Cargando…
Precarious transition: a mortality study of South African ex-miners
BACKGROUND: Despite their burden of a triple epidemic of silicosis, tuberculosis and HIV infection, little is known about the mortality experience of miners from the South African mining industry once they leave employment. Such information is important because of the size and dispersion of this pop...
Autores principales: | , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2018
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6042385/ https://www.ncbi.nlm.nih.gov/pubmed/29996801 http://dx.doi.org/10.1186/s12889-018-5749-2 |
_version_ | 1783339141918883840 |
---|---|
author | Bloch, Kim Johnson, Leigh F. Nkosi, Mlindeli Ehrlich, Rodney |
author_facet | Bloch, Kim Johnson, Leigh F. Nkosi, Mlindeli Ehrlich, Rodney |
author_sort | Bloch, Kim |
collection | PubMed |
description | BACKGROUND: Despite their burden of a triple epidemic of silicosis, tuberculosis and HIV infection, little is known about the mortality experience of miners from the South African mining industry once they leave employment. Such information is important because of the size and dispersion of this population across a number of countries and the progressive nature of these diseases. METHODS: This study included 306,297 South African miners who left the industry during 2001–2013. The study aimed to calculate crude and standardised mortality rates, identify secular trends in mortality and model demographic and occupational risk factors for mortality. RESULTS: Crude mortality rates peaked in the first year after exit (32.8/1000 person-years), decreasing with each year from exit. Overall mortality was 20% higher than in the general population. Adjusted annual mortality halved over the 12 year period. Mortality predictors were being a black miner [adjusted hazard ratio (aHR) 3.30; 95% confidence interval (CI) 3.15–3.46]; underground work (aHR 1.33; 95% CI 1.28–1.39); and gold aHR 1.15 (95% CI 1.12–1.19) or multiple commodity employment (aHR 1.15; 95% CI 1.11–1.19). CONCLUSIONS: This is the first long-term mortality assessment in the large ex-miner population from the South African mining industry. Mortality patterns follow that of the national HIV-tuberculosis epidemic and antiretroviral treatment availability. However, ex-miners have further elevated mortality and a very high mortality risk in the year after leaving the workforce. Coordinated action between the mining industry, governments and non-governmental organisations is needed to reduce the impact of this precarious transition. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12889-018-5749-2) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-6042385 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-60423852018-07-13 Precarious transition: a mortality study of South African ex-miners Bloch, Kim Johnson, Leigh F. Nkosi, Mlindeli Ehrlich, Rodney BMC Public Health Research Article BACKGROUND: Despite their burden of a triple epidemic of silicosis, tuberculosis and HIV infection, little is known about the mortality experience of miners from the South African mining industry once they leave employment. Such information is important because of the size and dispersion of this population across a number of countries and the progressive nature of these diseases. METHODS: This study included 306,297 South African miners who left the industry during 2001–2013. The study aimed to calculate crude and standardised mortality rates, identify secular trends in mortality and model demographic and occupational risk factors for mortality. RESULTS: Crude mortality rates peaked in the first year after exit (32.8/1000 person-years), decreasing with each year from exit. Overall mortality was 20% higher than in the general population. Adjusted annual mortality halved over the 12 year period. Mortality predictors were being a black miner [adjusted hazard ratio (aHR) 3.30; 95% confidence interval (CI) 3.15–3.46]; underground work (aHR 1.33; 95% CI 1.28–1.39); and gold aHR 1.15 (95% CI 1.12–1.19) or multiple commodity employment (aHR 1.15; 95% CI 1.11–1.19). CONCLUSIONS: This is the first long-term mortality assessment in the large ex-miner population from the South African mining industry. Mortality patterns follow that of the national HIV-tuberculosis epidemic and antiretroviral treatment availability. However, ex-miners have further elevated mortality and a very high mortality risk in the year after leaving the workforce. Coordinated action between the mining industry, governments and non-governmental organisations is needed to reduce the impact of this precarious transition. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12889-018-5749-2) contains supplementary material, which is available to authorized users. BioMed Central 2018-07-11 /pmc/articles/PMC6042385/ /pubmed/29996801 http://dx.doi.org/10.1186/s12889-018-5749-2 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Bloch, Kim Johnson, Leigh F. Nkosi, Mlindeli Ehrlich, Rodney Precarious transition: a mortality study of South African ex-miners |
title | Precarious transition: a mortality study of South African ex-miners |
title_full | Precarious transition: a mortality study of South African ex-miners |
title_fullStr | Precarious transition: a mortality study of South African ex-miners |
title_full_unstemmed | Precarious transition: a mortality study of South African ex-miners |
title_short | Precarious transition: a mortality study of South African ex-miners |
title_sort | precarious transition: a mortality study of south african ex-miners |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6042385/ https://www.ncbi.nlm.nih.gov/pubmed/29996801 http://dx.doi.org/10.1186/s12889-018-5749-2 |
work_keys_str_mv | AT blochkim precarioustransitionamortalitystudyofsouthafricanexminers AT johnsonleighf precarioustransitionamortalitystudyofsouthafricanexminers AT nkosimlindeli precarioustransitionamortalitystudyofsouthafricanexminers AT ehrlichrodney precarioustransitionamortalitystudyofsouthafricanexminers |