Professional Documents
Culture Documents
Rodney Ehrlich, Centre for Occupational and Environmental Health Research, University of Cape Town
Approx 3 per 100 p-y (1-7 per 100 p-y) 89% HIV+: 19 per 100 p-y HIV- : 7.7 per 100 p-y MDR: 3.6% XDR: 0.2% ? 22-30%
Proportion of DR cases
(Calver. 2010)
1. Current epidemiology
Detection and early Education treatment Risk education ?Out of dust, ?Limit service
Latent TB Treatment Previous TB/lung damage ? Age ? Silicosis Early detection Silica dust load in lung Individual protection
HIV prevalence Latent TB prevalence Migrant labour Crowding Silica dust levels
Rate / 1000
335
252
33
Year of autopsy
Black White
Proposition: Silicosis, and probably a silica filled lung, is a form of acquired immune deficiency
Fatal attraction
Lung macrophage and silica particle Lung macrophage and tubercle bacilli
Impairs
About 3 700/10-5
Cumulative silica exposure (by quartile) and relative odds of PTB at autopsy
2.2 2 1.8 1.6 1.4 1.2 1 Adjusted for silicosis No silicosis at autopsy
Hnizdo and Murray. Occup Environ Med 1998;55:496-502
SA Foreign Total
1988
2006
Silicosis
31% 24-36%
PTB history
29% (Rx) 51% (Rx)
Transkei (ex-)
(Trapido et al.1998)
26% (hx)
1Hnizdo 2Park
Governance1
Private vs public interest mining vs the rest? Regional coordination Overcoming state fragmentation The concept of mineworker entitlement
1Stuckler
et al. 2010
Mining should have an expanded section in the new HIV and TB strategic plan