OVERVIEW OF THE EPIDEMIOLOGICAL AND HEALTH RISK STUDY CONDUCTED UNDER THE MULTIPOINT PLAN

Abstract

ISEE-345 Introduction: Epidemiological and health risk studies are being conducted under the Multipoint Plan (MPP) in order to better characterise the health outcomes associated with environmental pollutant exposure in the South Durban industrial basin. Aim: The primary objectives of the study are to: determine the health status of the Durban South residents, with specific reference to respiratory health outcomes and other chronic diseases; investigate the relationship between environmental pollution, these health outcomes and the quality of life within this community, particularly among susceptible populations; and describe the range of ambient exposures and to assess the potential risks posed by such exposures to the health of the community in the Durban South. This study is a collaboration between the Universities of KwaZulu-Natal and Michigan and the Durban Institute of Technology. The oversight structures of the MPP include the three tiers of government and community and industry representatives. Methods: Based on specific selection criteria, seven primary schools in each of four south Durban and three comparative north Durban communities were selected to participate in the study. All the pupils from randomly selected one or two grade four class(es) and additional known asthmatics were invited to participate in the study (n=420). These children, their caregivers, heads of their households and additional adults (n=1000) within the households were subjected to different interview instruments assessing health outcomes, health services utilisation, socio-economic status, and nutrition. All children had baseline spirometry, methacholine challenge tests, skin prick testing, serum continine, lead and manganese assessments, and 400 adults had spirometry and methacholine challenge assessments. All children participated in four three week cycles of intensive monitoring of respiratory function, taken four times during the school day. These consisted of lung function assessments together with simultaneous symptoms and activities logs and daily diaries. Pollutants measured at each of the schools included continuous sulphur dioxide and carbon monoxide, 24 hour particulate matter (≤10 μm dia). At two schools, ozone and fine fraction particulate matter (<2.5 μm) was also measured. Apart from these conventional pollutants, various metals, volatile organic compounds, dioxins and furans are being measured to characterise exposure as part of the health risk assessment (HRA). The HRA will also make use of historical data, review other exposure pathways, and develop models to estimate risks of specific health outcomes due to pollutant exposure. Results: Data collection has been completed on all children and most household participants. Environmental monitoring is ongoing, with data for the conventional pollutants and toxics available since May, 2004. Conclusion: This study represents one of the largest environmental health studies undertaken in Southern Africa. While focussing on respiratory outcomes, a wide spectrum of health outcomes related to a variety of environmental pollutants are being investigated.