Confronting the growing epidemic of silicosis and TB among small-scale miners
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Published version
Author(s)
Type
Journal Article
Abstract
An estimated 49.5 million small-scale miners (SSM) globally are exposed to very
high levels of silica during their work. The substantial morbidity and mortality of
silicosis and tuberculosis (TB) among workers exposed to such levels have been
clearly documented. This Viewpoint raises concern at the failure to respond to a
growing epidemic of lung disease – predominantly silicosis and TB – among SSM.
We structure our argument around five points.
First, we outline the huge burden of lung disease among SSM. Current estimates of
disease prevalence yield approximately 450,000 microbiologically confirmed
prevalent TB cases and 2.75 million prevalent silicosis cases globally among SSM.
Second, we critically examine these figures in the context of high silica exposures.
Given the very high intensities reported among SSM, between four and 2400 times
the United States Permissible Exposure Limit, we believe the reported high
prevalences of silicosis and TB are plausible. Third, we illustrate the failure to
support research that aims to understand and mitigate the epidemic of silicosis and
TB among SSM. Fourth, we examine the historic, socioeconomic and political factors
shaping the current epidemic. The small-scale mining industry has grown rapidly
over two decades, driven by upstream factors such as unemployment, climate
change and the growing mineral demand. These continued pressures suggest that
this growth will accelerate. Finally, we recommend solutions appropriate to the early
stages of a response and the large-scale mobilization required. A funded global
platform to bring together stakeholders is needed to facilitate research and action. A
key intervention is silica dust reduction, building on studies which demonstrate
effective and inexpensive technologies and practices.
We conclude that an urgent and coordinated response is needed to address the
devastating health impacts of silicosis and TB in SSM and their preventable
workplace causes.
high levels of silica during their work. The substantial morbidity and mortality of
silicosis and tuberculosis (TB) among workers exposed to such levels have been
clearly documented. This Viewpoint raises concern at the failure to respond to a
growing epidemic of lung disease – predominantly silicosis and TB – among SSM.
We structure our argument around five points.
First, we outline the huge burden of lung disease among SSM. Current estimates of
disease prevalence yield approximately 450,000 microbiologically confirmed
prevalent TB cases and 2.75 million prevalent silicosis cases globally among SSM.
Second, we critically examine these figures in the context of high silica exposures.
Given the very high intensities reported among SSM, between four and 2400 times
the United States Permissible Exposure Limit, we believe the reported high
prevalences of silicosis and TB are plausible. Third, we illustrate the failure to
support research that aims to understand and mitigate the epidemic of silicosis and
TB among SSM. Fourth, we examine the historic, socioeconomic and political factors
shaping the current epidemic. The small-scale mining industry has grown rapidly
over two decades, driven by upstream factors such as unemployment, climate
change and the growing mineral demand. These continued pressures suggest that
this growth will accelerate. Finally, we recommend solutions appropriate to the early
stages of a response and the large-scale mobilization required. A funded global
platform to bring together stakeholders is needed to facilitate research and action. A
key intervention is silica dust reduction, building on studies which demonstrate
effective and inexpensive technologies and practices.
We conclude that an urgent and coordinated response is needed to address the
devastating health impacts of silicosis and TB in SSM and their preventable
workplace causes.
Date Issued
2025-04-01
Date Acceptance
2025-01-21
Citation
The Lancet Public Health, 2025, 10, pp.E343-E346
ISSN
2468-2667
Publisher
Elsevier
Start Page
E343
End Page
E346
Journal / Book Title
The Lancet Public Health
Volume
10
Copyright Statement
© 2025 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.
License URL
Subjects
Silicosis
Tuberculosis
Small-scale mining
Publication Status
Published
Date Publish Online
2025-02-25