During apartheid the South African gold mining industry was focused on production and profit. The attention given to occupational dust-related disease was woefully inadequate.
Whilst a significant number of white gold miners have also contracted silicosis in the past 50 years the vast majority of silicosis victims from South African gold mining will have been black miners who undertook the dustiest jobs. In that regard, a senior Anglo American medical doctor, Dr Robert Cowie, who was a leading industry authority on silicosis and TB in gold miners, noted in his 1987 thesis that “the working conditions for black South African miners differ in that they are the labourers in a labour-intensive industry and are thus subjected to higher personal exposures of dust." Black miners have also borne the brunt of silico-TB. As noted by Dr Cowie in his 1987 thesis, “The well-recognised association between silicosis and pulmonary tuberculosis has a special significance in this working population with its origins in areas where tuberculosis is endemic.”
Throughout the last century South African gold miners undertook dusty jobs, generally unprotected by effective respirators or by effective dust control in the underground workings.
In 1994 the South African Government commissioned the Leon Commission of Inquiry into Safety and Health in the Mining Industry. The Leon Commission found that dust levels in mines had not changed in 50 years and that this presented an unacceptable risk of silicosis. They concluded that whilst there had been research completed on occupational diseases, this was biased towards white miners. Research had not been done on black miners since the 1930s.
The Inquiry stated that the regulatory framework for health and safety in mines were both inadequate and were not enforced. They stated that the scale of death, injury and disease were such that remedial action had to be taken urgently. The Inquiry led to the Mine and Health and Safety Act 1996 which sought to provide a legal framework for creating a safe working environment.
The gold mining industry has conducted no epidemiological studies on black miners. However, prevalence studies published in authoritative journals by others consistently show that black South African ex gold miners suffer from high rates of silicosis and TB.
A 1998 study by Trapido found a prevalence of between 22% and 36% in ex gold miners living in Libode, Eastern Cape. Approximately one third of the miners recruited to Anglo American Free State mines were from the former “Transkei” in the Eastern Cape
A 2008 study by Girdler-Brown in June 2008 found a prevalence of 25% in gold miners, now living in Lesotho, formerly employed at Anglo American South Africa's President Steyn Mine in the Free State. The authors state that:
"These high rates of lung disease amongst former gold miners are of national concern. These findings and their consistency with previously published reports on the prevalence of respiratory disease in ex miners provide a compelling case for improved statutory surveillance and reporting of silicosis and TB among former gold miners not just for compensation purposes, but also to monitor the effectiveness of control measures aimed at reducing the risk".
Approximately one third of the miners recruited to Anglo American Free State mines were from Lesotho.
In ‘Occupational respiratory diseases in the SA mining industry’ Gill Nelson describes that between 1975 and 2007 the proportion of black miners with silicosis increased tenfold from 3% to 32%; whereas the increase in white men was slight, from 18% to 22%.
In light of the above and the fact that the industry employed hundreds of thousands of miners each year for decades, tens of thousands of former gold miners will have potentially contracted silicosis and silico-TB.
The high rates of silicosis and TB in ex-miners are not disputed by the industry, but the industry claims to have introduced dust improvements since 2000, such that any new cases of silicosis would have been eliminated by 2013.