South African Medical Research Council (SAMRC)
Building a healthy nation through research and innovation


Environment and Health Research Unit


Terms and Conditions
to visit this site

Current Projects 

Climate and Health

The increased frequency and intensity of weather events associated with climate change, is expected to pose the highest risks in settings of under-development, such as informal settlements or areas with poor quality formal housing. To investigate the risks and adaptation measures that may protect and promote the health of vulnerable South African communities, the E&HRU has embarked on a portfolio of climate and health research projects:

  • Heat and Health
    Seed funding has been awarded to the Unit through the MRC Flagship programme to start looking at heat related risks to health in small and medium sized towns in South Africa. The work will include the identification of towns at particular risk of heat waves, investigating current heat coping mechanisms and an examination of the relationship between heat waves and hospital admissions.
  • Weather-based Early Warning Systems
    The Unit has submitted an application for funding to examine the utility of weather based early warning systems to reduce levels of malaria, diarrhoeal disease and pneumonia following adverse weather events (high precipitation, heat waves and very cold spells).


  • Wright CY, Mathee A, Garland R. Climate change, human health and the role of Environmental Health Practitioners. South African Medical Journal, 2014 (accepted).
  • Mathee A, Oba J, Rose A. Climate Change Impacts on Working People (the Hothaps Initiative): Findings of the South African Pilot Study. Global Health Action, 2010, 3(10): 5612.
Urbanization and Health

More than half of the world’s population now lives in cities, and more than two-thirds are expected to do so within the next 30 years. The health of the world’s people is therefore increasingly a matter of urban health. However, urban growth, especially in sub-Saharan Africa, has occurred mainly in informal settlements and other areas of concentrated disadvantage, with the prospect of increasing burdens of ill health and rising inequities.

Urbanization and Health 

Johannesburg is part of an urban agglomeration, including the municipalities of Tshwane (Pretoria) and Ekurhuleni, of more than 10 million people. This area attracts people from rural areas in South Africa, as well as from elsewhere on the African continent. The resultant demand for housing has led to overcrowded housing and the growth of informal settlements.

To gain further understanding of changing urban dynamics and health challenges in settings of urban poverty, the Johannesburg-based World Health Organisation Collaborating Centre for Urban Health (WHOCCUH) initiated a panel study in 2006 to monitor socio-environmental conditions and health status in five housing settlements. The Health, Environment and Development Study comprises a pre-determined set of dwellings which is visited each year and a pre-structured questionnaire is administered to a suitable respondent. Information on socio-economic status, living conditions, food security, lifestyle factors and health status (acute, chronic and mental health) is collected. Usually, and additional environmental monitoring component is also undertaken, such as sampling of yard soil for metal content analysis, sampling of drinking water for microbiological quality assessment or installation of data loggers for measurement of indoor temperature, is also undertaken.

The HEAD study is an increasingly rich source of data, providing unique insights into urban environment and health challenges and trends. Here are some publications that are based on, or linked to, HEAD study data (copies of these and other publications may be obtained by writing to Ms Mirriam Mogotsi at

  • Jassat W, Naicker N, Naidoo S, Mathee A. Rodent control in urban communities in Johannesburg, South Africa: from research to action. International Journal of Environmental Health Research, 2013, 23(6): DoI 10.1080/09603123.2012.755156
  • de Wet T, Harpham T, Plagerson S, Mathee A. Good housing, poor health: living in formal versus informal housing in Johannesburg, South Africa. International Journal of Public Health, 2011, 56: 625 – 633.
  • Combrink A, Irwin N, Laudin G, Naidoo K, Plagerson, Mathee A. Highly elevated prevalence of Hookah Pipe smoking among secondary school students in a disadvantaged community in Johannesburg. South African Medical Journal, 2010, 100(5): 297-299.
  • Plagerson S, Patel V, Harpham T, Kielmann K, Mathee A. Does money matter for mental health? Evidence from the Child Support Grants in Johannesburg, South Africa. Global Public Health, 2010, 6(7): 760-776.
  • Mathee A, Harpham T, Barnes B, Swart A, Naidoo S, de Wet T and Becker P. Inequity in poverty: the emerging public health challenge in Johannesburg. Development Southern Africa, 2009, 26 (5): 721- 732.
  • Mathee A, Harpham T, Naicker N, Barnes B, Plagerson S, Feit M, Swart A, Naidoo S. Overcoming fieldwork challenges in urban health research in developing countries: a research note. International Journal of Social Research Methodology, 2009, 23: 1464 - 5300.
  • Mathee A, Singh E, Mogotsi M, Timothy G, Maduka B, Oliver J, Ing D. Lead- based paint on playground equipment in public children’s parks in Johannesburg, Tshwane and Ekurhuleni. South African Medical Journal, 2009, 99: 819 – 821.
Lead poisoning prevention

Lead poisoning is a serious public health problem in South Africa. Leaded petrol was used until 2006, and legislation to control the use of lead in paint was only introduced in 2009, contributing to elevated blood lead levels in children in many parts of the country. Even low blood lead concentrations in children have been associated with reductions in intelligence scores, behavioural disturbances such as hyperactivity and shortened concentration spans, and the emergence of aggressive or violent behaviour. At elevated blood lead concentrations, effects such as anaemia, damage to virtually all organs have been while, while highly elevated blood lead levels may result in permanent muscular paralysis, coma and death.

Currently the Unit is investigating lead exposure from the smelting of lead in subsistence fishing communities to make fishing sinkers, in communities in the vicinity of mining activities, from the use of lead-based ammunition amongst recreational and other shooters, and lead poisoning from the consumption of Ayurvedic medicines. A special programme is also underway to examine the relationship between lead exposure and the emergence of aggressive or violent behaviour in young adults.

Below is a selection of journal articles emanating from this programme of work:

  • Mathee A, Khan T, Naicker N, Kootbodien T, Naidoo S, Becker P. Lead exposure in young school children in South African subsistence fishing communities. Environmental Research, 2013, 126, 179-183.
  • Naicker N, Norris S, Mathee A, von Schirnding Y, Richter L. Prenatal and adolescent blood lead levels in South Africa: Child, maternal and household risk factors in the Birth to Twenty cohort. Environmental Research, 2010, 110(4): 355 – 362.
  • Mbongwe B, Mpuchane M, Zhai M, Barnes B, Mathee A. Exposure to Lead among Children in the City of Gaborone – Results of a Pilot study. Journal of Environmental Health Research, 2010, 10(1): 17 – 26.
  • Mathee A, Singh E, Mogotsi M, Timothy G, Maduka B, Oliver J, Ing D. Lead- based paint on playground equipment in public children’s parks in Johannesburg, Tshwane and Ekurhuleni. South African Medical Journal, 2009, 99: 819 – 821.
  • Norman R, Mathee A, Barnes B, van der Merwe L, Bradshaw D; South African Comparative Risk Assessment Collaborating Group. Estimating the burden of disease attributable to lead exposure in South Africa in 2000. South African Medical Journal, 2007, 97: 773-80.
  • Mathee A, Röllin H, Levin J, Naik I. Lead in Paint: Three Decades Later and Still a Hazard for African Children? Environmental Health perspectives 2007, 111(3): 321-322.
  • Mathee A, Rollin H, von Schirnding Y, Levin J, Naik I. Reductions in blood lead levels among school children following the introduction of unleaded petrol in South Africa. Environ Research, 2006, 100(3): 319-22.
  • Montgomery M, Mathee A. A preliminary study of residential paint lead concentrations in an African city; Johannesburg. Environmental Research 2005; 98:279-83.
  •  Mathee A, von Schirnding Y, Montgomery M, Röllin H. Lead poisoning in South African children: the hazard at home. Reviews in Environmental Health 2004; 3-4.
Mining and Health Research Programme

The operation of mines, as well as the period after closure, may potentially cause exposure in downstream communities, to a range of hazardous substances, including, dust and particulate matter, toxic metals (such as lead, mercury, arsenic and cadmium) and radiation.

The Unit has been building a partnership of researchers and stakeholders, to further investigate the health implications of living close to or downstream from mining land. Earlier work demonstrated elevated blood lead concentrations in children living in the mining town of Aggeneys in the Northern Cape and elevated metal concentrations in vegetables harvested from a school vegetable gardens located in close proximity to a mine dump.

Pilot research projects are currently underway to determine the toxic metal content of soil collected from the gardens in settlements near mine tailings dump, and to prepare for a larger study on exposure to uranium, lead and radon around mining land.


Publications from the Mining and Health Research Programme

  • Kootbodien T, Mathee A, Naicker N, Moodley N. Heavy metal contamination in a school vegetable garden in Johannesburg. South African Journal of Medicine, 2012, 102(4): 226 – 227.
  • von Schirnding YER, Mathee A, Kibel M, Robertson P, Strauss, N and Blignaut R. (2003) A study of pediatric blood lead levels in a lead mining area in South Africa. Environmental Research 93, 259-63.


Contact the Webmaster
Last updated:
29 February, 2016
 Developed by Corporate & Marketing Communications, South African Medical Research Council
   Intranet login