Dr Thuthula Balfour-KaipaHead: Health DepartmentChamber of Mines of South Africa

Putting South Africa First

CHAMBER OF MINES OF SOUTH AFRICA

Presentation to the Parliamentary

Portfolio Committee on Health

5 September 2012

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OutlineBackground to mining industryMagnitude of occupational diseasesApproach by industryTuberculosisApproach to TBChallenges CompensationEx-Mineworker ProjectConclusion

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Background information on mining industry

Variable Total mining industry (2009)

Chamber of Mines (2009)

Number of Mines

>1000 248

Employees

Platinum

183 914 (2008)149 869

Gold 160 102 143 268

Coal 70 703 57 343

Others 77 203 (2008) 27 580

Total 419 922 (2008) 389 068

Chamber members represent: < 20% of mines - 85% of employees - 80% of production - 80% of gold employees

in three companies

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Occupational diseases in mining industry

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Trends for NIHL

Marked reductions over time but evidence of plateauing 5

Trends for silicosis

No signs of a decline

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Trends for TB

Stabilising and indications of decline

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ApproachPrevention of exposures

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TripartiteMine Health and Safety Council

Established under MHSA to promote health and safety.

Funded through levies from mining companies.Tripartite representation.Products include guidelines and audit tools.

Regulation and monitoring by Department of Mineral Resources Duty of employers under MHSA to review hazards,

risks, do occupational hygiene measurements and establish medical surveillance.

Annual and monthly reporting of occupational diseases, inspection of occupational health service.

Censoring where required.9

Industry Milestones2008- Industry milestones for 2013

Noise• After 2008 - no deterioration in hearing greater than

10% amongst occupationally exposed individuals• 2013 - total noise emitted by all equipment installed in

any workplace must not exceed a sound pressure level of 110dB(A)

Dust• 2008 - 95% of all exposure measurement results below

OEL for respirable crystalline silica of 0.1mg/m3

• 2013 - no new cases of silicosis will occur amongst previously unexposed individuals

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2011 - Summit Commitments2011 Industry Summit on Health and Safety

recognised progress made and need for accelerate meeting of milestones. New commitments:Re-examine the return to risk-work of miners

with HIV/AIDS, TB and Silicosis. Investigate the policy and regulatory

framework to reduce the silica OEL in line with international benchmarks.

Develop a standard operating procedure for independent verification of dust measurements reported by mines.

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MOSH Learning Hub

Chamber initiative, established in 2008.Principle is to promote the adoption of

leading practices throughout industry.Dust and noise teams to address silica dust

and noise.Identify leading practices from companies

and disseminate to others.

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Tuberculosis

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Risks for tuberculosis

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HIV a key driver of TB epidemic in SA and mining industry

DOH TB Strategic Plan, 2007

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Response: Tripartite initiatives

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New Tripartite Summit Commitments Referral system to ensure

access to continued treatment

beyond employment.

Establishment of a national

repository on employee health

information.

Ensure that renewals and new

mining licenses have strategic

and operational plans for TB,

HIV and AIDS.

Promote access for families and

immediate communities.

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Response: Chamber initiatives

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TB Reviews Internal reviews by Chamber

members: 2010 and 2011

External reviews in three

biggest gold companies :2011

Report on gold companies

submitted to Ministers of

Health and DMR.

External reviews of platinum

companies in 2012.

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Results of TB Reviews in gold sector

Areas of strength Areas of improvementDOTS programmesTB culture Hospitalisation Laboratory servicesPharmacy servicesPharmaceutical services

Keeping of TB registersPatient referral systemsPolicies on contractorsCase finding

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Challenges for TB

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CompensationCOIDA (Dept of Labour)

All occupational diseases except cardiopulmonary organs of mineworkers

Administered by Rand Mutual Assurance (RMA) in mining.

ODMWA (Dept of Health)

Occupational lung diseases in mineworkers (and works)

Two compensation systems 22

Constitutional Court ruling on ODMWAMankayi versus AngloGold Ashanti case:

The issue before court:Whether section 35(a) of COIDA extinguishes the

common law right of mineworkers to claim for occupational injuries or diseases from negligent owners

The judgment“employee” in section 35(1) of COIDA only applies to

those under COIDA, not employees under ODMWA.Constitutional matter of right to freedom and security

under section 12 (1)(c). Extinguishing common law right impinges on this right. This is particularly so if one cannot claim against COIDA but can only get paltry compensation under ODMWA.

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Differences between COIDA and ODMWA

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Differences between COIDA and ODMWA

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Differences between COIDA and ODMWA

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Challenges with ODMWAShort-term

Administrative inefficiencies leading to non payment for compensatable diseases (delays and non-nationals),

no adjustment to benefits.No indemnity for employers.

Medium-term Status of Fund - Liabilities that are accumulating due to:Non –payment of compensation due to minersUnclear quantum of deficit as per valuations.Inadequate benefits, as per Mankayi judgment.

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Ex-Mineworker ProjectTripartite initiative between DOH, NUM and

Chamber to improve access for mineworkers to compensation.

R42 million funding over 6 years from 2007Three components

Benefit examination sitesSupport to CCOD and MBODSocio-economic development

Benefit examination sites set up or strengthened in Nongoma, Mthatha, (Butterworth), North West and Free State.

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Progress with project

Very slow, dependant on provincial departments of health.

Major blockage in payouts at CCOD.

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Way forward with compensation

Situation is untenable.Review of the compensation systems

required. Aim should be better benefits and restoration

of “no fault”, functioning compensation system.

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ConclusionOccupational diseases in mining are mainly

silicosis, NIHL and occupational TB.Progress is being made in the control of these

diseases, but concerns persist around silicosis.The compensation for occupational lung

diseases is inadequate and administrative inefficiencies cause great hardship for mineworkers.

All stakeholders need to work together in preventing occupational diseases and improving the health of mineworkers.

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