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Project 7: Action on silica, silicosis and tuberculosis |
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Background and justification
Silica exposure and silicosis have re-emerged as very serious public health issues in southern Africa because:
- Dust control is inadequate in both the mining and non-mining sectors and the development of small mines throughout the region is likely to expose more workers to more silica dust
- There is a large burden of undetected lung disease in former silica exposed miners now living in labour-sending areas
- Silicosis is common in industrial workers and in gold miners and the attendant tuberculosis risk is high
- Recent research has found that silica dust, independent of silicosis, increases the risk of tuberculosis.
(This section has been shortened : see WAHSA Phase I protocol for full background)
Objectives
- Reduction of silica dust exposure in key industries
- Improved prevention of tuberculosis in silica exposed workers
Indicators for objectives? attainment
- At least one key enterprise in each of two countries has initiated programmes to reduce exposure to silica dust
- Needs are identified regarding chemoprophylaxis therapy and further knowledge on the association between increased tuberculosis risk and workplace air concentrations of quartz by mid third year
Activities
- A regional quality-assured dust and quartz measurement facility is established at NIOH by end of first year
- Four packages on dust and its control - one each for workers, managers, inspectors and practitioners including occupational hygienists ?are developed by mid year two
- Seminars are held for inspectors to enable dust measurement and improve knowledge on dust control solutions in key target industries
- Multi-country sector-based participatory seminars by the end of the second year
- Joint planning of an action programme for reducing silica dust exposure in two key enterprises each in two countries before the end of year three
- At least one key enterprise in each of the two countries initiates the implementation of the action programme
- Establish a regional quality-assured dust and quartz measurement facility
- Organise expert-group meetings on chemoprophylatic therapy, silicosis surveillance, and active and passive case finding in workplaces, aiming at creating a basis for a draft preliminary quartz standard for southern Africa by the end of year three
- As appropriate, develop research protocols on chemoprophylaxis therapy and the association between increased tuberculosis risk and workplace air concentrations of quartz
- Co-ordinate activities with the country-specific programmes on the Global Elimination of Silicosis
Target group
Primary target groups are the employers and employees of the dusty industries and the inspectorates who identify and implement dust control legislation. Secondary groups are the practitioners who diagnose silicosis and who control dust at enterprise level.
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