SASOM Annual Congress 2018

SASOM NEWS

This year’s Congress of The South African Society of Occupational Medicine (SASOM) took place on 22 and 23 June at the Protea Hotel by Marriott, Oliver Tambo International Airport, Kempton Park, Gauteng. The meeting of the SASOM Executive Committee (ExCo) was held on the first evening. The Congress was attended by approximately 150 participants, including delegates, invited presenters, session chairs and a record number of exhibitor organisations (13). The Congress offered participants a very comprehensive and varied programme (a total of 21 presentations) aligned with the theme ‘Occupational Health – Looking Back to Move Forward: Old Lessons Inform Solutions for new issues’. The Congress Organising Committee takes this opportunity to thank and recognise the contributions from the presenters, exhibitors and delegates.

Day 1                                       
Prof. Daniel (Daan) Kocks, SASOM Chair, opened the Congress by welcoming the participants, and Ms Denise Minnie, President of the South African Society of Occupational Health Nursing Practitioners (SASOHN), chaired the first session.

The first presentation, titled ‘Asbestos 1: The original nano-particle’ was delivered by Dr Jim teWaterNaude, owner and manager of Diagnostic Medicine, a public interest medical firm, and lecturer at the School of Public Health at the University of Cape Town (UCT). Dr teWaterNaude is also on retainers for organisations that compensate victims of dust diseases from exposure to asbestos, viz. the Asbestos Relief Trust, the Kgalagadi Relief Trust, and the Q(h)ubeka Trust. He described asbestos-related diseases, with a focus on the South African situation, and covered aspects of pathogenesis of dust and related diseases of the lung.

Ms Milly Ruiters, Chief Director: Compensation for Occupational Injuries and Diseases (COID) Services, Department of Labour (DoL), followed with a presentation titled ‘The Compensation Fund (CF): Providing faster, reliable and accessible COID services’. MsRuiters illustrated how the CF is well on its way to achieving its goal of providing an effective, client-centric service by 2020, and confirmed that, during the 2017-18 financial year, the CF adjudicated a total of 179 689 claims. Importantly, the CF is currently investing in the Occupational Health and Safety Inspectorate to prevent injury and disease.

Dr Greg Kew, an occupational medicine specialist and lecturer at UCT (and a SASOM ExCo member) delivered the third presentation, on noise-induced hearing loss (NIHL) and audiometric screening. He reviewed the diagnostic criteria for NIHL and summarised the issues introduced by South African legislation and screening technologies, and why the current system is not suited to identifying early NIHL. Dr Kew also shared his preliminary findings from the analysis of 28 000 audiograms, spanning a period of four years, at a South African workplace.

 


The more, the merrier – Approximately 150 participants attended the two-day SASOM Annual Congress 2018, held at the Protea Hotel by Marriott, Oliver Tambo International Airport, Kempton Park, Johannesburg

Photograph: Claudina Nogueira

The second session, chaired by Dr Lucas Mosidi of the CF, kicked off with a ‘food for thought’ presentation delivered by Prof. Karen Hofman, Director: Priority Cost Effective Lessons for Systems Strengthening, South Africa (PRICELESS SA). Prof. Hofman’spresentation,  Sugary beverages: Costs and consequences for South Africa’s workers’, showed how the prevalence of obesity in South Africa has risen alongside the increased consumption of sugar-sweetened beverages, resulting in increasing employee absenteeism and turnover, decreased productivity, major financial strains for individuals, families and employers, and other negative consequences for the workforce. While the introduction of a ‘sugar tax’ in South Africa in 2018 was a good start to decreasing the impact of sugar-related obesity, Prof. Hofman emphasised the ongoing need for complementary worksite interventions to create healthier social norms for eating. In support of this topic, no sugary beverages or eats were available to the participants during the Congress.

Mr Brian Mongoma, Deputy Head and Occupational Hygienist: Minerals Council, South Africa, followed with a presentation titled ‘Collaboration between occupational hygiene, ventilation engineering and occupational medicine, within the South African mining industry’. He stressed the need for cooperation between occupational physicians and other healthcare professionals to improve the wellbeing of employees, and discussed the challenges faced in linking occupational hygiene data with control measures, as well as medical surveillance systems.

The sixth presentation, delivered by Dr Jan Lapere, a private practitioner in occupational medicine, medico-legal and social labour law (and also a SASOM ExCo member), was titled ‘An update of SASOM Guideline 3: Management of absenteeism due to illness or injury’. He discussed ‘sick certification’ and how the occupational medical practitioner is the knowledgeable and empowered professional expert, competent to deal with ill-health non-conformity issues in employment. He reminded SASOM members that they have access to expert advice on queries related to sick absence, such as dealing with colleagues’ sick certificates and holistic confidentiality concerns around sick reporting.

The session following the lunch break was chaired by Dr Jack Meintjes from the University of Stellenbosch. The first speaker, Prof. Mary Ross, is an honorary life member of SASOM, and is affiliated with the University of the Witwatersrand. Prof. Ross, a specialist in occupational medicine, public health medicine and travel medicine, with extensive working experience in the mining sector globally, delivered a presentation titled ‘Occupational infectious agents: A global perspective’, which was an excellent review of the global history of occupational infections, and described the major advances in terms of prevention. Additionally, Prof. Ross spoke of infectious agents as occupational hazards, and outlined the main challenges in terms of surveillance and management, which continue to be faced by health practitioners.

 


Friends, South Africans, fellow Countrymen – Prof Daan Kocks, SASOM Chair, declared the Congress officially open, and welcomed all the participants 
Photograph: SASOM National Office

This global perspective paved the way for the next speaker, Prof. Anton Stoltz from the University of Pretoria and the Steve Biko Academic Hospital’s Clinical Research Unit, who presented ‘Infectious diseases sapience’. He reported on studies conducted in his laboratory, which evaluated airborne transmission of multidrug-resistant tuberculosis (MDR-TB) and the various types of control measures. His take-home message was that only a few organisms can be considered to be transmitted in a truly airborne manner, and that the differences between droplet and droplet nuclei in the mode of transmission are important factors to consider for infection control in health practitioners. His use of amusing public health awareness video clips to illustrate concepts was very appreciated by the audience.

Dr Jan Lapere followed with a second presentation, reporting back on a meeting that he attended, representing SASOM at the Health Professions Council of South Africa (HPCSA). SASOM was invited by the South African Medical Association (SAMA) to participate in a discussion with the HPCSA, with reference to the employment of medical practitioners by private enterprises. As anticipated, his report-back generated much interest from the Congress participants, who took full advantage of this opportunity of legal expertise to ask numerous questions and engage with Dr Lapere.

The last two presentations of the day were delivered by the current Presidents of SASOM’s sister organisations, the Southern African Institute for Occupational Hygiene (SAIOH) and SASOHN. 
 

 Double Trouble – The Department of Labour’s Compensation Fund was well represented at the Congress by Ms Milly Ruiters (stage left), Chief Director of COID Services who presented, and Dr Lucas Mosidi (stage right), Director of Medical Services, who chaired a session Photograph: Sr Marthie Kocks

Ms Julie Hills (SAIOH President) presented ‘Failures and opportunities: Health professional impact in improving the standard of asbestos fibre analysis and service levels in South Africa’. Ms Hills highlighted that professionals who have been responsible for providing survey and monitoring services for asbestos fibres have been hindered by a lack of formal training in this speciality subject. She showed the positive effects that formal proficiency-based training can have, and how formal training can improve the standards of the services available in South Africa, putting them on a par with those provided by international peers. These improvements will also aid in more efficient implementation of the new Asbestos Regulations.

As a wrap-up to the first day of the Congress, Ms Denise Minnie presented ‘Calling occupational health to the forefront’. She reported on a scoping review on various broad aspects of occupational health, viz. historic milestones, legal frameworks, stakeholder involvement, and marketing and awareness strategies implemented in South Africa. She stressed that increased involvement in leadership, public health, and government decision - and policy-making processes are needed to enhance the quality of occupational health as a priority, and that penalties for non-compliance must be enforced. 

Day 2

The second day kicked off with a session chaired by Ms Julie Hills. The first offering was by Prof. Rajen Naidoo, Head of Discipline: Occupational and Environmental Health, University of KwaZulu-Natal. His presentation ‘Occupational health – Is history shaping our future?’ was a thought-provoking account of the history of occupational health and occupational medicine, and how it remains imperative that we continue to heed the lessons learned over the past century from experiences in South Africa and globally. He stressed that a key feature of protecting workers’ health has been the slow response to known hazards, and that increased national and global surveillance systems, documenting case studies, and a commitment to address interventions at the source, are critical.
Ms Jeanne-Marie Tucker, Senior Technical Advisor at the Clinton Health Access Initiative (CHAI), followed with a presentation titled ‘Development of the National Health Insurance (NHI) Framework: Taking the first step in defining the path to Universal Health Coverage (UHC) in South Africa’. Ms Tucker elaborated on the progress of the Service Benefits Framework (SBF) of the NHI, which is an internal process on which the National Department of Health has embarked, to define the current services provided in the public sector, with their associated clinical protocols and unit costs. The SBF of the NHI is therefore the starting point to identifying and addressing policy gaps and misalignments. In due course, the SBF will be expanded to capture community-based primary healthcare and hospital services, and to provide the data required to drive costing and priority-setting models for the NHI.  As anticipated, this ‘hot topic’ presentation elicited an animated question and answer session.


Support behind the scenes – Mr Jaco Botha (left), appointed recently as Project Coordinator in the SASOM Office, was the ‘mover and shaker’ who ensured the smooth running of the Congress in terms of administration and organisational back-up. He was ably supported on site by Mrs Amanda Combrinck (right) Photograph: SASOM National Office

 Dr Andy Thomson, an independent occupational medicine specialist, was the next speaker, with a very technically impressive and culturally-diverse savvy presentation titled ‘Applying South African experience to a state-of-the-art chemical manufacturing complex in Saudi Arabia’. He spoke of his experience in designing and implementing a comprehensive health strategy and services in Saudi Arabia, at the largest chemical manufacturing plant ever built in one stage. Dr Thomson elaborated on the steps that he followed to establish the successful health strategy at the chemical plant, from understanding the local culture and legislation as well as the company being serviced, to an in-depth evaluation of all the likely health risks and the elements that would eventually determine and inform the health programmes to be implemented. His take-home message was that implementation should be through a phased approach, following sound project management principles, with clear roles, accountability, and measurement of key performance indicators.

Dr Murray Coombs, a SASOM member and the current Chair of the International Commission on Occupational Health (ICOH) Scientific Committee on Occupational Health in the Chemical Industry (MEDICHEM), wrapped up the session with a short information presentation on the Joint SASOM-MEDICHEM Annual Conference which will be held in Johannesburg from 31 July to 3 August 2019. The theme of the Conference is ‘Control of Substances Hazardous to Health: Old and Emerging Issues’. The development of the programme and preliminary planning has started in earnest, and members will be kept updated.

The second session of the day followed the lunch break, and was chaired by Prof. Rajen Naidoo, who introduced Dr Jim teWaterNaude and his second presentation titled, ‘Asbestos 2: Designing fibre-free futures’. As a follow-on to his introductory asbestos presentation on the first day, Dr teWaterNaude addressed asbestos policy options and challenges, tying them in with the prevention/control paradigm of public health, and discussed current work towards a worldwide ban on asbestos. He presented a contextual ‘cradle-to-grave’ framework to elucidate exposures to asbestos – occupational, para-occupational and environmental. 
Dr Jack Meintjes, an occupational medicine and infection control specialist from Tygerberg Hospital and Stellenbosch University, followed with a presentation titled ‘An update: Dealing with radiation as a hazard’, which was based on a review of South African (and applicable international) legislation and recent literature. He gave a short description of unpublished data of an ongoing research project, which highlighted the impact of non-ionising radiation, and how it is still neglected in the medical community. The National Nuclear Regulator’s recent request for the development of a short course in ionising radiation (to which he is contributing) indicates the need for specific training of occupational medicine practitioners in this field, while non-ionising radiation continues to be an under-estimated risk in South African workplaces. 


Pot luck – Fellowes Beswick exhibited at the Congress and donated an ergonomics hamper for a raffle. L to R: Ms Jolene Dickie (Fellowes Beswick), Prof. Daan Kocks (SASOM Chair), and Dr Lucas Mosidi (Compensation Fund), who was the lucky winner Photograph: Claudina Nogueira

Dr Steve Goosen, SASOM ExCo member and director of Drs Goosen Staunton and Partners Inc., gave a report-back on the 5th South African TB Conference, held in Durban from 12 to 15 June 2018. His presentation focussed on the main learnings from the Conference which had the theme ‘Step Up – Let’s Embrace All to End TB’, and aimed to share major advances made in TB prevention, diagnosis, treatment and care, especially in the six high-burden countries (India, Indonesia, China, Nigeria, Pakistan and South Africa). These advances follow the World Health Organization (WHO) Declaration of 2014 – ‘End TB Strategy’ – which boosted the drive towards epidemic control and elimination. The Conference programme was arranged in daily sub-themes as follows: (i) Finding the missing patients, (ii) Social and biological determinants of the TB cascade, and (iii) Managing drug-resistant TB. SASOM has recently endorsed and pledged its support for the two ICOH Statements on TB, viz. ‘Preventing TB among Health Workers’ and ‘Preventing TB among Silica-Exposed Workers’. SASOM is of the opinion that TB management in workplace health services can make a significant contribution towards the eradication of TB, particularly in countries with high TB burdens, such as South Africa (where there is also a high burden of silicosis and HIV which, in combination, increase the predisposition to developing TB in affected populations). Importantly, these diseases are preventable, and there needs to be a concerted effort to prevent exposures, instead of focussing solely on treatment (and compensation where applicable), once the disease is diagnosed. 
The last session of the second day followed the lunch break, and was chaired by Ms Claudina Nogueira from the University of Pretoria, SASOM ExCo member and ICOH Vice President, who introduced Dr Sebolelo Seape, a psychiatrist in private practice and Chair of the Psychiatry Management Group. Dr Seape’s presentation ‘Screening for mental illness in the workplace’ provided an overview of mental health conditions in South Africa, and how the majority of those affected are in the economically productive age group. Hence, there is a large amount of money lost to the economy due to absenteeism, ‘presenteeism’, poor productivity, and the possible loss of lives and property; early detection and intervention programmes would yield positive outcomes in terms of mental health management. Dr Seape drew on her experience as a panel member for the Health Ombud on the Esidimeni Inquiry (2016-2017), and stressed that the occupational health practitioner should have the competence, experience and theoretical knowledge on issues of mental health to enable him or her to devise processes that can be used to prioritise employees, without unnecessary legal exposure to the company, and minimising harm to others and the company.


SSEM Mthembu Medical (Pty) Ltd. was one of the thirteen exhibitors at the Congress Photograph: SASOM National Office
 

Continuing with the theme of mental health, the second presentation of the afternoon was delivered by Dr Hetta Gouse, Chief Research Officer of the HIV Mental Health Research Unit at UCT. Her presentation ‘Addressing HIV-Associated Neurocognitive Disorders (HAND) in the workplace’ detailed the findings of a cross-sectional quantitative descriptive study conducted via e-mail survey, of SASOM and SASOHN members, to investigate the knowledge of HAND among occupational health professionals. While it was evident that practitioners have some awareness of HAND, major obstacles to screening for, and management of, HAND are lack of knowledge and experience, availability of screening tools, and time. Dr Gouse introduced the audience to the application of ‘NeuroScreen’, a mobile health screener for HAND, and proposed it as an effective screener for use by practitioners.

The last presentation of the Congress was delivered by Dr Thérèse Maarschalk, a specialist in various fields (anaesthetics, obstetrics, tropical medicine, palliative medicine, occupational health) and Chief Medical Officer at Travel Doctor Corporate. Dr Maarschalk presented ‘Pregnancy in the workplace: SASOM Guideline 23’, which provides guidance on protecting the health of women against potential hazards and risks during pregnancy, after birth, and while breastfeeding. Dr Maarschalk elaborated on the applicable legislation and the responsibilities of the employer, employee and the occupational health service providers, and discussed physiological, physical and psychological changes brought about by pregnancy. She also used flow charts to describe the importance of workplace and individual health and safety risk assessments for pregnant and breastfeeding workers.

A couple of the exhibitors held a lucky draw during the second day of the Congress, and two delegates were the fortunate winners of an ergonomics hamper (donated by Fellowes Beswick) and book vouchers (donated by the National Institute for Occupational Health, NIOH).

Prof. Daan Kocks declared the Congress closed on the afternoon of the second day, and thanked all who contributed to making the Congress possible, and a successful event. Delegates who completed and submitted the Congress evaluation forms for both days earned 15 Continuing Professional Development points (CEUnits) for full attendance, from SAMA.

 

SASOM PROGRAMME 2018

SASOM 2018 Annual General Meeting and Conference

The next SASOM Conference, themed ‘Research Informs Action’, will take place on 24 November 2018, to coincide with the Annual General Meeting (AGM), and will be organised and hosted by the SASOM Western Cape Chapter, at the Protea Hotel by Marriott in Stellenbosch.

 

Report by:

Claudina Nogueira

SASOM ExCo Member and ICOH Vice President

 e-mail: claudinanogueira@hotmail.com

Daan Kocks

SASOM Chair

e-mail: info@sasom.org

Jaco Botha

Project Coordinator in the SASOM Office
e-mail: info@sasom.org

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