There is a heavy burden of occupational lung disease among past and present mine workers in South Africa, and the National Institute for Occupational Health (NIOH) plays a pivotal role not only in identifying compensable diseases in deceased mine workers, but also in the resultant statutory compensation process.
This service is however underutilised by mine workers, and has therefore prompted us, as the NIOH, to call on industry stakeholders, including employers and trade unions, to assist by informing mine workers about the service.
The number of autopsies submitted to the NIOH has been declining since 2010. While this may reflect the decreasing number of mine workers currently employed in the industry, some older mine workers are suffering from occupational lung disease.
There is therefore a need to facilitate access to the compensation system for current and retired mine workers in South Africa and for mine workers from labour sending areas in neighbouring Southern African Development Community (SADC) countries.
The autopsy service performed by the NIOH Pathology Division is a statutory requirement for deceased miners, in line with the Occupational Diseases in Mines & Works Act (ODMWA).
The Division examines the cardio-respiratory organs of mine workers, regardless of the clinical cause of death, and such autopsies can only be done with the written consent of the deceased’s next of kin.
The lungs are placed in formalin and into a red box, and must be accompanied with a completed P form from the sender. This is then couriered or sent to the NIOH, where it is verified upon receipt.
The Pathology team examines the organs for the presence of certain compensable lung diseases, which are caused by exposures in a mine. Only if the deceased has a compensable lung disease will his/her family receive compensation.
Under ODMWA, only certain occupational diseases are compensable including silicosis, asbestosis, coal worker’s pneumoconiosis, mixed dust fibrosis, tuberculosis, lung cancer, obstructive lung disease(emphysema), asbestos related diseases, cancer of the lung in asbestos exposed cases, mesothelioma and progressive systemic sclerosis(not skin).
If any of these diseases are found during the autopsy, the severity of the disease will be determined and compensation will be awarded according to the severity. Severity of between 10% and 40% is rated as 1st degree, while a severity level of 40% or above is regarded as 2nd degree.
The Pathology team captures the particulars of the deceased, their labour history and the autopsy report findings on computerised databases. The information is then sent electronically to the Certification Committee at the Medical Bureau for Occupational Diseases (MBOD).
The MBOD then reviews the mining service and previous submissions and then determines if the case is compensable in the 1st or 2nd degree. A certificate will subsequently be issued to the deceased’s family and the Compensation Commissioner.
At this time, the Commissioner authenticates the beneficiaries and calculates the amount of compensation, which is then paid to the dependents of the deceased.
What is important to note is that only certain individuals can give consent for an autopsy including the surviving spouse or next of kin, a legal guardian, or an individual authorised to dispose of the remains.
What remains a concern is that many mine workers are not aware of this autopsy process. Employers and trade unions can play a crucial role in helping inform miners of this so that families of deceased miners may possibly be compensated.
AUTHOR: Dr Spo Kgalamono, acting executive director of the National Institute for Occupational Health (NIOH)