Presentation to the Portfolio Committee on Health 22 August 2012 Occupational Health and
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Presentation to the Portfolio Committee on Health 22 August 2012 Occupational Health and Workers’ Compensation
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Presentation to the Portfolio Committee on Health 22 August 2012 Occupational Health and Workers’ Compensation. Overview. Background Occupational health issues Compensation system Activities of Department of Health Way forward. Global Worker Health. - PowerPoint PPT Presentation
Transcript of Presentation to the Portfolio Committee on Health 22 August 2012 Occupational Health and
Presentation to the Portfolio Committee on Health
22 August 2012
Occupational Health and Workers’ Compensation
OverviewOverview
• Background
• Occupational health issues
• Compensation system
• Activities of Department of Health
• Way forward
• Background
• Occupational health issues
• Compensation system
• Activities of Department of Health
• Way forward
Global Worker HealthGlobal Worker Health
• 7 billion people with 3 billion workers
• 2m die every year from occ injuries & diseases
• 160 m new cases of occ diseases• 250 m occ accidents & 300 000
fatalities• 4% of world GDP
• 7 billion people with 3 billion workers
• 2m die every year from occ injuries & diseases
• 160 m new cases of occ diseases• 250 m occ accidents & 300 000
fatalities• 4% of world GDP
Occupational Health in South AfricaOccupational Health in South Africa
• fragmentation of policy and legislative framework (Health, Labour,
Mineral Resources)
• inadequate occupational health system
• no surveillance of injuries and diseases
• deficient occupational health services
• lack of human resources for occupational health
• problems of access, coverage and equity in compensation systems
• concerns about mining sector, migrant workers (internal and cross
border)
• fragmentation of policy and legislative framework (Health, Labour,
Mineral Resources)
• inadequate occupational health system
• no surveillance of injuries and diseases
• deficient occupational health services
• lack of human resources for occupational health
• problems of access, coverage and equity in compensation systems
• concerns about mining sector, migrant workers (internal and cross
border)
Workers’ Compensation in South Africa
Demography of Workers in South Africa
Demography of Workers in South Africa
• 17m work (13m formal & 4m informal)
• 17m work (13m formal & 4m informal)
Labour Force Survey. Statistics South Africa, 2008
Workers per Employment Sector (‘000)
Labour Force Survey. Statistics South Africa, 2008
Gender Distribution of Workers
The Second EconomyThe Second Economy
Migrant Mine Workers in South AfricaMigrant Mine Workers in South AfricaYear RSA Mozambique Lesotho Swaziland % Non-
RSA
1920 74 452 77 921 10 439 3 449 57
1940 178 708 74 883 52 044 7 152 49
1960 141 406 101 733 48 824 6 623 62
1980 233 055 39 636 96 308 5 050 44
1995 122 562 55 140 87 935 15 304 58
2000 99 575 57 034 58 224 9 360 57
2010* 152 486 35 782 35 179 5 009 34
* Data from TEBA
Occupational Ill-healthOccupational Ill-health• hard to find data; if found, difficult to interpret• 3822 persons with occ diseases reported to DoL in 2005 (45 per 100 000 workers)• 3 die every day from accidents• Mine Health & Safety (2005)
• 196 411 miners exposed to airborne pollutants (44.5%)• R50m paid to 1392 miners (occ lung disease)
• 480 000 undiagnosed / uncompensated persons*
• hard to find data; if found, difficult to interpret• 3822 persons with occ diseases reported to DoL in 2005 (45 per 100 000 workers)• 3 die every day from accidents• Mine Health & Safety (2005)
• 196 411 miners exposed to airborne pollutants (44.5%)• R50m paid to 1392 miners (occ lung disease)
• 480 000 undiagnosed / uncompensated persons*
Naidoo R. WAHSA Project Report 2.1.10. 2007, * Nogueira C, et al. WAHSA Project 7
Disease Rates per 1000 autopsies
Pathaut: 1998, 2008
Reference: PATHAUT Database, NIOHPathaut, NIOH. 2010
Nelson et al. Three decades of silicosis: disease trends at autopsy in South African gold miners. Environ Health Perspect. 2010
Gold Price (2000 – current)
Wilson K. NIOH. 2011
FatalitiesTarget: 20% reduction in the incidence of compensated work-relatedfatalities by 30 June 2012 with an interim target of 10% by 2006–07.Result: The interim target was achieved in 2006–07 and a 17%decrease has been recorded up to 2007–08. Figure 2 shows that aslong as this improvement is maintained the 2012 target is achievable.
Aspirational targetTarget: Australia to have the lowest work-related traumatic injury fatalityrate in the world by 2009.Result: While Australia has one of the fastest falling fatality rates amongthe best performing countries world wide, it has remained in 7th place.
Safe Work, Australia.
2010
HIV Prevalence (Review)Year of Study Author Study
Population HIV
Prevalence
2000 Rees et al. Gold miners 27%
2003 Lurie Gold miners (migrants) 25.9%
2006 Stevens et al. Platinum miners 24.6%
2008 Anglo Coal Coal Miners 15%
2009 Anglo Gold Ashanti Gold Miners 30%
2009 Impala Platinum (Implants) Platinum Miners 23%
TB Incidence (Review)
Year of Study Author Study
Population TB Incidence (per 100 000)
2007South African Department of Health Tuberculosis Strategic Plan for South Africa 2007 – 2011
Gold Mining Industry
3 000 to 7 000
2008 Brendan V Girdler-Brown, Neil W White, Rodney I Ehrlich, Gavin JChurchyard
779 former gold miners in Free State
2 198
2009 AngloGold Ashanti Gold miners 2 900
2009 Anglo Platinum Platinum Miners 1 200
Commodity ClinicsTotal
employedNew TB (2009)
Incidence rate per 100 000
Coal 9 8 994 38 423
Diamond 4 4 365 11 252
Gold 5 82 157 1 288 1 568
Platinum 4 30 212 134 444
Other 20 13 990 37 264
Total 38 139 718 1 508 1 079
Incidence Rates of TB by Commodity
Global and SA TB incidence 139 and 948 per 100 000 population respectively
Occupational Exposure Limits for Silica (2008)
Country / Province# OEL (mg / m3)
Argentina 0.05#British Columbia 0.025
Chile 0.04
Ireland 0.05
Italy 0.05
Japan 0.03
Portugal 0.05
USA - ACGIH* 0.025
USA - NIOSH* 0.05
*Advisory organisationSource: Maciejeska A. 2008. Int J of Occ Med & Env Health 21 (1): 1-23
Mining Sector in South Africa • 18 Trillion Rand sector (net asset value)
• Employs 500 000 persons
• 2 200 entities
• 7.7% of annual GDP DMR 2010
DMR Database of Mines & Quarries (2010)
Province Coal Diamond Gold Platinum Other Total
Eastern Cape 0 0 0 0 140 140
Free State 2 2 6 0 40 61
Gauteng 6 3 25 2 129 167
Kwazulu-Natal 12 0 1 0 120 133
Limpopo 3 0 1 12 134 156
Mpumalanga 85 0 14 0 89 194
North West 0 199 6 25 97 327
Northern Cape 0 152 0 0 76 228
Western Cape 0 20 0 0 177 197
Total 108 395* 53 45 1 002 1 603
* Diamond mines were mostly mineral rights rather than active mines
In summary…
• Problem – lack of proper system, fragmentation, measurement ?
• Paradox – collecting lots of data, little or no analysis, some reports
• Pressure – multiple fronts• Potential for change• Promise ….
COM. 2011
Approach of Department of
Health to Development of
the Occupational Health
System
Workers Compensation (CCOD)
Workers Compensation (CCOD)
• Phase 1– Review and restructure CCOD, MBOD and NIOH
(unified management structure)– Review of Strategic Plan– Policy & legislative reforms to ODMWA– Enhance corporate governance and management– Develop surveillance system– Conduct research– Effective and efficient compensation system for
miners / ex-miners
• Phase 1– Review and restructure CCOD, MBOD and NIOH
(unified management structure)– Review of Strategic Plan– Policy & legislative reforms to ODMWA– Enhance corporate governance and management– Develop surveillance system– Conduct research– Effective and efficient compensation system for
miners / ex-miners
Workers Compensation (CCOD)
Workers Compensation (CCOD)
• Effective and efficient compensation system for miners / ex-miners• Clear backlogs• Improve Turn-Around-Times (claims
certification, processing & payments)• Ensure financial sustainability of the Fund• Decentralised benefit examinations (labour
sending areas inside and outside South Africa)
• Effective and efficient compensation system for miners / ex-miners• Clear backlogs• Improve Turn-Around-Times (claims
certification, processing & payments)• Ensure financial sustainability of the Fund• Decentralised benefit examinations (labour
sending areas inside and outside South Africa)
Major Urgent InterventionsMajor Urgent Interventions
• Preparation of 2010/11 and 2011/12 annual reports
• Development of 2012/13 APP
• Response to Auditor-General’s report
• Establish medical inspectorate
• Strengthen links to Dept of Mineral Resources (Risk Committee)
• Enhance Governance and Management
• Preparation of 2010/11 and 2011/12 annual reports
• Development of 2012/13 APP
• Response to Auditor-General’s report
• Establish medical inspectorate
• Strengthen links to Dept of Mineral Resources (Risk Committee)
• Enhance Governance and Management
The Compensation Fund (2012/13)
The Compensation Fund (2012/13)
• One national office (Johannesburg)• One national office (Johannesburg)
2011/12 2012/13
Fund Asset R1.77b R1.75b
Fund Liability R1.8b
Revenue R317m R313m
Expenditure R202m R309m
Surplus R115m R4m
Fund ReviewFund Review
• 188 monthly pensions
• 14094 claims paid since 2003; 41
claims last year (Eastern Cape project)
• 188 monthly pensions
• 14094 claims paid since 2003; 41
claims last year (Eastern Cape project)
CCOD Preliminary Analysis (2010/11)
CCOD Preliminary Analysis (2010/11)
CCOD Preliminary Analysis (2010/11)
CCOD Preliminary Analysis (2010/11)
CCOD Preliminary Analysis (2010/11)
CCOD Preliminary Analysis (2010/11)
Gender & Race of Claimants (2010/11)
Gender & Race of Claimants (2010/11)
Number of
Claims
Male African Coloured White
OSB1 269 97% 96% 3% 1%
OSB2 200 100% 91% 2% 7%
TB75% 253 99% 98% 1% 1%
TB1 40 100% 100% 0 0
TB2 54 100% 91% 4% 5%
Development of Occupational Health System
Development of Occupational Health System
• Links to Primary Health Care– 1 nurse at each facility trained to recognise work
related injuries & diseases– 1 doctor and 1 nurse at district hospital trained to
manage work related injuries & diseases– Links to social services– Links to SA State Social Security Agency
(payment of claims)– Links to private providers
• Links to Primary Health Care– 1 nurse at each facility trained to recognise work
related injuries & diseases– 1 doctor and 1 nurse at district hospital trained to
manage work related injuries & diseases– Links to social services– Links to SA State Social Security Agency
(payment of claims)– Links to private providers
Development of Occupational Health System
Development of Occupational Health System
• Occupational health unit at specialist hospital to manage workers with ill-health
• Occupational health academic units• Links to NHI
– Ensure collection systems in pilot districts get revenue from compensation system for work related diseases and injuries
• Development of surveillance system for occupational health
• Occupational health unit at specialist hospital to manage workers with ill-health
• Occupational health academic units• Links to NHI
– Ensure collection systems in pilot districts get revenue from compensation system for work related diseases and injuries
• Development of surveillance system for occupational health
Occupational Health SystemOccupational Health System
• Phase 2– Innovative models for occupational health services– Support the development of an integrated social
security system for workers– Development of infrastructure and human resources
for occupational health– Ensure appropriate funding for the occupational health
system (prevention, treatment & care, rehabilitation & compensation)
– Work with the Departments of Mineral Resources, Labour and Public Service & Administration in achieving a better health system for worker's health
• Phase 2– Innovative models for occupational health services– Support the development of an integrated social
security system for workers– Development of infrastructure and human resources
for occupational health– Ensure appropriate funding for the occupational health
system (prevention, treatment & care, rehabilitation & compensation)
– Work with the Departments of Mineral Resources, Labour and Public Service & Administration in achieving a better health system for worker's health
Policy, Planning, Co-ordinating & Funding Inputs
Policy, Planning, Co-ordinating & Funding Inputs
• Briefing to Minister of Health
• Briefing to Portfolio Committee
• Briefing to Ministers of Labour, Mineral
Resources & Finance
• Briefing to National Health Council
• Information to trade unions & employer bodies
• Briefing to Minister of Health
• Briefing to Portfolio Committee
• Briefing to Ministers of Labour, Mineral
Resources & Finance
• Briefing to National Health Council
• Information to trade unions & employer bodies
In History…Barrier Miner (Broken Hill, NSW : 1888 - 1954), Monday 13 November 1922, page 1National Library of Australia http://nla.gov.au/nla.news-article45589068MINERS' PHTHISIS IN AFRICATile South African Union legislature's select committee on public accountsreports that the compensation fundout of which compensation has to bepaid to miners' phthisis victims onthe Rand has still to face a liabilityestimated at £l4,000,000. As the exhaustedmines close down it falls withcumulative effect on the survivingmines. The committee considers thatno time should be lost in laying downmeasures to ensure the adequacy of thefund.
Miners’ Phthisis Act 19 of
1912
1556
1633-1714
1500 BCr
• Hippocrates – Lead (4th BC)
• Pliny – Zinc & Sulphur (1st AD) –
animal bladder• Galen – Lead & Copper (2nd AD)
1907
1910
1913
1902 - 3Milner
Commission
1930Int.
Silicosis Conf
AJ Orenstein’s pioneering work on dust (NIOH)
1959
COM Dust Committee
1914
1994Leon
Mr Thembekile Mankayi vs
AngloGold Ashanti
2011
Erasmus
1975
2012 COM vs CCOD
& Health
“Prav
in targe
ts bonuse
s”
“Mine boss who smeared coal on face
arrested” pg 16
Tuesday, Nov 15, 2011
34 miners died & 9 trapped – Sizhuang Coal Mine in Yunnan
province
LONMIN ... 16 August 2012
"Two hundred thousand subterranean heroes who, by day
and by night, for a mere pittance, lay down their lives to
the familiar 'fall of rock' and who, at deep levels, ranging
from 1,000 to 3,000 feet in the bowels of the earth,
sacrifice their lungs to the rock dust which develops
miners' phthisis and pneumonia."
Sol Plaatje, first Secretary General of the African National Congress, describing the lives of miners in 1914
About a hundred years ago…
Acknowledgement• Visionary leadership of the Minister of Health, DG and
senior officials of the Department of Health• Minister of Mineral Resources and the Department of
Mineral Resources• Chair and members of Audit and Risk Committee of
CCOD• Office of the Auditor-General• Our team at NIOH – NHLS, CCOD, MBOD
Together we can!
[email protected] – 712 6413
“Fit for work,
Fit for life,
Fit for tomorrow”HSE, 2005
