Regional Centre of Excellence on Occupational Health and Safety established in Kitwe, Zambia

The Southern Africa Tuberculosis and Health Systems Support (SATBHSS) Project is aimed at improving coverage and quality of key tuberculosis (TB) control and occupational lung disease ­services, and strengthening regional capacity to tackle the burden of TB and occupational diseases. Countries implementing the project took leadership in various thematic areas in tackling the scourge of TB as follows: Zambia – Occupational Health and Safety; Malawi   Community TB Care and Integrated Disease Surveillance; Mozambique – MDR-TB (Multi-drug-resistant TB) and Childhood TB Management; and Lesotho – Community-based Management of TB. The efforts are geared towards ensuring mutual capacity strengthening, knowledge sharing and harmonisation of practices.

The main objective of the Centre of Excellence (COE) on Occupational Health and Safety (OHS) in Zambia is to attain the highest standards of mines safety, health and environmental protection, medical surveillance, diagnosis and rehabilitation of persons with occupational diseases. Specific objectives include:
• Scale up workplace surveys to ensure effective dust control measures
• Scale up medical surveillance for occupational lung diseases
• Establish a central management information system for OHS
• Establish and strengthen collaborations with relevant institutions locally and internationally
• Enhance research and innovations in OHS to prevent occupational lung diseases
• Improve on human resource capacity for occupational health and safety and TB
• Upgrade physical infrastructure to meet international standards
• Ensure compensation of certified workers

Figure 1: COE on OHS roll-out plan

Infrastructure upgrade
The project implementing partners, including the Government of Zambia, the African Union Development Agency (AUDA-NEPAD), the East, Central and Southern Africa Health Community (ECSA-HC), and The World Bank, identified the Occupational Health and Safety Institute (OHSI) in Zambia as the location for the COE. The Institute was renovated to host the digital B reader training equipment, and a total of nine B reading machines were installed to replace the old X-ray film readers. Studies have demonstrated that digital and traditional film images were comparable in reading silicosis and tuberculosis.1,2 The use of traditional film-screen radiography (FSR) has been a gold standard in the recognition and evaluation of interstitial lung diseases but is becoming increasingly obsolete.3 The COE is a regional knowledge hub for the reading and interpretation of digital X-ray films. The COE, in collaboration with the Mines Safety Department and the Ministry of Labour, will include occupational hygiene and silica dust laboratory analysis services; a complete package of medical surveillance; and referrals for treatment, rehabilitation and compensation.  

Human resources development
In November 2018, a group of experts from NIOSH, comprising Dr Cara Halldin: Coal Workers’ Health Surveillance Program team leader; Prof. Bob Tallaksen: NIOSH certified B reader; Prof. Jack Parker: Professor of Medicine, Radiology and Public Health; Ms Anita Wolfe: public health analyst and Coal Workers’ Health Surveillance Program Coordinator; and Mr Travis Markle: digital radiography system manager, trained a total of 18 occupational medical doctors and radiologists from Lesotho, Malawi, Mozambique and Zambia.

In January 2019, Prof. David Rees and Dr Spo Kgalamono from NIOH did a facility and equipment evaluation visit. They pledged to support the Centre with an X-Ray viewing box to support the digital equipment. In May 2019, they will train 27 Zambian district medical officers and radiologists. The COE has opened up to other countries in the region that might want to have their medical officers trained in B-reading.


Table 1: Old and the new COE in pictures

Updates on project activities

Updates can be obtained from:
• Website:
• Twitter:
• Facebook:
• YouTube:

1. Ehrlich R, Franzblau A, Meyers C, and teWaterNaude JM. Digital radiological surveillance of silicosis and related tuberculosis in the South African mining ­industry: practical and technical considerations. Occup Health Southern Afr. 2018; 24(2):38-42.
2. Franzblau A, teWaterNaude J, Sen A, D’Arcy H, Smilg JS, Mashao KS, et al. Comparison of digital and film chest radiography for detection and medical surveillance of silicosis in a setting with a high burden of tuberculosis. Am J Ind Med. 2018: 61(3):229-238. DOI: 10.1002/ajim.22803.
3. Laney AS, Petsonk EL, Wolfe AL, Attfield MD. Comparison of storage phosphor computed radiography with conventional film-screen radiography in the recognition of pneumoconiosis. Eur Respir J. 2010; 36: 122–127. DOI: 10.1183/09031936.00127609.

Report by:
Norman Khoza: OHS Specialist: SAIOH Member:
Chimwemwe Chamdimba: Policy Specialist:
Dr. William Sitembo: Deputy Director: Occupational Health and Safety Institute (OHSI):
African Union Development Agency (AUDA-NEPAD)
230 15th Road, Randjiespark, 1685

Tel: +27 (0)11 256 3502

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