Occupational lung diseases among former goldminers in two labour sending areas

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.