Objectives. To compare and contrast the prevalence of pneumoconiosis in two
groups of former migrant mineworkers in southern Africa, and to examine th
e effectiveness of the South African compensation system for occupational l
ung diseases.
Design. Comparison of two cross-sectional studies and follow-up data on com
pensation results.
Setting. The village of Thamaga, Botswana and the rural area of Libode, Eas
tern Cape, South Africa.
Subjects. Two hundred and thirty-four former underground mineworkers in Tha
maga, and 238 in Libode.
Main outcome measures. Prevalence and severity of pneumoconiosis, prevalenc
e of radiological signs of tuberculosis (TB), Medical Bureau for Occupation
al Diseases (MBOD) certification committee decisions, and compensation resu
lts.
Results. Prevalence of pneumoconiosis greater than or equal to 2/1 was 15.4
% in Libode and 13.6% in Thamaga. Significantly more Libode than Thamaga su
bjects (51.1% versus 29.0%) reported past TB treatment. Radiological signs
of pulmonary TB were also more prevalent in Libode (33.3% v. 23.9%). Twenty
-six per cent of Libode men and 16.1% of Thamaga men were certified with co
mpensable disease. Libode payments were finalised within 30 months, whereas
Thamaga cases only began receiving payments 52 months after medical. exami
nation, with 11 cases still pending 66 months after medical examination.
Conclusion. There was a high prevalence of pneumoconiosis in both study gro
ups. Many men were eligible for compensation but were previously uncompensa
ted. The higher rate of compensable disease in the Libode group may relate
to the higher prevalence of TB, as well as more active follow-up by the stu
dy group, including a large number of appeals. Socio-political changes in S
outh Africa between 1994 and 1996 may also have influenced compensation res
ults.