Zambia Assessment of Tuberculosis (TB) and HIV in the Mines (ZATHIM): implications for programs and policies.

BACKGROUND: Mineworkers in Southern Africa have the highest rates of tuberculosis (TB) among working populations in the world (The World Bank, Benefits and costs associated with reducing tuberculosis among Southern Africa's mineworkers, 2014), making mineworkers a key population for TB program efforts. The current evaluation aimed to characterize mineworkers and former (ex-) mineworkers, and assess knowledge, attitudes and practices related to TB and HIV care among mineworkers and healthcare workers (HCWs) in Zambia. METHODS: A mixed-methods evaluation of current and former (ex-) mineworkers and HCWs was conducted in the Copperbelt and North-Western provinces, Zambia. Knowledge, attitudes and practices (KAPs) related to TB care and policies were assessed using a structured survey. Focus Group Discussions (FGDs) were conducted with current and ex-mineworkers to understand perceptions, practices, and barriers related to accessing healthcare for TB. RESULTS: Overall, 2,792 mineworkers and 94 HCWs completed the KAP survey, and 206 (171 current, 71 ex-) mineworkers participated in FGDs. Mineworkers and ex-mineworkers were knowledgeable about TB symptoms (cough; 94%), transmission (81.7%) and treatment (99.2%). Yet, barriers to seeking care were evident with 30% of mineworkers experiencing cough, and 19% reporting 2 or more TB symptoms at the time of the survey. The majority of mineworkers (70.9%) were aware of policies barring persons from working after a diagnosis of TB, and themes from FGDs and HCW comments (n = 32/62; 51.6%) recognized fear of job loss as a critical barrier to providing timely screening and appropriate care for TB among mineworkers. The majority (76.9%) of mineworkers indicated they would not disclose their TB status to their supervisor, but would be willing to share their diagnosis with their spouse (73.8%). CONCLUSION: Fear of job loss, driven by governmental policy and mistrust in mining companies, is a major barrier to healthcare access for TB among mineworkers in Zambia. As a result of these findings, the government policy prohibiting persons from working in the mines following TB disease is being repealed. However, major reforms are urgently needed to mitigate TB among mineworkers, including ensuring the rights of mineworkers and their communities to healthy living and working environments, improved social responsibility of mining companies, and facilitating choice and access to affordable, timely, and high-quality healthcare services.

Malaria prevention and care seeking among gold miners in Guyana.

Despite being a priority population in malaria elimination, there is scant literature on malaria-related behavior among gold miners. This study explores the prevalence and factors influencing malaria prevention, care seeking and treatment behaviors in Guyana gold mining camps. A cross sectional survey was conducted among adult gold miners living in mining camps in the hinterland Regions 1 (Barima-Waini), 7 (Cuyuni-Mazaruni), and 8 (Potaro-Siparuni). Multivariable logistic regressions explored factors associated with miners' self-report of mosquito net use, prompt care-seeking; self-medication; and testing for malaria. A third of miners used a mosquito net the night preceding the survey and net use was higher among those who believed that net use was the norm in their camp (aOR: 3.11; 95% CI:1.65, 5.88). Less than half (45%) of miners had a fever in the past 12 months, among whom 36% sought care promptly, 48% tested positive for malaria while 54% self-medicated before seeking care. Prompt care-seeking was higher among miners with high malaria knowledge (aOR: 1.44; 95% CI: 1.01, 2.05). Similarly, testing rates increased with secondary education (aOR: 1.71; 95% CI: (1.16, 2.51), high malaria knowledge (aOR: 1.45; 95% CI: 1.02, 2.05), positive beliefs regarding malaria transmission, threat, self-diagnosis, testing and treatment, and, trust in government services (aOR: 1.59; 95% CI (1.12, 2.27) and experience of a prior malaria episode (aOR: 2.62; 95% CI: 1.71, 4.00). Self-medication was lower among male miners (aOR: 0. 52; 95% CI: 0.32, 0.86). Malaria prevention and care seeking behaviors among miners are somewhat low and influenced by mosquito net usage, perceived norms, malaria knowledge and prior episode of confirmed malaria. Study findings have implications for malaria interventions in the hinterland regions of Guyana such as the mass and continuous distribution of insecticide treated nets as well as community case management initiatives using trained malaria testing and treatment volunteers to curb malaria transmission among remote gold mining populations. These include efforts to identify and address gaps in distributing mosquito nets to miners and address miners' barriers to prompt care seeking, malaria testing and treatment adherence. Targeted social and behavior change messaging is needed on net acquisition, use and care, prompt care-seeking, malaria testing and treatment adherence. Additional efforts to ensure the overall sustainability of the community case management initiative include increased publicity of the community case management initiative among miners, use of incentives to promote retention rates among the community case management volunteer testers and public private partnerships between the Guyana Ministry of Health and relevant mining organizations.

A Comprehensive Review of Work-Related Musculoskeletal Disorders in the Mining Sector and Scope for Ergonomics Design Interventions.

OCCUPATIONAL APPLICATIONS Work-related Musculoskeletal Disorders (WMSDs) are prevalent in many industries worldwide, including the large and labor-intensive mining sector. A systematic review was carried out to understand problems in the mining sector issues from three broad perspectives: 1) the prevalence of WMSDs among miners; 2) the association of occupational, psychosocial, environmental, and other risk factors with WMSDs causation; and 3) ergonomics interventions already proposed or implemented, and scope for design interventions. Our review revealed that automation, job aids, and displays are methods suitable for ergonomic design interventions. Ergonomic intervention strategies at various hierarchical levels, and the successive way forward as proposed in our review, could act as a catalyst in formulating problem-specific solution strategies by the participation of diverse stakeholders to implement a more human-centric workplace.

TECHNICAL ABSTRACT Background Work-related Musculoskeletal Disorders (WMSDs) are prevalent in the mining sector. While there are numerous factors responsible for the occurrence of WMSDs in this labor-intensive sector, research pertaining to ergonomic design interventions that address various causative factors has not been thoroughly addressed. Purpose We aimed to present an overview of WMSDs in the mining sector, along with plausible intervention strategies in diverse task contexts as suggested by earlier researchers. We also sought to identify the prominent research gaps and propose a way forward to formulate context-specific solutions by involving all stakeholders. Methods Relevant research publications were identified from electronic databases (Google Scholar and ScienceDirect) using appropriate search terms applicable to the mining sector and WMSDs. The literature search was restricted to journal papers, conference proceedings, books, reports, and relevant websites in the English language published between 1990 and 2020. Results Information extracted from the literature review was categorized under three broad topics: 1) the prevalence of WMSDs among miners; 2) associations of psychosocial, occupational, environmental, and other risk factors with WMSDs; and 3) ergonomics interventions in the mining sector. Following the systematic literature review, we outline ergonomics intervention strategies at various levels and provide future research directions to assist all stakeholders in implementing appropriate and context-specific ergonomics design interventions to provide a more human-centric workplace. Conclusions Based on our findings, it is evident that there is an urgent need for formulating and applying job-related ergonomics design intervention plans for occupational safety and well-being of miners in the mining sector.

Occupational noise induced hearing loss in the mining sector in South Africa: Perspectives from occupational health practitioners on how mineworkers are trained.

The aim of this study was to explore the perspectives of occupational health practitioners (OHPs) regarding education and training of mineworkers on occupational noise induced hearing loss (ONIHL) and its impact on mineworkers' health. Qualitative, in-depth telephonic and face-to-face interviews were conducted with 16 OHPs. Purposive and snowball sampling was utilized to recruit participants. Data were analysed using inductive thematic analysis. Three themes emerged from the data: seeing is believing, not my department, barriers and facilitators to raising awareness (with two subthemes -blame it on the language and level of education, and compensation pay-outs). Superficially, OHPs believe that mineworkers are aware of the impact of noise health, however, the OHPs are not knowledgeable on how the mineworkers are educated on ONIHL and its latent consequences. Furthermore, language, low levels of education and literacy, as well as financial constraints are factors found to affect education and training of the mineworkers about the risks of ONIHL. If the mining industry is committed in eliminating ONIHL, they should prioritize health literacy, and mines need to have an effective awareness raising plan in place at every mine. This plan should consider diversity of the workforce, including linguistic as well as educational level diversity.

Occupational injury burden among gold miners in Ghana.

The mining environment is particularly dangerous in low- and middle-income countries. We sought to better understand the burden, characteristics and risk factors associated with gold mining, through a household survey of 1,029 miners in four districts, in Ghana. We found a high burden of injuries, with 25.5% of workers injured in the past year, giving an incidence of 19.67 injuries per 200,000 hours worked. Notably, an increase in injury risk was associated with work in the informal mining sector (galamsey), with an adjusted injury incidence ratio of 1.57 (95%CI: 1.12, 2.19) compared with miners in the formal sector. Half of gold miners in Ghana work in galamasey, and this sector is a high priority for safety promotion. Improving the safety of the equipment, which accounted for nearly half (46.2%) of galamsey-related injuries, could be a prime target for improving safety.

Those Who Don't Return: Improving Efforts to Address Tuberculosis Among Former Miners in Southern Africa.

Despite increasing awareness regarding the role of oscillating migration in the mining industry as a major driving force in the spread of tuberculosis (TB) throughout southern Africa, very little work has focused on the historical and contextual factors which may contribute to former migrant miners' present-day risk of TB. Most research regarding migration-related and occupational influences on TB has been done on current miners still employed by the mining industry. Through both a historical and contemporary lens, this paper explores and elucidates the need to address the TB epidemic among former migrant mine workers and provides considerations to improve current interventions among this critical population.

Effects of human and organizational deficiencies on workers' safety behavior at a mining site in Iran.

OBJECTIVES: Throughout the world, mines are dangerous workplaces with high accident rates. According to the Statistical Center of Iran, the number of occupational accidents in Iranian mines has increased in recent years. This study investigated and analyzed the human and organizational deficiencies that influenced Iranian mining accidents. METHODS: In this study, the data associated with 305 mining accidents were analyzed using a systems analysis approach to identify critical deficiencies in organizational influences, unsafe supervision, preconditions for unsafe acts, and workers' unsafe acts. Partial least square structural equation modeling (PLS-SEM) was utilized to model the interactions among these deficiencies. RESULTS: Organizational deficiencies had a direct positive effect on workers' violations (path coefficient, 0.16) and workers' errors (path coefficient, 0.23). The effect of unsafe supervision on workers' violations and workers' errors was also significant, with path coefficients of 0.14 and 0.20, respectively. Likewise, preconditions for unsafe acts had a significant effect on both workers' violations (path coefficient, 0.16) and workers' errors (path coefficient, 0.21). Moreover, organizational deficiencies had an indirect positive effect on workers' unsafe acts, mediated by unsafe supervision and preconditions for unsafe acts. Among the variables examined in the current study, organizational influences had the strongest impact on workers' unsafe acts. CONCLUSIONS: Organizational deficiencies were found to be the main cause of accidents in the mining sector, as they affected all other aspects of system safety. In order to prevent occupational accidents, organizational deficiencies should be modified first.

Ending on a positive: Examining the role of safety leadership decisions, behaviours and actions in a safety critical situation.

Safety leadership is an important factor in supporting safe performance in the workplace. The present case study examined the role of safety leadership during the Bingham Canyon Mine high-wall failure, a significant mining incident in which no fatalities or injuries were incurred. The Critical Decision Method (CDM) was used in conjunction with a self-reporting approach to examine safety leadership in terms of decisions, behaviours and actions that contributed to the incidents' safe outcome. Mapping the analysis onto Rasmussen's Risk Management Framework (Rasmussen, 1997), the findings demonstrate clear links between safety leadership decisions, and emergent behaviours and actions across the work system. Communication and engagement based decisions featured most prominently, and were linked to different leadership practices across the work system. Further, a core sub-set of CDM decision elements were linked to the open flow and exchange of information across the work system, which was critical to supporting the safe outcome. The findings provide practical implications for the development of safety leadership capability to support safety within the mining industry.

Emerging Environmental Justice Issues in Nuclear Power and Radioactive Contamination.

Nuclear hazards, linked to both U.S. weapons programs and civilian nuclear power, pose substantial environment justice issues. Nuclear power plant (NPP) reactors produce low-level ionizing radiation, high level nuclear waste, and are subject to catastrophic contamination events. Justice concerns include plant locations and the large potentially exposed populations, as well as issues in siting, nuclear safety, and barriers to public participation. Other justice issues relate to extensive contamination in the U.S. nuclear weapons complex, and the mining and processing industries that have supported it. To approach the topic, first we discuss distributional justice issues of NPP sites in the U.S. and related procedural injustices in siting, operation, and emergency preparedness. Then we discuss justice concerns involving the U.S. nuclear weapons complex and the ways that uranium mining, processing, and weapons development have affected those living downwind, including a substantial American Indian population. Next we examine the problem of high-level nuclear waste and the risk implications of the lack of secure long-term storage. The handling and deposition of toxic nuclear wastes pose new transgenerational justice issues of unprecedented duration, in comparison to any other industry. Finally, we discuss the persistent risks of nuclear technologies and renewable energy alternatives.

New approach for reduction of diesel consumption by comparing different mining haulage configurations.

The mining operations of loading and haulage have an energy source that is highly dependent on fossil fuels. In mining companies that select trucks for haulage, this input is the main component of mining costs. How can the impact of the operational aspects on the diesel consumption of haulage operations in surface mines be assessed? There are many studies relating the consumption of fuel trucks to several variables, but a methodology that prioritizes higher-impact variables under each specific condition is not available. Generic models may not apply to all operational settings presented in the mining industry. This study aims to create a method of analysis, identification, and prioritization of variables related to fuel consumption of haul trucks in open pit mines. For this purpose, statistical analysis techniques and mathematical modelling tools using multiple linear regressions will be applied. The model is shown to be suitable because the results generate a good description of the fuel consumption behaviour. In the practical application of the method, the reduction of diesel consumption reached 10%. The implementation requires no large-scale investments or very long deadlines and can be applied to mining haulage operations in other settings.

A comparative life cycle assessment of material handling systems for sustainable mining.

In this comprehensive LCA comparison study, main objectives are to investigate life cycle environmental impacts of off-highway mining trucks and belt conveyors in surface mining. The research methodology essentially entails determination of the functional unit as 20,000 tons/day coal production transported for 5 km distance. After the system boundary was selected as the entire life cycle of material handling systems including pre-manufacturing of steel parts and plastic components, manufacturing, transportation, and utilization data was compiled from equipment manufacturers and the Eco-invent database. Life cycle impact categories for both material-handling systems were identified and the developed model was implemented using SIMAPRO 7.3. Climate change and acidification were selected as major impact categories as they were considered to be major concerns in mining industry. Although manufacturing stage had a significant impact on all of the environmental parameters, utilization stage was the hotspot for the selected impact categories. The results of this study revealed that belt conveyors have a greater environmental burden in climate change impact category when compared to the trucks. On the other hand, trucks have a greater environmental burden in acidification impact category when compared to the belt conveyors. This study implied that technological improvement in fuel combustion and electricity generation is crucial for the improvement of environmental profiles of off-highway trucks and belt conveyors in the mining industry. The main novelty of this study is that it is the first initiative in applying LCA in the Turkish mining industry.

Platinum and Gold Mining in South Africa: The Context of the Marikana Massacre.

Mining is a source of extraordinary wealth, but its benefits often do not accrue to the workers and communities most involved. This paper presents two case studies of mining in South Africa to reflect on the history and legacy of mining both through observation and through the voices of affected communities. Interviews and observations on field visits to the platinum and gold mining areas of South Africa in the immediate aftermath of the Marikana massacre highlight this legacy--including vast quantities of tailings dumps and waste rock, lakes of polluted water and a devastated physical and social environment, high unemployment, high rates of occupational injury and disease including silicosis with co-morbidities, absent social security, and disrupted rural and agricultural communities. Exploitative conditions of work and the externalization of the health and environmental costs of mining will require international solidarity, robust independent trade unions, and a commitment to human rights.

[Occupational health risks in transport workers of mi ning chemical enterprise in Kolsk Transpolar area].

The study covered features of work conditions, occupational risks and health state in 574 workers of automobile and railway transport, engaged into transportation of lobe rock in Kolsk Transpolar area. Findings are higher risk of occupationally conditioned (onychomycosis, obesit arterial hypertension and peptic ulcer of duodenum/stomach) and occupational diseases (neurosensory deafness, radiculopathy, vibration disease) in rock handler drivers. Conclusion was made on necessity to improve prophylaxis and treatment of health disorders in these workers.

Reforming Miners' Lung Disease Compensation in South Africa--Long Overdue but What Are the Options?

A number of countries have workers' compensation systems which reserve specific arrangements for workers in certain sectors, notably mining. This article describes the current impetus to reform of the century-old South African mining compensation system. It is intended as a case study of the implications of harmonization of two disparate compensation systems for occupational lung disease, specifically in relation to equity in financial benefits, equity in coverage, linkage of compensation to disease prevention, and efficient administration. After decades of neglect, it is clear that while inferior financial benefits for miners are no longer tenable, the costs of equalization are not supportable by the current actuarial status of the miners' Compensation Fund. There is also an argument for two miner-specific entitlements to be retained--free medical examinations for ex-miners and autopsy-based posthumous compensation. A new dispensation to support the casualties of a declining industry will require sustained political will.

Sleights of Hand: South Africa's Gold Mines and Occupational Disease.

South Africa's gold mines were the first to compensate silicosis and tuberculosis as occupational diseases. They were also the first mines to introduce a state-sanctioned regime of medical surveillance. Despite those innovations, the major mining houses are currently facing class actions by former miners with occupational lung disease. The obvious reason for this medical and legislative failure is to be found in the economic fabric of South Africa's gold industry. In this article, I will argue that it is also found in the system of mine medicine, which was designed to hide rather than reveal the actual disease rates.

A Social Movements' Perspective on Human Rights Impact of Mining Liberalization in the Philippines.

When it comes to minerals like gold, copper, or nickel, the Philippines ranks among the world's richest countries, but it has continued to perform poorly in terms of human and economic development. In the belief that foreign investments will bring development, the government in 1995 liberalized its mining industry allowing full foreign ownership and control of the mining activities. After almost two decades of mining liberalization, the country has never achieved its goal of development but is now reeling from the adverse impacts of large-scale corporate mining on the environment and lives of mining-affected communities. Moreover, human rights violations against anti-mining activists and environmental advocates have escalated at an alarming rate making the country one of the most dangerous places for land and environmental defenders. But social movements are now taking big steps to empower the people, especially the mining-affected communities, to confront the adverse impacts of corporate mining and to reverse the current path of the mining industry to one that aims to achieve national industrialization where national development is prioritized over transnational corporations' interests.

The Marikana Massacre: Why Heads Must Roll.

The massacre of thirty-four striking platinum miners on the 16 August 2012 near the village of Marikana in South Africa revealed the collusion of the state, mining capital, and sections of the labor movement. Analysis of the buildup to the killings highlight the way the mining industry systematically ignored evidence of the potential for social conflict as a result of its labor policies over many years. Further, the way in which the killings unfolded and were covered up are evidence that justice was denied to workers and their families. It should provide a sobering reminder of the power of elite alliances and the elite capture of seemingly democratic institutions within the labor movement, even in a post-apartheid South Africa.

The Perceived Consequences of Gold Mining in Postwar El Salvador: A Qualitative Study.

OBJECTIVES: We investigated themes related to the health and environmental impacts of gold mining in El Salvador. METHODS: Over a 1-month period in 2013, we conducted focus groups (n = 32 participants in total) and individual semistructured interviews (n = 11) with community leaders until we achieved thematic saturation. Data collection took place in 4 departments throughout the country. We used a combination of criterion-purposive and snowballing sampling techniques to identify participants. RESULTS: Multiple themes emerged: (1) the fallacy of economic development; (2) critique of mining activities; (3) the creation of mining-related violence, with parallels to El Salvador's civil war; and (4) solutions and alternatives to mining activity. Solutions involved the creation of cooperative microenterprises for sustainable economic growth, political empowerment within communities, and development of local participatory democracies. CONCLUSIONS: Gold mining in El Salvador is perceived as a significant environmental and public health threat. Local solutions may be applicable broadly.