A statistical analysis of

common occupational
diseases among South African
miners from 2000 to 2003
Zeleke Worku, Ph.D. ABSTRACT
Senior lecturer of Objective: To describe basic demographic and health-related characteristics of mine workers included in the
biostatistics,
South African Mines Occupational Diseases Database (SAMODD), and to estimate prevalence proportions of
School of Health
Systems and Public occupational diseases commonly experienced by mineworkers for the years between 2000 and 2003.
Health, Design: Cross-sectional prevalence proportions of common occupational diseases experienced by South Afri-
University of Pretoria, can mine workers.
Tel: (012) 841 3280, Settings: Occupational health records of South African miners belonging to the Directorate of Occupational
Cell: 082 870 2758,
Medicine of the Department of Minerals and Energy (SAMODD) were used for data analysis.
Fax: (012) 841 3308,
e-mail: Subjects and methods: Occupational health records of 37 206 South African miners employed at several mines
worku@med.up.ac.za scattered all over the country between 2000 and 2003 were analysed. Crude point prevalence proportions and
incidence rate ratios of common occupational diseases were estimated. Data analysis was done in the statisti-
Molly Ohaju, MD, cal package STATA Version 8.
Director: Occupational
Results: Cardio-respiratory tuberculosis (CRTB) was the most prevalent occupational disease at 40,55%. The
Medicine,
Department of second most prevalent occupational disease was noise-induced hearing loss at 32,36%. The prevalence of
Minerals and Energy, pneumoconiosis* was 15,37%. The prevalence of silicosis was 14,51%. The prevalence of chronic obstructive
Tel: (012) 317 9460, airways disease was 1,99%. Heat related diseases were least prevalent at 0,02%. Incidence rate ratios of CRTB
Cell: 082 465 0160, were significant in 2000 in gold mines, in 2001 in platinum, asbestos mines, in 2002 in platinum mines, and in
Fax: (012) 317 9543,
2003 in all mines. Over the 4-year period, 64 of the 37 206 miners (0,17%) died.
e-mail:
Molly.Ohaju@dme.gov.za Conclusion: Based on SAMODD health records, cardio-respiratory tuberculosis, noise-induced hearing loss
and pneumoconiosis* are the 3 most prevalent occupational diseases among South African mine workers.
* Pneumoconiosis – includes all other causes except silica and asbestos.

INTRODUCTION and safety providers working in collaboration with the

This study is based on the analysis of 37 206 occupa-
tional health records (SAMODD) of South African mine
workers employed at various mines all over South Africa
between 2000 and 2003. The SAMODD database is
the first nationally-owned and systematically organized
database containing information on the occupational
health and safety of South African mine workers
scattered all over the country. The objective of this study
is to describe demographic characteristics of mine
workers included in the SAMODD database along with
prevalence proportions of occupational diseases com-
monly experienced by South African mine workers.
Although the various mines routinely collect and
analyse data on the occupational health and safety of
South African mine workers, no similar standard on data
collection, analysis and reporting has so far been im-
plemented at the national level and across all mines.
Lack of reliable databases and health records, under-
reporting of health data, and failure to establish a
uniform national recording and reporting system have
always been a major problem affecting occupational
health and safety professionals serving the mining
industry1. The establishment of the SAMODD occupa-
tional health and safety database for all South African
miners is a significant step in bringing the plight of South
African miners to the attention of occupational health
Department of Minerals and Energy (DME). The
database enables occupational health and safety pro-
fessionals and policy makers to assess the burden of
occupational diseases such as tuberculosis, noise-
induced hearing loss and silicosis on South African
mine workers objectively and quantitatively.
BACKGROUND OF PROBLEM AND LITERATURE
REVIEW
Several researchers have shown that tuberculosis (TB),
noise-induced hearing loss, pneumoconiosis* and silicosis
are occupational diseases commonly experienced by South
African mine workers, and that South African mineworkers
in many cases originate from areas where the incidence of
tuberculosis is extremely high. According to the National
Department of Health, TB rates in mines are over 10
times higher than the national average2. Tuberculosis is
often highly associated with HIV. The annual incidence
of new pulmonary tuberculosis in South African mines
rose from 0,53% in 1991 to 1,0% in 1997, and the
incidence of tuberculosis was higher among HIV-positive
mine workers than among HIV-negative mine workers
from 1992 onwards3. Tuberculosis is also significantly
associated with silicosis. The study by Meel4 on former
mine workers has shown that the relative risk for
Continued on page 18

16 SEPTEMBER/OCTOBER 2004 OCCUPATIONAL HEALTH SOUTHERN AFRICA

 Continued from page 16
tuberculosis for men with silicosis is 5 times more than
that for men without silicosis. Several studies on South
African mine workers over the past several years and in
various circumstances have consistently shown that
cardio-respiratory tuberculosis, noise-induced hearing
loss, pneumoconiosis*, silicosis and chronic obstructive
airways diseases and AIDS are highly prevalent occu-
pational diseases that are commonly experienced by
South African mine workers5,6,7,8,9,10, and that the spread
of HIV worsens the health condition of mine workers who
suffer from one or more of the above disease types.
South African mines are overburdened by a high
prevalence of tuberculosis and HIV. In 1997, the South
African Medical Research Council reported that South
Africa had 419 cases of tuberculosis per 100 000 of the
total population. Of these, 32,8% were probably infected
with HIV. The tuberculosis problem in South Africa is
largely a result of historical neglect and poor health man-
agement systems, compounded by the legacy of frag-
mented health services. Prior to the introduction of the
tuberculosis register in 1995, cure rates were unknown.
In 1997, a cure rate of only 54% could be recorded11.
OBJECTIVE OF STUDY
The objective of this study is to describe basic demo-
graphic and health-related characteristics of mine
TABLE 1. TOTAL NUMBER OF COMPLETE HEALTH RECORDS
OF MINERS AND DEATHS BY YEAR.
2000 2001 2002 2003
No. of records 5137 14 452 12 189 5428
No. of deaths 2 53 6 3
(0,04%) (0,37%) (0,05%) (0,06%) (0,17%)
TABLE 2. DEMOGRAPHIC CHARACTERISTICS OF MINERS BY YEAR.
workers included in the South African Mines Occupa-
tional Diseases Database (SAMODD), and to estimate
crude point prevalence proportions of occupational
diseases commonly experienced by mine workers for
the years between 2000 and 2003.
METHODS OF DATA ANALYSIS
Demographic and socio-economic characteristics of the
37 206 mineworkers in the study are described in terms
of proportions and averages. For each of the years
2000, 2001, 2002 and 2003, crude point prevalence
proportions were calculated for occupational diseases
experienced by miners who had complete occupational
health records. All point prevalence proportions
reported in this study are crude, and an assumption is
made that in each of the years 2000, 2001, 2002 and
2003, miners whose health records were analysed were
examined over a similar and short period of time.
Point prevalence proportion is defined as follows12:
s
p= where
e
p = Point prevalence proportion = prevalence
s = Number of sick miners at a specific time
e = Total number of miners exposed at a specific
time
The statistical package STATA Version 8 was used
for data analysis.
RESULTS
Total In the year 2000, 2 out of 5137 miners (0,04%) died. In
37 206 the year 2001, 53 out of 14 452 miners (0,37%) died. In
64 the year 2003, 6 out of 12 189 miners (0,05%) died. In
the year 2003, 3 out of 5428 miners (0,06%) died. Over
the 4-year period, 64 of the 37 206 miners (0,17%) died.

Variable of study 2000 2001 2002 2003 Average

Average age in years 42,48 45,59 45,17 47,79 45,26
Average duration of service in years 17,01 5,93 4,57 16,66 11,04
Proportion of female miners 0,12% 0,09% 0,12% 0,11% 0,11%
Miners with hearing loss 243 (4,73%) 805 (5,57%) 1558 (12,78%) 915 (16,86%) 881 (9,99%)
Average percentage hearing loss 29,97% 34,55 % 33,33% 36,67% 33,63%
Disease caused death 5 (0,10%) 19 (0,13%) 8 (0,07%) 0 8 (0,08%)
Employment status changed 18 (0,35%) 41 (0,28%) 33 (0,27%) 31 (0,57%) 31 (0,37%)
Disease reportable 5037 (98,05%) 14 220 (98,39%) 11 959 (98,11%) 5370 (98,93%) 9147 (98,37%)
Submission of compensation request 4465 (86,95%) 11 728 (81,32%) 10 212 (87,45%) 4283 (88,71%) 7672 (86,11%)
Average number of days needed to
process a request for compensation 184 197 16 61 115

TABLE 3. DISTRIBUTION OF AGE OF MINERS BY YEAR.

Age category 2000 2001 2002 2003

≤30 years 303 (5,90%) 263 (1,82%) 286 (2,35%) 77 (1,42%)

(30, 40] years 1573 (30,62%) 3120 (21,59%) 2755 (22,60%) 807 (14,87%)
(40, 50] years 2396 (46,64%) 6665 (46,12%) 5654 (46,39%) 2295 (42,28%)
(50, 60] years 804 (15,65%) 3840 (26,57%) 3006 (24,66%) 2014 (37,10%)
> 60 years 61 (1,19%) 564 (3,90%) 488 (4,00%) 235 (4,33%)
Total 5137 14 452 12 189 5428

18 SEPTEMBER/OCTOBER 2004 OCCUPATIONAL HEALTH SOUTHERN AFRICA

The average age of miners was 45,26 years. The aver- TABLE 4. DURATION OF SERVICE OF MINERS BY YEAR.

age duration of service of the miners was 11,04 years. Service in years 2000 2001 2002 2003
Only 0,11% of miners were female. 9,99% of miners ex- ≤5 years 11,84% 46,98% 56,88% 17,13%
perienced hearing loss. The average percentage hearing (5, 10] years 9,07% 10,38% 10,09% 9,65%
loss was 33,63%. Only 0,08% of deaths were caused by (10, 15] years 17,54% 6,91% 5,30% 12,93%

disease. 0,37% of miners had to change their employ- (15, 20] years 21,90% 5,45% 3,35% 21,41%

ment status due to disease. 98,37% of all diseases (20, 25] years 25,97% 3,13% 2,07% 18,70%
(25, 30] years 9,05% 0,95% 1,06% 13,54%
experienced by the miners were reportable.
(30, 35] years 3,35% 0,28% 0,46% 4,77%
Requests for compensation were made for 86,11%
(35, 40] years 0,78% 0,07% 0,17% 1,09%
of all reportable diseases. On average, 115 days were
(40, 45] years 0,19% 0,00% 0,00% 0,59%
needed to process a request for compensation.
> 45 years 0,31% 25,86% 20,63% 0,18%
Table 1 shows the distribution of complete health
records of miners and the number of dead miners for
the years 2000, 2001, 2002 and 2003. and short period of time. The table shows that all in all, cardio-
Table 2 gives a summary of demographic charac- respiratory tuberculosis (CRTB) was the most prevalent
teristics. On average, only 0,11% of miners were fe- occupational disease at 40,55%. The second most preva-
male. Only 0,08% of deaths were caused by disease. lent occupational disease was noise-induced hearing
Only 0,37% of miners have had to change their em- loss(NIHL) at 32,36%. The third most prevalent disease
ployment status due to occupational diseases. 98,37% was ‘other occupational diseases’ (OTHER DISEASES)
of all diseases experienced by the miners were report- at 30,46%. The fourth prevalent disease was pneumo-
able. Requests for compensation were made for 86,11% coniosis* (PNEU) at 15,37%. The fifth most prevalent
of all reportable diseases. On average, 115 days were disease was silicosis (SLCS) at 14,51%. The sixth most
needed to process a request for compensation. prevalent disease was chronic obstructive airways dis-
Table 3 gives a summary of the age distribution of ease (COAD) at 1,99%. The least prevalent disease was
miners by year. The overall average age of the 37 206 heat related disease (HEAT) at 0,02%.
miners in the study was 45,26 years. Figure 2 gives a graphical summary of prevalence
Table 4 gives a summary of the duration of service rates of occupational diseases presented in Table 8. The
of miners by year. The overall average duration of serv- table shows that the prevalence of noise-induced hearing
ice of the miners was 11,04 years. The table shows
proportions. It can be seen from the table that in the
years 2001 and 2002, roughly half of all miners had
durations of services less than or equal to 5 years only,
and that above 20% of all miners had durations of
services more than 45 years.
Table 5 gives a summary of percentage hearing loss
experienced by the miners in the study by year. All in
all, 9,99% of miners experienced hearing loss. The
average percentage hearing loss was 33,63%.
Table 6 shows the distribution of miners by mine type
and year. It can be seen from the table that the majority
of miners worked in gold mines.
Table 7 shows the proportion of miners by exposure
type and year. The table shows that 17,26% of all min-
ers have been exposed to airborne diseases. All in all,
2684% of all miners have been exposed to either
airborne diseases, noise, chemical, heat or radiation.
Figure 1 shows an overall graphical summary of the
information presented in Table 7.

POINT PREVALENCE PROPORTIONS

OF COMMON OCCUPATIONAL DISEASES
Table 8 shows yearly and average crude point preva-
lence proportions of 7 common diseases experienced
by the miners in the study. An assumption is made that in
each of the years 2000, 2001, 2002 and 2003, miners whose
health records were analysed were examined over a similar

OCCUPATIONAL HEALTH SOUTHERN AFRICA SEPTEMBER/OCTOBER 2004 19

 FIGURE 1. AVERAGE PROPORTION OF MINERS EXPOSED TO CHEMICALS.

TABLE 5. PERCENTAGE HEARING LOSS OF MINERS BY YEAR.

Percentage hearing loss 2000 2001 2002 2003

≤25 55 (1,07%) 78 (0,54%) 233 (1,91%) 121 (2,23%)
(25, 50] 175 (3,41%) 667 (4,62%) 1244 (10,21%) 737 (13,58%)
> 50 13 (0,25%) 60 (0,42%) 81 (0,66%) 57 (1,05%)
Total 243 (4,73%) 805 (5,57%) 1558 (12,78%) 915 (16,86%)

TABLE 6. NUMBER OF MINERS BY MINE TYPE AND YEAR.

Mine type 2000 2001 2002 2003

Gold 4561 (88,79%) 12173 (84,23%) 7864 (64,52%) 4462 (82,20%)
Platinum 45 (0,88%) 651 (4,50%) 256 (2,10%) 72 (1,33%)
Coal 169 (3,29%) 319 (2,21%) 839 (6,88%) 166 (3,06%)
Asbestos 16 (0,31%) 117 (0,81%) 84 (0,69%) 8 (0,15%)
Diamond 74 (1,44%) 121 (0,84%) 58 (0,48%) 16 (0,29%)
Other mines 272 (5,29%) 1071 (7,41%) 3088 (25,33%) 704 (12,97%)
Total 5137 14 452 12 189 5428

TABLE 7. PROPORTION OF MINERS BY TYPE OF EXPOSURE AND YEAR.

Exposure type 2000 2001 2002 2003 Average

Airborne 8,21% 20,59% 27,25% 13,00% 17,26%
Noise 3,25% 9,94% 22,36% 2,03% 9,40%
Chemical, heat or radiation 0% 0,45% 0,06% 0,20% 0,18%
Total exposed 11,47% 30,98% 49,66% 15,24% 26,84%
Unexposed 88,53% 69,02% 50,34% 84,76% 73,16%

TABLE 8. PREVALENCE PROPORTIONS OF OCCUPATIONAL DISEASES BY YEAR.

Disease type 2000 2001 2002 2003 Average Rank

COAD 108 (2,10%) 300 (2,10%) 245 (2,01%) 94 (1,73%) 1,99% 6

CRTB 2121 (41,29%) 6080 (42,07%) 4438 (36,41%) 2303 42,43%) 40,55% 1
NIHL 1423 (27,70%) 4131 (28,58%) 4523 (37,11%) 1956 (36,04%) 32,36% 2
PNEU 840 (16,35%) 2366 (16,37%) 1924 (15,78%) 705 (12,99%) 15,37% 4
SLCS 796 (15,50%) 2224 (15,39%) 1813 (14,87%) 667 (12,29%) 14,51% 5
HEAT 0 3 (0,02%) 7 (0,06%) 0 0,02% 7
Other diseases 214 (41,79%) 5155 (35,67%) 3117 (25,57%) 1020 (18,79%) 30,46% 3
Total 5137 14 452 12 189 5428

20 SEPTEMBER/OCTOBER 2004 OCCUPATIONAL HEALTH SOUTHERN AFRICA

FIGURE 2. PREVALENCE PROPORTIONS OF OCCUPATIONAL DISEASES BY YEAR.
loss increased from 27,70% in 2000 to 36,04% in 2003.
The prevalence of silicosis decreased over the same
period from 15,50% to 12,29%. The prevalence of other
occupational diseases decreased sharply from 41,79%
to 18,79%.
DISCUSSION
Between 2000 and 2003, 64 of the 37 206 miners
(0,17%) died. Hence, the mortality rate of miners due
to occupational diseases was low at less than 1% of
the study population.
Everything considered, results of this study show
that above 10% of all miners have been adversely
affected by occupational diseases such as CRTB, NIHL,
PNEU and SLCS over the years 2000 to 2003.
RECOMMENDATIONS
The following recommendations are made based on
findings of the study:
1. The mines should be urged to report complete data
on occupational health and safety to the Information
Technology (IT) Department of the DME regularly on
all their miners. Underreporting of valuable data from
the various provincial mines and offices may have
introduced bias to the findings of this study.
2. Efforts should be made to reduce the prevalence
proportions of occupational diseases such as CRTB,
NIHL, PNEU and SLCS at all mines.
LIMITATIONS OF STUDY
The various mines in the provinces did not report valu-
able and complete data on the occupational health and
safety of miners to the IT Department of the DME. As a
result, underreporting of valuable data from the vari-
ous provincial mines and offices may have introduced
bias to the findings of this study.
Although yearly data was available for the years
2000, 2001, 2002 and 2003, longitudinal data analysis
could not be done as data was not collected from the
OCCUPATIONAL HEALTH SOUTHERN AFRICA
same miners year after year. This is because reporting
of records to the Head Office of the DME by provincial
mines was only done partially. As a result, only cross-
sectional data analysis could be done.
All point prevalence proportions reported in this
study are crude, and an assumption is made that in
each of the years 2000, 2001, 2002 and 2003, miners
whose health records were analysed were examined
over a similar and short period of time.
* Pneumoconiosis – includes all other causes except
silica and asbestos.
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