RESUMEN
In Zimbabwe, artisanal and small-scale miners (ASMs) have a high prevalence of tuberculosis (TB), human immunodeficiency virus (HIV), and silicosis. Previous studies on ASMs utilised programme data, and it was not possible to understand reasons for the high prevalence of these comorbidities. We conducted a cross-sectional study to investigate the knowledge, attitudes, and practices of ASMs regarding TB, HIV, and silicosis. We enrolled a convenience sample of 652 ASMs. Their mean (standard deviation) age was 34.2 (10.8) years. There were 602 (92%) men and over 75% had attained secondary education. A total of 504 (80%) of the ASMs knew that TB is a curable disease, and 564 (87%) knew that they were at higher risk of TB than the general population. However, they were less likely to know that HIV increases the risk of TB disease, 340 (52%), with only 226 (35%) who perceived the risk of TB infection to be high among ASMs. Only 564 (59%) were aware that silica dust causes permanent and incurable lung diseases. Six hundred and twenty (97%) showed a positive attitude towards healthcare when they were sick, and 97% were willing to use special respirators to prevent dust inhalation. On practices, only 159 (30%) reported consistent use of either cloth or respirators to prevent dust inhalation. Three hundred and five (49%) ASMs reported consistent use of condoms outside their homes and 323 (50%) reported use of water to suppress dust. Only 480 (75%) of ASMs sought healthcare services when sick. ASMs cited challenges of accessing healthcare services due to lack of money to pay for healthcare (50%), long distances to clinics (17%), and the shortage of medicines at clinics (11%). Effective control of TB, silicosis, and HIV among ASMs requires addressing the identified knowledge gaps and barriers that are faced by ASMs in accessing personal protective equipment and healthcare services. This will require multisector collaboration and the involvement of ASMs in co-designing a package of healthcare services that are tailored for them.
Asunto(s)
Infecciones por VIH , Silicosis , Tuberculosis , Masculino , Humanos , Adulto , Femenino , VIH , Estudios Transversales , Zimbabwe/epidemiología , Conocimientos, Actitudes y Práctica en Salud , Tuberculosis/epidemiología , Tuberculosis/prevención & control , Tuberculosis/complicaciones , Silicosis/epidemiología , Silicosis/etiología , Infecciones por VIH/epidemiología , Infecciones por VIH/prevención & control , Infecciones por VIH/complicaciones , Polvo/análisisRESUMEN
BACKGROUND: Though mining remains a vital shiftwork industry for U.S. commerce, problems of continued prevalence of mineworker fatigue and its mitigation persist. Publications and reports on fatigue in mining appear to be rich and diverse, yet variable and remote, much like the industry itself. METHODS: The authors engaged in a brief nonexhaustive overview of the literature on sleep and fatigue among mineworking populations. RESULTS: This overview covers: potential sources of fatigue unique to mine work (e.g., monotonous and disengaging Work Tasks, underground environments and light exposure, remote work operations); evaluation of mitigation strategies for mineworker fatigue or working hours (e.g., shift-scheduling and training); and areas for future research and practice (e.g., fatigue risk management systems in mining, mineworker sleep and fatigue surveillance, lighting interventions, and automation). CONCLUSIONS: Fatigue continues to be a critical challenge for the mining industry. While research on the problems and solutions of mineworker fatigue has been limited to date, the future of fatigue research in mining can expand these findings by exploring the origins, nature, and outcomes of fatigue using advancements in lighting, automation, and fatigue risk management.
Asunto(s)
Mineros , Fatiga/epidemiología , Fatiga/etiología , Humanos , Minería , Prevalencia , SueñoRESUMEN
CONTEXT: In the South African mining sector, cardiorespiratory-specific autopsies are conducted under the Occupational Diseases in Mines and Works Act (ODMWA) on deceased mineworkers to determine eligibility for compensation. However, low levels of autopsy utilisation undermine the value of the service. OBJECTIVE: To explore enablers and barriers to consent that impact on ODMWA autopsy utilisation for posthumous monetary compensation. METHODS: In-depth interviews were conducted with mineworkers, widows and relatives of deceased mineworkers as well as traditional healers and mine occupational health practitioners. RESULTS: A range of socio-cultural barriers to consent for an autopsy was identified. These barriers were largely related to gendered power relations, traditional and religious beliefs, and communication and trust. Understanding these barriers presents opportunities to intervene so as to increase autopsy utilisation. CONCLUSIONS: Effective interventions could include engagement with healthy mine-workers and their families and re-evaluating the permanent removal of organs. The study adds to our understanding of utilisation of the autopsy services.