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Coal mining as a risk factor for tuberculosis - Commodity or circumstance?
Nevadna Singh1, Elvis M Irusen1
1Division of Pulmonology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
Southern African Journal of Infectious Diseases
|May 13, 2025
Summary
Tuberculosis (TB) incidence in South African coal mines dramatically decreased by over 70% following active case-finding and treatment interventions. Socioeconomic factors and comorbidities, not just coal exposure, are key drivers of TB risk in mining communities.
Area of Science:
- Occupational Health
- Epidemiology
- Public Health
Background:
- The association between mining and tuberculosis (TB) is established, particularly in South Africa.
- The specific pathophysiological link between coal mining and TB requires further elucidation, with many studies citing association over causality.
Purpose of the Study:
- To investigate the impact of targeted interventions on TB incidence in South African coal mines.
- To explore the underlying factors contributing to TB risk in coal mining populations.
Main Methods:
- Implementation of a focused intervention program involving active case-finding and treatment within coal mines.
- Comparative analysis of TB incidence rates before and after the intervention, against historical and national figures.
Main Results:
- A significant reduction in TB incidence, exceeding 70%, was observed in the coal mines post-intervention.
- The post-intervention TB incidence was substantially lower than historical rates and the national average.
Conclusions:
- Active case-finding and treatment are highly effective in reducing TB incidence in coal mining settings.
- Socioeconomic factors and comorbidities, in addition to coal exposure, are critical drivers of TB risk and require focused attention alongside screening.
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