Field N, Murray J, Lim M, Glynn J, Sonnenberg P
Lancet 2011; 377: 299-300.
As researchers of morbidity and mortality in the South African mining industry, we recognise the unprecedented attention on the 33 Chilean miners, and the subsequent World Report in The Lancet (Oct 23, p 1379),1 as an opportunity to raise awareness of the plight of miners worldwide.
Mining is a hazardous occupation. In the USA, where mining is highly regulated, rates of fatal injury among miners were four-fold higher than for employees in all industries. 2 In China, 6·4 deaths per day occur among miners working in registered coal pits alone (extrapolating to 440 deaths in the 69 days the Chilean miners were underground).3 For each miner killed, many are injured, some with long-term disability.
In addition to the direct risks of mine accidents, miners experience other preventable causes of death and disease, in the workplace and beyond. This partly reflects their socio-economic position and that many are “oscillating migrants”.4 The interaction of three mine-related diseases—silicosis, HIV infection, and tuberculosis—results in South African gold miners having the highest rate of tuberculosis in the world. 4 In HIV-positive miners, natural deaths far outstrip all unnatural causes (mine accidents, road traffic accidents, homicides, suicides). Even among HIV-negative miners, about half of deaths are unnatural, but mine accidents account for only a third of these. 5 Worldwide, mining is associated with fatal asbestos-related disease, lung cancer, and pneumoconiosis, and exposure to toxic environmental pollutants, such as mercury.