Abstract
BackgroundOccupational health laws must recognise the constitutional requirement of substantive equality, and its role in ‘the progressive realisation’ of the rights provided by Section 27.ObjectivesOur main aim is to review current South African occupational health law (vis-à-vis workers’ constitutional rights) in relation to hearing loss. We focus on gaps in the law regarding occupational hearing loss in South Africa.MethodOur review of legal texts relies on experience as a methodological device augmented by the use of a critical science. Guided by literature or evidence synthesis methodologies, South African primary and secondary laws were reviewed along with unpublished (non-peer-reviewed) grey literature. An established six-step framework guided our thematic analysis. A semantic approach aided the critical interpretation of data using the Bill of Rights as a core analytical framework.ResultsFour themes are discussed: (1) separate and unequal regulatory frameworks; (2) monologic foregrounding of noise; (3) minimisation of vestibular disorders; and (4) dilution of ototoxic agents. The highly divided legal framework of occupational health and safety in South Africa perpetuates a monologic ‘excessive noise-hearing loss’ paradigm that has implications for the rights of all workers to equal protections and benefits. There is a need to harmonise occupational health and safety law, and expand the scope of hearing-protection legislation to include the full range of established ototoxic hazards.ConclusionOccupational audiology is dominated by efforts to address noise-induced hearing loss. A ‘noise’ despite the reality of workers’ exposures to a range of ototoxic stressors that act synergistically on the ear, resulting in audio-vestibular disorders.
Highlights
In this review, we present an understanding of occupational hearing loss (OHL) in relation to South African health law
Significant advances and gains made in labour practices since 1994, but unfair discrimination still pervades the workplace
There is a lack of understanding by key role-players as to the meaning and complexity of unfair discrimination in its entirety
Summary
We present an understanding of occupational hearing loss (OHL) in relation to South African health law. The literature on OHL is characterised by a lack of data This notch in epidemiological healthcare literature is an artefact of audiology’s history as a healthcare practice, in South Africa (Osewe & Nkrumah, 2018). Our raison d’être is entwined with the Constitution in Chapter Two of the South African Bill of Rights, which outlined standards for equality and the provision of healthcare services that all subordinate law, policy and administrative actions must meet. Occupational health laws must recognise the constitutional requirement of substantive equality, and its role in ‘the progressive realisation’ of the rights provided by Section 27
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