The role of employment-based exposure to hazardous substances in driving tuberculosis diagnosis among working-age men in South Africa

Abstract

Background: South Africa is one of the most tuberculosis-burdened countries in the world. As an emerging economic powerhouse in the continent, the country’s highly industrialized landscape provides both opportunity and probable morbidity/mortality in a “developmental disease-induced paradox” wherein development provisions better quality of life for beneficiaries whilst simultaneously making them more susceptible to disease as a result thereof. This study examines the association between employment-based exposure to hazardous substances and tuberculosis diagnosis among men aged between 18 and 65 years in South Africa. Methods: The study used data from the South Africa Demography and Health Survey. It constituted a sample size of 1,532 working-age men between 18 and 65 years. Bivariate regression was used to examine the relationship between employment-based exposure to hazardous substances and diagnosis of tuberculosis. Thereafter, an adjusted binary regression model was employed to examine the relationship between employment-based exposure to hazardous substances and tuberculosis diagnosis while adjusting for covariates. Analysis was conducted in STATA 16.0. Results: The study found 7% of men that participated in the study were diagnosed with TB in South Africa. Both the unadjusted and adjusted models revealed that men who reported being exposed to hazardous substances such as smoke, dust, and fumes were significantly more likely to be diagnosed with tuberculosis compared to men that reported not being exposed to such hazardous substances at work (UOR: 2.15; p<0.05; CI: 1.44-3.19; AOR: 1.83; p<0.05; CI: 1.15-2.90). Variables such as age, province, ethnicity, educational attainment, and asthma were also found to be statistically associated with tuberculosis diagnosis among men who participated in the study. Conclusion: The study reveals that men of working age in South Africa are susceptible to a developmental disease-induced paradox linked to TB diagnosis, one in which industrialization and the opportunities it avails for populations increase their risk of disease. As such, companies operating in South Africa should employ improved health and safety regulations to better safeguard employees from TB diagnosis. Moreover, to better manage the burden of disease, the South African government should strengthen its health infrastructure to trace and treat men diagnosed with the disease to facilitate ongoing economic development.