The Pulmonary Disability Legislation of South Africa: A Rationale for Its Enactment

Our plain-English summary of The Pulmonary Disability Legislation of South Africa: A Rationale for Its Enactment, by G. W. H. Schepers (1958).

The study

• Author: G. W. H. Schepers
• Published: 1958
• Type of article: Journal article
• Our copy: from Johns-Manville's own medical library. The article is still under copyright, so we describe it here rather than post it.

In plain English

This article examined South Africa's 1952 'pulmonary disability' amendment to its Silicosis Act. The amendment covered heart and lung impairment from dusty work that had substantially and permanently reduced capacity for manual work. Silicosis and tuberculosis themselves were excluded, though the disability could occur alongside either. The amendment was described as the result of a long struggle to protect workers at gold mines and at other mines with breathing hazards. The article's data come from gold miners and do not concern asbestos. The author compared the legal definitions of the three conditions. About 1000 white miners had been certified, about one-third without silicosis or tuberculosis. The author analysed 155 first-stage cases without either disease. Most had become disabled before their 18th year of dusty work; men with silicosis were almost a decade older. Few cases were found among men the article calls 'Negro laborers'. The main conditions described were chronic bronchitis, emphysema and cor pulmonale (heart strain from lung disease). The author concluded that pulmonary disability without radiographic silicosis, or with early silicosis, was increasingly replacing macronodular and massive silicosis as the cause of incapacity among white miners.

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: Analysis and commentary on South African compensation legislation, with descriptive data on certified cases among gold miners
• Who was studied: Gold miners on South African (Witwatersrand) gold mines certified under the pulmonary disability legislation: about 1000 white miners, with a subgroup of 155 first-stage cases without silicosis or tuberculosis; some figures for 'Negro laborers'
• Exposure: Work in dusty occupations in gold mines, including mineral (quartz) dust; asbestos is not discussed
• Main results:
  • The legislation was described as the culmination of a long struggle for greater health protection of workers at gold mines and at other types of mines with known respiratory hazards that the existing silicosis legislation did not appear to cover
  • The legal definition required that the impairment had substantially and permanently diminished the person's capacity for manual work
  • The legal definition of pulmonary disability did not include silicosis or tuberculosis themselves
  • Among the roughly 1000 certified white miners, in about one-third pulmonary disability was found on its own, without silicosis or tuberculosis
  • In the remaining certified white miners, pulmonary disability was found together with silicosis or tuberculosis
  • Of those isolated cases, more than two-thirds were first-stage disability and the rest second-stage
  • Among the 155 first-stage cases without tuberculosis or silicosis, the large majority had become functionally incapacitated before the 18th year of service in dusty occupations
  • Tuberculosis cases mostly occurred before the 14th year of service in dusty occupations
  • Most men with silicosis were almost a decade older than those with pulmonary disability; only men with tuberculosis were, on average, younger
  • The number of cases found among 'Negro laborers' was described as surprisingly low
  • The dominant clinical syndromes were chronic bronchitis, emphysema and cor pulmonale
• The authors' conclusion: The authors concluded that pulmonary disability without radiographic silicosis, or with early silicosis, was progressively taking over the role formerly played by macronodular and massive silicosis in causing physical incapacity among white miners
• Limitations the authors state:
  • The trend curves in Figure 1 were described as slightly idealized
  • Because the cases had accumulated over many years, men recorded with silicosis first may actually have developed their disability first

Topics

Medical terms in this study, explained in our Lexicon: Silicosis, Emphysema, Cor Pulmonale.

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