title: Indoor Temperatures in Patient Waiting Rooms in Eight Rural Primary Health Care Centers in Northern South Africa and the Related Potential Risks to Human Health and Wellbeing.
abstract: Increased temperatures affect human health and vulnerable groups including infants, children, the elderly and people with pre-existing diseases. In the southern African region climate models predict increases in ambient temperature twice that of the global average temperature increase. Poor ventilation and lack of air conditioning in primary health care clinics, where duration of waiting time may be as long as several hours, pose a possible threat to patients seeking primary health care. Drawing on information measured by temperature loggers installed in eight clinics in Giyani, Limpopo Province of South Africa, we were able to determine indoor temperatures of waiting rooms in eight rural primary health care facilities. Mean monthly temperature measurements inside the clinics were warmer during the summer months of December, January and February, and cooler during the autumn months of March, April and May. The highest mean monthly temperature of 31.4 ± 2.7 °C was recorded in one clinic during February 2016. Maximum daily indoor clinic temperatures exceeded 38 °C in some clinics. Indoor temperatures were compared to ambient (outdoor) temperatures and the mean difference between the two showed clinic waiting room temperatures were higher by 2-4 °C on average. Apparent temperature (AT) incorporating relative humidity readings made in the clinics showed 'realfeel' temperatures were >4 °C higher than measured indoor temperature, suggesting a feeling of 'stuffiness' and discomfort may have been experienced in the waiting room areas. During typical clinic operational hours of 8h00 to 16h00, mean ATs fell into temperature ranges associated with heat-health impact warning categories of 'caution' and 'extreme caution'.
authors.affiliation: Environment and Health Research Unit, South African Medical Research Council, Pretoria 0001, South Africa. cwright@mrc.ac.za.|Department of Geography, Geoinformatics and Meteorology, University of Pretoria, Pretoria 0002, South Africa. cwright@mrc.ac.za.
authors.forename: Caradee Y
authors.initials: CY
authors.lastname: Wright
authors.affiliation: Environment and Health Research Unit, South African Medical Research Council, Durban 4091, South Africa. renee.street@mrc.ac.za.|Discipline of Occupational and Environmental Health, University of KwaZulu-Natal, KwaZulu-Natal 4041, South Africa. renee.street@mrc.ac.za.
authors.forename: Renée A
authors.initials: RA
authors.lastname: Street
authors.affiliation: Environment and Health Research Unit, South African Medical Research Council, Durban 4091, South Africa. nokulunga.cele@mrc.ac.za.
authors.forename: Nokulunga
authors.initials: N
authors.lastname: Cele
authors.affiliation: Environment and Health Research Unit, South African Medical Research Council, Doornfontein, Johannesburg 2094, South Africa. zama.kunene@mrc.ac.za.
authors.forename: Zamantimande
authors.initials: Z
authors.lastname: Kunene
authors.affiliation: Biostatistics Unit, South African Medical Research Council, Durban 4091, South Africa. yusentha.balakrishna@mrc.ac.za.
authors.forename: Yusentha
authors.initials: Y
authors.lastname: Balakrishna
authors.affiliation: Environment and Health Research Unit, South African Medical Research Council, Pretoria 0001, South Africa. pnalbers@gmail.com.|Department of Geography, Geoinformatics and Meteorology, University of Pretoria, Pretoria 0002, South Africa. pnalbers@gmail.com.
authors.forename: Patricia N
authors.initials: PN
authors.lastname: Albers
authors.affiliation: Environment and Health Research Unit, South African Medical Research Council, Doornfontein, Johannesburg 2094, South Africa. angie.mathee@mrc.ac.za.|University of Johannesburg, Doornfontein, Johannesburg 2094, South Africa. angie.mathee@mrc.ac.za.|University of the Witwatersrand, Braamfontein, Johannesburg 2000, South Africa. angie.mathee@mrc.ac.za.
authors.forename: Angela
authors.initials: A
authors.lastname: Mathee
mesh_terms: D000368:Aged; D000389:Air Conditioning; D002648:Child; D002980:Climate; D005260:Female; D006358:Hot Temperature; D006801:Humans; D008297:Male; D011320:Primary Health Care / Q000706:statistics & numerical data*; D019035:Rural Health Services / Q000706:statistics & numerical data*; D013019:South Africa; D013696:Temperature; D014691:Ventilation
keywords: South Africa; climate change; clinics; indoor temperature; rural; waiting rooms