Occupational lung diseases in South African miners at autopsy: 2020 surveillance report

ABSTRACT

The Pathology Division at the National Institute for Occupational Health (NIOH) provides autopsy services for deceased workers who worked in controlled mines or works under the provisions of the South African Occupational Diseases in Mines and Works Act, 1973 (Act No. 78 of 1973). This report describes the ages, commodities, employment durations, and occupational cardio-respiratory diseases in miners whose organs were submitted for autopsies in 2019 and 2020. Data were exported from the PATHAUT database into STATA for analysis. Differences in the proportions of disease (expressed per 1 000) were calculated using the Pearson's chi-square test; significance was set at p ≤ 0.05. There were 759 and 557 records of deceased miners and ex-miners in 2019 and 2020, respectively. Pulmonary tuberculosis decreased from 192/1 000 in 2019 to 153/1 000 autopsies in 2020, and silicosis decreased from 246/1 000 to 223/1 000. However, neither decrease was significant. There was a significant increase in the rate of asbestosis from 50/1 000 in 2019 to 79/1 000 in 2020. Pulmonary tuberculosis (TB), emphysema, and silicosis were the most frequent diseases, with high rates. There was a non-significant decrease in occupational respiratory disease rates in 2020 from 2019, but these remain higher than the rates seen in the early 1990s. The NIOH continues to conduct autopsy surveillance on miners to support compensation for families, and the development of policy and intervention programmes in the mining industry