From the editor - November

Gill Nelson, Editor-in-Chief

Thank you to those who responded to the ongoing problem of asbestos exposure, featured in our previous issue. Asbestos exposure in South Africa has been a health hazard for decades; initially occupational through mining and milling of the asbestos-containing ore, and now primarily environmental. In an unexpected move, the United States’ Environmental Protection Agency (EPA) is supporting the reintroduction of some uses of asbestos (see Letter to the Editor on page 170 opposite.)

Many of you will be aware of Dr Irving Selikoff’s seminal research in South Africa on the link between asbestos exposure and mesothelioma,1 but you might be unaware that he also established a cohort of insulators who worked with asbestos. The Insulators Tissue Bank was established in 2012 and Andy Todd, Professor of Environmental Medicine and Public Health at the Icahn School of Medicine at Mount Sinai, New York, is reconstructing and updating the ­mortality information for Dr Selikoff’s cohort of 17 800 insulators (

Tuberculosis is a huge problem in South Africa, particularly among silica-exposed workers whose risk of developing this infectious disease is high.2 Perry Gottesfeld, Executive Director of Occupational Knowledge International (OK International), estimates that 230 million workers are exposed to silica dust, most of whom are in countries with the highest tuberculosis prevalence rates, and that it costs more than US$ 40 000  to treat a single case of drug-resistant TB in Africa.3 In a positive move, the United Nations General Assembly has called for prevention programmes to reduce tuberculosis among miners and other workers exposed to silica dust, which could prevent 300 000 new cases, annually.4 This initiative has been endorsed by, amongst others, the International Commission on Occupational Health (ICOH), Dr Sophia Kisting (Executive Director, National Institute for Occupational Health (NIOH)), Dr Eric Goosby (United Nations Special Envoy on Tuberculosis), and Dr Roberto Lucchini (Director of the Division of Occupational Medicine at the Icahn School of Medicine at Mount Sinai, New York). 

Our featured research papers focus on other important ongoing workplace issues, namely, health and safety awareness, airborne infection control, and hearing protection. From studying contract cleaners in Johanneburg, Wellington Mudenha et al. concluded that the workers’ awareness of their own health and safety responsibilities was poor, in spite of training and having read the relevant Act. Brenda Morrow and her research colleagues investigated the ventilation systems in several emergency care ­centres in the Western Cape province, finding that none of the 19 isolation rooms in the study complied with the National Core Standards’ ideal requirements in terms of air pressure and airflow. Rikhotso and his co-researchers analysed various adequacy rating methods for assessing hearing-protection devices used in a chemical manufacturing company in the Free State province. They concluded that the Octave-Band Method is the most accurate of the procedures, and that it should be used when selecting hearing-protection devices.

The year has flown by and this is the last issue of Occupational Health Southern Africa for 2018. On behalf of the editorial team, I thank you for your support and wish you well over the holidays. We hope that you return rested and invigorated in January.



1. Selikoff IJ, Churg J, Hammond EC. Relation between exposure to asbestos and mesothelioma. N Engl J Med 1965; 272:560-565. Available from: (accessed 12 Nov 2018).
2. Rees D, Murray J. Silica, silicosis and tuberculosis. Int J Tuberc Lung Dis. 2007; 11(5):474-484.
3. Gottesfeld P, Reid M, Goosby E. Preventing tuberculosis among high-risk workers. Lancet. 2018; 6:e1274-e1275. Available from: S2214-109X(18)30313-9 (accessed 12 Nov 2018).
4. Occupational Knowledge International. UN prioritizes tuberculosis prevention in high-risk occupations. Medical Press September 25, 2018. Available from: (accessed  12 Nov 2018).

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