Work-related tuberculosis (TB) remains a public health concern in low- and middle-income countries. The use of vital registration data for monitoring TB deaths by occupation has been unexplored in South Africa. Using underlying cause of death and occupation data for 2011 to 2015 from Statistics South Africa, age-standardised mortality rates (ASMRs) were calculated for all persons of working age (15 to 64 years) by the direct method using the World Health Organization (WHO) standard population. Multivariate logistic regression analysis was performed to calculate mortality odds ratios (MORs) for occupation groups, adjusting for age, sex, year of death, province of death, and smoking status. Of the 221,058 deaths recorded with occupation data, 13% were due to TB. ASMR for TB mortality decreased from 165.9 to 88.8 per 100,000 population from 2011 to 2015. An increased risk of death by TB was observed among elementary occupations: agricultural labourers (MORadj = 3.58, 95% Confidence Interval (CI) 2.96–4.32), cleaners (MORadj = 3.44, 95% CI 2.91–4.09), and refuse workers (MORadj = 3.41, 95% CI 2.88–4.03); among workers exposed to silica dust (MORadj = 3.37, 95% CI 2.83–4.02); and among skilled agricultural workers (MORadj = 3.31, 95% CI 2.65–4.19). High-risk TB occupations can be identified from mortality data. Therefore, TB prevention and treatment policies should be prioritised in these occupations.
Waste-picking is an income-generating opportunity for individuals living in poverty. Waste picking is associated with a range of risk factors for common mental disorders (CMD). This study aimed to determine the prevalence and factors associated with CMD among waste pickers in Johannesburg. A cross-sectional study analyzed secondary data for 365 waste pickers. A validated Self-Reporting Questionnaire (SRQ-20) was used to assess CMD. Multivariable logistic regression was fitted to identify factors associated with CMD. The overall prevalence of CMD among waste pickers was 37.3%. The odds of having CMD were 2.5 and 3.2 higher in females and cigarette smokers, respectively (p = 0.019 and p = 0.003). Life enjoyment (Adjusted odds ratio [aOR] 0.54, p = 0.02) and a good quality of life (aOR 0.34, p ≤ 0.001) were associated with lower odds of CMD. The high prevalence of CMD among waste pickers was significantly associated with cigarette smoking, being female, not enjoying life, and a poor quality of life. Mental health awareness of CMD will assist with the prevention, early detection, and comprehensive management of CMD among waste pickers.
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