CHAMBER OF MINES OF SOUTH AFRICA Presentation to the Parliamentary Portfolio Committee on Health 5 September 2012 Dr Thuthula Balfour-Kaipa Head: Health Department Chamber of Mines of South Africa CHAMBER OF MINES OF SOUTH AFRICA Putting South Africa First

Outline Background to mining industry Magnitude of occupational diseases Approach by industry Tuberculosis Approach to TB Challenges Compensation Ex-Mineworker Project Conclusion

Background information on mining industry Variable Total mining industry (2009) Chamber of Mines (2009) Number of Mines >1000 248 Employees Platinum 183 914 (2008)149 869 Gold 160 102 143 268 Coal 70 703 57 343 Others 77 203 (2008) 27 580 Total 419 922 (2008) 389 068 Chamber members represent: < 20% of mines - 85% of employees - 80% of production - 80% of gold employees in three companies The Chamber of Mines is a legitimate representative of employers as members account for 85% of employees in the whole industry. The three gold companies, Harmony Gold, Goldfields and AngloGoldAshanti account for 80% of employees in the gold sector. This means that actions by these three companies can have a major impact on silicosis and TB control.

Occupational diseases in mining industry

Trends for NIHL Marked reductions over time but evidence of plateauing

Trends for silicosis No signs of a decline

Trends for TB Stabilising and indications of decline

Approach Prevention of exposures Tripartite Milestones Research Employers MOSH Learning Hub Company Dust/noise suppression Prevention of exposures

Tripartite Mine Health and Safety Council Established under MHSA to promote health and safety. Funded through levies from mining companies. Tripartite representation. Products include guidelines and audit tools. Regulation and monitoring by Department of Mineral Resources Duty of employers under MHSA to review hazards, risks, do occupational hygiene measurements and establish medical surveillance. Annual and monthly reporting of occupational diseases, inspection of occupational health service. Censoring where required.

Industry Milestones 2008- Industry milestones for 2013 Noise Dust After 2008 - no deterioration in hearing greater than 10% amongst occupationally exposed individuals 2013 - total noise emitted by all equipment installed in any workplace must not exceed a sound pressure level of 110dB(A) Dust 2008 - 95% of all exposure measurement results below OEL for respirable crystalline silica of 0.1mg/m3 2013 - no new cases of silicosis will occur amongst previously unexposed individuals

2011 - Summit Commitments 2011 Industry Summit on Health and Safety recognised progress made and need for accelerate meeting of milestones. New commitments: Re-examine the return to risk-work of miners with HIV/AIDS, TB and Silicosis. Investigate the policy and regulatory framework to reduce the silica OEL in line with international benchmarks. Develop a standard operating procedure for independent verification of dust measurements reported by mines.

MOSH Learning Hub Chamber initiative, established in 2008. Principle is to promote the adoption of leading practices throughout industry. Dust and noise teams to address silica dust and noise. Identify leading practices from companies and disseminate to others.

Tuberculosis TB recognised as health hazard in SA mining in 1890 TB Commission established in 1912 TB classified as compensable disease in SA in 1916

Risks for tuberculosis

HIV a key driver of TB epidemic in SA and mining industry DOH TB Strategic Plan, 2007

Response: Tripartite initiatives

New Tripartite Summit Commitments Referral system to ensure access to continued treatment beyond employment. Establishment of a national repository on employee health information. Ensure that renewals and new mining licenses have strategic and operational plans for TB, HIV and AIDS. Promote access for families and immediate communities.

Response: Chamber initiatives TB Task Team TB Reviews TB Interest Group

TB Reviews Internal reviews by Chamber members: 2010 and 2011 External reviews in three biggest gold companies :2011 Report on gold companies submitted to Ministers of Health and DMR. External reviews of platinum companies in 2012.

Results of TB Reviews in gold sector Areas of strength Areas of improvement DOTS programmes TB culture Hospitalisation Laboratory services Pharmacy services Pharmaceutical services Keeping of TB registers Patient referral systems Policies on contractors Case finding

Challenges for TB

Compensation Two compensation systems COIDA (Dept of Labour) ODMWA (Dept of Health) All occupational diseases except cardiopulmonary organs of mineworkers Administered by Rand Mutual Assurance (RMA) in mining. Occupational lung diseases in mineworkers (and works) Two compensation systems

Constitutional Court ruling on ODMWA Mankayi versus AngloGold Ashanti case: The issue before court: Whether section 35(a) of COIDA extinguishes the common law right of mineworkers to claim for occupational injuries or diseases from negligent owners The judgment “employee” in section 35(1) of COIDA only applies to those under COIDA, not employees under ODMWA. Constitutional matter of right to freedom and security under section 12 (1)(c). Extinguishing common law right impinges on this right. This is particularly so if one cannot claim against COIDA but can only get paltry compensation under ODMWA.

Differences between COIDA and ODMWA

Differences between COIDA and ODMWA

Differences between COIDA and ODMWA

Challenges with ODMWA Short-term Medium-term Administrative inefficiencies leading to non payment for compensatable diseases (delays and non-nationals), no adjustment to benefits. No indemnity for employers. Medium-term Status of Fund - Liabilities that are accumulating due to: Non –payment of compensation due to miners Unclear quantum of deficit as per valuations. Inadequate benefits, as per Mankayi judgment.

Ex-Mineworker Project Tripartite initiative between DOH, NUM and Chamber to improve access for mineworkers to compensation. R42 million funding over 6 years from 2007 Three components Benefit examination sites Support to CCOD and MBOD Socio-economic development Benefit examination sites set up or strengthened in Nongoma, Mthatha, (Butterworth), North West and Free State.

Progress with project Very slow, dependant on provincial departments of health. Major blockage in payouts at CCOD.

Way forward with compensation Situation is untenable. Review of the compensation systems required. Aim should be better benefits and restoration of “no fault”, functioning compensation system.

Conclusion Occupational diseases in mining are mainly silicosis, NIHL and occupational TB. Progress is being made in the control of these diseases, but concerns persist around silicosis. The compensation for occupational lung diseases is inadequate and administrative inefficiencies cause great hardship for mineworkers. All stakeholders need to work together in preventing occupational diseases and improving the health of mineworkers.