Health Study and Health Risk Assessment at Richards Bay
Gondwana Environmental Solutions was appointed to supply and install ambient monitoring systems as well as to conduct a health study and health risk assessment as a consequence of exposure to atmospheric contaminants.
Background
Gondwana Environmental Solutions, a member of Palace Group companies, was appointed by the Department of Agriculture, Environmental Affairs and Rural Development in KwaZulu Natal, in partnership with the uMlhathuze municipality to supply and install ambient monitoring systems as well as to conduct a health study and health risk assessment as a consequence of exposure to atmospheric contaminants. This project stems from a study deviced by the DAEARD firstly to describe the range of ambient exposure of criteria pollutants and secondly to assess the potential risks posed by such exposure on the populations of Richards Bay and Esikwini areas of the uMlhathuze municipality.
The rapid rise of industrialisation, commercialisation and associated urbanisation has potentially affected human
health in the area due to, but not limited to, urban outdoor air pollution, not only from the large industrial sector, but also from indoor air pollution (domestic fuel burning). Urban (and rural) populations are affected by outdoor
air pollution over short- and long-term basis. The effects of air pollution are varied, depending on an array of factors, which include · The temporal exposure scale; · The type of pollutant; · The concentration of the pollutant; and · The susceptibility of the population towards adverse effects of a particular pollutant.
Furthermore, micro- and macro-environmental factors (e.g. weather and climate patterns and topography) will contribute to the above-mentioned factors; however, these are more complex to determine over a short-term basis. Health effects stemming from air pollution received a great deal of attention from the World Health
Organization (WHO), which produced air quality guidelines aimed for global use in 1987 and have since updated their work based on latest available information (WHO 2006). The main pollutants of particulate matter (PM10 and PM2.5), ozone (O3), nitrogen dioxide (NO2) and sulphur dioxide (SO2) all contribute to upper respiratory problems, particularly relating to lung functionality over the short- and / or long-terms (WHO 2006).
Execution of project
A variety of methods have been employed to determine the health status of local communities in Richards Bay. These methods include the review of medical records from local clinics, questionnaires conducted with participation from patients of the local clinics and learners at local schools, and conducting spirometer tests, which determine lung functionality.
Clinic medical records from Richards Bay Clinic (RBC), located at the Civic Centre, were reviewed and the information from the medical records was consolidated to identify the number of cases of recorded upper respiratory symptoms compared with the total number of patients.
The medical files have been reviewed since January 2009 until July 2011, for each month. Information extracted from these documents includes amongst other things:- The total number of patients diagnosed with upper respiratory illness (the diagnosis was conducted by the health practitioner); and The type of upper respiratory symptoms, which included; cough and chest pains; flu and fever / wheezing; asthma; sore throat; nasal congestion / nose irritation to name a few.
The yearly trends in diagnoses from the RBC indicate that approximately 13% of all patients visiting the RCB were diagnosed with URI in 2009, 10% in 2010 and 10% in 2011. Of those patients diagnosed with URI, the most common URI’s included cough and / or chest pains, flu and /or fever and / or wheezing, asthma and headaches over all three years . These four symptoms account for approximately 70% of URI symptoms between 2009 and 2011.
Questionnaires were developed by GES to determine key factors of the local community in terms of gender, smoking habits, age, residential location, race, occupation, household fuel usage and the patients’ health. Questionnaires were distributed to any willing participant at the Richards Bay and Mandlanzini clinics;
patients were not selected based on their type of ailment. The aim of the questionnaires is to develop a database of knowledge to assist with identifying the groups of people (if any) that are more adversely affected by air quality
conditions than other groups. It is anticipated that the main persons affected by air quality are the young, old and vulnerable (i.e. have greater sensitivity to external forces / conditions than the average person). A total of 152
patients from the Mandlanzini Clinic have participated in questionnaires whilst a total of 52 questionnaires were received from the Richards Bay Clinic.
A spirometer was used to conduct lung function testing on local members of the community to determine asthma and respiratory problems prevalence. This test is not confined to only those members of the community who have been diagnosed with upper respiratory illnesses. These tests are currently ongoing.
Insight
Research from previous global studies on the relationship between air pollution and respiratory (upper and lower) illnesses indicate that increases in ambient air pollution, both indoor and outdoor, result in increases in the occurrence of respiratory illness symptoms. According to research done and published in the Bulletin of the World Health Organization by N Bruce, R Perez-Padilla and R Albalak titled ‘Indoor air pollution in developing countries: a major environmental and public health challenge’ the susceptibility of various population groups to air pollution in developing countries indicates that women and children are the most susceptible to a variety of air pollutants.
The dependency of communities in developing countries on biomass fuels for day-to-day activities (cooking,warmth and light), result in high levels of indoor pollution. This is apparent in the local communities of Richards Bay where, while electricity is the primary household fuel, wood and other biomass fuel-types are used. Richards Bay is characterized by a large rural population (Integrated Development Plan 2011/2012) and in general, it is these populations that rely heavily on biomass fuels.
Conclusion
Whilst installation of ambient monitoring systems have been completed and results are being analysed, more work needs to be done to complete this study. Questionnaires continue to be distributed to local schools and clinics for a more comprehensive sampling and community representation, further lung function tests are being conducted on participants to determine asthma and respiratory problem prevalence and medical records continue to be amalgamated into the collected datasets.
Studies of this nature will go a long way in ensuring the health of citizens globally, ensuring responsible business practices as well as ensuring acceptable air quality standards and greener environments.