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Int. J. Environ. Res. Public Health 2018, 15(12), 2756;

Tuberculosis Mortality by Occupation in South Africa, 2011–2015

National Institute for Occupational Health, National Health Laboratory Service, Braamfontein, Johannesburg 2001, South Africa
School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Witwatersrand 2193, South Africa
Environmental Health Department, Faculty of Health Sciences, University of Johannesburg, Johannesburg 2028, South Africa
Author to whom correspondence should be addressed.
Received: 29 October 2018 / Revised: 28 November 2018 / Accepted: 1 December 2018 / Published: 5 December 2018
(This article belongs to the Special Issue Occupational Epidemiology)
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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 (MORadj = 3.58, 95% Confidence Interval (CI) 2.96–4.32), cleaners (MORadj = 3.44, 95% CI 2.91–4.09), and refuse workers (MORadj = 3.41, 95% CI 2.88–4.03); among workers exposed to silica dust (MORadj = 3.37, 95% CI 2.83–4.02); and among skilled agricultural workers (MORadj = 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. View Full-Text
Keywords: tuberculosis; occupation; mortality; age-standardised mortality rates tuberculosis; occupation; mortality; age-standardised mortality rates

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Kootbodien, T.; Wilson, K.; Tlotleng, N.; Ntlebi, V.; Made, F.; Rees, D.; Naicker, N. Tuberculosis Mortality by Occupation in South Africa, 2011–2015. Int. J. Environ. Res. Public Health 2018, 15, 2756.

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