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Incidence of tuberculosis and HIV and progression of silicosis and lung function impairment among former Basotho gold miners.

Abstract：

BACKGROUND:Pulmonary tuberculosis and HIV incidence, mortality, and the progression of silicosis and lung function impairment are described over a 1-year period in migrant ex-gold miners from Lesotho. METHODS:Seven hundred seventy-nine Basotho miners were followed for 1 year starting 18 months after lay-off from a South African gold mine in 1998. At baseline and follow-up, they underwent a respiratory symptom interview, physical examination, HIV test, chest radiograph, and spirometry. RESULTS:Five hundred thirteen of 779 (65.9%) participants attended both baseline and follow-up visits. HIV incidence was 5.4/100 person-years (95% CI: 3.4-8.2). Prevalence of silicosis (ILO score > or =1/1) was 26.6% at baseline and 27.0% at follow-up. Active tuberculosis diagnosed at baseline was a strong predictor of radiological progression of silicosis. Lung function as measured by FEV(1) declined an average of 91 ml between visits (95% CI: 67-116 ml). Calculated minimum incidence of tuberculosis was 3,085/100,000/years (95% CI: 1,797-4,940) at follow-up. Of those seen at baseline, 18 died before their scheduled follow-up visit (mean age: 51 years). CONCLUSIONS:High rates of mortality and of HIV infection and pulmonary tuberculosis were found in this cohort after leaving the South African goldmines. Continuing lung function loss was also apparent. A partnership between the South African mining industry and governments in labor-sending areas of Southern Africa is needed to provide continuity of care and access to HIV and tuberculosis treatment and prevention services. Active silicosis surveillance and an improved statutory compensation system are also needed. These findings can serve as a baseline against which the impact of such interventions can be assessed.

journal_name

Am J Ind Med

journal_title

American journal of industrial medicine

authors

Park HH,Girdler-Brown BV,Churchyard GJ,White NW,Ehrlich RI

doi

10.1002/ajim.20767

subject

Has Abstract

pub_date

2009-12-01 00:00:00

pages

901-8

issue

eissn

0271-3586

issn

1097-0274

journal_volume

pub_type

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Incidence of tuberculosis and HIV and progression of silicosis and lung function impairment among former Basotho gold miners.