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Global warming, the increase in heatwaves and periods of intense heat, is a major problem across the world, including in South Africa. Heat exposure has adverse health impacts, ranging from dehydration and heat stroke to death. The transport sector and its users are vulnerable to heat exposure both in vehicles and in places where they wait for transport. We investigated the heat perceptions and experiences of minibus commuters and the minibus taxi industry in minibus taxis and minibus taxi ranks to inform an intervention to prevent adverse health impacts from heat exposure in the City of Tshwane. Commuters (n = 279), drivers and marshals (n = 46) reported feeling hot in minibus taxis and minibus taxi ranks, experiencing sweating, headaches, exhaustion and dizziness. Some participants reported opening windows and doors, drinking water/cold drinks, removing a jersey and fanning themselves to try and cool down. All participants suggested solutions to address heat exposure in minibus taxis and minibus taxi ranks, including more shelters and trees for shade, the provision of water, benches and potentially an air-conditioned building for waiting/holding periods between trips. In consultation with our stakeholders, we prepared educational awareness materials about heat risks to health and actions to take when it is hot, and these were distributed through the minibus taxi sector in the City of Tshwane. Future research needs include measuring temperatures in these settings and rolling out large-scale interventions to protect health and well-being in a changing climate. Significance: Heat exposure has adverse health impacts, ranging from dehydration to death. The transport sector and its users are vulnerable to extreme heat. We investigated the heat experiences and perceptions of minibus commuters and the minibus taxi industry to inform an intervention to prevent adverse health impacts from heat exposure in the City of Tshwane. We prepared educational awareness materials about heat risks to health and actions to take when it is hot, and these were distributed through the minibus taxi sector. Future research needs include measuring temperatures in these settings and rolling out large-scale interventions to protect health and well-being in a changing climate.

Temperature extremes vary across Africa. A continent-wide examination of the impacts of heat on health in Africa, and a synthesis of Africa-informed evidence is, however, lacking. A systematic review of articles published in peer-reviewed journals between January 1992 and April 2019 was conducted. To be eligible, articles had to be Africa-specific, in English, and focused on how heatwaves and high ambient temperatures affect morbidity and mortality. A secondary systematic analysis on policies and interventions comprising 17 studies was also conducted, and the findings synthesised together with those of the 20 primary studies. Eleven studies showed that high ambient temperatures and heat waves are linked with increased mortality rates in Africa. These linkages are characterised by complex, linear and non-linear (J or U) relationships. Eight of the nine primary studies of morbidity outcome reported that an increase in temperature was accompanied by raised disease incidence. Children and the elderly were the population groups most vulnerable to extreme heat exposure. Location-specific interventions and policy suggestions include developing early warning systems, creating heat-health plans, changing housing conditions and implementing heat-health awareness campaigns. In summary, this review demonstrates that, while heat-health relationships in Africa are complex, extreme temperatures are associated with high mortality and morbidity, especially amongst vulnerable populations. As temperatures increase across Africa, there is an urgent need to develop heat-health plans and implement interventions. Future studies must document intervention effectiveness and quantify the costs of action and inaction on extreme heatrelated mortality and morbidity. Significance: • Empirical evidence shows that the relationship between heat and human health is complex in the African This complexity has implications for the development of interventions and policies for heathealth on the continent. • This review is important for African policymakers, practitioners and others who support Africa’s adaptation to climate change. Through this review, a compendium of Africa-specific and relevant empirical information is aggregated and made readily available to various interested and affected parties.

We describe the measurement and spatial variability of particulate matter (PM) chemical composition, PM10 and PM2.5 in the Greater Tubatse Municipality, South Africa. Monthly samples were collected over 12 months (July 2015 to June 2016) using the inexpensive and easy to operate passive samplers of the University of North Carolina. Sites for sample collection were located at private residences, a church, a hospital and a school. Concentrations of PM10, PM2.5 and PM chemical components were determined using computer-controlled scanning electron microscopy with energy-dispersive X-ray spectroscopy. The annual observed concentrations at all sites were below the South African National Ambient Air Quality Standards of 40 μg/m3 for PM10 and 25 μg/m3 for PM2.5. The Cr-rich and CrFe-rich particles showed substantial heterogeneity with high concentrations observed near the chrome smelters, and Si-rich particles were highest near the silicon mine. SiAl-rich particles were highest at sites close to busy roads, while SiAlFe-rich particles were less spatially distributed. The low spatial variability of SiAlFe-rich particles indicates that these elements are mainly found in crustal material. Using the synoptic meteorological parameters of The Air Pollution Model, we were unable to effectively determine correlations between PM10 and mixing height, Monin–Obukhov length, air pollution potential, or coefficient of divergence. Significance: • We have shown that the use of University of North Carolina passive samplers coupled with computer-controlled scanning electron microscopy is effective in determining the chemical composition of PM. • The use of passive samplers is a cheap and effective method to collect data in remote areas of South Africa which have limited or no electricity supply. • Assessment of the spatial distribution of PM and PM chemical components can assist in the development of effective air quality management strategies.

The city of Pretoria in South Africa receives considerable solar ultraviolet radiation (UVR) because of its low latitude (22–35°S) and relatively clear skies. Certain meteorological factors affect the amount of solar UVR that reaches the ground; the most dominant factors being stratospheric ozone, cloud cover and solar zenith angle. It is known that overexposure to solar UVR may lead to the development of adverse health conditions, the most significant being skin cancer. Outdoor workers spend a significant amount of time outside and are thus susceptible to this risk. In this case study, we estimated, for the first time, the realtime solar UVR exposure of an outdoor worker in Pretoria. Measurements were made on 27 and 28 May 2013 using a handheld ultraviolet index (UVI) meter calibrated against a science-grade biometer at the South African Weather Service in Pretoria. Personal exposure estimation was used to discern the pattern in diurnal and annual sunburn risk for the outdoor worker. Ambient UVR levels ranged from 0 UVI to 4.66 UVI and the outdoor worker’s potential exposure estimates regularly exceeded 80% of these levels depending on the time of day. The risk of sunburn was evident; however, actual incidents would depend on individual skin photosensitivity and melanin content, as well as sun protection used. Further research is needed to determine the personal exposure estimations of outdoor workers in other provinces in which solar UVR levels may be equally high, or higher than those in Pretoria.

Photoprotection messages and ‘SunSmart’ programmes exist mainly to prevent skin cancers and, more recently, to encourage adequate personal sun exposure to elicit a vitamin D response for healthy bone and immune systems. Several developed countries maintain intensive research networks and monitor solar UV radiation to support awareness campaigns and intervention development. The situation is different in sub-Saharan Africa. Adequate empirical evidence of the impact of solar UV radiation on human health, even for melanomas and cataracts, is lacking, and is overshadowed by other factors such as communicable diseases, especially HIV, AIDS and tuberculosis. In addition, the established photoprotection messages used in developed countries have been adopted and implemented in a limited number of sub-Saharan countries but with minimal understanding of local conditions and behaviours. In this review, we consider the current evidence for sun-related effects on human health in sub-Saharan Africa, summarise published research and identify key issues. Data on the prevalence of human diseases affected by solar UV radiation in all subpopulations are not generally available, financial support is insufficient and the infrastructure to address these and other related topics is inadequate. Despite these limitations, considerable progress may be made regarding the management of solar UV radiation related health outcomes in sub-Saharan Africa, provided researchers collaborate and resources are allocated appropriately.

Exposure to solar ultraviolet (UV) radiation is known to have both adverse and beneficial consequences for human health. Sunburn and skin cancer are probably the most well-known acute and chronic adverse health impacts. These themes have recently been discussed in the media for the general public; consequently interest in sun protection is growing. The promotion of the use of practical personal strategies to reduce adverse health risks, such as healthy sun behaviour, sun protection mechanisms and solar ultraviolet radiation awareness tools, is increasing. One such tool is the personal UV index (UVI) monitor, promoted commercially as a viable tool for sun awareness; however, such instruments have not been scientifically evaluated in a South African context. Here, two different types of personal UVI monitors, commercially available in South Africa, were compared with a research-grade UVB biometer for a continuous 7-h period on 02 March 2012 in Pretoria. One of the two personal UVI monitors showed reasonable agreement with the UVB biometer, whereas the other monitor overestimated UVI by up to 4 UVI units. When comparing two identical products manufactured by the same company, one monitor overestimated UVI twofold, suggesting inter-instrument variability may be a concern. Commercially available, personal UVI monitors should be used with caution as a public health tool for sun awareness in South Africa.