Tuberculosis, mining and silica

From the early years following its inception in 1886, South African gold mining was characterised by racial stratification and circular migrant labour from neighbouring colonies (later states), systems which underlay the labour and health profile of the industry for the next century.1 By the second decade of the twentieth century legal provisions were in place for regular physical and radiographical examination of new and returning miners for silicosis and tuberculosis. Specific legislation provided for compensation for silicosis (1912) and tuberculosis (1916),2 including postmortem compensation based on autopsy. This system of examination and compensation has persisted to this day, although much amended and contested along the way, and extended to mining sectors other than gold. Of particular note is the standardised pathology autopsy database in Johannesburg which was digitised in 1975 as Pathology Automation System (PATHAUT).3 The database now contains information on well over 100 000 lung autopsies.3 PATHAUT has enabled a number of highly informative studies. While an autopsy database is subject to selection forces producing patterns different from those that would be measured in living populations, the large numbers, long duration of observation and the standardisation of technique make PATHAUT a valuable source of information on epidemiological trends.3 4 The latest example, demonstrates trends in pulmonary tuberculosis in …

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