A research report submitted to the Faculty of Health Sciences, University of the
Witwatersrand, Johannesburg, in partial fulfillment of the requirements for the degree of
Master of Medicine in Community Health (Occupational Medicine)
Johannesburg, March 2017. / Introduction: The Occupational Diseases in Mines and Works Act (ODMWA) 1973 (as
amended in 2002) provides for compensation of occupational lung diseases in living and
deceased miners and ex-miners. Certification data constitute a valuable source of information
on occupational diseases in the mining industry.
Objectives: The objectives of the study were: i) To describe the extent and type of
compensable lung diseases in South African mining from 2004-2012, by commodity; ii) to
describe certification trends over 2004-2012; iii) to examine specific issues related to some of
the compensable occupational lung diseases (including service duration in coal miners with
coal workers’ pneumoconiosis by coal type, describe asbestos related diseases in women and
number of miners with exclusive diamond miners certified with mesothelioma during this
period); iv) to determine the odds of developing mesothelioma from chrysotile mining and
other associated risk factors and v)to determine time from the certification to compensation
payment, using a proportion of cases certified in 2009, 2010 and 2011 financial years.
Methods: A descriptive analysis was conducted using the Medical Bureau of Occupational
Diseases (MBOD) dataset using claims from living miners, certified from 2004 up to 2012,
certified with compensable disease, for the first three objectives. For the fourth objective, the
MBOD database was used to select diseases with considerable numbers from the 2009, 2010
and 2011 years. A ten percent sample of each disease group was selected through random
sampling using stata 12, to determine time to compensation, joined with Commission for
Compensation of Occupational Diseases (CCOD) compensation database. Stataversion 12
was used to clean and analyse data. For the fifth objective, a case control analysis was
conducted to estimate the risk of mesothelioma from miners with exclusively chrysotile
mining, using exposure data from an external database.
Results: There were67660 compensable disease certifications from 2004 to 2012 financial
years, in living current and ex-miners. Almost 62% of the certification outcomes for
compensable diseases were from tuberculosis alone, comprising of current, first and second
degree TB. First and second degree diseases with no tuberculosis comprised 27% and 1.3%
respectively. There were 6601 diseases (9.7%) certified as second-degree with tuberculosis.
The proportion of specific diseases other than tuberculosis comprised of silicosis (14%);
silico-tuberculosis (9%);obstructive airways disease (2.2%);coal workers’ pneumoconiosis
(0.5%); asbestos pleural disease (6.7%) ; asbestos interstitial disease (5.2%); mesothelioma
(0.2%); lung cancer (0.04%) and 0.1% were from other diseases.
Females contributed 3.8% to the disease burden while black miners had 92%. Twenty five
percent of the compensable diseases were from ex-miners and 49 179from active miners.
Although 63% of compensable diseases were from unknown commodity (missing), 30%
were from gold mining. The certification trends for pneumoconiosis and tuberculosis peaked
in 2008, with statistically significant trend for asbestosis (p=0.01) and silico-TB (P=0.038).
Examination of the specific issues showed no statistically significant difference between
CWP certification from anthracite and bituminous coal ranks with regards to service duration,
silicosis was certified in 544 platinum miners but none of them had exclusively platinum
mining. Asbestos related disease was certified in 2241 women, with 55.4% being pleural
disease in the first degree and none of the certified women were younger than 30 years of
age, and the average service duration was approximately seven years (mean=6.97 years, SD
6.37 years).
From the sample of 389 certified cases, 26.5% (n=103) were certified at the end of the 2012
financial years. The mean time to compensation 38 months, 36 months and 19.4 months for
2009, 2010 and 2011 financial years respectively.
The case-control analysis found no statistically significant association between chrysotile
mining and mesothelioma from univariate analysis (OR=2.0 p>0.05; 95% CI: 0.7-5.4); as
well as multivariate analysis (OR=1.5; p>0.05; 95%CI: 0.4-5.2) compared to the reference
group.
Conclusion:The burden of occupational lung diseases in living current miners and ex-miners
is high, mainly from tuberculosis during this period, irrespective of the commodity and
population group. A significant finding from this study was the significant proportion of
miners certified with pneumoconiosis with less than fifteen years of mining service. The
number of women certified during this period was mainly from asbestos related diseases, a
far lesser number of women were certified with disease from other commodities. The
findings from this study support what was reported in literature namely; unacceptably long
time to compensation; incomplete documentation of exposure history in the form of service
records and no established risk for mesothelioma from exclusive chrysotile miners. / MT2017
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:wits/oai:wiredspace.wits.ac.za:10539/23207 |
| Date | January 2017 |
| Creators | Ndaba, Nompumelelo Angeline |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Type | Thesis |
| Format | application/pdf, application/pdf |
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