Every three years, the oldest scientific association in its field, the centenarian International Commission on Occupational Health, hosts an annual conference – this year in Dublin, Ireland. It speaks volumes that it turned to South Africa’s National Institute for Occupational Health (NIOH) to take the lead on a position paper on TB among health workers, and contributed to a paper on TB among silica-exposed workers. This was not just because the continent has one of the highest occurrences of the disease, but because the NIOH is highly respected in its field.

Sophia Kisting-Cairncross, NIOH executive director and recipient of the University of Cape Town’s President of Convocation Medal (2017), explains that the organisation earned global credibility because it takes a multidisciplinary approach to health and safety, be that in the public or private sector nationally, regionally and internationally.

It does this through the provision of discipline-specific services such as specialised laboratories; collaborations with the WHO and its 44 occupational health collaborating centres; the International Labour Organisation; and several regional and global universities; and the dissemination and acquisition of new information and training.

‘The scientific rigour that we apply to our work is recognised, which has become one of our greatest strengths,’ according to Kisting-Cairncross.

‘This been achieved by what can be considered a very small group of individual practitioners and specialists who, with the support of a dedicated service network, undertake an enormous amount of work to help inform policy and practice in the world of work, based on factual and credible analysis.’

The NIOH is innovative, as demonstrated by its collaboration with the University of British Columbia in Canada, with the introduction of the Occupational Health and Safety Information System. Now in its fourth derivative, the latest two updates undertaken solely by the NIOH, this user-friendly technology allows users to upload surveillance and other health and safety data, so that reports can be generated automatically for monitoring and improving the occupational healthcare sector (OHS) and further use in research.

‘Users include government and industry [employees] at large, who collect occupational healthcare sector data from their work environments. This is not information that should be feared in terms of recording negative situations. We want to learn from the data on how to do things better and do things better and strengthen primary prevention,’ says Kisting-Cairncross.

‘For example, we want to know what happens when workers are exposed to chemicals; what created that exposure; what interventions were applied; and the recorded outcomes.

‘The acquired knowledge allows us to find answers to complex problems that will influence new or improved standards and prevent, at source, dominant illnesses from prevailing.’

Data such as this is not easily acquired. OHS statistics may be available but they aren’t regularly updated. ‘You can’t always depend on the data to inform strategic decisions either,’ says Kisting-Cairncross.

‘For instance, as is recorded officially, noise-induced hearing loss in the mining sector is declining significantly, and that is excellent news, but can we take a strategic decision that interventions are working?

‘It is very necessary that we have access to state- and enterprise-level data sources so that we can collaborate and assist with the analysis, justify it and report collaborative scientific findings that will benefit all.’

Information services are a core offering of many national institutes of health worldwide, due partly to the scarcity of sources of information elsewhere, as is the case in South Africa, explains Kisting-Cairncross. She adds that the ‘extent and diversity of the information offered by the NIOH is a source of pride. We also have a unique accessible national OHS reference library that serves well beyond the borders of South Africa’.

Another laudable introduction by the NIOH, which also responds to the call for knowledge generation, is the establishment of the Aerogen Science – Promoting Innovative Research (ASPIRE) laboratory. The state-of-the-art, world-first laboratory serves as a regional and global resource for research into preventive interventions aimed at reducing the transmission of airborne infectious pathogens, such as TB.

Other NIOH laboratories offer analytical chemistry, immunology and microbiology, occupational hygiene, and pathology and toxicology. Discipline-specific services include occupational medicine with a national referral clinic for complicated occupational health problems, occupational hygiene, toxicology, immunology, microbiology and epidemiology, as well as HIV and TB.

‘The independent and objective contribution the NIOH makes to good public health impacts significantly on the intellectual, academic and scientific world of work in Africa,’ says Kisting-Cairncross.

‘As such we will continue to be the catalyst for important positive changes in occupational health globally.’

By Kerry Dimmer