living in poverty, young children, women, the elderly and people with pre-existing diseases, are susceptible to new or exacerbated health threats resulting from climate change. Environmental Health Practitioners (EHPs) can play an important role in helping communities adapt to climate change health impacts, however, effective coordination of this requires further understanding of their roles in implementing climate change-related adaptation actions in communities.MethodsA cross-sectional survey using convenience sampling was undertaken at the January 2017 conference for EHPs hosted by the South African Institute of Environmental Health in Cape Town. All EHPs who attended the conference were invited to complete a study questionnaire that requested information on participant demographics, as well as climate change related-knowledge, practices and perceptions.ResultsMajority of participating EHPs (n = 48; 72.8%) had received formal or informal training on climate change and health. Thirty-nine percent of EHPs indicated that they had a climate change and health-related committee / working group in their department, a policy or strategy (41.0%) and budget allocated for climate change and health-related work (51.5%). A total of 33.3% had participated in climate change-related projects. Majority (62.2%) of EHPs believed that they should play a supportive role in addressing climate change while 37.8% believed that EHPs should play a leading role.ConclusionsRecognising the need for raising awareness about climate change adaptation as well as implementing appropriate interventions to combat climate-related ill health effects, especially among vulnerable groups, EHPs are well-placed to adopt significant roles in helping communities to adapt to climate change.
One of the greatest threats to public health is personal exposure to air pollution from indoor sources. The impact of air pollution on mortality and morbidity globally and in South Africa is large and places a burden on healthcare systems for treatment and care of air pollution-related diseases. Household air pollution (HAP) exposure attributed to the burning of solid fuels for cooking and heating is associated with several adverse health impacts including impacts on the respiratory system. The researchers sought to update the South African evidence on HAP exposure and respiratory health outcomes from 2005. Our quasi-systematic review produced 27 eligible studies, however, only four of these studies considered measures of both HAP exposure and respiratory health outcomes. While all of the studies that were reviewed show evidence of the serious problem of HAP and possible association with negative health outcomes in South Africa, no studies provided critically important information for South Africa, namely, local estimates of relative risks that may be applied in burden of disease studies and concentration response functions for criteria pollutants. Almost all of the studies that were reviewed were cross-sectional, observational studies. To strengthen the evidence of HAP exposure-health outcome impacts on respiratory health, researchers need to pursue studies such as cohort, time-series and randomised intervention trials, among other study designs. South African and other researchers working in this field need to work together and take a leap towards a new era of epidemiological research that uses more sophisticated methods and analyses to provide the best possible evidence. This evidence may then be used with greater confidence to motivate for policy-making, contribute to international processes such as for guideline development, and ultimately strengthen the evidence for design of interventions that will reduce HAP and the burden of disease associated with exposure to HAP in South Africa.
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