Effects of commodity on the risk of emphysema in South African miners

  • Sithembile L. MabilaEmail author
  • Kirsten S. Almberg
  • Lee Friedman
  • Robert A. Cohen
  • Ntombizodwa Ndlovu
  • Naseema Vorajee
  • Jill Murray
Original Article



To examine associations between mine commodity such as coal, platinum, or diamonds and emphysema among South African miners at autopsy.


We examined the association between mine commodity and emphysema using the Pathology Automation (PATHAUT) database, 1975–2014. Exposure was characterized as longest tenure in each commodity. We constructed separate multivariable logistic regression models for black and white miners. Smoking was assessed in a sub-analysis of white miners.


Among black miners, coal mining was significantly associated with increased odds of emphysema [OR = 2.39 (95% CI 1.86, 3.07)] when compared to gold mining. Asbestos was also associated with significantly increased odds of emphysema among black miners [OR = 1.47 (95% CI 1.01, 2.12)]. No associations between commodity and emphysema were observed among white miners. Cumulative years of exposure and age at death were significant predictors for emphysema for both black and white miners. Smoking was a significant predictor of emphysema in the sub-analysis of white miners with smoking information, but no effect of commodity was observed.


We observed a significant association between coal mining and emphysema among black miners. Adverse health effects of coal mining are evidenced by more than twofold increase in emphysema among black coal miners compared to gold miners. This suggests that South African Coal miners are exposed to high dust concentrations or more damaging components compared to other commodities, resulting in elevated risk of emphysema.


Emphysema Mining Occupation Commodity South Africa PATHAUT 



The research and researchers were supported in part by the National Institute of Occupational Safety and Health (NIOSH) Training Program Grant # T42/OH008672.

Conflict of interest

All authors have declared that they have no conflicts of interest that may be relevant to the submitted work.

Supplementary material

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Supplementary material 1 (DOCX 15 kb)
420_2019_1483_MOESM2_ESM.docx (36 kb)
Supplementary material 2 (DOCX 36 kb)


  1. Akanbi MO, Taiwo BO, Achenbach CJ et al (2015) HIV associated chronic obstructive pulmonary disease in Nigeria. J AIDS Clin Res. CrossRefGoogle Scholar
  2. Attfield MD, Morring K (1992) The derivation of estimated dust exposures for U.S. coal miners working before 1970. Am Ind Hyg Assoc J 53:248–255. CrossRefGoogle Scholar
  3. Braun L, Kisting S (2006) Asbestos-related disease in South Africa. Am J Public Health 96:1386–1396. CrossRefGoogle Scholar
  4. Chakrabarti B, Calverley PM, Davies PD (2007) Tuberculosis and its incidence, special nature, and relationship with chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis 2:263–272Google Scholar
  5. Chamber of Mines SA (2017) Mining in SA—Chamber of Mines South Africa. Accessed 13 Mar 2017
  6. Churg A, Zay K, Li K (1997) Mechanisms of mineral dust-induced emphysema. Environ Health Perspect 105:1215–1218Google Scholar
  7. Cohen RAC, Patel A, Green FHY (2008) Lung disease caused by exposure to coal mine and silica dust. Semin Respir Crit Care Med 29:651–661. CrossRefGoogle Scholar
  8. Crawford NP, Bodsworth PL, Hadden GG (1982) A study of apparent anomalies between dust levels and pneumoconiosis at British collieries. Ann Occup Hyg 26:725–744. CrossRefGoogle Scholar
  9. Diaz PT, King MA, Patch ER et al (2000) Increased susceptibility to pulmonary emphysema among HIV-seropositive smokers. Ann Intern Med 132:369–372CrossRefGoogle Scholar
  10. Drummond MB, Kirk GD, Astemborski J et al (2012) Association between obstructive lung disease and markers of HIV infection in a high-risk cohort. Thorax 67:309–314. CrossRefGoogle Scholar
  11. Drummond MB, Merlo CA, Astemborski J et al (2013) The effect of HIV infection on longitudinal lung function decline among IDUs: a prospective cohort. AIDS 27:1303–1311. CrossRefGoogle Scholar
  12. Fukuchi Y (2009) The aging lung and chronic obstructive pulmonary disease. Proc Am Thorac Soc 6:570–572. CrossRefGoogle Scholar
  13. Ghio AJ, Quigley DR (1994) Complexation of iron by humic-like substances in lung tissue: role in coal workers’ pneumoconiosis. American Journal of Physiology-Lung Cellular and Molecular Physiology 267:L173–L179. CrossRefGoogle Scholar
  14. Halbert RJ, Natoli JL, Gano A et al (2006) Global burden of COPD: systematic review and meta-analysis. Eur Respir J 28:523–532. CrossRefGoogle Scholar
  15. Hessel P, Goldstein B, Davies J et al (1987a) Pathological findings in mine workers: I. Description of the PATHAUT database. Am J Ind Med 12:71–80CrossRefGoogle Scholar
  16. Hessel PA, Hnizdo E, Goldstein B, Sluis-Cremer GK (1987b) Pathological findings in mine workers: II. Quality of the PATHAUT data. Am J Ind Med 12:81–89. CrossRefGoogle Scholar
  17. Hnizdo E, Vallyathan V (2003) Chronic obstructive pulmonary disease due to occupational exposure to silica dust: a review of epidemiological and pathological evidence. Occup Environ Med 60:237–243. CrossRefGoogle Scholar
  18. Hnizdo E, Sluis-Cremer GK, Abramowitz JA (1991) Emphysema Type in Relation to Silica Dust Exposure in South African Gold Miners. Am Rev Respir Dis 143:1241–1247. CrossRefGoogle Scholar
  19. Hnizdo E, Churchyard G, Dowdeswel R (2000) Lung function prediction equations derived from healthy South African gold miners. Occup Environ Med 57:698–705. CrossRefGoogle Scholar
  20. Huang X, Laurent PA, Zalma R, Pezerat H (1993) Inactivation of alpha 1-antitrypsin by aqueous coal solutions: possible relation to the emphysema of coal workers. Chem Res Toxicol 6:452–458CrossRefGoogle Scholar
  21. Human Sciences Research Council (2011) South Africa Mining Sector Employment Forecast to 2025. Accessed 16 Nov 2016
  22. Kgokong N, Vorajee N, Lakhoo D et al (2018) Pathology division surveillance report: demographic data and disease rates for January to December 2017. Accessed 27 May 2019
  23. Kuempel ED, Wheeler MW, Smith RJ et al (2009) Contributions of dust exposure and cigarette smoking to emphysema severity in coal miners in the United States. Am J Respir Crit Care Med 180:257–264. CrossRefGoogle Scholar
  24. Lurie M, Williams M, Zuma K et al (2003) The impact of migration on HIV-1 Transmission in South Africa: sexually transmitted diseases. Am Sex Transm Dis 30:149–156CrossRefGoogle Scholar
  25. Mabila SL, Almberg KS, Friedman L et al (2018) Occupational emphysema in South African miners at autopsy; 1975–2014. Int Arch Occup Environ Health. CrossRefGoogle Scholar
  26. McCunney RJ, Morfeld P, Payne S (2009) What component of coal causes coal workers’ pneumoconiosis? J Occup Environ Med 51:462–471. CrossRefGoogle Scholar
  27. Murray J, Sonnenberg P, Nelson G et al (2007) Cause of death and presence of respiratory disease at autopsy in an HIV-1 seroconversion cohort of southern African gold miners. AIDS 21(Suppl 6):S97–S104. CrossRefGoogle Scholar
  28. Naidoo RN, Robins TG, Murray J et al (2005) Validation of autopsy data for epidemiologic studies of coal miners. Am J Ind Med 47:83–90. CrossRefGoogle Scholar
  29. Naidoo R, Seixas N, Robins T (2006) Estimation of respirable dust exposure among coal miners in South Africa. J Occup Environ Hyg 3:293–300. CrossRefGoogle Scholar
  30. Ndlovu N, Nelson G, Vorajee N, Murray J (2016) 38 years of autopsy findings in South African mine workers. Am J Ind Med 59:307–314. CrossRefGoogle Scholar
  31. Nelson G (2013) Occupational respiratory diseases in the South African mining industry. Glob Health Action. CrossRefGoogle Scholar
  32. Nelson G, Girdler-Brown B, Ndlovu N, Murray J (2010) Three decades of silicosis: disease trends at autopsy in South African gold miners. Environ Health Perspect 118:421–426. CrossRefGoogle Scholar
  33. Osinubi OY, Gochfeld M, Kipen HM (2000) Health effects of asbestos and nonasbestos fibers. Environ Health Perspect 108:665–674Google Scholar
  34. Petsonk EL, Rose C, Cohen R (2013) Coal mine dust lung disease. New lessons from an old exposure. Am J Respir Crit Care Med 187:1178–1185. CrossRefGoogle Scholar
  35. Poinen-Rughooputh S, Rughooputh MS, Guo Y et al (2016) Occupational exposure to silica dust and risk of lung cancer: an updated meta-analysis of epidemiological studies. BMC Public Health 16:1137. CrossRefGoogle Scholar
  36. Ramos LMM, Sulmonett N, Ferreira CS et al (2006) Functional profile of patients with tuberculosis sequelae in a university hospital. Jornal Brasileiro de Pneumologia 32:43–47. CrossRefGoogle Scholar
  37. Rees D, Phillips JI, Garton E, Pooley FD (2001) Asbestos lung fibre concentrations in South African chrysotile mine workers. Ann Occup Hyg 45:473–477CrossRefGoogle Scholar
  38. Rees D, Murray J, Nelson G, Sonnenberg P (2010) Oscillating migration and the epidemics of silicosis, tuberculosis, and HIV infection in South African gold miners. Am J Ind Med 53:398–404. CrossRefGoogle Scholar
  39. RSA (1973) Occupational disease in mines and works act. Government Printer, PretoriaGoogle Scholar
  40. Santo Tomas LH (2011) Emphysema and chronic obstructive pulmonary disease in coal miners. Curr Opin Pulm Med 17:123–125. CrossRefGoogle Scholar
  41. Stanton D, Belle B, Dekker K, Plessis J (2006) Mining industry best practice on the prevention of silicosis. Mine Health and Safety Council, BraamfonteinGoogle Scholar
  42. UNAIDS (2006) 2006 Report on the global AIDS epidemic. A UNAIDS 10 anniversary special edition. Accessed 28 Jan 2019
  43. van Walbeek C (2002) Recent trends in smoking prevalence in South Africa—some evidence from AMPS data. S Afr Med J 92:468–472Google Scholar
  44. Wallaert B (2006) OCCUPATIONAL DISEASES|Coal Workers’ pneumoconiosis. In: Shapiro GJLD (ed) Encyclopedia of respiratory medicine. Academic Press, Oxford, pp 191–201CrossRefGoogle Scholar
  45. Walton WH, Dodgson J, Hadden GG, Jacobsen M (1975) The effect of quartz and other non-coal dusts in coal workers’ pneumoconiosis Part I: Epidemiological studies. Inhaled Part 4(Pt 2):669–690Google Scholar
  46. Zay K, Loo S, Xie C et al (1999) Role of neutrophils and alpha1-antitrypsin in coal- and silica-induced connective tissue breakdown. Am J Physiol 276:L269–L279Google Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Division of Environmental and Occupational Health Sciences, School of Public HealthUniversity of Illinois at ChicagoChicagoUSA
  2. 2.National Institute of Occupational HealthJohannesburgSouth Africa
  3. 3.School of Public HealthUniversity of WitwatersrandJohannesburgSouth Africa
  4. 4.School of PathologyUniversity of WitwatersrandJohannesburgSouth Africa

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