Painkiller sales suspended

Johannesburg - Healthcare company Adcock Ingram Holdings [JSE:AIP] on Friday confirmed that it had suspended promotion and sales of its dextropropoxyphene (DPP)-containing medicines in SA.

Shares of the drugmaker tumbled 2.3% to R64.98 after it said South Africa would ban drugs containing the pain-killer dextropropoxyphene, or DPP, on safety concerns.

The US Food and Drug Administration (FDA) withdrew DPP from the US market on November 19, after the FDA determined that the benefits of DPP for pain relief at US recommended doses outweighed the safety risk and as such the regulator requested that suppliers voluntarily withdraw any drugs containing DPP from the US market.

According to media reports, new research showed the drug was linked to serious abnormal heart rhythms.

In June 2009, the propoxyphene-containing products were banned in the European Union because of fatal overdoses. The UK banned it in 2005.

DPP is a compound with pain-relieving properties that is found in three of Adcock Ingram's drugs - Synap Forte, Lentogesic and Doxyfene, the group said.

Synap Forte is a popular medicine to relieve pain, particularly after operations and for back pain.

Following the FDA announcement, Adcock Ingram said it engaged in discussions with the Medicines Control Council (MCC) of the department of health relating to the implications of the US data to patient safety in South Africa.

"Adcock Ingram has now become aware that the MCC has resolved, inter alia, that all DPP containing medicines be withdrawn from the South African market," it said.

Adcock Ingram noted that its drugs containing DPP contributed approximately R200m to its revenue for the financial year ended September 30 2010.

"Adcock Ingram has not, as yet, received any formal communication from the MCC regarding withdrawal of its DPP containing medicines," it said.

Be safe this Christmas

There is generally a lot of work that has to be done on time for Christmas, with pressure to get jobs finished before the break.

Whatever the situation, work has to be well-planned so safety is a priority.

There's not much difference between the incident that kills and the one from which people walk away saying, ‘that was close’.

Only this month, a man received dreadful burns when working on an advertising board, and another lost a finger and had two others badly cut while using a power saw.

It’s a busy time for everyone, but now is the time to ensure safe systems are in place for all your workers – new or old, experienced and beginners.

Getting on top of training and supervision issues, making sure shortcuts aren’t encouraged or taken, is important, so is making sure people have the right equipment to do their job safely.

Planning the work, letting someone know where you are and having some means of communication in case something happens could save your life.

Remember:

• plan your work and ensure workers are properly trained and supervised

• apply all safety measures, particularly if you’re working at height

• if you’re not sure, ask your Health and Safety representative

• understand the equipment you’re using and use it correctly – particularly if it has been hired and you are unfamiliar with it. Companies hiring equipment are required to provide training or instructions

• if you are working on your own, keep your phone on you in case you need to call for help

• make sure someone knows where you are and when you’ll be home.

9 ways to make sure your machinery is effectively guarded

1. Conduct a risk assessment to immediately make yourself aware of all the hazards and risks attached to the machines.

2. The machine operator must inspect all machine guards every day before he starts working.

3. Make all cleaning staff aware of the importance of obeying instructions regarding cleaning procedures/replacement of guards.

4. Correctly train and monitor all operators working on moving machinery, and record this training in writing. Often the machines come with a manual that includes the safe methods for using the machine. Use this to train the operators. Or draw up safe work procedures for the safe use of each dangerous machine. Have operators sign a simple “acknowledgement of training” form.

5. Display a notice warning of moving machinery in a prominent position. This should either be a sign stating “beware moving machinery” or alternatively a pictogram.

6. Develop safe work procedures for hazardous moving machinery and ensure you’ve trained relevant employees in these procedures.

7. Have all moving machinery and guards inspected on a monthly basis by the Health and Safety Representative. You must ensure that Machine Guarding is listed as an item for Health and Safety Representatives to inspect on a monthly basis.

8. Have a competent person inspect all moving machinery and guards on a monthly basis (this is someone who has the relevant knowledge and experience), or people nominated and deemed competent for this purpose.

9. Number each machine and record these numbers on the checklist/register.

Use these 3 documents to inspect your machine guards

• Health and Safety Representative checklist
• Safe work procedures
• "Competent Person” inspection checklist

22 ways to keep flammable liquids from incinerating your business

When I was younger I dated a gent who was too impatient to build a braai like every other person. His favourite method for preparing the fire was to pour turps or paraffin over the charcoal, light a match and toss it in. The resulting inferno meant we usually had to wait longer than usual to cook our meat because the flames were just too hot!

Now, this is an example of carelessness when it comes to flammable liquid, but the fact is some of us need to use it to do our jobs. Here are the 22 requirements you must fulfill to use flammable liquids.

1.Custom build the room, cabinet or enclosure where you use the substance with fire-resistant material (GSR 4(2), OHSA).

2.Don’t allow the creation of a fire or explosion hazard. You must extract flammable or explosive vapours from the room (GSR 4(2)(a), OHSA).

3.Effectively disperse or dilute the vapours from its use or application into the atmosphere by providing extraction fans (GSR 4(2)(b), OHSA).

4.Don’t contaminate any other part of your workplace with the vapour. The extraction’s outlet must lead into the atmosphere and not into another room in the workplace (GSR 4(2)(c), OHSA).

5.Provide effective intake and exhaust ventilators to remove all flammable vapours from the store, cabinet or enclosure (GSR 4(3), OHSA).

6.If the air supply and extraction is horizontal, the average air speed measured 1.5m above floor level must be at least 0.5 metres per second (GSR 4(4)(a), OHSA).

7.If the air supply is vertical and extraction is done through slits or a grill along the side wall at floor level, the average air speed measured 1.5m above floor level must be at least 0.4 metres per second (GSR 4(4)(b), OHSA).

8.If the air supply is vertical and extraction is done through a grill over the whole of the floor area, the average air speed measured 1.5m above floor level must be at least 0.3 metres per second (GSR 4(4)(c), OHSA).

9.Provide every employee spraying flammable liquid with a suitable respirator, mask or breathing apparatus.

10.All ducts trunks and enclosures must be of fire-resistant material, of a smooth interior finish and you must regularly clean these (GSR 6(a), OHSA).

11.Keep the ventilation system going during working hours and after hours for at least the period of time it takes to clear the vapour from the room’s atmosphere to below 25 % of the lower explosive limit of that vapour (GSR 6(b), OHSA).

12.Don’t obstruct the flow of air towards the intake of the ventilation and draw the spray or vapour away from any employee operating the equipment (GSR 6(c), OHSA). Do this by instructing the spray to be directed towards the extraction intake.

13.If the floor area exceeds 20 square metres, the room must have at least two separate entrances at two opposite sides of the room with doors opening outwards that can’t be locked (GSR 7(a), OHSA).

14.Fit the room with an inspection window of strengthened or shatterproof glass that no one can open (GSR 7(b), OHSA).

15.You and your employees may not take any fire, flame, naked light or static producing item into the room. Post “no smoking” and “no open flames” signs indicating such prohibitions at all the entrances to the room (GSR 8(a)(i), OHSA).

16.Don’t allow any smoking in such a room and you must post signs prohibiting smoking at all the entrances to the room (GSR 8(a)(ii), OHSA).

17.Employees may not conduct any process capable of sparks or fire or apply any application of heat to dry the sprayed items before the atmosphere has been cleared of all vapour (GSR 8(a)(iii), OHSA).

18.Clear and safely dispose of all waste from the room daily (GSR 9(a), OHSA).

19.You may only keep one day’s requirement of flammable liquid in the room (GSR 9(b), OHSA).

20.You must tightly close the containers in which you partially store flammables or where you also keep other stock when not in use and safely remove and dispose of empty containers daily (GSR 9(c), OHSA).

21.Keep the room, all fans, ducts, trunks and enclosures clean and in good working order (GSR 9(d), OHSA).

22.Use tools that don’t cause sparking to clean, scrape or scour (GSR 9(d), OHSA).

7de Laan: Our health and safety professionals have their eyes on you!

Question

My question may seem a bit silly as it’s based on a soapie, where things normally don’t work out the way they’re supposed to. But, I thought it’s an interesting situation and I want to know what we would have to do in reality. The soapie I was watching was 7de Laan. One of the characters injured himself walking up a staircase. He was trying to force past people, coming down the staircase, while lugging a heavy wardrobe! The accident happened when the railing he was pressing against broke, causing him to fall backwards and land on his back, breaking his hand in the process. It turned out the bolts on the staircase were rusted and brittle. Now, the interesting part of this scenario is the lawyer on the soapie claimed the owner of the block of flats was responsible, and could be sued.

1.    The person injured isn’t a tenant.

2.    The owner has an appointed maintenance person responsible for maintenance.

3.    The person injured had to force himself up against the railings as he wasn’t in a position to get past the people moving downwards, and surely they weren’t at fault for not letting him past?

4.    Would the court not suggest that the injured character should’ve waited to let the people come down first before going up the stairs with the wardrobe?

5.    We obviously don’t know whether the building has a sign up stating that people use the building at their own risk, but would that change the outcome?

6.    Can the injured actually sue the owner for damages, and where would the OHSA fit in as the owner is not employing this visitor? I would think that the only claim this person would have is against the owner’s insurance under liability cover?

7.    This is a reportable injury. Who reports this?

Answer

Interesting! The owner of the building is the Section 16.1 appointee, so is ultimately responsible. You have to find out whether he has a Section 37.2 mandatory agreement with the maintenance company. Does the public have access to the building? Are the stairs on a maintenance schedule? These are the types of questions the DoL will ask the owner. It’s the same as a situation where there’s oil on the supermarket floor and someone slips and hurts his back. He must have seen the oil, but keeps on walking. Now it’s his fault. Remember, the root cause of the injury was the rusted bolts and not squeezing by. If there’s a maintenance plan and the company or worker didn’t adhere to it, then the maintenance person will have to answer for the injury.

Drinking water at the correct time

2 glasses of water after waking up - helps activate internal organs

1 glass of water 30 minutes before a meal - helps digestion

1 glass of water before taking a bath - helps lower blood pressure

1 glass of water before going to bed - avoids stroke or heart attack

HIV / AIDS news

South Africa could cut the number of new HIV infections to below 200000 a year by 2020, more than one-half of the current level, with the right policies, but reaching the goal will be costly, a report on Friday said.

South Africa has the most infected people of any country in the world with 5,7-million with HIV, according to data from the United Nations Programme on HIV/Aids (UNAids). Around 18% of South Africans aged between 15 and 49 are infected.

"This situation poses huge financial dangers and risks for the country, particularly at a time when South Africa is feeling the negative effects of the global economic recession," the report said.

The report recommends drawing up and funding more effective plans for prevention, treatment and halting the transmission of the virus from infected parents to their children.

Even if it implements these plans, a further five-million more South Africans will be infected with HIV over the next two decades, according to the report from the Centre for Economic Governance and Aids in Africa and the Results for Development Institute.

The government has allocated several billion dollars a year for treatment, prevention and drugs aimed at keeping HIV infections in check.

Total costs over the next two decades to reduce the number of new infections are estimated to be as much as $102-billion if the country steps up spending on drugs, increases the number of those receiving treatment and plans to prevent the spread of the disease, the report said.

"South Africa is beginning to make important inroads in its efforts to slow the number of new infections and bring life saving treatment to those who need it", said Robert Hecht, one of the report's authors and managing director of the Results for Development Institute.

UNAids said that access to treatment for the human immunodeficiency virus (HIV) - an incurable viral infection that causes Aids and infects around 33,4-million people around the world - has increased 12-fold in six years, and 5,2-million people are now getting the drugs they need.

Sub-Saharan Africa remains the region hardest hit by HIV, accounting for 67% of all people living with the virus worldwide, 71%of Aids-related deaths and 91% of all new infections among children.

African nations whose populations have been devastated by Aids have made big strides in fighting HIV, with new infections down 25% since 2001 in some of the worst hit places, a recent UN report said.

Amputations Related To The Workplace

Amputations are widespread in the workplace. Most of all workplace amputations occur in the manufacturing sector. The rest occur in construction, agriculture, wholesale, retail and service industries.

These injuries result from the use of machines such as presses, conveyors, shaping machines, saws, hand tools, forklifts, doors and trash compactors.

One must recognize contributing factors for amputations such as hazardous mechanical components and hazardous mechanical motions like rotating machinery.

Employees operating and caring for machinery perform activities that present potential amputation hazards. Most of these activities involve servicing and maintenance of machinery such as machine inspection, cleaning jams and cleaning of machines. Therefore understanding the mechanical components of machinery will help workers avoid injury.

The primary method for preventing amputations is to safeguard machines. Safeguarding of machines can be done by guards which provide physical barriers that prevent access to danger areas and by safeguarding devices to prevent operator contact with hazardous machine motion or if any part of an individual’s body is within the hazardous portion of the machine.

There are four types of machine guards:

1.Fixed machine guards are barriers that permit operators to reach the danger area and permanently enclose the hazard area.

2.Adjustable machine guards are barriers that adjust and can be constructed to suit many situations. It may however require frequent maintenance.

3.Interlocking machine guards shuts off power and prevents machine start-up when guard is open. It requires periodic maintenance.

4.Self-adjusting machine guards moves according to the size of the stock entering point of operation and is commercially available but does not provide maximum protection.

Risk indicators in the workplace to look for include:

•Unguarded moving parts of machinery;

•Machine guards which are loose, incomplete or allow people to put parts of their body through, or climb over, under or around;

•Machinery which is able to be started without the guard being in its correct position;

•Machinery which is not maintained in good working order;

•Machinery which is able to be inadvertently started;

•Moving parts or controls which are difficult to see due, possibly because of poor lighting;

•Untrained operators working with machinery;

•Cluttered or confined work areas at machines;

•Work practices which require employees to rush their work;

•Mobile machines and vehicles being operated outside of designated areas;

•Incorrect use of equipment.

Here are a few examples of what can be done to stop amputations from happening. Employers should, for example, make sure that:

•All moving parts of machinery are guarded and the guards cannot be readily removed;

•Guards are designed and constructed which prevent people (either whole body or parts of) coming in contact with moving parts during machine operation;

•Machine work areas are clearly defined, for example, by marking floor areas, and by limiting access to only those employees authorised to work with the machines;

•Safe working procedures are developed for all machinery and promoted in the workplace;

•All machinery is regularly inspected, services and tested by qualified persons;

•Controls are located within easy reach of the operator and cannot be unintentionally turned on;

•Work areas are well lit and uncluttered;

•Regular inspections of guarding integrity are carried out;

•Correct tools are used for the job.

Safeguards need to be properly designed, constructed, installed, used and maintained to ensure that the workers are protected.

How to influence worker OHS attitudes

We can all agree that the development and maintenance of good Health and Safety attitudes is an important aspect of workplace Health and Safety. The correct attitude will provide you with the foundation on which you will implement interventions that will minimize hazards, prevent incidents, and create a safer, healthier workplace.

Here is a list of 6 strategies that you can employ:

1. Talk about Health and Safety. The more you talk about the importance of Health and Safety, the more you encourage discussion at management level, supervisory level, and employee level. The more you talk about OHS, the more you generate interest, inclusion, and the sharing of information. Just talking about occupational safety and health, draws attention to it and makes it important.

2. Encourage Health & Safety suggestions. Who knows their jobs better than the workers who perform them? It is important to listen to them. Encourage workers to talk to you about their ideas for making their jobs and other workers’ jobs safer. This approach not only produces some excellent ways to improve safety conditions and performance, but it also involves employees in the improvement process. Involvement creates buy-in.

3. Act promptly to correct hazards and improve safety conditions. Whenever you identify hazards or employees bring them to your attention, act promptly to correct the situation. Then take it a step farther and try to create an even safer situation. If you don’t get in there and fix safety problems-even the minor ones-right away, employees will think you don’t care, so why should they. If you ignore safety problems, so will employees.

4. Provide excellent Safety and Health training and information. Make sure employees have the skills, knowledge, and understanding they need to work safely and avoid incidents. Well-trained employees quickly develop good Health and Safety attitudes and make safety a priority.

5. Reward safe performance. Catch workers doing something safe and make a big deal about. Praise safe performance loud and clear for all to hear. When workers who have bad or so-so attitudes see that others are getting recognition for their good attitudes, they’ll want to get in on that, too.

Make it clear to employees and supervisors that safety performance is a key part of employee performance appraisals. When employees realize that raises, promotions, and other rewards depend on having a good safety attitude, they’re going to take workplace safety more seriously.

6. Set a positive example. Make sure that managers and supervisors throughout your workplace set a positive example and always exhibit a good Health & Safety attitude. Workers will notice and emulate their behavior.

8 vehicles your driver will require a PrDP for

If your employees drive any of the following vehicles, they must hold a valid license card, endorsed with an appropriate PrDP:

1. Bus, vehicle or minibus seating more than 12 passengers (driver included), whether or not it has enough seats, and irrespective of its weight.
2. Any vehicle used to transport people for payment, e.g. a taxi or ambulance.
3. Goods vehicle, weighing over 3500kg
4. Breakdown vehicle e.g. a tow truck
5. Heavy goods vehicle, loaded or empty (codes: C1, C, EC1 and EC)
6. Goods vehicle carrying dangerous goods
7. Road tank vehicle for petroleum-based flammable liquids
8. People who drive these vehicles occasionally, such as truck salesmen, diesel mechanics (who need to test drive the vehicles) also need to have a PrDP

6 ways to manage contractors in your workplace

1. Make your contractors sign a contract.
2. The contractor must attend an induction course or training regarding the company’s health and safety rules. The company must provide such training.
3. Ensure compliance with legal requirements regarding acts and regulations.
4. The contractor must carry out a risk assessment before commencement of the actual work in terms of the contract..
5. Ensure that a Certificate of Good Standing is issued by the Workman’s Compensation Commissioner in the same month the work is to commence.
6. Conduct a site audit/inspection.

Polygraph testing

by : Johanette Rheeder

Employers are often faced with misconduct or criminal activities such as misappropriation of property or theft in its work environment, without knowing exactly where, how and by whom it is committed. It is crippling the business and the employer is at its wits-end how to find the culprits! To make things worse, you suspect that there are accomplices amongst your employees, sharing in the illegal proceeds and helping to hide the crime!

What to do? Can you send all your employees for a polygraph test?
This is what happened in the case of Amalgamated Pharmaceuticals Ltd v Grobler NO and others[2] where the third, fourth and fifth respondents were dismissed for misappropriation of company property. A polygraph test showed that they could be responsible for the serious stock losses suffered by the applicant. The Labour Court agreed with the reasoning of the Commissioner who found that, in practice, a polygraph does not serve to prove that someone is actually lying, for the questions are often too broad to exclude that which is neither intended nor sought. And it most definitely does not prove that someone is guilty. It is merely an indication of deception.

It has been widely accepted by the Labour Court and the CCMA in cases such as Sosibo & others and[3] that, polygraph testing in the workplace is highly contentious and the admissibility of its results remains moot. The sole reliance by the employer on unspecific polygraph results is insufficient to discharge the onus in terms of section 192 of the Labour Relations Act 66 of 1995 to prove that the dismissal was fair. To discharge this onus, the test of a balance of probabilities is used. To only present polygraph evidence is not enough to show that the dismissal was fair because there is no corroborating evidence.

Does that mean that an employer cannot use polygraph testing?
No, it does not, however there are some strict rules relating to polygraph tests that need to be adhered to, unless the employer wants the test to be found unreliable, unfairly applied and useless in the CCMA or the Labour Court!

Firstly, the employer cannot force any employee to submit to such a test. Refusal to do so does not indicate guilt and is also not necessarily grounds for dismissal. Preferably, the employer should obtain written consent.

Secondly, the employer should agree with the Polygraphists on the questions to be asked. It should not be vague, otherwise the employer will sit with answers that do not take his case any further.

Consent means informed consent. For that purpose the employee should be informed that the examinations are voluntary, the reasons for and type of questions should be explained, it should be explained that he/she has a right to have an interpreter and should he/she prefer, another person may be present during the examination, provided that person does not interfere in any way with the proceedings.

Generally, employers are permitted to use the polygraph test to investigate specific incidents where employees had access to the property which is the subject of the investigation and there is reasonable suspicion that the employee was involved in the incident.

The employer must also been subjected to economic loss or injury to the employer’s business like theft of company property or the employer is involved in situations such as combating dishonesty in positions of trust, or combating serious alcohol, illegal drugs or narcotics abuse or fraudulent behaviour within the company or deliberate falsification of documents and lies regarding the true identity of the people involved.

Polygraph results cannot be released to any person but only to an authorised person. Generally it is the person specifically designated in writing by the employer whom requested the examination.

Polygraphists have been accepted as expert witnesses whose evidence needs to be tested for reliability. Therefore the Polygraphists should be called to testify as an expert witness. He must testify how the test was performed, his qualifications, the type of test used and the questions asked and if necessary, a medical doctor should also testify on the issue of manipulating body functions to mislead the Polygraphists, if that becomes an issue at the hearing.

The remaining question is whether their refusal could be said to have been a breach of their duty of good faith. Although an employee has a duty to act in good faith, it is accepted by the CCMA and the Labour Court that it does not follow that this duty extended to an obligation to undergo polygraph tests. It might be that the employee can be expected not to hamper the investigation, but a refusal in itself should not be seen as an act of hampering the investigation. It should be remembered that in our law, the employer must prove the guilt of the employee and the employee must not prove his innocence through polygraph testing.

Polygraph testing is highly contentious and the admissibility of its results is often in dispute. If they are to be accepted as relevant, such tests must at the very least be supported by corroborative evidence[4].

Wear yellow with Lance - 2 October 2010

This Saturday, Lance Armstrong will be wearing yellow to raise awareness of the 28 million people living with cancer worldwide—and we invite you to join him and thousands of others in wearing your support.

Right now, cancer kills more people than AIDS, malaria and tuberculosis combined—but incredibly; cancer is not at the top of the world’s agenda.

Together, we can change that. Supporters like you have already made yellow the universally recognized symbol of the fight against cancer, and on October 2, LIVESTRONG Day, you can use that symbol to join in a global statement of strength and courage.

Wear yellow with Lance on LIVESTRONG Day—Saturday, October 2.

There’s a great tradition at our LIVESTRONG Challenge events: thousands of supporters wear yellow and cheer on participants as they head towards the finish line.

That home stretch has become known as the Yellow Mile. It represents solidarity and support for the fight against cancer—and it’s a powerful moment to witness the whole community standing together as one.

In just four days, you can help Lance extend that Yellow Mile all around the globe. The more people who wear yellow on LIVESTRONG Day, the closer we’ll move towards ending the stigma against cancer—and, one day, to a world completely free from the disease.

Join Lance and supporters in more than 50 different countries by wearing yellow on LIVESTRONG Day.

Let’s show the world that we’re tough enough to take on cancer—and win.

Thanks,

LIVESTRONG

Consumer Protection Act

The DTI has, not unexpectedly, deferred the implementation date of the Consumer Protection Act to 31 March 2011.

This provides some breathing space for input into regulations, and for industries / associations to lobby their statutory / regulatory bodies to apply for exemption from provisions of the Act where their own legislation adequately protects the rights of consumers (patients).

Billions to be spent to upgrade hospitals: Minister

Published 27 Sep 2010 Article by: Sapa0 Comments South Africa will spend billions to improve health care by renovating dilapidated hospitals, Health Minister Aaron Motsoaledi said on Monday.

"We will put massive investment -- it will be more than what the country spent during the soccer World Cup," Motsoaledi told reporters at Inkosi Albert Luthuli Hospital in Durban.

Motsoaledi, doctors, engineers and Development Bank of SA (DBSA) representatives were attending a workshop aimed at preparing for the revamp of Durban's King Edward VIII Hospital.

The hospital was one of five that would receive a massive, billion-rand face lift, Motsoaledi said.

The other hospitals were Nelson Mandela Academic Hospital in the Eastern Cape, Dr George Mukhari and Chris Hani Baragwanath Hospitals in Gauteng and the Limpopo Academic Hospital.
"The revitalisation is [part] of the ten point programme which is needed in preparation of the National Health Insurance (NHI). I am here to start that process."

He said they had decided to involve all health stakeholders in the revitalisation programme.

"This has never been done before. We are discussing how it can be done and we will be forming task teams."

Motsoaledi said the actual cost of revamping hospitals would be known after the teams had started their work.

Dr Massoud Shaker, provincial health department head of infrastructure, said the project manager for King Edward would be appointed before the end of the year.

DBSA divisional executive Lucy Chenge said her bank would be a partner and "possibly finance it".

Lift, Escalator And Passenger Conveyor Regulations, 2010

Take note that the Minister of Labour has under section 44(1) of the Occupational Health and Safety Act, Act 85 of 1993 incorporated the hereinafter listed standards into the Lift, Escalator And Passenger Conveyor Regulations, 2010.

This notice was given in Government Gazette 33561,Regulation Gazette 9380 Government Notice Regulation GNR. 829 dated 17 September 2010.

The incorporated standards are:
• "SANS 1543": the specification for escalators and passenger conveyors, published by the South African Bureau of Standards;
• "SANS 1545-1": the specification for lifts: Safety rules for the construction and installation of lifts: Part 1: Electric lifts, published by the South African Bureau of Standards;
• "SANS 1545-2": the specification for lifts: Safety rules for the construction and installation of lifts: Part 2: Hydraulic lifts, published by the South African Bureau of Standards;
• "SANS 1545-3": the specification for lifts: Safety rules for the construction and installation of lifts: Part 3: Lifts for persons with physical disabilities (stair-lifting platforms), published by the South African Bureau of Standards;
• "SANS 1545-4": the specification for lifts: Safety rules for the construction and installation of lifts: Part 4: Lifts for persons with physical disabilities (vertical platforms), published by the South African Bureau of Standards;
• "SANS 1545-5": the specification for lifts: Safety rules for the construction and installation of lifts, Part 5: Electric and hydraulic access, goods only lifts, published by the South African Bureau of Standards;
• "SANS 1545-6": the specification for lifts: Safety rules for the construction and installation of lifts: Part 6: Rack and pinion lifts, published by the South African Bureau of Standards;
• "SANS 1545-9": the specification for lifts: Safety rules for the construction and installation of lifts: Part 9: Lift landing doors fire resistance testing, published by the South African Bureau of Standards;
• "SANS 50280": standard for the design, safe use and maintenance of scissors lifts, published by the South African Bureau of Standards;
• "SANS 10360": the standard for the maintenance and repair of electric and hydraulic powered lifts, escalators and passenger conveyors, published by the South African Bureau of Standards;
• "SANS 21": the specification for escalators, safety rules for the construction and installation of escalator and passenger conveyors;
• "SANS 50081-1": the specification for electric lifts, safety rules for the construction and installation of lifts, published by the South African Bureau of Standards;
• "SANS 50081-2": the specification for hydraulic lifts, safety rules for the construction and installation of hydraulic lifts, published by the South African Bureau of Standards.

The World Health Statistics 2010

The World Health Statistics 2010 (based on 2009 data) has been released recently.

Country outcomes are listed in tables and includes outcomes of each of the MDG’s.

It covers per country and per region:
Mortality and burden of disease, Cause-specific mortality and morbidity, Selected infectious diseases: number of reported cases, Health service coverage, Risk factors (drinking water, tobacco, LBW, etc), Health workforce, infrastructure and essential medicines, Health expenditure, Health inequities and Demographics.

It shows the following, amongst others, for South Africa:
• Life expectancy has declined from 59 in 1990 to 52 in 2008 for males, and from 68 to 55 for females.
• By 2008, SA is reported as having 8 doctors per 10 000 population, 41 nurses per 10 000 and 3 pharmacists per 10 000.
• As far as the availability of essential medicines are concerned, no data is available for the public sector, but the private sector is reported as having 71% of selected generic medicines available.
• In terms of health expenditure:
o SA spent 8.5% of GDP on health in 2000, and 8.6% of GDP in 2007.
o Government spent 10.9% of its total budget on health in 2000, and 10,8% of its total budget on health in 2007.
o The % of private expenditure has decreased slightly over the same period from 59.5% to 58.6%, of which 93.9% are reported as “out-of-pocket” spend in 2007
o On a per capita basis, SA has increased total health spend from $803 to $1148 at average exchange rate of which $290 and $375 are government per capita spend. (figures in PPP also available)

For the African continent, the following are pertinent:
• “Despite … gains, the coverage of critical interventions such as oral rehydration therapy (ORT) for diarrhoea and case management with antibiotics for acute respiratory infections (ARIs) remains inadequate. As a result, diarrhoea and pneumonia still kill almost 3 million children under 5 years old each year, especially in low-income countries.”
• “While there were some improvements in the WHO African Region, less than 50% of TB cases were reported in this region in 2008.”
• “In the WHO African Region (where HIV prevalence among adults was the highest) only 45% of pregnant women in need in low-income and middle-income countries received treatment…”
• “Non-communicable diseases and injuries caused an estimated 33 million deaths in developing countries in 2004 and will account for a growing proportion of total deaths in the future. Tackling risk factors such as tobacco use, unhealthy diets, physical inactivity and the harmful use of alcohol (while also dealing with the socioeconomic impact of cardiovascular diseases, cancers, chronic respiratory diseases and diabetes) will depend not only upon effective healthcare services but also upon actions taken in a variety of policy domains.”

Broken sewage works info not for public - govt

Water

Published 15 Sep 2010 Article by: Sapa0 Comments Information on hundreds of dysfunctional sewage treatment plants will not be made public, the government said on Wednesday.

In a written reply to Parliamentary questions, Water and Environmental Affairs Minister Buyelwa Sonjica said that revealing such information could lead to "serious misinterpretation" of the data.

"What is available and was published... in the 2009 Green Drop Report, is the summary of the performance of each of the 449 WWTWs [waste water treatment works] that were assessed," she said.

The Green Drop Report - an audit of 449 of South Africa's 852 municipal WWTWs, conducted between August 2008 and July 2009 - was released, after long delays, in April this year.

According to the document, a total of 403 facilities were not assessed owing to, among others, "municipal officials not sufficiently confident in their levels of competence" and "municipalities not managing waste water services according to expected requirements".

It also found that of the 449 works that were assessed, skills shortages had resulted in many not being operated correctly and "the effluent water quality is no longer compliant".

Among the Parliamentary questions posed to Sonjica - by Democratic Alliance (DA) MP Annette Lovemore - was whether information for all WWTWs would be made available to the public, and if not, why not.

The Minister replied: "No, such detail [sic] information is not available to the public. Revealing details of such a high technical nature will lead to unnecessary additional administrative challenges and serious misinterpretation."

Speaking to Sapa, Lovemore said that not making public information on potential threats to people's health was unacceptable.

"It's not acceptable. Each municipality is required to report on results [from WWTWs] each month. If there is a health risk, people should be told."

She said that over and above the risks to human health of sewage water finding its way into rivers and streams, the contaminated water also affected crop irrigation, drinking water for livestock and the health of the environment.

In her reply, Sonjica further said that not all WWTWs had been issued licenses or permits to operate. She did not say how many.

Reasons for municipal sewage works not having operating licenses included that some had not applied for one, some did not meet the standard required for a license, and others had "insufficient capacity" to submit the application.

Her department had launched a special project "to address the current backlog in licences", she said.

Health Awareness Topics for October

( Month of October : Mental Health Awareness Month)

1 – International Day for older persons
1 – National inherited disorders day

6-10: Eye Care awareness week

8 – International day for Nature Disaster reductions

11 – 16 National Nutrition Week

10 – World Mental health day

12- 20 – World Bone and joint week
12 – arthritis awareness day

14 World Sight Day

15 – National Foetal Alcohol Syndrome Day

16 – World Food day

17 – World Trauma day
17 – World Spine Day
17 – International day for eradication of poverty

20 – National Down Syndrome Awareness
20 – World Osteoporosis day

21 – 25 Infection Control Week

23 – National Iodine Deficiency Disorder day

24 - World Polio Day

29 – World Stroke Day

4 legal requirements when training your employees

When you train your employees, remember these four legal requirements…

4 legal requirements when training your employees

1. You must provide any information, instruction, training and supervision that may be necessary to ensure, as far as is reasonably practicable, the health and safety at work of your employees (Section 8(e),OHSA)

2. You must ensure that your employees fully understand the hazards associated with the work they perform, and the plant or machinery they use. They must also have the authority to implement the precautionary measures you’ve taken (Section 8(i), OHSA)

3. You must inform all employees regarding the scope of their authority (as contemplated in Section 37( 1)(b) (Section 8)(j), OHSA)

4. You must instruct your employees on the proper use, maintenance and limitations of the safety equipment and facilities you’ve provided (Section 2.5, General Safety Regulations, OHSA). This means training them accordingly

Cosatu released Economic Policy

Cosatu released its Economic Policy document today (“A Growth path towards full employment”). Its views on nationalisation, changes in taxation, ownership, etc were widely reported in the media (http://www.timeslive.co.za/Politics/article658469.ece/Highlights--Cosatus-key-economic-policy-proposals).

The views on healthcare were, however, not so widely reported. It includes the following:

COSATU supports the DoH’s 10 Point Plan, but states that nevertheless, there is a need for the advisory committee on NHI to urgently conclude on path of transition towards the NHI, and mandate the National Treasury to translate the commitment to the NHI into Rands and Cents, by making the necessary budgetary allocations to phase in the system.

The key challenges facing the healthcare sector are :

1. Staff shortages;
2. availability of medicines (incl improved efficiency between warehouses, hospitals and clinics); Infrastructure backlogs;
3. Inadequate systems ( ICT, Management, Administrative support);
4. availability of equipment.
   
   • 70% of the case load in the public health system is now taken up by HIV/ AIDS cases, crowding out the capacity to treat other medical conditions.
   • There is a disconnection between national policy and the allocation of resources (e.g. a hospital CEO doesn’t meaningfully control staff, budget or procurement).
   • Under-regulation of the private health sector and overconcentration of resources. In this, COSATU proposes that “the state should minimize and where possible eliminate the profit motive, build internal capacity and should reverse reliance on Private Public Partnerships.”
   
   The COSATU proposals include:
   • Integrate Community Care Workers into the public service. The state should lead the process of training, particularly the training of nurses and doctors and resist the incursion of the profit motive in the process, Department of Health to establish a Nursing Directorate (Increase the Nurse/people ratio from 4 (per 1000 people) to 8 per 1000 and the ratio of physicians to 1000 people to 1 over the short to medium term from the current 0.69
   • Improved administration (incl an ICT system for efficient record keeping and information flows).
   • Improved medicine delivery systems to patients.
   • Review the pay structure, conditions of employment and career development in the health system.
   • The state should establish a pharmaceutical company:
   “The pharmaceuticals sector is also dominated by a few large players and plays an important role in the health system. In line with the need to address health disparities, a state-owned pharmaceutical company needs to be set up in order to produce medicines on a non-profit basis. This is important especially in the light of the HIV/AIDS pandemic and the vulnerability of the Southern African region to diseases. The state pharmaceutical company therefore puts the democratic state in a powerful position to have impact on the health profile of the Southern African population, not just South Africans and will reduce the vulnerability of the region from being exploited by multinational pharmaceutical companies.”
   
   The full document is available at: http://us-cdn.creamermedia.co.za/assets/articles/attachments/29577_cosatu_booklet.pdf

Refugees Act, 1998

To amend the Refugees Act, 1998, so as to amend, insert and delete certain definitions; to clarify how applications for refugee status rejected as manifestly unfounded and unfounded must be dealt with; to empower the Director-General to establish the Status Determination Committee; to revise the provisions relating to withdrawal of refugee status; and to provide for matters connected therewith.

3 basic steps to a lock-out procedure

There are three basic steps to a lock-out procedure: PRE, MID and POST. Make sure you include each in your procedure.

PRE-lock-out starts with the issue of a lock-out or work permit by the responsible person. This is followed by the drawing of locks and keys, de-activating the equipment or process through conventional or other means and the securing of the lock on the lock-out device. This is accompanied by the completion and hanging of the tag on the lock. This tag will show who is working on the machine and the date on which the lock-out was one. It also makes it easy to see if the lock-out is currently in use.

MID-lock-out continues by ensuring that the correct control has been locked, effectively disconnecting the power. Secure the key on the person who performed the lock-out and start the maintenance or other work. This stage continues until all work is complete.

Warning!

The removal of the lock by someone other than the one who placed it there should only be allowed under extreme circumstances, and then only with the express authority of the person who signed the permit, e.g. in the absence of the key holder. Once all activities are completed, get permission to remove the lock and tag and to restore the power supply.

POST-lock-out begins with a thorough inspection to remove all tools, loose parts and other maintenance equipment. Replace all the machine guards and other guards. Personnel must all be accounted for and be clear of all moving or hazardous mechanisms. Power is then restored and the necessary tests carried out before resuming normal operation.

Do not let medication trip you up

Did you know that certain medicines can increase the risk of falls in the elderly? This is according to a report by the Medical Control Council. Knowing which medicines are a problem could prevent a serious accident.

Take action:
If you're 65 or older, or a loved one is, then it's important to take note of the following: sedatives and tranquillisers seem to be particularly problematic in terms of falls and consequent fractures. Antidepressants, antihypertensives, hypoglycaemic agents and alcohol may also increase the risk. Discuss the use of these medicines with your doctor – especially if you're at risk, or already suffering from, osteoporosis.

Just how long after an IOD must our company continue paying?

Compensation for temporary total or partial disablement

“(3)(a) Notwithstanding section 29 the employer in whose service an employee is at the time of the accident shall be liable for the payment of the compensation referred to in subsection (1) for the first three months from the date of accident.”

Medical practitioners must be insured

Regulations published on 30 August 2010 under the Health Professions Act require health practitioners, which include doctors, specialists, dentists and psychologists practising for their own account, whether in partnership, association or by way of a company allowed for in the Act, to obtain professional indemnity insurance. The insurance must be obtained from an insurer registered under the Short-term Insurance Act.

The requirement does not extend to those practitioners employed, for example, by the State at provincial hospitals. That is presumably on the basis that the State is liable for the negligent conduct of those professionals and has the financial means to meet any judgment.
Medical practitioners have not previously been required to be appropriately insured for medical malpractice claims. In some circumstances, patients with meritorious medical malpractice claims against practitioners have found the practitioner to be uninsured and without any funds to meet a judgment.

So much for the good news!

There are problems with the regulations.

The extent of the insurance cover required is not stipulated. Even cover of R10 000.00 per an event is wholly inadequate. On the face of the regulation, a medical practitioner who obtains professional indemnity cover for R1.00 will comply with the regulation.

The regulation is also silent on what would be considered adequate cover in the aggregate. For example, where an obstetrician obtains cover for an exposure of say R10m for any claim, that is well and good but will be of a limited benefit where there are two or three such claims. The aggregate should therefore not be limited to the amount of a single claim. A greater annual aggregate of all possible claims is needed.

The question also arises whether the cover must be taken out for claims made during the insured period. Nor is provision made for any run-off cover. For example, a doctor will comply with a regulation where at all times while practising, the doctor had maintained a professional indemnity insurance policy in place but immediately the practitioner retires, the policy ceases. Cover is therefore needed for all claims that arose during the practitioner's working life during which the professional indemnity cover was maintained.

Because of the general three year prescription period and a longer period (up to 19 years) when the patient is a minor, a claim may only be made against the practitioner well after retirement or when the practitioner has ceased to practise medicine and embarked on another career.

These issues should have been dealt with.

Where a practitioner has indemnity cover from an entity other than a short-term insurer, for example, through membership of a recognised society or organisation such as a medical protection society, then that society or organisation has to register as an insurer under the Short-term Insurance Act within four months of 30 August 2010.

That four month registration period is clearly too short and extensions may have to be granted.

The regulations are promulgated under a section of the Health Professions Act which allows the Minister of Health to determine conditions under which a practitioner may practise, after consultation with the Health Professions Council. It is presumed that the appropriate consultations were held and that the effect of requiring indemnity cover to be obtained only via a registered insurer was duly considered. But was this attempt to force medical protection societies to register as insurers subject to proper consultation?

Practitioners with an independent practice who currently have indemnity cover via membership of a recognised society or organisation will have a four month period of grace within which to obtain insurance through a registered insurer. That may involve the relevant society or organisation obtaining the appropriate registration, alternatively, the mounting of any successful challenge by the relevant society or organisation to the regulations or insuring for limited losses only.

Written by: Donald Dinnie, Director, Deneys Reitz Inc.

Man's arm wedged inside machine

A man was injured on Thursday when his arm was caught in a mechanical steel-drum wrapping machine at a factory on Langeberg Road in Durban, KwaZulu-Natal paramedics said.

"It is thought that the man had been using the machine to wrap steel drums in heavy duty plastic prior to their being transported. While doing so, the man's arm was caught in the moving part of the machine," said Netcare 911 spokesperson Jeff Wicks.

Wicks said other workers in the factory shut down the power and the machine was immediately switched off.

"Officers of Netcare911's specialised rescue unit arrived at the factory to find the man's arm still firmly wedged inside the machine," said Wicks.

The rescue team used advanced rescue tools to free him. His arm was not amputated.

"The man was treated and stabilised at the scene by paramedics before he was transported to the hospital for the care he required," said Wicks.
- Sapa



Published on the Web by IOL on 2010-09-02 13:35:23

Foetal Alcohol Syndrome

What is Foetal Alcohol Syndrome?
Foetal Alcohol Syndrome refers to a group of abnormalities in growth and development that occur in children whose mothers consumed excessive amounts of alcohol whilst pregnant.

Incidence
• The World Health Organisation describes foetal alcohol syndrome as the most preventable cause of mental retardation worldwide.
• Previous studies have indicated that South Africa has one of the highest incidences of foetal alcohol syndrome in the world.
• The Western Cape had an incidence of foetal alcohol syndrome of around 7.5% in children in 2001. The Northern Cape had an incidence over 10% in children.
• Higher incidences of foetal alcohol syndrome are associated with higher levels of poverty and lower levels of education.
• High risk communities in South Africa have at least a 4 fold higher incidence of foetal alcohol syndrome than high risk communities in developed countries.

How Alcohol affects the Developing Foetus
• Alcohol exposure affects the development and function central nervous system and endocrine system of the foetus.
• Alcohol exposure can also cause abnormal gene expression in the foetus.
• The consumption of alcohol affects the blood flow to the uterus. As the blood flow is decreased, the oxygen nutrient delivery to the foetus is compromised. Without sufficient oxygen and nutrients, the growth and development of the baby is affected.
• The majority of the development happens during the 1st trimester. Alcohol consumption during the 1st trimester is therefore very dangerous and can result in a number of developmental disorders.
• The 2nd and 3rd trimester involves mostly growth for the foetus. Excessive alcohol consumption during the 2nd and 3rd trimester results in slowed growth of the foetus. This can result in a low birth weight and smaller stature as the child grows.
• Oxidative stress on the developing foetus as a result of the alcohol also plays a role in the abnormal growth and development of the foetus.

The Effects of Foetal Alcohol Syndrome
• It is very difficult to estimate the extent of the effects that alcohol consumption during pregnancy has on a foetus. One reason for the difficulty is the natural variations in intelligence and development of children as a result of genetics and environment.
• Whilst children with severe foetal alcohol syndrome are easily identified, milder cases may never be recognised. We will never know what the child’s potential may have been if the mother had not consumed alcohol during pregnancy.
• Foetal alcohol syndrome can have a far-reaching impact on the community. If these children are not correctly diagnosed and managed then they are less likely to progress in school and are at risk of repeated failure in academic and learning environments. If these children drop out of school they are more likely to turn to crime, drugs and violence, than other children. This has a long term impact on the health, safety and economy of the community.

Signs and Symptoms
• Children who are born with foetal alcohol syndrome have a number growth and developmental disorders ranging in severity. Milder cases of FAS may never be diagnosed.
• Children with severe foetal alcohol syndrome will be smaller than children of the same age.
• FAS children will also have a lower IQ than other children.
• These children will display abnormal behavioural characteristics. These include very short attention and concentration spans which are often associated with hyperactivity (as seen in Attention Deficit Disorder).
• FAS children also frequently display signs of aggression and can be very difficult for teachers and caregivers to handle.

Diagnosis
The diagnosis of FAS is based on the presence of the following abnormalities:

Size:
• Low weight
• Small height
• Small occipito-frontal circumference

Appearance:
• Small inner canthal distance
• Decreased length of the palpebral fissure
• “Railroad track” ears
• Strabismus
• Ptosis
• Flat nasal bridge
• Anteverted nares
• Thin border of upper lip
• Hirsutism
• Oral clefts

Behaviour:
• Attention-deficit disorder
• Hyperactivity

Coordination:
• Fine motor dysfunction

Cardiac:
• Cardiac abnormalities such as a cardiac murmur and cardiac malformations

Safe levels of Alcohol during Pregnancy
• There is still much debate as to what exactly the safe levels of alcohol consumption during pregnancy are.
• Therefore the best advice for women, is not to drink at all during pregnancy.
• Studies have indicated that 2 drinks a day, or 1 binge drinking session of 6 or more drinks, is sufficient to cause foetal alcohol syndrome

Treatment
• There is no way to reverse the effects of foetal alcohol syndrome.
• The child’s growth and development cannot be accelerated or improved.
• Developmental disorders can be managed with occupational and speech therapy, physiotherapy and other classes which teach language, motor, learning and social skills. Managing the difficult behaviour can be very trying for caregivers, teachers and parents.
• A skilled group of professionals is needed to improve the child’s behaviour, social skills, learning and development.
• Unfortunately most of these cases occur in poorer communities where access to the appropriate care for the child is limited.
• Furthermore, the parents of children with foetal alcohol syndrome are often alcoholics and often live in poverty. These parents are unable to care for their child properly and the child is unlikely to have access to the necessary therapies.

Prevention
• Alcohol related damage may be done to the foetus before the women realise that they are pregnant.
• Women of childbearing age should be counselled on the possible effects of alcohol consumption on a developing foetus.
• Women who are alcoholics or who partake in excessive alcohol consumption should be educated on the use of contraception in order to prevent accidental or unwanted pregnancies.
• Effective prevention involves preventing alcoholism, reducing poverty and preventing unplanned pregnancies. Achieving this is complex and difficult and involves designing and implementing effective protocols and strategies for awareness campaigns and community education. It also includes increasing the resources and staff to manage the prevention strategies.

Dr. Carrie Minnaar (M.Tech Hom.)

Swimmer's Ear

What is Swimmer’s Ear?

• Swimmer’s ear refers to otitis externa as a result of water exposure.
• Otitis externa is the medical term for inflammation of the lining of the external ear. “Otitis” refers to inflammation of the lining of the ear and “externa” refers to the external part of the ear.

Otitis externa can be acute or chronic
• Acute otitis externa is usually a result of a bacterial infection.
• Chronic otitis externa is less painful, but is more difficult to treat. It is most commonly due to fungal infections. Chronic swimmer’s ear may be more common in children with eczema and allergies.

Signs and Symptoms of Swimmer’s Ear
• The first symptom is usually itching and irritation of the external ear.
• As the condition progresses the ear becomes painful and swollen.
• Occasionally there may be a light discharge from the ear. If present, the discharge is usually clear and not very thick.
• The child may also complain of a blocked sensation in the affected ear, especially if there is swelling and a discharge.
• On examination, the patient will report pain when pressing on the tragus and pulling the ear lobe or auricles.
• The ear canal will appear red and inflamed when viewed through the otoscope.
• Occasionally the hearing may also be affected, however this resolves as the symptoms resolve.

Pathogenesis
• As the water enters the ear and becomes trapped in the ear, it causes the lining of the external ear to swell and become inflamed.
• Ear canals should be dry with a healthy amount of wax production to trap foreign particles and keep the earcanal free of pathogens.
• When the ear canal is wet and swollen it is more prone to infections. Secondary infections resulting from swimmer’s ear are usually bacterial or fungal infections.

Transmission
Swimmer’s ear is not a contagious condition and children with swimmer’s ear therefore do not need to be kept away from other children. The child may be booked off school if the condition is particularly painful and is affecting the child’s ability to concentrate and carry out his or her activities.

Diagnosis
• The diagnosis of swimmer’s ear is based on history and exposure to water, as well as clinical presentation and examination.
• In complicated cases that are not resolving, doctors may take a swab of the ear to identify the pathogen involved.

Complications
• A secondary bacterial infection may be a complication of swimmer’s ear. The most common bacterial causes of an outer ear infection are streptococcus and staphylococcus bacteria.

• Signs of a bacterial infection of the external ear include:
* Severe pain in the ear
* Severe swelling of the ear which may even extend to the side of the face
* A thick, purulent or yellow discharge from the ear
* Local swollen lymph nodes
* Fever and chills
* Pallor
* Nausea & Vomiting

• Fungal infections of the external ear may also occur as a result of trapped water in the ear. Fungi thrive in warm, dark and wet conditions. The predominant symptoms in these cases are severe itching and irritation as well as pain.
• Rarely the infection may spread elsewhere in the body.

Treatment
• Supportive treatment for swimmer’s ear is important and involves pain management. For children the most commonly recommended analgesics is ibuprofen.
• Applying warmth can also soothe the pain and inflammation and increase the drainage of the discharge. A warm facecloth or hot water bottle can be used, but caution must be taken not to burn the ear or skin.
• Swimming may slow the recovery time and children are usually advised to keep their ears dry until the symptoms have resolved.
• The inflammation is usually self limiting and in uncomplicated cases the symptoms should resolve within 3 to 7 days.
• Secondary bacterial infections are treated with antibiotics and secondary fungal infections are treated with antifungal medication.
• Antibiotics may be administered orally or in the form of ear drops.
• Ear grommets or a ruptured ear drum are contraindications for administering medicine, such as antibiotic ear drops, into the ear.
• It is also important that children with swimmer’s ear do not use ear buds or any other item in the ear to scratch or rub the ear. Ear buds can compact the wax, forming clumps of ear wax which can trap water, and can further irritate the ear canal.

Prevention
• The best way to prevent swimmer’s ear is to avoid getting the ears wet.
• Children with repeated swimmer’s ear who do not want to avoid swimming may benefit from using ear plugs whilst swimming. Special ear plugs are available for use during swimming to keep the water out of the ears. Children may also be advised to refrain from swimming under the water and must be taught to dry their ears properly after swimming.
• Children should not use ear buds to clean their ears.
• After water exposure children should try turning their heads so that the ear is facing downwards (ear to shoulder). This position can be held for a few minutes to encourage the water to run out and should be done on both the left and right sides. To improve the drainage of water out of the ear the auricle of the ear can also be pulled gentle in different directions whilst the ear is facing downwards. Ears should then be dried properly with a towel.
• Grommets, or ear tubes, are sometimes inserted into children’s tympanic membranes to allow the drainage of the middle ear. These children may be at risk of swimmer’s ear and complications such as otitis media if they spend a lot of time underwater. It is advisable that these children use appropriate ear plugs whilst swimming to prevent water from entering their ears.
• Swimming in polluted or dirty water can increase the risk of ear infections. Children should be advised
against swimming in unclean or contaminated rivers or damns, especially if they are prone to swimmer’s ear.
• Using 3 drops per ear of a 50/50 alcohol and white vinegar mixture before and after swimming can help reduce the risk of swimmer’s ear. Alcohol and vinegar restore the pH balance of the ear, have antiseptic properties and increase the rate of evaporation of water in the ear canal.

Voluntary Disclosure Programme and Taxation Laws Second Amendment Bill [B29 - 2010]

To -

• introduce a voluntary disclosure programme;
• amend the Transfer Duty Act, 1949, so as to provide for electronic submission of returns and electronic payment of duty;
• amend the Income Tax Act, 1962, so as to amend certain provisions;
• amend the Unemployed Insurance Contributions Act, 2002, so as to effect a technical correction;
• amend the Mineral and Petroleum Resources Royalty (Administration) Act, 2008, so as to
• amend certain provisions; and
• provide for matters connected

UPDATES TO NOTE
The following changes in Legislation were passed that could impact on Occupational Health and Safety Practitioners

Commencement of Amendments to the:
•Domestic Violence Act
•Magistrates' Court Act
•Maintenance Act

Amendments have been made to the Policies and Regulations published under the following Acts:
•Health Professions Act
•National Education Policy Act
•National Environmental Management Act

Compensation for Occupational Injuries and Diseases Act and Regulations (130/1993)
•Standard Assessment Rate Changes 2009 and 2010

Health Professions Act and Regulations (56/1974)
• Amendment of Ethical Rules of Conduct for Practitioners Registered under the Health Professions Act, 1974
• Regulations relating to Fines which may be Imposed by a Committee of Enquiry against Practitioners found Guilty of Improper or Disgraceful Conduct under the Health Professions Act, 1974

7 ways to create a culture of reporting incidents

1. Create a safe and open style of communication. It is okay for the lowest ranked worker to talk openly with anyone, including the MD, on matters of health and safety.
2. Pay attention to reported incidents and acknowledge there is an underlying problem or issue.
3. Do something about hazardous situations that are reported.
4. Provide feedback to all staff about the incidents and what you’re doing to reduce risk or prevent a recurrence.
5. Don’t blame people for the incident.
6. Establish the underlying causes that led to the incident.
7. Take preventative action to make sure no further incidents occur.

Skipping Breakfast

Think your mornings are too busy for breakfast? Think again, you're not doing yourself any favours. This is really the most important meal of the day. Your body has been fasting (hopefully) all night, so you need to kick-start your metabolism and get some energy for the day. By having a breakfast, you can prevent unhealthy snacking mid-morning. It improves your attention span and allow you to work better

Take action:

Even if you must get up 15 minutes earlier in the morning, start your day with a good meal. A healthy meal could be: a bowl of oats, a fruit smoothie or boil an egg on wholewheat toast.