Mining: South Africa's legacy and burden in the context of occupational respiratory diseases

Our plain-English summary of Mining: South Africa's legacy and burden in the context of occupational respiratory diseases, by R.N. Naidoo (Global Health Action, 2013).

The study

• Author: R.N. Naidoo
• Journal: Global Health Action
• Published: 2013;6:1-3
• Type of article: Historical article
• Cited by: 7 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

In plain English

This article was an invited commentary, not an original study. The author reviewed the history of mining-related lung disease in South Africa, mainly silica exposure, silicosis and tuberculosis. The author also commented on research by Gill Nelson that used PATHAUT, a South African autopsy surveillance system. According to the commentary, Nelson's work reported three things. Among impoverished miners, silicosis increased almost 10-fold, reached an absolute prevalence of 32%, and showed a two-fold racial difference. Among platinum miners, silicosis rates were very low, with adjusted rates from 0.4% to 0.06% depending on the definition. Among diamond miners, asbestos-related diseases were few, yet some cases of asbestosis or asbestos pleural disease did occur. The author noted that asbestosis cannot be attributed to environmental exposure. The author called the diamond-miner and platinum-miner findings very preliminary, with small numbers of disease cases and limited exposure assessment. PATHAUT also has inherent biases in how miners come to autopsy. The author concluded that medical surveillance should improve and that exposure in these workforces should be better described. The author added that mining companies are responsible for assessing, monitoring and effectively controlling exposures.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Invited commentary on another researcher's (Gill Nelson's) studies. It reports no original data.
• Who was studied: No population was studied by the author. The commentary discusses Nelson's autopsy-based research on South African miners, drawn from the PATHAUT autopsy surveillance system and including gold, platinum and diamond miners.
• Exposure: Silica dust in mining, discussed mainly in relation to silicosis and tuberculosis. Asbestos exposure among diamond miners is also discussed. No asbestos fiber types are named.
• Main results:
  • Attributed to Nelson's research, not this commentary: among impoverished miners there was an almost 10-fold increase in silicosis, an absolute prevalence rate of 32%, and a two-fold racial difference. The cited Nelson study concerns autopsies of South African gold miners.
  • Attributed to Nelson: very low silicosis prevalence among platinum miners, with adjusted rates from 0.4% to 0.06% depending on the definition. The author suggested this probably reflects low silica exposures and silica content not exceeding 1%.
  • Attributed to Nelson: asbestos-related diseases among diamond miners were expectedly low in number, but some cases of asbestosis or asbestos pleural disease were found. The author stated that both conditions require substantial exposure over a long period.
  • The author's own view: although mesothelioma has been documented in environmentally exposed people, asbestosis cannot be attributed to environmental exposure. The author wrote that Nelson provides exposure information supporting a work-related cause.
• The authors' conclusion: The author concluded that Nelson's findings, while very preliminary, suggest the need for more work. Medical surveillance programmes should be improved and exposure in these working populations better described. Mining companies have a responsibility to assess exposures and to ensure they are monitored and effectively controlled.
• Limitations the authors state:
  • The author stated that the findings of asbestos-related disease among diamond miners and silicosis among platinum miners are very preliminary, that the numbers of disease cases are small, and that the assessment of exposure was limited.
  • The author stated that PATHAUT has inherent biases in how miners come to autopsy, which vary by mining entity, racial group and residential area. The author judged these biases unlikely to have affected Nelson's findings.

Related studies

• The social context of occupational disease: asbestos and South Africa — J. Myers (1981)
• Occupational respiratory disease in mining — M.H. Ross, J. Murray (2004)
• Health effects of amosite mining and milling in South Africa — J. Murray, G. Nelson (2008)
• Respiratory effects of exposure to dust in taconite mining and processing — T.C. Clark, V.A. Harrington, et al. (1980)
• Excess mortality from stomach cancer, lung cancer, and asbestosis and/or mesothelioma in crocidolite mining districts in South Africa — J.L. Botha, L.M. Irwig, et al. (1986)
• Re: "Excess mortality from stomach cancer, lung cancer, and asbestosis and/or mesothelioma in crocidolite mining districts in South Africa" — H.P. Hart (1987)

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