With South Africa’s long history as a major minerals producer, occupational lung diseases have been the high price paid by workers for many generations.
It is also an issue with which the mining industry, government, trade unions and healthcare workers have grappled for years.
Occupational lung disease refers to the group of diseases known as pneumoconiosis, which occurs as a result of long-term exposure to harmful dust or gases that are inhaled in the workplace.
Some of the more commonplace conditions in South Africa include coal workers’ pneumoconiosis, or black lung as it is often called, and asbestosis, which affects those who have been in contact with asbestos. Workers exposed to the smelting of bauxite, a key ingredient of aluminium, may suffer from bauxite fibrosis and silicosis is caused by the inhalation of quartz silica dust that is Âpresent in deep-level underground gold mines.
Mild cases may initially be asymptomatic. Once significant fibrosis has set in, the signs and symptoms of pneumoconiosis are similar and involve shortness of breath, wheezing, a chronic and persistent cough, chest pains, fatigue, loss of appetite and weight loss. In the latter stages of the disease patients can suffer cardiac failure and cyanosis (blue lips).
Unfortunately, the signs and symptoms of occupational lung disease are often apparent only after many years of constant exposure to the culprit dust or gas; in some cases it can be as much as 30 years.
In recent years much effort has been made to ensure that mining industry stakeholders understand and manage dust control at the mines. It has resulted in many new initiatives being introduced, such as wet drilling, dust suppression through water-spraying devices, more effective ventilation techniques and allowing for more time between blasting and when miners re-enter the workplace, as well as respirators for miners in high-risk areas.
These initiatives have led to a significant reduction in new cases of silicosis among the workforce. By 2006 the occupational lung diseases rate in mines in the country was down to 10 in 1 000 employees. By 2013 the industry expects no new cases of silicosis to occur among previously unexposed workers. But the plight of former miners living in rural areas is proving to be the biggest challenge — and many of these men remain undiagnosed.
The migrant labour system that prevailed during apartheid also left a cruel legacy of making it extremely Âdifficult to monitor the rehabilitation and care of those who contracted occupational lung disease. Compounding this problem is the estimated one million miners who have left the industry in the past 20 years.
Regrettably, there is no specific treatment for the occupational lung diseases common in South Africa and prevention is the only answer. Obviously, if the sufferer still works in an environment that exposes him to the cause of the condition, it is crucial to remove him from that environment to Âprevent the disease from getting worse.
Only supportive treatments are available, including cough medicine, bronchodilators and, in advanced cases, oxygen. The patient also needs to be educated on how to limit his exposure to irritants and if he smokes he must stop immediately.
Immunisation with pneumococcal and flu vaccinations is recommended, given the sufferers’ propensity for respiratory infections. In extreme cases a lung transplant may be the only option. Those suffering from occupational lung disease are also susceptible to tuberculosis and must be tested regularly.
Occupational lung disease will be discussed on SABC2’s Bonitas House Call on June 25 at 9am
This article originally appeared in the Mail & Guardian newspaper as a sponsored feature