Background: Emergency medical care (EMC) and medical rescue environments are physically demanding and potentially hazardous to patients and emergency care providers. Emergency medical care students must be physically prepared to operate effectively and safely in diverse hazardous situations and environments. Currently, little has been published about the unique physical preparedness requirements of EMC students exposed to EMC and medical rescue training.
Objectives: To describe the perspectives of academic staff and EMC students, with regards to the physical preparedness of undergraduate EMC students at three higher education institutes (HEIs) in South Africa.
Methods: In this descriptive cross-sectional study, a purpose-designed quantitative question- naire was administered to probe the perspectives of EMC students and academic staff members involved in the teaching of Medical Rescue and Physical Preparedness modules within the undergraduate EMC degree programmes.
Results: One hundred and seventeen EMC students and 12 academic staff members participated in the study. Most respondents were male: 77 (65.8%) students and 11 (91.7%) academic staff members. Most students agreed (n = 113, 96.6%) that it is important for EMC students to be physically fit and healthy. There was agreement among students (n = 104, 88.9%) and staff (n = 11, 91.7%) that emergency care and rescue workers should be able to swim. It was agreed that all EMC programmes should assess physical preparedness and use similar assessments.
Conclusion: Physical preparedness and the assessment thereof are important components of the EMC degree programme. A validated physical preparedness assessment tool should be developed to address the specific physically strenuous learning outcomes associated with the BHSc EMC programme. This assessment should be standardised at the different HEIs offering the programme, and the assessment should be the same irrespective of student age, sex, and physical attributes.

Background: Personal protective equipment (PPE), including hearing protection devices (HPDs), can minimise the adverse health impacts of occupational exposures when properly designed, selected, used, and maintained. Wearer acceptance, compatibility with other protective clothing, and environmental conditions aff ect the use of PPE. The selection of HPDs should consider wearer comfort and the need for eff ective radio communication to increase fi eld usage and eff ectiveness, in addition to their attenuation capabilities.
Objective: To assess the comfort rating of HPDs that are concurrently used with radio communication at three chemical manufacturing plants in South Africa.
Methods: A mixed methods cross-sectional study design, incorporating fi eld observations, a questionnaire survey, and noise measurements, was used. Visits to three chemical plants (A, B, and C) involved 1) noise level measurements, 2) the collection of HPDs in use, and 3) administration of a questionnaire, which was designed to elicit information about workers’ subjective rating of comfort (isolation and radio communication) when using the devices. Data were analysed, descriptively, using Stata V13.
Results: Average noise levels were highest in plant C, followed by plants A and B. Nineteen diff erent HPDs were used across the three chemical plants. All were designed for eff ective attenuation against medium and high frequencies, but only nine were designed for eff ective attenuation across all frequencies. Fiftyfour workers completed the questionnaire, 15 (27.8%) of whom felt completely isolated when using HPDs. Twenty-fi ve (46.3%) rated radio communication as bad when using HPDs.
Conclusion: The feeling of isolation and the quality of radio communication is subjective, varies amongst workers, and is infl uenced by both the spectral noise characteristics of the plant and the HPD used. To promote usage of HPDs and minimise the feeling of isolation and discomfort, the selection of devices should take the radio communication needs of workers into account.

Background: Inhalation of flour dust is associated with respiratory health effects, but there has been little research conducted on flour mill workers in South Africa. South Africa has an occupational exposure limit (OEL) for grain dust, but no OEL for flour dust. The former is used as the OEL for flour dust, despite the difference in composition and particle size of the two dusts. Flour mill workers report work-related respiratory health effects; therefore, it is essential to establish an OEL for flour dust.
Objectives: We assessed reported respiratory symptoms and pulmonary function amongst workers in a flour milling company, and associated factors.
Methods: This cross-sectional study was conducted at a flour mill in KwaZulu-Natal province, South Africa, amongst 63 employees: 48 mill workers and 15 office workers. Self-reported symptoms (chest tightness/breathing difficulties, dry cough, sneezing, and running/blocked nose) and work-related factors were elicited in 2021, using a questionnaire. Pulmonary function data were obtained from medical records; personal dust exposures from 2017, 2019, and 2021 were obtained from environmental monitoring reports. Categorical data, including respiratory symptoms and pulmonary function, were summarised using frequencies and percentages. Logistic regression was used to assess the association between exposure and respiratory symptoms, with odds ratios (ORs) and 95% confidence intervals (CIs) reported. Multiple linear regression was used to identify predictors of pulmonary function.
Results: The proportions of mill and office workers who reported respiratory symptoms was similar (50.0% and 46.7%, respectively). Mill workers had slightly higher adjusted odds of reported respiratory symptoms than office workers, but this was not statistically significant. In general, the forced expiratory volume in one second/forced vital capacity (FEV1 /FVC) ratios of the office workers and the laboratory staff were higher than those of the mill workers in other departments. The FEV1 /FVC ratios were slightly higher amongst all participants in 2020, during the severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) pandemic, than in 2019. Age was a predictor of pulmonary function (β = -0.377 (p = 0.007) in 2019 and β = -0.393 (p = 0.006) in 2020). Some mill workers were exposed to dust at concentrations exceeding the OEL for grain dust.
Conclusion: Although mill workers had slightly poorer pulmonary function than office workers, the prevalences of reported respiratory symptoms were similar. However, the high dust exposures in the milling and packing departments indicate that there is a need for improved dust control measures. The establishment of an OEL for flour dust will go a long way to protecting worker health.

The legalisation of cannabis for private use in South Africa has created significant challenges for workplace substance testing protocols. The landmark Enever v Barloworld case demonstrated the inadequacy of traditional ‘zero-tolerance’ approaches that fail to consider job-specific risks and privacy implications. In this paper, I propose a comprehensive risk assessment methodology for workplace cannabis testing, using a risk matrix approach. The process includes hazard identification, risk analysis, job role categorisation into high, medium, and low-risk categories, and the establishment of appropriate testing protocols with evidence-based THC thresholds. The methodology advocates for oral fluid testing with differentiated THC thresholds (2 ng/mL for high-risk roles and 5 ng/mL for medium/low-risk roles) and tailored testing scenarios based on risk level. By implementing this structured approach, employers can balance their duty to maintain workplace safety with employees’ constitutional rights to privacy, creating testing regimens that are proportionate, defensible, and aligned with current legal precedents.