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

Abstract

Death and (hearing) disability as collateral damage for workersEvery day, 6000 women and men die because of occupational fatalities. Of those who survive, 160 million live with disabling injuries or illnesses (International Labour Organisation, 2019). Amongst this workforce, hearing loss is the main contributor to disability-adjusted life years for approximately one in five workers (WHO, 2018). This highly preventable disability is a global concern. Occupational noise exposure is a major cause of hearing loss (Basner, 2019). The general perception is that occupational hearing loss is greater in industrialised (minority world) countries like in Australia, New Zealand, North America and other European countries. However, in less industrialised (majority world) regions, ~21% of workers (vs. ~16% in the minority world) experience disabling hearing loss (Basner et al., 2014;Nelson, Nelson, Concha-Barrientos, & Fingerhut, 2005).In, sub-Saharan Africa, the World Bank recently (2016-2017) commissioned a study on occupational health in the mining sector (Osewe & Nkrumah, 2018). According to this report, hearing loss accounted for 18% of the burden of injury among ex-mine workers in Lesotho, Mozambique, South Africa and Swaziland. Historically, this is not unusual given how migrant workers across the world were (and continue) to work in 3D (dirty, dangerous and difficult) jobs (Pillay, 2013). Osewe and Nkrumah also presented a novel model of worker-centred hearing healthcare across hearing screening, audiological management and aural rehabilitation. Significantly, from an early Background: Chemical exposure leading to ototoxicity is a fresh challenge for occupational healthcare in South Africa. Objectives:The critical question is: 'what is known about occupational ototoxic chemicals with or without noise exposure in South Africa?' Method: This qualitative, mapping study was completed with published (peer-reviewed) and grey literature from 1979-2019. Data was analysed using the Preferred Reporting Items for Systematic reviews and Meta-Analyses: extension for Scoping Reviews and the Nursing and Allied Health Resources Section subcommittee on Mapping the Literature of Nursing and Allied Health (adapted). Numerical analysis of article type was completed, but the primary focus was on capturing patterns/trends using thematic analysis and ideology critique.

Occupational Hearing Loss for Platinum Miners in South Africa: A Case Study of Data Sharing Practices and Ethical Challenges in the Mining Industry

“…The use of machine learning systems to improve data quality and protect personal information has been legislated in South Africa [ 17 , 24 ], but data automation intended to guide medical decision still presents challenges. The participating mine used MS Excel and QMed to record miners’ data.…”

“…The mine adhered to the rules that govern patient confidentially and protection of personal information with regard to occupational medical record keeping [ 24 ]. The National Health Act [ 26 ], Booklet 5 of the HPCSA [ 24 ], the MHSA [ 34 ], and the POPI Act [ 16 ] clearly state that healthcare professionals are mandated to record health data for all users (patients and/or employees) and to design electronic information systems to ensure the security of health records. By using MLSs for big data storage, the mine complied with these requirements.…”

“…There are factors, other than noise, that are associated with hearing loss [ 8 , 19 ], such as ageing, being male and black, genetic predisposition, exposure to recreational noise [ 19 ], and treatments for tuberculosis and HIV [ 19 , 20 , 21 , 22 , 23 ]. Exposure to chemicals (nitrogen sulphide and carbon monoxide) emitted during some mining processes have also been reported to increase the risk of hearing loss, but research on this is limited in the South African mining industry [ 24 ]. Studies using miners’ HCP records have shown that data on common medical conditions (tuberculosis, cancer and HIV) and treatments thereof [ 22 ], as well as data on occupational exposures (dust and chemicals) that are associated with ONIHL, are often kept separately from HCP data [ 16 , 19 ].…”

“…While the protection of miners’ data is ensured by these acts and rules [ 17 , 24 , 26 , 28 ], the mining companies impose additional restrictions to data access for external medical practitioners and researchers, citing the protection of miners’ medical information as the reason for doing so.…”