38 years of autopsy findings in South African mine workers

Ndlovu, Ntombizodwa; Nelson, Gill; Vorajee, Naseema; Murray, Jill

doi:10.1002/ajim.22574

Cited by 19 publications

(10 citation statements)

References 23 publications

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“…A major limitation of this study is that the autopsy data do not represent all deceased South African miners due to inadequate provision of autopsy services for former black miners in labour sending areas 27. This was exacerbated by the overall decline in mine employment, which may partially explain the annual decreases in autopsy numbers from the late 1980s.…”

Section: Discussionmentioning

confidence: 93%

Four decades of pulmonary tuberculosis in deceased South African miners: trends and determinants

et al. 2018

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Changes in PTB time trends and determinants reflect the complex social and political environment in which mining occurs. Silica dust reduction remains a key intervention for tuberculosis reduction, together with tuberculosis and HIV treatment and management. The autopsy data provide reliable information to monitor progress towards the achievement of industry and national targets to reduce tuberculosis.

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Section: Discussionmentioning

confidence: 93%

Four decades of pulmonary tuberculosis in deceased South African miners: trends and determinants

et al. 2018

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“…The cardio-respiratory organs were removed with consent at the site where mineworkers died, placed in formalin and sent to the NIOH for examination by specialist anatomical pathologists. The nature and extent of occupational lung diseases, including asbestos-related diseases, were recorded and captured on the Pathology Automation (PATHAUT) database [ 23 ].…”

Section: Methodsmentioning

confidence: 99%

Asbestos-related diseases in mineworkers: a clinicopathological study

et al. 2017

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The accurate diagnosis of asbestos-related diseases is important because of past and current asbestos exposures. This study evaluated the reliability of clinical diagnoses of asbestos-related diseases in former mineworkers using autopsies as the reference standard.Sensitivity, specificity, positive predictive value and negative predictive value were calculated.The 149 cases identified had clinical examinations 0.3–7.4 years before death. More asbestos-related diseases were diagnosed at autopsy rather than clinically: 77 versus 52 for asbestosis, 27 versus 14 for mesothelioma and 22 versus 3 for lung cancer. Sensitivity and specificity values for clinical diagnoses were 50.6% and 81.9% for asbestosis, 40.7% and 97.5% for mesothelioma, and 13.6% and 100.0% for lung cancer. False-negative diagnoses of asbestosis were more likely using radiographs of acceptable (versus good) quality and in cases with pulmonary tuberculosis at autopsy.The low sensitivity values are indicative of the high proportion of false-negative diagnoses. It is unlikely that these were the result of disease manifestation between the last clinical assessment and autopsy. Where clinical features suggest asbestos-related diseases but the chest radiograph is negative, more sophisticated imaging techniques or immunohistochemistry for asbestos-related cancers should be used. Autopsies are useful for the detection of previously undiagnosed and misdiagnosed asbestos-related diseases, and for monitoring clinical practice and delivery of compensation.

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“…Silica‐related lung disease however remains a major health issue in the mining sector in low‐ and middle‐income countries. In China, over half a million silicosis cases were reported between 1991 and 1995, and in excess of 10 000 deaths over three decades from silicosis have been reported in South African miners . Recent outbreaks of pneumoconiosis in the mining sector in the USA and Australia demonstrate that even in developed countries, vigilance needs to be constantly maintained regarding control of dust levels …”

Section: Introductionmentioning

confidence: 99%

“…In China, over half a million silicosis cases were reported between 1991 and 1995, 3 and in excess of 10 000 deaths over three decades from silicosis have been reported in South African miners. 4 Recent outbreaks of pneumoconiosis in the mining sector in the USA and Australia demonstrate that even in developed countries, vigilance needs to be constantly maintained regarding control of dust levels. 5,6 Silicosis is a fibrotic respiratory disease caused by the inhalation and deposition of respirable crystalline silica (SiO 2 ) (particles <10 μm in diameter).…”

Section: Introductionmentioning

confidence: 99%

Silica‐associated lung disease: An old‐world exposure in modern industries

et al. 2019

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Despite silica dust exposure being one of the earliest recognized causes of lung disease, Australia, USA, Israel, Turkey and other countries around the world have recently experienced significant outbreaks of silicosis. These outbreaks have occurred in modern industries such as denim jean production, domestic benchtop fabrication and jewellery polishing, where silica has been introduced without recognition and control of the hazard. Much of our understanding of silica‐related lung disease is derived from traditional occupations such as mining, whereby workers may develop slowly progressive chronic silicosis. However, workers in modern industries are developing acute and accelerated silicosis over a short period of time, due to high‐intensity silica concentrations, oxidative stress from freshly fractured silica and a rapid pro‐inflammatory and pro‐fibrotic response. Appropriate methods of screening and diagnosis remain unclear in these workers, and a significant proportion may go on to develop respiratory failure and death. There are no current effective treatments for silicosis. For those with near fatal respiratory failure, lung transplantation remains the only option. Strategies to reduce high‐intensity silica dust exposure, enforced screening programmes and the identification of new treatments are urgently required.

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38 years of autopsy findings in South African mine workers

Abstract: High levels of disease persist. Black ex-miners are underrepresented, indicating a need for strategies to improve awareness and provision of autopsy facilities in labor-sending areas.

Cited by 19 publications

References 23 publications

Four decades of pulmonary tuberculosis in deceased South African miners: trends and determinants

Four decades of pulmonary tuberculosis in deceased South African miners: trends and determinants

Asbestos-related diseases in mineworkers: a clinicopathological study

Silica‐associated lung disease: An old‐world exposure in modern industries

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