OPINION: Gains and gaps in SA mine health and safety – SABC News – Breaking news, special reports, world, business, sport coverage of all South African current events. Africa’s news leader.

Examining occupational health and safety trends in South African mining requires a critical, data-driven narrative that recounts key indicators and interrogates the forces shaping them. From 2016 to 2025, regulatory interventions, epidemiological shifts and persistent structural challenges interacted in complex ways. This analysis considers whether genuine improvement has occurred across mine health and safety.

Occupational exposures are dominated by three hazards: airborne pollutants, excessive noise and heat. These directly affect the prevalence of occupational lung diseases, noise-induced hearing loss and heat-related disorders. Reported occupational lung diseases have declined markedly over the past decade. Asbestosis cases fell from 635 in 2016 to 12 by 2021.

Similarly, pulmonary tuberculosis among mineworkers has declined, with reported cases dropping from 2,580 in 2017 to 839 in 2023. This is significant given the historical burden of tuberculosis in mining communities, often exacerbated by silica dust exposure and high rates of HIV co-infection.

These trends align with broader improvements. The Department of Mineral and Petroleum Resources reported a 17% decline in occupational disease cases, from 2 233 in 2023 to 1 864 in 2024; the Minerals Council reported a 72% fall in incidence since 2014. However, notifications remain lagging indicators affected by surveillance, diagnosis and disease latency.

Noise exposure remains a pervasive risk, with over 234 000 employees nationally exposed above the occupational exposure limit of 85 dB(A). The platinum group metals sector accounts for the largest share of these exposures. Despite this, the number of reported noise-induced hearing loss cases has not followed a consistent downward trend. While there was a notable spike in 2019 (966 cases), subsequent years saw fluctuations, with 702 cases reported in 2024.

This suggests that while engineering controls and hearing conservation programs may have mitigated some risk, gaps in implementation or reporting persist, particularly in high-risk commodities such as gold and platinum.

Noise exposure is a leading indicator of future disease. In 2024, tripartite stakeholders adopted 2034 milestones limiting equipment emissions to 104 dB(A) and preventing new noise-induced hearing loss cases among workers entering the industry from 2025. These targets confirm that prevention must prioritise engineering controls rather than protective equipment or post-exposure surveillance.

Thermal stress, particularly heat exposure, is another area of concern, especially in deep-level gold and platinum mines. The percentage of employees exposed to heat above the occupational exposure limit has varied across commodities and years, reflecting both climatic variability and the effectiveness of ventilation and cooling interventions.

Medical incapacity cases attributable to occupational diseases have generally declined, from 2,741 in 2017 to 440 in 2021, indicating some success in primary prevention and early intervention strategies. However, non-occupational disease-related incapacity remains substantial, underscoring the growing burden of non-communicable diseases and mental health disorders within the workforce.
The epidemiological profile of non-communicable diseases and mental health conditions in the South African mining industry has shifted dramatically between 2021 and 2025. Metabolic risk factors, including hypertension, obesity, and dyslipidaemia, have surged from 79,319 reported cases in 2021 to 188 222 in 2025. Diabetes mellitus cases have also increased, albeit at a slower rate, reaching 17,632 in 2025.

Mental health disorders, while still underreported, have shown a worrying rise, with cases more than doubling from 599 in 2021 to 1,289 in 2025. This trend reflects broader societal shifts but also points to the psychosocial stresses inherent in mining work, including shift patterns, job insecurity, and exposure to traumatic events.

Mortality data further illuminate the health landscape. In 2025, 816 natural deaths were reported across mining commodities, with gold, platinum, and coal sectors accounting for nearly three-quarters of these deaths. Notably, 20% of deaths were attributed to non-communicable diseases or chronic conditions, but a staggering 76.6% of deaths lacked sufficient detail for reliable classification. This data gap hampers targeted interventions and underscores the need for improved health surveillance and cause-of-death attribution.

Infectious disease control, particularly for HIV and tuberculosis, remains a cornerstone of occupational health in the South African mining industry. HIV counselling and testing rates have improved, with 85.9% of employees counselled and 67% tested in 2025. The HIV positivity rate has declined to its lowest point at 1.8%, with the platinum sector consistently outperforming others in HIV counselling and testing coverage.

Tuberculosis screening coverage reached 97.1% in 2025, and all diagnosed cases were initiated on treatment. Importantly, the incidence of multidrug-resistant tuberculosis has stabilized between 2% and 4%, while extensively drug-resistant tuberculosis has become virtually non-existent. The tuberculosis incidence rate in the South African mining industry fell to 178 per 100,000 in 2025, the lowest on record, although the gold sector continues to lag with a rate of 348 per 100,000.

Mining’s tuberculosis rate is below the national burden: World Health Organisation-derived World Bank data estimate 389 cases per 100,000 people in 2024, versus the industry’s 178 in 2025. Despite differing periods and surveillance systems, this indicates strong mining-specific gains, although gold’s rate of 348 shows that concentrated risk persists.

Despite these gains, several systemic challenges persist. Prevention gaps, particularly in risk assessment and exposure control, remain evident. Data quality and classification inconsistencies limit actionable intelligence, while fragmented health programs undermine end-to-end prevention. The rising tide of non-communicable diseases and mental health disorders presents a new frontier for occupational health, demanding integrated interventions that transcend traditional silos. Budgetary constraints, especially in smaller mines, further impede the scaling of effective tuberculosis and HIV programs.

Strategic interventions have been proposed to address these challenges. These include strengthening risk assessment and engineering controls, improving data integration and quality, closing the loop on corrective actions, and fostering collaboration across occupational hygiene, ventilation engineering, and occupational medicine. There is also a call to broaden workforce health prevention to encompass non-communicable diseases and mental health, alongside traditional occupational risks.

Ultimately, the imperative is clear: a healthy workforce is foundational to safety, productivity, and the long-term resilience of the mining industry.

Dr. Clarence Tshitereke, an honorary professor at Unisa’s Thabo Mbeki School of Public & International Affairs, is Chief of Staff at the Minerals & Petroleum Resources Ministry, writing in his capacity as part of the Government Communication & Information System.