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

Abstract

Occupational healthcare is implicit in public law via regulatory laws and explicit in private law in the employment law sub-branch via the occupational health and safety laws. There are at least 11 laws, within public law (administrative law) and private law (commercial law) branches, requiring 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-àvis 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by literature or evidence synthesis methodologies, South African primary and secondary laws were reviewed along with unpublished (non-peerreviewed) grey literature.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.

Chemicals, noise and occupational hearing health in South Africa: A mapping study

“…Notably, these medications also have an impact on the vestibular system, resulting in vertigo or dizziness (Khoza-Shangase, 2018). While there is some appreciation of the ototoxic effects of relevant medications (Wium & Gerber, 2016), chemicals are rarely recognised as ototoxic agents in South African occupational settings and are not identified as contributing to occupational hearing loss (Manning & Pillay, 2020). Johnson and Morata (2010) reported impact on cochlear and central auditory processing structures owing to ototoxic properties from several solvents, for example, styrene, toluene, xylene, ethylbenzene, trichloroethylene, n-hexane, jet fuel, white spirit and other solvent mixtures.…”

“…Occupational hearing loss is configured exclusively on the meme that noise exposure is the only toxin. For a more detailed analysis of this bias and/or omission in the law, see Manning and Pillay (2020).…”