The burden of silicosis, pulmonary tuberculosis and COPD among former Basotho goldminers.

BACKGROUND The burden of silicosis, pulmonary tuberculosis and COPD is described in 624 South African gold miners 18 months after cessation of work. METHODS This was a prevalence study. Questionnaires were administered, and spirometry, chest radiography, tuberculosis investigations, and urine HIV antibody assays were performed. RESULTS Attendance was 80.1% (624/779), mean age 49.4 years, and mean employment duration 25.6 years. Most subjects had had medium (26.5%) or high (65.4%) dust-exposure jobs. Current smoking rate was 35%, with ever smoking 61%. HIV antibodies were detected in the urine in 22.3%. Prevalences were: silicosis 24.6%, past tuberculosis 26%, current tuberculosis 6.2%, airflow obstruction 13.4%, and chronic productive cough 17.7%. Almost 50% of these miners had at least one of these respiratory conditions. CONCLUSIONS A heavy burden of silicosis, tuberculosis and COPD was present in this group of former goldminers. Intensification of work place dust control measures and TB and HIV prevention activities are needed on South African gold mines. In labor sending communities investment is needed in silicosis and tuberculosis surveillance as well as HIV treatment and care.