The overarching objective of the research study funded by the Clean Air Fund (CAF) is to understand the impacts of air pollution (ambient) on human health within the three government Air Pollution Priority Areas. This epidemiological study will apply a retrospective, longitudinal methodology, together with a case crossover analysis as a sensitivity study and will be stratified by seasons. The health effects will include the all-cause mortality datasets from Stats SA and morbidity data from Department of Health Information System (1997 to 2019). The morbidity data will include Asthma, Pneumonia under 5, new cases of TB and Rheumatoid Diseases (1997 to 2023).

The study aligns with the objectives of the National Department of Health’s National Air Quality and Health Steering Committee and will feed into their Five-Year Air Quality and Health Strategic Plan for South Africa. The goal of the National Strategy is to generate evidence on the health and wellbeing of South Africans in relation to air pollution exposure, and this proposed study will do that for the Priority areas in South Africa. The co-PIs are Prof Caradee Wright and Dr Chantelle Howlett-Downing.

Key investigators: Prof Caradee Wright (Caradee.wright@mrc.ac.za) and Dr Chantelle Howlett-Downing (Chantelle.Howlett-Downing@mrc.ac.za)

Funded by the National Research Foundation, this project aims to understand heat perceptions and heat-health risks among commuters and taxi industry members (i.e., drivers, marshals, owners) while in minibus taxi ranks in the City of Tshwane (Gauteng province). In collaboration with the City of Tshwane and the Tshwane Taxi Industry (TTI), we will gather information from commuters and the taxi industry that will inform interventions (e.g., big trees, benches) to roll out in taxi ranks to curb heat-health risks and improve thermal comfort while making use of taxi ranks.

Key investigator: Prof Caradee Wright (caradee.wright@mrc.ac.za)

This multi-country study funded by the Medical Research Foundation is investigating the role of climate in muscle function, physical performance, and the metabolome among older people in South Africa, Zimbabawe and The Gambia.

Key Investigators: Dr Thandi Kapwata (thandi.kapwata@mrc.ac.za)

Globally, billions of individuals earn their livelihoods in the informal economy. As a sub-group of the informal sector, cottage industries offer small-scale services that typically operate from households. As with most informal work, cottage industries are not regulated and thereby are often characterized by lack of legal recognition, social protection and labour rights. Cottage industries can also contribute to environmental pollution as they frequently operate in unsafe and unregulated conditions. This can lead to the release of toxic substances (such as metals) into the surrounding environment, which can contaminate soil, water and air. The aim of this study was to describe home-based occupationally related sources of toxic metals within urban communities and compare blood lead (Pb) levels in households exposed to home-based and informal work in Johannesburg, South Africa. This study is undertaken in collaboration with the University of São Paulo (Brazil) and is funded through the SA National Research Foundation (NRF) and the São Paulo Research Foundation (FAPESP) of Brazil Joint Science and Technology Research Collaboration.

Key investigator: Dr Renée Street (renee.street@mrc.ac.za)

Coal combustion for electricity generation releases pollutants that adversely affect both the environment and human health. Residents near coal-fired power stations (CFPS) are particularly vulnerable to negative health outcomes due to emissions from these facilities. This study, funded by the Foreign, Commonwealth, and Development Office (FCDO), aims to review and summarize global research on the health effects of CFPS, with a specific focus on South Africa. The objectives include analyzing mortality and morbidity rates (specifically tuberculosis and pneumonia prevalence) in districts with CFPS and comparing them to similar regions without CFPS. The findings will be shared at a workshop in Gauteng, offering both in-person and virtual participation.

Key Investigator: Dr. Caradee Wright (caradee.wright@mrc.ac.za)

In collaboration with Pure Earth and the SAMRC, this study will investigate the artisanal aluminium cookware supply chain in South Africa, focusing on material sourcing, manufacturing, distribution, retail, and end-use. Previous research has identified lead (Pb) and other harmful metals in these pots, urging the need for further assessment. The aim of this exploratory, qualitative study is to map stakeholders and practices particularly within informal settings in Limpopo, Mpumalanga, and KwaZulu-Natal and identify points for intervention. Data collection methods include observations, semi-structured interviews, and photovoice activities with participants. Additionally, X-ray fluorescence (XRF) readings will be conducted on raw materials, cookware at manufacturing sites, markets, and food vendors to measure Pb exposure levels. The expected outcomes include gaining a comprehensive understanding of the stakeholders involved in the supply chain, developing a detailed supply chain map and identifying areas of improvement and intervention to support efforts to reduce exposure to toxic metals.

Key Investigators: Renee Street (renee.street@mrc.ac.za); Melissa Nel (melissa.nel@mrc.ac.za)

The SAMRC is one of several high-level partners collaborating with the University of Cape Town (UCT) on this Wellcome Trust funded project. HABVIA aims to address evidence gaps on the human health and wider social outcomes of heat adaptation in sub-Saharan Africa (SSA). The study, which is spread across four heat-vulnerable sites in Ghana and South Africa, will (i) gather high-quality cohort data on physiological and mental health, alongside climate, environmental and socio-economic information; (ii) implement heat adaptations have been co-produced with local communities and (iii) develop and test heat warning systems to support these adaptations.

For more information, contact Dr Thandi Kapwata (Thandi.Kapwata@mrc.ac.za); supported by E&HRU study team (Dr Tracey Laban, Dr Nomfundo Mahlangeni and Dineo Hlagala)

Early childhood development (ECD) plays a crucial role in shaping children's cognitive, social, and emotional development, laying the foundation for their future success. A safe and supportive environment is essential for optimal development, well-being and learning outcomes. The South African Medical Research Council’s (SAMRC) Environment and Health Research Unit (E&HRU) is partnering with DataDrive2030 on the Thrive by Five Index 2024 - the second round of the national survey of preschool child development. In a sub-sample of ECDs in Gauteng Province, the study will monitor temperature variations in the classroom and metal exposure in dust and soil in various areas of the school. This research will help us understand how environmental factors may impact young children’s health and learning conditions in ECDs.

Key Investigators: Dr Tahira Kootbodien and Dr Renee Street

Leveraging Environmental Air Pollution data for Epidemiological Studies (LEAP-Epi)

This project, entitled ‘Leveraging Environmental Air Pollution data for Epidemiological Studies’, is funded by the Royal Society of Engineering. In partnership with the University of Leicester, the University of the Witwatersrand and North-West University, we are testing and implementing low-cost sensors that measure air pollution in two South Africa sites, Soweto (Gauteng province) and Agincourt (Mpumalanga province). The project aims to understand how low-cost sensors fare compared to high grade instruments when collecting air quality data, as well as how they are received by communities and households when implemented in the dwellings and at schools.

Key investigators: Prof Caradee Wright (caradee.wright@mrc.ac.za) and Dr Tracey Laban (tracey.laban@mrc.ac.za)

Mine dumps are a major generator of wind-blown dust containing toxic metals such as lead. Lead has been associated with adverse health effects, especially neurocognitive and behavioural effects in children. Communities living close to gold mine dumps are at risk of elevated exposure to lead. A before and after intervention study is conducted in Soweto, Snake Park, a community situated at the base of the Durban Roodepoort Deep (DRD) Mine (DRD). The study aims to evaluate the impact of an educational and domestic hygiene intervention on exposure to indoor dust lead levels. The study will determine whether the interventions led to a reduction in indoor dust lead levels, and if shown to be effective, will inform the development of an awareness campaign to reduce lead exposure in communities located near gold mine dumps. The study holds the potential for a cost-effective measure to reduce exposure to mining-associated toxic substances, for hundreds of thousands of households living in the shadow of mining operations and other sites of elevated exposure to toxic substances from industrial sources.

Key investigator: Dr Vusi Nkosi (vusi.nkosi@mrc.ac.za)

The South African Medical Research Council’s (SAMRC) Environment and Health Research Unit (E&HRU) is partnering with national and international counterparts on the African and European continents to investigate the effects of poverty on psychological conditions – particularly depression.

Leading the NEET study is the University of Pretoria (UP). Other collaborators include: the University of Ibadan (Nigeria), the University of Leicester (UK), University of Dalhousie (Canada), as well as the University of Nottingham (UK). From a research standpoint, NEET is the first study of its kind examining how the lack of resources can contribute to young people experiencing psychological challenges such as depression – compounded by various barriers inhibiting overall success in life – using a unique methodological approach. The NEET Study is funded by the Wellcome Discovery Grant and aims to provide mental health practitioners with the necessary tools to effectively address a very pressing issue among youth populations globally.

For more information, contact Prof Caradee Wright (caradee.wright@mrc.ac.za)

Funded by the South African Medical Research Council (SAMRC), this study investigates how occupational and environmental exposures including job type, air pollution, noise, and extreme weather events affect the mental well-being of street traders in Durban, Johannesburg, and Pretoria. Data collection involves twelve focus group discussions and thirty key informant interviews. The study also utilizes secondary data from the South African Population Research Infrastructure Network (SAPRIN) to assess the impact of air pollution and weather on the mental health of informal workers. The findings are expected to provide valuable insights for developing targeted interventions to enhance the health and well-being of street traders.

Key Investigators: Dr. Busisiwe Shezi (busisiwe.shezi@mrc.ac.za).

The PLANET4HEALTH project is a funded from the Horizon EU research and innovation programme (G.A. No 101136652) providing new knowledge and tools on environment degradation and its impact on human, animal and ecosystem health. This project sees the collaboration of 17 partners (from 11 European countries and South Africa) and funding of approximately 6 million euros. It is led by Stefano Campostrini (Ca’ Foscari University of Venice – Italy) and Suzana Blesic (Institute for Medical Research, Belgrade – Serbia).

The South African Medical Research Council’s (SAMRC) Environment and Health Research Unit (E&HRU) will lead a case study on air pollution and health in South Africa, drawing together multiple datasets to inform technological innovations, such as application and policy solutions.

For more information, contact Prof Caradee Wright (caradee.wright@mrc.ac.za)

Various genetic approaches are used for AMR surveillance, but there are few harmonized, high-throughput platforms that target clinically relevant markers that indicate AMR mobility and multidrug resistance (MDR). Here we will develop and validate two promising technological platforms that can be readily incorporated into national and international integrated surveillance programs. Our digital droplet PCR platform will provide a highly sensitive unbiased method of resistance gene (ARG), mobile genetic element, and taxonomic gene co-occurrence in complex environments. This approach allows genetic source tracking of clinically relevant MDR pathogens in regions with suitable analytical facilities. In tandem, our multiplexed DNA-based electrochemical biosensor platform will facilitate on-site multiplexed quantification of MDR markers, which reduces the need for expensive analytical equipment and highly trained staff. This will be invaluable for AMR surveillance in low-resource regions. Both technological platforms will integrate taxonomic, ARG and mobility markers inferred from microbiological, epidemiological, and environmental data generated by the consortium. The diverse and multidisciplinary TEXAS team includes experts on technology development as well as policy guidance to international organizations on central to global integrated surveillance planning. This will promote adoption of selected targets, and implementation of the two platforms (validated against gold standard methods) for samples collected from low- and high-resource settings and differing sectoral contexts

Key Investigator: Dr Renée Street (renee.street@mrc.ac.za)

Mining has been a fundamental pillar of the South African economy for well over a century. For most of this period however, health has not been a key consideration in the planning and management of mining operations and human settlements. Extensive mining of gold in Johannesburg has left major tailings facilities and other mine waste deposits on the landscape. These tailings dams and mine dumps contain potentially toxic metals such as uranium. People who reside in close proximity may be exposed to elevated concentrations of uranium. Children are often more vulnerable to toxic pollutants than adults because of their developing nervous systems, greater gastrointestinal absorption, elevated dietary intake of contaminants and more contact with contaminated surfaces due to their play and hand-to-mouth activities. This study aims to characterize uranium concentrations by analyzing biological and environmental samples in children living in homes located at various distances downwind of a cluster of large mine tailings facilities in Johannesburg, compared with communities not living in close proximity to gold mine tailings facilities in Durban. The findings of this study will provide a better understanding of relevant uranium exposure pathways among children, and their respective significance, thereby encourage mandatory buffer zones to improve the health of the affected residents.

Key investigator: Dr Busisiwe Shezi (busisiwe.shezi@mrc.ac.za)

Climate change is associated with an increased risk of occurrence of climate-sensitive health outcomes such as hypertension, anxiety and depressive disorders in urban areas. Current evidence suggests that urban green spaces may have a protective effect against such health outcomes. However, almost all existing evidence originates from high-income countries. This study aims to fill this knowledge gap by assessing the association between residential surrounding greenness and hypertension, anxiety and depressive disorders among urban residents of Kampala, Uganda. This study will inform future research on the impact of residential greenness on the aforementioned health outcomes in other low-and-middle income countries like South Africa. The information generated from this study will be essential to stakeholders such as urban planners and public health authorities to guide action. 

For more information, contact Dr Busisiwe Shezi (busisiwe.shezi@mrc.ac.za)

The SAMRC Wastewater Surveillance and Research Programme monitors the non-infectious SARS-CoV-2 RNA, the fragments of the virus that causes COVID-19, in wastewater. The non-infectious SARS-CoV-2 RNA can be shed in feces of individuals that are symptomatic or asymptomatic. By testing wastewater weekly, we can measure the SARS-CoV-2 RNA signal and see whether it is increasing or decreasing. This has been used as an early indicator of COVID-19 case trends within a community.

Key investigator: Dr Renée Street (renee.street@mrc.ac.za)