Background: Access to radiotherapy services is critical for effective cancer treatment, yet patients in sub-Saharan Africa face numerous barriers to accessing these services. The region is experiencing a significant increase in cancer cases, with a more than 85% increase in cancer cases reported in the past decade, highlighting the critical role of radiotherapy in enhancing patient prognosis. This systematic review aims to explore the barriers to radiotherapy access in sub-Saharan Africa. The barriers explored will be used to inform the development of the framework to improve access to radiotherapy in the Gauteng provinces, South Africa. Methods: A systematic search of electronic databases was conducted to identify relevant studies published between January 2013 and December 2023. Studies reporting on barriers to radiotherapy access in SSA were included and put into four categories of barriers: health system factors, patient sociodemographic factors, patient factors, and provider factors. Data were synthesised using thematic analysis. Results: This review identifies geographical, financial, cultural, logistical, and systemic barriers to radiotherapy access in sub-Saharan Africa, including limited infrastructure, long travel distances, and inequitable distribution of services. Systemic barriers, including policy gaps and governance issues, also contribute to the inequitable distribution of radiotherapy services in the region. Conclusions: This systematic review highlights the diverse array of barriers to radiotherapy access in sub-Saharan Africa and emphasises the urgent need for targeted interventions to address these challenges.

Radon is a known carcinogen, and the accurate assessment of indoor levels is essential for effective mitigation strategies. While long-term testing provides the most reliable data, short-term testing (STT) offers a quicker and more cost-effective alternative. This review evaluated the accuracy of STT in predicting annual radon averages and compared testing strategies in Europe (where long-term measurements are common) and the United States (where STT is prevalent). Twenty (20) studies were systematically identified through searches in scientific databases and the grey literature, focusing on STT accuracy and radon management. This review revealed several factors that influence the accuracy of STT. Most studies recommended a minimum four-day test for initial screening, but accuracy varied with radon levels. For low levels (95%) in predicting annual averages. However, accuracy decreased for moderate levels (approximately 50% success rate), necessitating confirmation with longer testing periods (3 months). High radon levels made STT unsuitable due to significant fluctuations. Seasonality also played a role, with winter months providing a more representative picture of annual radon averages. STT was found to be a useful method for screening low-risk areas with low radon concentrations. However, its limitations were evident in moderate- and high-level scenarios. While a minimum of four days was recommended, longer testing periods (3 months or more) were crucial for achieving reliable results, particularly in areas with potential for elevated radon exposure. This review suggests the need for further research to explore the possibility of harmonizing radon testing protocols between Europe and the United States.

Over the years, prostate cancer (PCa) research has been of great interest, and trace metals have attracted a lot of attention due to their association with prostate cancer development and progression. PCa has a complex etiology, with genetic, environmental, and lifestyle factors being implicated. Trace metals such as zinc (Zn), mercury (Hg), selenium (Se), lead (Pb), cadmium (Cd), manganese (Mn), arsenic (As), and nickel (Ni) have garnered much attention in recent years, suspected of having direct links to the modulation of cancer risk and progression through their impacts on prostate cancer omics (genomics, epigenetics, proteomics, and transcriptomics). This has led to them being the subject of extensive research in this regard. In this review, we explored the influence of trace metals and offered a comprehensive analysis of the current knowledge on how trace metals affect the biology of prostate cancer at a molecular level by integrating findings from the recent literature to help suggest possible directions for future research.

This study evaluated the state of environmental health in the Republic of South Africa using the strengths, weaknesses, opportunities, and threats (SWOT) analysis framework. The internal and external factor evaluations were conducted by reviewing existing literature searched using a combination of keywords and boolean functions. The weighted score for the strengths and weaknesses was 0.79 and 1.04, respectively. The external factor evaluations findings revealed that environmental health has an equal amount of threats and opportunities, however, the threats outweigh the opportunities. The total weighted score for the internal and external factor evaluations was 1.83 and 2.25, respectively, which were below the average value of 2.5. The internal-external factors matrix indicated that environmental health in the Republic of South Africa needs to be refocused and re-aligned to public health protection. Failure to address the weaknesses and threats and optimise the strengths and opportunities may further weaken the provision of environmental health services.

Radon (Rn) is a radioactive gas with well-established carcinogenic properties. It is a significant contributor to natural background ionizing radiation exposure, accounting for over 50 % of human exposure. Prolonged exposure to radon gas has been conclusively linked to various health issues such as lung cancer, leukemia, and Chronic Obstructive Pulmonary Diseases (COPD). Despite this, there is a scarcity of comprehensive studies examining the quality of evidence establishing an association between indoor radon exposure and these health problems. We performed a systematic review of peer-reviewed research articles to explore the current evidence on the potential association between residential radon exposure and human health, specifically focusing on lung cancer, COPD, and leukemia. A comprehensive search was conducted on PubMed and Google Scholar using MeSH terms and keywords (residential radon, radon AND lung cancer, radon AND COPD, radon AND leukemia). The inclusion criteria focused on studies that analyzed the link between residential radon exposure and lung cancer, leukemia and COPD. We searched for peer-reviewed studies published from 2010 to 2024. Studies carried out in occupational settings were not considered. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework to select relevant studies. Reviewers independently collected data, resolving disagreements through discussion. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to evaluate evidence quality, and the study was registered with PROSPERO, CRD42024550735. The evidence indicating an associative or causal link between indoor radon and lung cancer was found to be of high quality or conclusive, particularly with stronger support from case-control studies. The findings for COPD and leukemia were inconclusive, indicating that additional research is necessary to establish a definitive link between residential radon exposure and these health outcomes. These associations was deemed moderate or inconclusive primarily due to methodological shortcomings, conflicting findings and the prevalence of weak study designs and poor exposure data. The existing evidence on the potential connection between residential radon exposure and the risk of COPD and leukemia is currently limited. In order to definitively confirm or disprove this association, more studies are needed. Further research is crucial to elucidate these relationships and to guide the development of effective public health interventions. The review found that the association between radon exposure and lung cancer was consistent with existing scientific knowledge. However, the evidence for association between indoor radon exposure and COPD was inconclusive. Additionally, evidence linking indoor radon exposure to leukemia was uncertain. Future research should use more robust study designs (cohort and case control studies) and directly measure long-term radon levels to investigate the potential association between residential radon exposure and COPD and leukemia.

Hospital mortuaries are responsible for the receipt and storage of deceased people. This exposes mortuary workers to a variety of health and safety hazards, which include physical, chemical, ergonomics, biological and psychosocial hazards/stressors. The aim of this study was to assess occupational health and safety practices (OHS) among government mortuary workers in Gauteng province. a cross-sectional descriptive study design was conducted between the year 2017 and 2018. A convenient sampling technique was used to sample 11 government hospitals in Gauteng Province. A total of 46 employees participated in the study. Data was collected using structured questionnaires and observational checklists. Ethical clearance and permission to conduct the study were obtained prior to the commencement of the study. Data was analyzed using Statistical Package for the Social Science (SPSS) version 25 software. thirty-one (67%) of the respondents did not know the concept of hazard. Observations indicated that 5 out of 11 (45%) facilities were well maintained with only 2 (18%) of the facilities had the participants wearing the required PPE on duty. There was no association between working experience and having a knowledge of the existing hazards. However, there was a high correlation (P<0.05) between training and adherence to safe practices. the OHS practices were poor amongst operational employees. The study highlights the significance of developing and implementing Occupational Health and Safety programmes. We recommend that these programmes should focus on occupational health and safety education, training, supervision, medical surveillance and monitoring strategies must be developed and implemented.