Oscillating migration and the epidemics of silicosis, tuberculosis, and HIV infection in South African gold miners

Abstract

Failure to control dust and tuberculosis has resulted in serious consequences decades later. The economic and political migrant labor system provided the foundations for the epidemics seen in southern Africa today.

Silica Exposures in Artisanal Small-Scale Gold Mining in Tanzania and Implications for Tuberculosis Prevention

“…(3) In mining communities with high exposures to crystalline silica these factors work together in a multiplicative interaction to greatly increase incidence of TB. This interaction has resulted in a measurable increase in active TB among miners in South Africa since the 1970s.…”

“…Increased prevalence of TB has even been noted in longitudinal studies among HIVnegative miners. (3) An increased prevalence of TB has also been noted in studies of granite workers exposed to crystalline silica and among other workers diagnosed with silicosis in the U.S. (1) The primary factors determining the pathogenicity of crystalline silica exposures are particle size and airborne concentration.…”

A century of miners' compensation in South Africa

“…The industry's recent history is one of decline, with employment peaking in 1988 at 480,000 and falling to 160,000 by 2006 [Harington et al, 2004]. Approximately half of those employed in 2007 were from neighboring countries, principally Mozambique and Lesotho [Rees et al, 2009]. Active miners are thus now outnumbered by former gold miners, among whom the prevalence of silicosis has been found in a recent cohort to be as high as 27% and the incidence of tuberculosis of the order of 3,000 per 100,000 [Park et al, 2009].…”

“…One hundred years later, the gold mining industry is struggling with a resurgent wave of silicosis and tuberculosis, mainly in black miners 1 [Ehrlich, 2007;Rees et al, 2009;Nelson et al, 2010], with tuberculosis fuelled further by the HIV epidemic [Corbett et al, 2000;Park et al, 2009]. The industry's recent history is one of decline, with employment peaking in 1988 at 480,000 and falling to 160,000 by 2006 [Harington et al, 2004].…”

History and medicine—The case of silicosis

“…Despite this vision, silicosis is still very much with us, whether in the epidemic form identified in the South African mining industry [Rees et al, 2009], in less visible epidemic form in a multitude of small operations in India [Jindal, 2013] or in outbreaks in novel settings [Kramer et al, 2012;Akgun et al, 2015]. At the political level, current efforts in the US to reduce the risk of silicosis and other silica related diseases have been stalled by representatives of corporate interests [Rosner, 2014].…”