Tuberculosis Mortality by Occupation in South Africa, 2011–2015

Tahira Kootbodien, Kerry Wilson, Nonhlanhla Tlotleng, Vusi Ntlebi, Felix Made, David Rees and Nisha Naicker
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Tahira Kootbodien: National Institute for Occupational Health, National Health Laboratory Service, Braamfontein, Johannesburg 2001, South Africa
Kerry Wilson: National Institute for Occupational Health, National Health Laboratory Service, Braamfontein, Johannesburg 2001, South Africa
Nonhlanhla Tlotleng: National Institute for Occupational Health, National Health Laboratory Service, Braamfontein, Johannesburg 2001, South Africa
Vusi Ntlebi: National Institute for Occupational Health, National Health Laboratory Service, Braamfontein, Johannesburg 2001, South Africa
Felix Made: National Institute for Occupational Health, National Health Laboratory Service, Braamfontein, Johannesburg 2001, South Africa
David Rees: National Institute for Occupational Health, National Health Laboratory Service, Braamfontein, Johannesburg 2001, South Africa
Nisha Naicker: National Institute for Occupational Health, National Health Laboratory Service, Braamfontein, Johannesburg 2001, South Africa

IJERPH, 2018, vol. 15, issue 12, 1-10

Abstract: Work-related tuberculosis (TB) remains a public health concern in low- and middle-income countries. The use of vital registration data for monitoring TB deaths by occupation has been unexplored in South Africa. Using underlying cause of death and occupation data for 2011 to 2015 from Statistics South Africa, age-standardised mortality rates (ASMRs) were calculated for all persons of working age (15 to 64 years) by the direct method using the World Health Organization (WHO) standard population. Multivariate logistic regression analysis was performed to calculate mortality odds ratios (MORs) for occupation groups, adjusting for age, sex, year of death, province of death, and smoking status. Of the 221,058 deaths recorded with occupation data, 13% were due to TB. ASMR for TB mortality decreased from 165.9 to 88.8 per 100,000 population from 2011 to 2015. An increased risk of death by TB was observed among elementary occupations: agricultural labourers (MOR adj = 3.58, 95% Confidence Interval (CI) 2.96–4.32), cleaners (MOR adj = 3.44, 95% CI 2.91–4.09), and refuse workers (MOR adj = 3.41, 95% CI 2.88–4.03); among workers exposed to silica dust (MOR adj = 3.37, 95% CI 2.83–4.02); and among skilled agricultural workers (MOR adj = 3.31, 95% CI 2.65–4.19). High-risk TB occupations can be identified from mortality data. Therefore, TB prevention and treatment policies should be prioritised in these occupations.

Keywords: tuberculosis; occupation; mortality; age-standardised mortality rates (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2018
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