Occupational health challenges and services in agriculture in South Africa

Purpose: Agriculture is a major source of employment in developing countries. However, it is also a source of considerable occupational injury and illness, and is also usually the sector with the least access to occupational health services. This study reviews the state of occupational health and occupational health services in South Africa, with attention to the legal frameworks at national and international level.  Methods: Review of secondary data sources was conducted to identify evidence pertaining to the burden of occupational disease and injury in agriculture in South Africa, and to the availability of services to address this burden. This included both peer-reviewed literature, as well as ‘grey literature’ published as reports, theses and unpublished studies such as country profiles assembled as part of the Work and Health in Southern Africa (WAHSA).  Results: The legal framework for occupational health and safety in agriculture in South Africa is relatively advanced, covering both prevention and compensation. However, there is no statutory framework, nor employer obligation for occupational health service delivery in agriculture. This is despite South African accession to ILO conventions on occupational health services and high levels of stated commitments in South Africa to the right to health, formulated in the South African constitution as access to health care, including occupational health services.  In practice, occupational health services for agricultural workers in South Africa are sparse, despite high levels of work-related morbidity and mortality, much of it unreported in formal surveillance systems.  Conclusions: Occupational health and safety in agriculture in South Africa is poorly served by the current regulatory framework, which is more suited to industrial forms of production. Because of the high burden of work-related illness and injury in agriculture, urgent interventions to create access to meaningful occupational health services are needed.