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Case studies
South Africa |
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7.2 Improving dust control delivers results
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The incidence of occupational
lung disease (OLD) has stabilised at AngloGold
thanks to increasing efforts to improve dust control
on the South African operations. Not only is this
evident in declining cases of compensation for OLD,
but monitoring of workplaces has shown a significant
decrease in exposure to harmful respirable dust
particles.
In the late-1990s an AngloGold team, as part of the
Department of Minerals and Energy?s (DME)
Occupational Hygiene Sub-Committee (OHSC),
identified improved measures to determine employees?
exposure to respirable silica dust. Following
representation by AngloGold to the DME to gain
permission to change these methodologies at its Vaal
River operations, a new method of monitoring
employee exposure to dust was established across all
of AngloGold?s South African operations by the end
of 1999. AngloGold?s new methodology conforms to the
requirements of the guidelines for a Code of
Practice for airborne pollutants as issued by the
Chief Inspector of Mines.
The implementation was undertaken in three phases: |
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Respirable dust
concentrations were determined for various
geographical areas and activities on each
mine; |
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Next came the
identification of critical occupations,
based both on historical reported cases of
OLD and continuous dust monitoring; |
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Finally, this led to the
development of new dust management tools
(such as an automated computerised system to
link measured exposures to employees?
medical records, as well as a new personal
dust monitoring system) and a new code of
practice for AngloGold?s South African
operations. |
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In 2001, AngloGold established
a Dust Steering Committee responsible for strategic
issues relating to dust management. Says Des
Wrigley, Manager Occupational Environment for
the South African operations, ?The steering
committee aims to achieve a quantum reduction in
dust exposure ? by 50% from 2001 to 2004 ? and we
are seeing improvements.?
In 2002, a Dust Technology and Innovation
Supporting Team was established to evaluate best
practice. The team comprises a range of occupational
hygiene professionals/practitioners and meets on a
monthly basis to share and review information and
practices both within the company and the industry
as a whole. If required, these are then adopted for
implementation throughout AngloGold.
Both major and minor control initiatives have flowed
from work to reduce dust exposure in identified
high-risk areas, occupations and tasks. During the
past two years these have included: |
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A footwall treatment
programme implemented at all South African
operations has treated more than 200 linear
kilometres in 2003. A harmless (molasses-based) chemical
is sprayed on the
footwall of major intake airways to trap the
dust on the footwall and prevent it from
becoming airborne. |
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The clearing of all vertical shafts and
implementation of maintenance programmes. Old mud and dust accumulations,
resulting from spillages, have been removed
(by means of shovels, watersprays, etc) from
the shafts. Programmes have been implemented
so that any new mud spillages in the shaft
are removed and/or cleaned as soon as
possible. |
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The design and
development of new and improved dust
filtration plants suitable for different
dust loads. This was done in conjunction
with various dust filtration suppliers. Nine
new design filter plants have already been
ordered for installation at Kopanang Mine
and it is anticipated that more of these
units will be purchased during 2004 to
replace some of the existing filter plants
that are not performing adequately. |
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The identification of
appropriate respiratory protection devices.
This was done by first considering the
dust filtration quality of various
respirators and secondly by determining
employees? preferences regarding respirators.
The selected respirators were then placed on
standard stock and a directive issued to
ensure that only these respirators are
used. |
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Work to identify
appropriate dust control mechanisms at ore
passes, which is being trialled at Tau Lekoa mine.
Here, the ore transport hopper is equipped
with low friction material to ensure that
the ore is emptied correctly and completely.
In the past some ore always remained in the
hopper after it was emptied and the dust
from this ore became airborne as the hopper
moved into the intake airway. By employing
the new methodology, no ore is left in the
hopper to become airborne. Dust
concentrations in the intake airway are thus
reduced and less airborne dust flows into
the working areas of the mine. |
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Development of a dust training video to
enhance training of all employees with
regard to dust management and personal
protection. The video is
currently being circulated to various
committees for approval. After final
approval the video will be used as an
induction training tool to educate our
employees on the dangers of dust and also on
how to protect themselves against dust. |
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Programmes that are to be
investigated during the year ahead include an in-stope
water blast system. This system will ensure that the
stope is automatically watered down directly after
the blast and should result in employees being
exposed to lower levels of dust when they enter the
stope at the start of the next shift. The treatment
of entire intake airways across the operations is
also planned (similar to the treatment applied to
footwalls, but now also including the sidewalls) as
well as an investigation into methodologies to
reduce dust exposure resulting from blowing over and
socket cleaning processes.
Says Des, ?When we measure exposure we look at the
concentration of dust. At the end of September 2003,
no employees had been exposed to total respirable
dust concentrations in excess of 1mg/m3 for four
consecutive quarters. The number of homogenous
exposure groups (which represent groups of employees
in a working area who are exposed to approximately
the same levels of dust concentration) exposed to
quartz dust concentrations of more than 0.05mg/m3
was zero for the second quarter in a row. The limit
specified by the Mine Health and Safety Act is
0.1mg/m3.
Although hazardous dust is less of an issue on
open cast mines, the South African dust control
teams have visited the Sadiola, Yatela and Morila
mines in Mali and Geita Gold Mine in Tanzania and
recommendations on dust control have been made to
the respective management teams at these operations. |
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| 7.3 Facing up to the challenge of silicosis |
The issue of silicosis amongst
mine workers on South Africa?s gold mines was
brought to the attention of the public during 2003
with the threat of a legal suit against a number of
South African mining companies. But the issue of
occupational lung disease or silicosis has long been
a key focus area for AngloGold?s safety and health
team, and indeed is an issue which the mining
industry as a whole has been grappling with for
decades. At AngloGold, the significant efforts made
in understanding, monitoring and managing dust
control and the medical surveillance and attention
attached to this, have yielded some success. (See
case study).
Intensive efforts have been and continue to be made to
both prevent and identify early silicosis and at the
same time to treat and compensate those who have
silicosis from past exposure. The development of
silicosis also leads to the increased risk of
contracting tuberculosis (TB) which is further
compounded by the presence of HIV. |
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Compensation for silicosis
Compensation for silicosis (and certain other
occupational lung diseases) is provided for in the
Occupational Diseases in Mines and Works Act (ODMWA)
of 1973. The Act is administered by the Compensation
Commissioner under the auspices of the national
Department of Health. Submissions for compensation
are routed via the Medical Bureau for Occupational
Diseases (MBOD) for assessment of impairment.
Central to the legislation and the notion of the
funding of compensation claims is that employees
with an impairment are guaranteed compensation and
the employer is protected from any subsequent civil
claim.
Premiums levied on mines to fund this compensation
are based on risk (calculated as a result of dust
measurements made on mines). Currently, AngloGold
pays 39 cents per employee per shift worked.How the legislation has changed?
The MBOD was established 100 years ago to effect
medical surveillance and compensation of white
miners. At the time, black miners were considered to
be temporary on the basis that they were recruited
by the industry on a nine-month contract. Also,
black miners were not deemed to be susceptible to
respiratory diseases as their total length of
service (and therefore exposure) was generally much
shorter than that of white miners. Black miners
underwent medical surveillance examinations by
doctors employed by The Employment Bureau of Africa
(TEBA) and later by mine-based
doctors.
Miners were first compensated under ODMWA in 1903.
However, compensation awards under ODMWA were
racially differentiated until 1993.
Prior to 1982, miners (black and white) who
developed a certifiable disease in the first degree
(which meant between 10 and 40% disability) were not
allowed to return to work as their certificate of
fitness was removed. This regulation changed in 1982
so that miners still fit to work (despite having
early silicosis or cured TB) were allowed to
continue working. ODMWA makes provision for free
medical examination of ex-mineworkers at the MBOD in
Johannesburg on a biennial basis. ODMWA also
provides for post-mortem compensation.
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| What
is silicosis? |
Silicosis, an occupational lung disease
(OLD), is caused by the inhalation of free
silica dust which is present in mining areas
where quartz concentrations are high, as is
the case in many deep-level gold mines. The
silica dust is inhaled and causes a fibrotic
(or scarring) reaction in the lung. Often
there are no symptoms of the disease. In
severe cases, breathlessness and coughing
are principal complaints.
Silicosis should not be confused with
asbestosis, a link that has been drawn by
some parties with an interest pursuing legal
action in SA. While silicosis is a serious
issue and disease, uncomplicated silicosis
is usually benign. However, there are
further factors at work, particularly in the
South African context. Silicosis predisposes
individuals to the development of TB,
especially when an employee is also HIV
positive. Although research has shown that
silicosis may lead to lung cancer, it is not
associated with mesothelioma, which is the
deadly form of lung cancer associated with
asbestosis. |
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Managing silicosis today
In addition to the programmes in place at the
AngloGold operations today, every employee who works in a
silica-risk environment has initial, periodic (three
yearly) and exit medical examinations consisting of
chest x-rays and lung function testing. AngloGold?s
TB control programme also requires that all
employees exposed to silica dust have six-monthly
x-rays to detect TB early, usually before the
employee becomes ill and infective to other
colleagues.
Cases of early silicosis (that are not eligible for
compensation) are dealt with in terms of AngloGold?s
Medically Affected Employee?s Policy (MAEP) where
attempts are made to place the affected employee in
a low-silica environment.
When employees are eligible for compensation,
AngloGold makes prompt submissions to the MBOD and
assists in ensuring speedy payment. Employees with
first degree silicosis can continue working although
they would be placed in a low-risk environment.
Those with second degree silicosis would no longer
be allowed to work in high-risk environments (such
as underground, or in metallurgical plants).
Since 1999, AngloGold has made provision for
ex-mineworkers to make use of its occupational
health centres near Orkney and Carletonville for
their biennial examinations.
To deal with the cases of ex-employees who may be
suffering from silicosis and who may not have been
compensated, AngloGold (through the Chamber of
Mines) has offered to enter into a partnership with
the State to identify such people so they may be
treated and compensated. Specifically, AngloGold has
offered to make available both its occupational
health centres and rural health care facilities for
assessment of impairment.
In conclusion, the issue of silicosis remains a
challenging one for the industry, but one in which
AngloGold acknowledges its role and its
responsibility in working with the State and the
industry as a whole to ensure that appropriate
measures are in place to limit exposure now and in
the future, and to secure compensation for those who may have
been exposed in the past. |
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| 7.4 Fitness for work –
a scientific approach to matching employees to job
requirements |
Physical fitness is a
prerequisite for jobs in many industries, but in the
mining sector it is not only necessary in terms of
productivity, but also fundamental to the
maintenance of good safety and health. With this in
mind, AngloGold Health Service (AHS) Occupational
Health division has developed a functional work
capacity (FWC) test battery to assess employees?
physical abilities to undertake a variety of
job-related tasks. The FWC test forms part of a
suite of existing assessments (such as medical,
physical and heat tolerance screening) and is
directly linked to medical surveillance, a statutory
requirement.
The FWC test comprises 19 elements simulating
representative functional work abilities and
embraces aspects such as mobility, work position and
effort in both restricted and unrestricted work
environments, as well as dexterity in different work
positions. Overall work capacity is also assessed.
Employees need only be assessed in those test
elements crucial to their specific job requirements.
?The term overall fitness embraces both medical and
physical fitness,? says Tia-Mari Hofmann, who is
an occupational therapist at the AHS West Wits
Occupational Health Centre, ?but excludes mental
well-being and aptitude which is assessed through
psychometric testing where necessary.?
Medical fitness comprises satisfactory health as
determined by a general medical examination and the
absence of critical contra-indications or
impairments as determined by a risk-based medical
examination or medical surveillance. Physical
fitness is a combination of age considerations,
anthropometry and physique, and heat tolerance.
The 19 elements that make up the test simulate
functional work demand ? each element has a specific
physiological workload that has to be completed in a
reasonable time.
Says Tia-Mari Hofmann, ?To avoid premature fatigue
and the onset of heat disorders, self-pacing at a
moderate work intensity is probably the most
important counter. In the development of the FWC
test, the norm or standard required was set at the
individual?s ability to undertake full-shift work at
a rate which, at the very least, can be regarded as
moderate. Normal healthy individuals, without any
special endurance training, can generally achieve
such work rates through self-pacing.
The FWC evaluation can be applied at three levels
with each level having a specific purpose. |
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Level 1: Job allocation
and re-allocation. Assessments of FWC at
this level are intended to provide a rating
of full-shift work capacity of healthy, fit
individuals. The performance ratings are
expressed in terms of various categories
which, in turn, facilitate job allocation
and, if indicated, job re-allocation. All
jobs of a physical nature in AngloGold were
analysed according to functional
requirements and the main tasks associated
with each job were identified. There is an
important distinction to be made between
those tasks regarded as critical and those,
although part and parcel of the job,
regarded as being of secondary importance.
Collectively, this information constitutes a
particular job profile.
The FWC test battery can be tailored to the
job profile and any employee, prospective or
otherwise, rated in objective terms.
Assessments are therefore specific and
resource-effective.
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Level 2:
Screening and rehabilitation. FWC
assessments at this level serve two
purposes, namely the development of an FWC
profile for the purpose of an overall
assessment, and monitoring of
rehabilitation.
Regarding rehabilitation, only selected FWC
elements are used to monitor progress. A
final assessment at this level may include
all of the elements prior to proceeding to
Level 1 assessments. Level 2 assessments
represent a more advanced (strenuous) stage
in rehabilitation, the entry level being
Level 3.
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Level 3:
Rehabilitation. The emphasis here falls on
functionality and not on endurance. Specific elements will depend on the nature
of the injury or limitation. |
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| Gert Geyer (left), with his supervisor
Andre Olewagen from Mponeng
Mine |
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In 2002, Gert Geyer, then an electrician
at Mponeng mine, was injured in a motor
bike accident. He sustained a brachial
plexus injury, leaving him with no elbow
flexion and limited handgrip function of
the left hand. Mr Geyer was referred for
an FWC assessment to establish whether
he could resume his normal duties. A
judgement based purely on his physical
appearance indicated that this would not
be possible, but when he was evaluated
on work samples that represented his
physical job requirements, the
assessment indicated that ? although he
had suffered a serious impairment ? he
had adapted so well to his limitations
that he was able to perform work tasks
in a safe and productive way. As a
result Mr Geyer returned to his previous
occupation as an electrician on the
winders. His supervisor, Mr Andre
Olewagen, is very pleased with his work
performance and indicated that he is a
motivated worker and an inspiration to
everyone he works with. |
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?The most direct benefit of an
FWC assessment as far as the employee is concerned
is that his physical skills, ability and work
capacity are matched to a specific job or range of
tasks. Premature fatigue and injury, and the
short-term consequences of a mismatch between
ability and demand, are therefore prevented or
minimised.
?In the longer term, the benefit is sustained good
health. Even in the event of injury or failing
health, FWC assessments enable a realistic
re-allocation of jobs and retention of rewarding
careers.
?From an employer?s perspective, there are enormous
gains in productivity, safety and health, and the
retention of skills.? |
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Alfred Nikka during his vocational
rehabilitation at the Functional Work Capacity
Test centre.
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| Alfred Nikka, a sampler
underground at TauTona mine, recently sustained a
below-the-knee amputation owing to a medical
condition. Mr Nikka was initially tested on the FWC
test battery after the completion of his acute
rehabilitation phase to determine his current
abilities and limitations to perform manual work.
The FWC test battery?s dual function of vocational
rehabilitation was also used to rehabilitate Alfred. His rehabilitation was monitored by means of
weekly FWC evaluations. When Alfred?s functional
work abilities reached a satisfactory level, a final
work assessment was done on the FWC test battery.
The results clearly defined Alfred?s abilities and
limitations in performing manual work. This
information, gathered at the end of 2003, is
assisting Human Resources in their search for a job
where he can still continue working as a
productive and safe employee. |
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| Benjamen
Hlabahlaba |
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Benjamen Hlabahlaba was a stope team
worker who was injured in 1981 when a
mono-rope ? a device used to transport
underground wooden support packs to the
workplace ? amputated all the fingers of
his right and dominant hand. After
medical intervention and rehabilitation
he was given a clerical job on the mine,
but he wanted to return to
his original job. He was tested using
the critical elements of the FWC test on
load handling in restricted work areas
and proved that, with only a pinch grip
he could perform this essential task in
a safe and productive manner. His test
scores complied with the standard set by
healthy in-service employees and, as a
result, he resumed his
original work.
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| 7.5 The fight against TB
– Aurum leads the way |
A ground-breaking study is
to be undertaken in the South African gold mining
industry by Aurum Health Research, which is
wholly-owned by AngloGold. Aurum is a member of the
international Consortium to Respond Effectively to
the AIDS/TB Epidemic (CREATE), which in turn is
funded by the Bill and Melinda Gates Foundation. The
study, which has been submitted to the Bill and
Melinda Gates Foundation and the Safety In Mines
Research Advisory Council (SIMRAC) for funding, has
an estimated budget in excess of $10 million and
will be undertaken in collaboration with several
gold mining companies, including AngoGold, the
Departments of Health, Labour and Mineral and Energy
Affairs, various labour unions and associations, and
international scientists from the London School of
Hygiene and Tropical Medicine and Johns Hopkins
University.
Says Prof. Gavin Churchyard, head of Aurum Health
Research, ?CREATE was established in response to a
growing recognition among TB and HIV experts that
innovative and even radical approaches to TB control
will be necessary to reverse the alarming trends in
the incidence of these diseases that have been
exacting a devastating toll on societies in the
developing world.?
During the 1990s it became apparent that, despite
meeting World Health Organisation (WHO) targets for
tuberculosis (TB) detection and cure, the incidence
of TB among employees in the South African gold
mining industry had risen sharply. As a result, TB
is now the principal cause of death in the workforce
with a five-fold increase in the rates of TB
coinciding with the onset of the HIV epidemic in
South Africa.
A comprehensive TB-prevention programme, which
included all aspects of the WHO?s TB control
strategy as well as X-ray screening, was
unsuccessful in reducing the incidence of TB.
Consequently, an alternative approach is being
investigated and plans are presently underway to
determine the likely effects of a community-wide TB
preventative therapy on TB rates in the South
African gold mining industry.
The rationale supporting this approach is that all
individuals at risk of developing TB in the
population would be treated rather than only those
identified as being high-risk, such as those who
have the HIV infection or silicosis. Furthermore, if
successful, such a programme would reduce the
transmission of TB between people, which would lead
to fewer TB cases occurring later, thus resulting in
improved control of the disease.
The aim of the study is to investigate the effect of
preventive therapy on TB prevalence rates among
miners in the South African gold mining industry.
The specific objective is to compare the efficacy of
nine months of TB preventive therapy using the TB
drug Isoniazid offered on a community-wide basis,
with that of standard care as currently practised in
the gold mining industry.
According to Prof. Churchyard, ?the aim is to
identify and evaluate novel strategies to reduce the
incidence of TB in groups with high rates of HIV and
TB infections. It is imperative that novel and
effective public health strategies are developed.
This is particularly so for the gold mining industry
which has a high burden of TB.?
TB has a high social and economic cost, both for the
individual concerned and the industry as a whole. It
is both an occupational and a compensable disease.
Improved health on the part of employees of the gold
mining industry would lead to improved quality of
life, improved productivity and much reduced costs.
This study is scheduled to begin in the first
quarter of 2004. The findings of the CREATE research
portfolio will be used to develop new global
policies to combat TB/HIV, a key criterion of
projects which the Bill and Melinda Gates Foundation
supports. CREATE will make a major contribution to
identifying efficacious strategies to reduce
suffering and death from HIV-related TB worldwide. |
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