BackgroundIt is now widely accepted that climate change is occurring as a result of the accumulation of greenhouse gases (GHG) in the atmosphere. With the prospect of a warmer world, increased attention is being devoted to the implications for worker well-being and work performance.ObjectivesThe ‘high occupational temperature health and productivity suppression’ (HOTHAPS) programme is a multi-centre health research and prevention programme aimed at characterising and quantifying the extent to which working people are affected by, or adapt to, heat exposure while working. The main aim of the current South African pilot study was to look at the perceptions of outdoor workers regarding their work environment in hot weather and how this affected their health and productivity levels.DesignA qualitative study utilising focus group discussions was employed in two sites, Johannesburg (which has a temperate climate) and Upington (located in the hottest part of South Africa).ResultsIn summary, the pilot study demonstrated that especially in Upington, where daily maximum temperatures may reach +40°C, workers reported a wide range of heat-related effects, including sunburn, sleeplessness, irritability, and exhaustion leading to difficulty in maintaining work levels and output during very hot weather. Few, if any, measures were being undertaken by employers to protect health or improve worker comfort.ConclusionThis pilot study has demonstrated that people working in sun-exposed conditions in hot parts of South Africa currently experience heat-related health effects, with implications for their well-being and ability to work and that further research is warranted. In this regard, the pilot study has proved valuable in informing the design, site, sample selection, and logistical planning for a proposed main study on the health and performance aspects of work in hot weather in South Africa.

Objective This study explored personal protective equipment (PPE) availability and PPE utilization among interventionalists in the catheterization laboratory, which is a highly contextualized workplace. Methods This is a cross-sectional study using mixed methods. Participants (108) completed a survey. A hyperlink was sent to the participants, or they were asked to complete a paper-based survey. Purposively selected participants (54) were selected for individual (30) or group (six) interviews. The interviews were conducted at conferences, or appointments were made to see the participants. Logistic regression analysis was performed. The qualitative data were analyzed thematically. Results Lead glasses were consistently used 10.2% and never used 61.1% of the time. All forms of PPE were inconsistently used by 92.6% of participants. Women were 4.3 times more likely to report that PPE was not available. PPE compliance was related to fit and availability. Conclusions PPE use was inconsistent and not always available. Improving the culture of radiation protection in catheterization laboratories is essential to improve PPE compliance with the aim of protecting patients and operators. This culture of radiation protection must include all those involved including the users of PPE and the administrators and managers who are responsible for supplying sufficient, appropriate, fitting PPE for all workers requiring such protection.

Background: Occupational exposure to ionising radiation poses potential health risks to radiation workers unless adequate protection is in place. The catheterisation laboratory is a highly contextualised workplace with a distinctive organisational and workplace culture. Objective: This study was conducted to understand the culture of radiation protection (CRP). Methods: This study was a qualitative study and data were collected through 30 in-depth and 6 group interviews with 54 purposively selected South African interventionalists (interventional radiologists and cardiologists). The participants included a diversity of interventionalists who varied in sex, geographic location and years of experience with fluoroscopy. The transcribed data were analysed thematically using a deductive and inductive approach. Results: ‘Culture of radiation protection’ emerged as a complex theme that intersected with other themes: ‘knowledge and awareness of radiation’, ‘radiation safety practice’, ‘personal protective equipment (PPE) utilisation’ and ‘education and training’. Conclusion: Establishing and sustaining a CRP provides an opportunity to mitigate the potentially detrimental health effects of occupational radiation exposure. Education and training are pivotal to establishing a CRP. The time to establish a culture of radiation in the catheterisation laboratory is now.

Background: Attracting healthcare professionals (HCPs) to rural areas and retaining them there remains a challenge. Current retention strategies focus on the factors that cause people to leave rural areas, but these strategies continue to fail to retain HCPs in these areas, and the situation in which there is a lack of quality and inadequacy of the type of health services is perpetuated. The literature describes factors that attract healthcare workers to work in rural areas, and this study contributes to a deeper understanding of this. Method: This was a qualitative study in which in-depth interviews and focus groups were used, together with an appreciative inquiry approach. Fourteen participants were purposively selected for the study. Data were coded and the themes extracted and critically analysed by two researchers. Ethics clearance was obtained from the University of the Free State. Results: Intrinsic themes included having a "calling" to work in an area, team work and community affiliation. Extrinsic themes related to the geographical location, diversity of work, functional referral networks, and strong management and leadership structures. Conclusion: This research offers a different way of viewing what attracts healthcare workers to work in rural areas by focusing on the positive factors that encourage them to remain, rather than on the negative factors that make them want to leave. The findings complement the existing literature, and also include fresh ideas with regard to understanding the reasons behind the retention of rural healthcare workers from an asset-based perspective. The resulting conceptual framework helped to foster a paradigm shift with respect to re-thinking the retention strategy.

Ionising radiation is a modality used in diagnostic and therapeutic medicine. The technology has improved and resulted in lower dose exposure but there has been an escalation in the quantity of procedures, their duration and complexity. These factors have meant increased occupational radiation exposure for interventionalists. Ionising radiation exposure can have detrimental health effects and includes radiation skin burns, various carcinomas, genetic and chromosomal aberrations and cataractogenesis of the lenses of the eye. The lenses of the eye are of the most radiosensitive organs and the risk of cataracts is high despite low radiation dose exposures. The use of personal protective equipment (PPE) is a method that can be used to mitigate the risk for developing lens opacifications. The consistent and effective utilisation of PPE is marred by availability, proper fit and ease of use when performing procedures. Radiation safety training is imperative to enforce a culture of radiation safety among interventionalists. The aim of this study was to quantify and describe cataracts among South African interventionalists and to understand their radiation safety practices. For this purpose, a cross sectional study was designed using multiple methods. A survey was conducted to determine the demographics and the risk factors of doctors exposed to radiation to doctors not exposed. The radiation workload and radiation safety practices of interventionalists were explored. Both groups had slit lamp examinations. The data were analysed analytically and a regression model developed looking at the outcomes and the risk factors. Qualitative in-depth interviews and group interviews were conducted to explore the perceptions of interventionalists regarding radiation safety. Deductive and inductive thematic analysis was done. Interdisciplinary research is challenging but offers tremendous opportunity for exploring and tackling complex issues related to securing a safe radiation work environment.