Children were 'more vulnerable to indoor air pollutants, including TB particles, than adults are, because (they) breathe more relative to their body weight and their bodies are less able to cope with the toxins', the doctors said. Picture: Brenton Geach

Cape Town - Overcrowded classrooms and poor ventilation increase the risk of pupils contracting tuberculosis at schools, say doctors from the Desmond Tutu HIV Centre – prompting education rights group Equal Education to call the matter a “public health emergency”.

This is part of a submission by Professor Robin Wood, Dr Carl Marrow and Michelle Nebergall of the Desmond Tutu HIV Centre to the Department of Basic Education, which called for public comment on draft regulations on school infrastructure norms and standards.

The submission was included among the department’s court papers in a case between it and Equal Education.

The case centred on compelling the department to publish final norms and standards.

The two sides reached an agreement last week that was made an order of the Bhisho High Court.

The agreement stipulated that Basic Education Minister Angie Motshekga publish the final regulations on school norms and infrastructure by November.

The Desmond Tutu HIV Centre, part of UCT’s department of medicine, said in its submission that the youth were “particularly vulnerable to (TB) infection”, and norms on classroom size should take this into account.

Children were “more vulnerable to indoor air pollutants, including TB particles, than adults are, because (they) breathe more relative to their body weight and their bodies are less able to cope with the toxins”, the doctors said.

According to World Bank data, South Africa has the second-highest incidence of TB in the world. In 2011, South Africa had 993 cases among every 100 000 people, second only to Swaziland’s 1 317.

The incidence of TB has more than doubled since 1990, when there were 428 cases among every 100 000 people, according to the South African Institute of Race Relations.

“It is imperative that norms and standards for school infrastructure address issues of ventilation and overcrowding in classrooms and educational spaces to protect the health of learners and teachers while they are in public schools,” said the doctors.

“Learners spend the second most amount of time indoors in schools, after their homes, making schools a significant environment where they are exposed to airborne pollutants, including TBbacteria.”

To combat TB in schools, classroom ventilation had to be improved and overcrowding decreased, the doctors said.

While “adequate ventilation” could simply mean opening windows and doors to reduce the amount of rebreathed air, classroom overcrowding was more difficult to overcome, they said.

“Overcrowding can result in unhealthy air because it increases the quantity of rebreathed air. When the number of individuals in a room exceeds the capacity of that room, then air circulation is curtailed and learners are forced to breathe in a higher volume of rebreathed air… which increases the chances of inhaling infectious agents such as TB particles.”

The doctors said any new norms should apply not only to permanent classrooms, but also temporary structures and spaces. The Desmond Tutu HIV Centre’s data indicated there were 400 000 new cases of TB in South Africa in 2011.

Department spokesperson Panyaza Lesufi could not be reached for comment. - Cape Times