Occupational and sociodemographic disparities in chronic respiratory disease mortality in south africa: a national analysis (2013-2019)
1
School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
2
Africa Health Research Institute, Mtubatuba, South Africa
3
Department of Family Medicine, School of Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
Popul. Med. 2026;8(Supplement Supplement 1):A1231
ABSTRACT
INTRODUCTION:
chronic respiratory diseases (CRDs) are a major cause of adult mortality globally and remain an important public health concern in south africa.¹ occupational exposures such as dust, fumes, and chemical agents are preventable risk factors, yet nationally representative evidence on occupational patterns of CRD mortality in south africa remains limited.²˒³
METHODS:
we conducted an analytical cross-sectional study using national mortality data from statistics south africa for 2013-2019. we included all registered deaths among individuals aged 18-75 years with known occupation and certified underlying cause of death. we identified CRD deaths using ICD-10 codes J30-J99 and coded them as a binary outcome. we summarised sociodemographic and occupational characteristics using descriptive statistics. we used multivariable logistic regression to estimate associations between occupational groups and CRD mortality, adjusting for age, sex, population group, province, education, marital status, and smoking status. we report results as adjusted odds ratios (aORs) with 95% confidence intervals (CIs).
RESULTS:
of 2373703 deaths, 79840 (3.4%) were attributed to CRDs, of which chronic obstructive pulmonary disease accounted for 40134/79840 (50.3%), followed by asthma at 15482/79840 (19.4%). proportional mortality was higher among males and older adults and was elevated among coloured (15623/200310; 7.8%) and white (14329/207573; 6.9%) population groups compared with black africans (42218/1627714; 2.6%). compared with professionals, individuals in elementary occupations had higher odds of CRD mortality (aOR 1.06; 95% CI 1.03-1.09), while managers, professionals, technicians, and service and sales workers had lower odds.
CONCLUSIONS:
occupational factors contribute to CRD mortality in south africa, particularly among lower-skilled workers. employers should strengthen exposure control measures and workplace monitoring in high-risk industries, while the department of employment and labour should enforce occupational health regulations more consistently. the department of health should integrate routine respiratory screening into occupational health and primary care services to improve early detection and prevention of CRD-related deaths.
chronic respiratory diseases (CRDs) are a major cause of adult mortality globally and remain an important public health concern in south africa.¹ occupational exposures such as dust, fumes, and chemical agents are preventable risk factors, yet nationally representative evidence on occupational patterns of CRD mortality in south africa remains limited.²˒³
METHODS:
we conducted an analytical cross-sectional study using national mortality data from statistics south africa for 2013-2019. we included all registered deaths among individuals aged 18-75 years with known occupation and certified underlying cause of death. we identified CRD deaths using ICD-10 codes J30-J99 and coded them as a binary outcome. we summarised sociodemographic and occupational characteristics using descriptive statistics. we used multivariable logistic regression to estimate associations between occupational groups and CRD mortality, adjusting for age, sex, population group, province, education, marital status, and smoking status. we report results as adjusted odds ratios (aORs) with 95% confidence intervals (CIs).
RESULTS:
of 2373703 deaths, 79840 (3.4%) were attributed to CRDs, of which chronic obstructive pulmonary disease accounted for 40134/79840 (50.3%), followed by asthma at 15482/79840 (19.4%). proportional mortality was higher among males and older adults and was elevated among coloured (15623/200310; 7.8%) and white (14329/207573; 6.9%) population groups compared with black africans (42218/1627714; 2.6%). compared with professionals, individuals in elementary occupations had higher odds of CRD mortality (aOR 1.06; 95% CI 1.03-1.09), while managers, professionals, technicians, and service and sales workers had lower odds.
CONCLUSIONS:
occupational factors contribute to CRD mortality in south africa, particularly among lower-skilled workers. employers should strengthen exposure control measures and workplace monitoring in high-risk industries, while the department of employment and labour should enforce occupational health regulations more consistently. the department of health should integrate routine respiratory screening into occupational health and primary care services to improve early detection and prevention of CRD-related deaths.
| eISSN: | 2654-1459 |
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