Looking to Promote a Culture of Sustainable Prevention in Occupational Health and Safety

Authors: Dr Sophia Kisting (NIOH Executive Director); Prof Jim Phillips; Prof David Rees and Ms Shanaz Hampson

Gold was discovered on the Witwatersrand in 1885 and just one year later the city of Johannesburg was founded. Even in these early days, the pioneering miners of the reef suffered from chest disease due to the dusty conditions in which they worked. South Africa became the centre for research into mining related diseases and this was acknowledged in 1930 when Johannesburg hosted the first International Silicosis Conference. Following on this work, the Pneumoconiosis Research Unit (PRU) came into being in 1956. Over the years the role of this unit has expanded not just to investigate disease in the mining industry but to look at all aspects of occupational health across sectors. Having celebrated its 60th anniversary in 2016 it is now the National Institute for Occupational Health (NIOH), which is part of the National Health Laboratory Service (NHLS).

The NIOH is a public health institute that focuses on providing Occupational and Environmental Health and Safety services across the public and private sectors, as well as the informal economy. This is primarily to improve and promote workers’ health and safety but very importantly to be a consistent catalyst for a mind-set change towards greater prevention in Occupational and Environmental Health and Safety. The institute achieves this through its mandate of: Knowledge generation and innovation, teaching and training activities and service delivery.

Knowledge Generation and Innovation

New knowledge through research is thus fundamental to a better World

As a World Health Organization collaborating centre for Occupational Health, a centre of excellence and a referral institute, the NIOH engages in activities that generate and improve local, regional and international knowledge through research in the fields of Occupational and Environmental Health and Safety. This is in line with national priorities and those of the African region as a whole. The institute collaborates with local and international institutions of higher learning to redress the legacy Occupational and Environmental Health and Safety issues throughout Africa.

New knowledge through research is thus fundamental to a better world of work and the reason why national institutes for occupational health around the world have research as a core function. This research is often interdisciplinary because of the complexity of modern workplaces. The NIOH has a proud research record of over 50 years. The institute has expanded its research mandate to not only focus on mineral particles and the health of miners but also to include diverse topics and research programmes such as: nanotechnology and health; asbestos in brake dust, schools and in homes; tuberculosis prevention inhealthcare workers; noise-induced hearing loss and hearing conservation; water quality in hospitals; health effects in populations living around gold mine tailings; and pesticides and adverse health effects to name a few. To fulfil its role as a centre of excellence, the Institute will continue conducting research and creating publications on both traditional and emerging issues challenging occupational health, for the benefit of workers and stakeholders. The research done by the NIOH is in itself important. But as important is the production of the next generation of skilled professionals. All over South Africa, and in many other parts of the world, are occupational health and hygiene professionals and researchers who acquired their skills at the NIOH.

Service Delivery

In order to control hazards you have to be able to identify and measure them. The NIOH provides laboratory-based, discipline-specific and information services to clients in many industrial sectors and government agencies. The Institute’s laboratory services include: asbestos identification and counting; diagnostic lung pathology; analytical chemistry (e.g. for biological monitoring specimens); the identification of components of dusts (respirable crystalline silica in particular); microbial air sampling; allergy diagnostics; nanoparticles and in-vitro risk assessments. Among the discipline-specific services are occupational medicine, occupational hygiene, occupational toxicology, immunology and microbiology, and occupational epidemiology.

Information services are a core service also of many national institutes of health around the world and the NIOH is no exception. Its unique library and information services provide occupational health professionals, occupational hygienists, industry, labour and academics with information that cannot be resourced elsewhere on the continent.

The NIOH is also very passionate about ensuring that the environmental contaminants emanating from workplaces are also monitored, measured and controlled so as to ensure minimum impact on the communities living in the surrounding areas.

The NIOH is also very passionate about ensuring that the environmental contaminants emanating from workplaces are also monitored, measured and controlled so as to ensure minimum impact on the communities living in the surrounding areas

The World Health Organisation (WHO) defines health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” In keeping with this broad definition, occupational health aims to maintain the highest level of physical, mental and social well-being of workers in all occupations. This is primarily done by ensuring that workplaces are healthy. This, in turn, means that workplace hazards (which pose significant risks) are promptly and accurately identified and controlled so as to protect the health of workers. However, the sole purpose of occupational health is not only to ensure that people who come into the workplace do not acquire illness, but also to safeguard the well-being of workers so that they maintain optimal health, and even to assist employees with non-occupational related illnesses to achieve higher levels of health and wellness. This could be in the form of programmes, policies and or services that ensure the creation of a “healthy workplace”. The NIOH is also very passionate about ensuring that the environmental contaminants emanating from workplaces are also monitored, measured and controlled so as to ensure minimum impact on the communities living in the surrounding areas.

The Sustainable Development Goals (SDGs) adopted by the United Nations in September 2015 include decent work, health, gender equity, youth employment, sustainable economies, and sustainable environments amongst their goals. Their objective was to produce a set of universally applicable goals that balances different dimensions of sustainable development mainly the environmental, the social, and the economic. The SDGs are intended to promote human rights, greater equity, peaceful and inclusive societies, create decent and sustainable jobs and address the enormous environmental challenges including climate change. Environmental pollution secondary to industrial activity contributes enormously to the burden of non-communicable diseases in many countries including our own. The NIOH strongly feels that this should constitute an important part of deliberations on effective and efficient interventions at workplaces.

The NIOH plans to contribute more in addressing the decent work deficit in South Africa

Looking forward, the NIOH plans to contribute more to addressing the decent work deficit in our country and also to support efforts related to inequality at work. Furthermore, it is imperative that the NIOH supports all efforts to nurture a culture of sustainable prevention of occupational injuries and diseases as well as non-communicable diseases that may exacerbated by conditions of work. Important areas that will require more attention relates to gender concerns at work; workers who may be considered more vulnerable including migrant workers, subcontracted workers and workers with disabilities. The NIOH plans to take a lead in the management of workplace stress as it has identified and recognized the this an area that requires more study and service development. In light of this, it has established a Mental Health Unit in its Occupational Medicine & Epidemiology Division. This unit has started doing research into occupational stress in South Africa, and plans to support both employees and employers in their efforts to reduce this increasingly common, and serious, occupational health problem. This would involve developing employee assistance programmes aimed at individual workers including strategic approaches to identifying and mitigating risk factors at an organizational level, thereby creating healthy, safe and ultimately sustainable workplaces.