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INTRODUCTION : Household air pollution from domestic solid fuel use remains a global public health concern, particularly in low‑income communities. This study assessed associations between household fuel use, indoor air pollution, and respiratory health outcomes in two Mpumalanga communities in South Africa. METHODS : A cross‑sectional study was conducted in KwaZamokuhle and eMzinoni between July 2019 and February 2020. Indoor PM2‧5 concentrations were measured using Airmetrics MiniVol samplers and TSI DustTrak II monitors. We carried out household surveys, lung function tests and allergen sensitivity testing and performed multivariable logistic regression to assess associations between indoor pollutant exposure and respiratory health outcomes. RESULTS : Indoor and ambient PM2‧5 concentrations in KwaZamokuhle were more than twice as high as those in eMzinoni, exceeding both national standards and WHO Air Quality Guidelines. Coal use for heating was more prevalent in KwaZamokuhle and appeared directly related to elevated PM2‧5 levels. Approximately 9% of participants exhibited signs of obstructive airway disease, and 25% had positive results for allergen sensitisation. Although the associations between PM2‧5 levels, solid fuel use and measured respiratory outcomes did not reach statistical significance, consistent trends in the expected direction were observed, suggesting a potential relationship that warrants longitudinal studies with larger sample sizes. CONCLUSION : These findings suggest complex, possibly nonlinear relationships between indoor air pollution and respiratory health effects. The study underscores the urgent need for a greater use of clean energy alternatives and increased public awareness about the risks of household air pollution in low‑income South African communities.

Objectives The present study describes latex sensitisation and allergy prevalence and associated factors among healthcare workers using hypoallergenic latex gloves at King Edward VIII Hospital in KwaZulu-Natal, South Africa. Design Cross-sectional study. Setting A tertiary hospital in eThekwini municipality, KwaZulu-Natal, South Africa. Participants 600 healthcare workers were randomly selected and 501 (337 exposed and 164 unexposed) participated. Participants who were pregnant, with less than 1 year of work as a healthcare worker and a history of anaphylactic reaction were excluded from the study. Primary and secondary outcome measures Latex sensitisation and latex allergy were the outcome of interest and they were successfully measured. Results The prevalence of latex sensitisation and allergy was observed among exposed workers (7.1% and 5.9%) and unexposed workers (3.1% and 1.8%). Work-related allergy symptoms were significantly higher in exposed workers (40.9%, p<0.05). Duration of employment was inversely associated with latex allergy (OR 0.9; 95% CI 0.8 to 0.9). The risk of latex sensitisation (OR 4.2; 95% CI 1.2 to 14.1) and allergy (OR 5.1; 95% CI 1.2 to 21.2) increased with the exclusive use of powder-free latex gloves. A dose–response relationship was observed for powdered latex gloves (OR 1.1; 95% CI 1.0 to 1.2). Atopy (OR 1.5; 95% CI 0.7 to 3.3 and OR 1.4; 95% CI 0.6 to 3.2) and fruit allergy (OR 2.3; 95% CI 0.8 to 6.7 and OR 3.1; 95% CI 1.1 to 9.2) also increased the risk of latex sensitisation and allergy. Conclusions This study adds to previous findings that healthcare workers exposed to hypoallergenic latex gloves are at risk for developing latex sensitisation highlighting its importance as an occupational hazard in healthcare. More research is needed to identify the most cost effective way of implementing a latex-free environment in resource-limited countries, such as South Africa. In addition more cohort analysis is required to better understand the chronicity of illness and disability associated with latex allergy.