1. CHAMBER OF MINES OF SOUTH AFRICA
Presentation to the Parliamentary Portfolio Committee on Health
5 September 2012
Dr Thuthula Balfour-Kaipa
Head: Health Department
Chamber of Mines of South Africa
CHAMBER OF MINES OF SOUTH AFRICA
Putting South Africa First

2. Outline Background to mining industry
Magnitude of occupational diseases
Approach by industry
Tuberculosis
Approach to TB
Challenges
Compensation
Ex-Mineworker Project
Conclusion

3. Background information on mining industry
Variable
Total mining industry (2009)
Chamber of Mines (2009)
Number of Mines
>1000
248
Employees
Platinum
(2008)
Gold
Coal
70 703
57 343
Others
77 203
(2008)
Total
(2008)
Chamber members represent:
< 20% of mines
- 85% of employees
- 80% of production
- 80% of gold employees
in three companies
The Chamber of Mines is a legitimate representative of employers as members account for 85% of employees in the whole industry. The three gold companies, Harmony Gold, Goldfields and AngloGoldAshanti account for 80% of employees in the gold sector. This means that actions by these three companies can have a major impact on silicosis and TB control.

4. Occupational diseases in mining industry

5. Trends for NIHL
Marked reductions over time but evidence of plateauing

6. Trends for silicosis
No signs of a decline

7. Trends for TB
Stabilising and indications of decline

8. Approach Prevention of exposures Tripartite Milestones Research
Employers
MOSH Learning Hub
Company
Dust/noise suppression
Prevention of exposures

9. Tripartite Mine 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.

10. Industry Milestones 2008- Industry milestones for 2013 Noise Dust
After no deterioration in hearing greater than 10% amongst occupationally exposed individuals
total noise emitted by all equipment installed in any workplace must not exceed a sound pressure level of 110dB(A)
Dust
% of all exposure measurement results below OEL for respirable crystalline silica of 0.1mg/m3
no new cases of silicosis will occur amongst previously unexposed individuals

11. Summit Commitments
2011 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.

12. 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.

13. Tuberculosis TB recognised as health hazard in SA mining in 1890
TB Commission established in 1912
TB classified as compensable disease in SA in 1916

14. Risks for tuberculosis

15. HIV a key driver of TB epidemic in SA and mining industry
DOH TB Strategic Plan, 2007

16. Response: Tripartite initiatives

17. 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.

18. Response: Chamber initiatives
TB Task Team
TB Reviews
TB Interest Group

19. 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.

20. Results of TB Reviews in gold sector
Areas of strength
Areas of improvement
DOTS programmes
TB culture
Hospitalisation
Laboratory services
Pharmacy services
Pharmaceutical services
Keeping of TB registers
Patient referral systems
Policies on contractors
Case finding

21. Challenges for TB

22. Compensation Two compensation systems COIDA (Dept of Labour)
ODMWA (Dept of Health)
All occupational diseases except cardiopulmonary organs of mineworkers
Administered by Rand Mutual Assurance (RMA) in mining.
Occupational lung diseases in mineworkers (and works)
Two compensation systems

23. Constitutional Court ruling on ODMWA
Mankayi 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.

24. Differences between COIDA and ODMWA

25. Differences between COIDA and ODMWA

26. Differences between COIDA and ODMWA

27. Challenges with ODMWA Short-term Medium-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 miners
Unclear quantum of deficit as per valuations.
Inadequate benefits, as per Mankayi judgment.

28. Ex-Mineworker Project
Tripartite initiative between DOH, NUM and Chamber to improve access for mineworkers to compensation.
R42 million funding over 6 years from 2007
Three components
Benefit examination sites
Support to CCOD and MBOD
Socio-economic development
Benefit examination sites set up or strengthened in Nongoma, Mthatha, (Butterworth), North West and Free State.

29. Progress with project
Very slow, dependant on provincial departments of health.
Major blockage in payouts at CCOD.

30. 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.

31. Conclusion
Occupational 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.