Key Global Initiatives
As with many developing and even developed countries, South Africa has a dearth of accurate statistics on the incidence and prevalence of occupational diseases and hazard exposure. Establishment of a robust and reliable national occupational disease surveillance system is a high priority both in a nationally and global context to benchmark the current status and to develop occupational health indicators for South Africa to assess improvement.
With international support from many sources such as the World Health Organisation, the Faculty of Occupational Medicine in the United Kingdom and the Fogarty Foundation in the United States, the development of postgraduate training and research capacity has been enhanced. The NIOH has established the first Masters coursework and research programme in Occupational Hygiene in South Africa and is involved in the development of the specialty of Occupational Medicine. There is also an expansion of the variety and number of short courses, workshops and seminars to maximize capacity development in emerging fields such as occupational toxicology, clinico-pathological based improvement in medical practice, ergonomics and occupational allergy.
The NIOH has made a major contribution to national and global occupational health literature since its inception in the middle of the last century. The number of long service staff members and network of previous researchers and graduates associated with the NIOH facilitates cohort studies and the continuity provided by “corporate memory”. There is increasing international collaboration in research and publications in both the traditional areas of expertise at the NIOH and developing fields such as biomarkers through the development of academic and funding affiliations with South African and international institutions.
Similar to communicable diseases, occupational diseases can be regarded as traditional, emerging and re-emerging. Important traditional foci of occupational health are the chemical and physical hazards resulting mainly in respiratory diseases and noise induced hearing loss. Emerging conditions such as musculoskeletal, psychosocial disorders, reproductive dysfunction and occupational infections have resulted in a rapid expansion of the scope of occupational health over the last 20 years. The NIOH has responded accordingly with the recent development of ergonomics and bioaerosols units; an expansion and improvement of the library service to provide for “modern” as well as “traditional” occupational health issues; the development of the SADC Clearing House; and creation of a Resource Centre for greater use by trade unions and worker groups with the development of appropriate promotional materials.
Probably the most pressing re-emerging disease receiving global attention is silicosis which has been targeted for global eradication. Silica exposure and silicosis is of particular significance in southern Africa where the concomitant occupational tuberculosis is being fuelled by the multiplicative interaction of HIV infection with silicosis. Involvement of NIOH will include the Global Elimination of Silicosis Programme in the SADC region; the Sida (Swedish International Development and Co-operation Agency) sponsored Work and Health Programme in Southern Africa, and the WHO/ILO Joint Effort on Occupational Health and Safety in Africa. NIOH, as one of the few African WHO occupational health collaborating centres, has a pivotal role to play in these global initiatives. NIOH contributions include participation in international discussions on occupational exposure limits for silica, piloting the new “control banding” approach to risk assessment in small and medium enterprises and establishing an X-ray diffraction (XRD) laboratory for the NIOH to be a regional reference centre for silica dust analysis.
NIOH will function as a knowledge institute, which is an integral part of the national occupational health and safety system, to develop and support occupational health services. All training, service and research is directed towards building national capacity, in collaboration with global partners and within a multi-disciplinary milieu, with the ultimate goals being to promote healthy conditions in the workplace and improve the health of the South African workforce.