<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0256-9574</journal-id>
<journal-title><![CDATA[SAMJ: South African Medical Journal]]></journal-title>
<abbrev-journal-title><![CDATA[SAMJ, S. Afr. med. j.]]></abbrev-journal-title>
<issn>0256-9574</issn>
<publisher>
<publisher-name><![CDATA[Health and Medical Publishing Group]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0256-95742012000600009</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[Silicosis: 10 000 gold miners getting set to sue]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Bateman]]></surname>
<given-names><![CDATA[Chris]]></given-names>
</name>
</contrib>
</contrib-group>
<aff id="A">
<institution><![CDATA[,  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>06</month>
<year>2012</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>06</month>
<year>2012</year>
</pub-date>
<volume>102</volume>
<numero>6</numero>
<fpage>338</fpage>
<lpage>340</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.za/scielo.php?script=sci_arttext&amp;pid=S0256-95742012000600009&amp;lng=en&amp;nrm=iso&amp;tlng=en"></self-uri><self-uri xlink:href="http://www.scielo.org.za/scielo.php?script=sci_abstract&amp;pid=S0256-95742012000600009&amp;lng=en&amp;nrm=iso&amp;tlng=en"></self-uri><self-uri xlink:href="http://www.scielo.org.za/scielo.php?script=sci_pdf&amp;pid=S0256-95742012000600009&amp;lng=en&amp;nrm=iso&amp;tlng=en"></self-uri></article-meta>
</front><body><![CDATA[ <p align="right"><font face="Verdana, Arial, Helvetica, sans-serif" size="2"><b>IZINDABA</b></font></p>     <p>&nbsp;</p>     <p><font face="Verdana, Arial, Helvetica, sans-serif" size="4"><b>Silicosis -    10 000 gold miners getting set to sue</b></font></p>     <p>&nbsp;</p>     <p>&nbsp;</p>     <p align="center"><img src="/img/revistas/samj/v102n6/09f01.jpg"></p>     <p>&nbsp;</p>     <p><font face="Verdana, Arial, Helvetica, sans-serif" size="2"><b>Tagged as victims    of 'the world's biggest, longest running industrial disaster; dwarfing Chernobyl',    10 000 known silicosis-affected southern African gold miners are finally set    to negotiate a payout that could induce a painful paroxysm of shareholder coughing    across the Johannesburg Stock Exchange.</b></font></p>     <p><font face="Verdana, Arial, Helvetica, sans-serif" size="2">Richard Spoor,    the lead lawyer who a year ago secured a landmark Constitutional Court ruling    allowing lung-diseased miners to sue their employers for substantial damages    (under common law), said the application for certification of a class action,    plus a process for establishing liability, would come before the South Gauteng    High Court 'within months'.</font></p>     <p><font face="Verdana, Arial, Helvetica, sans-serif" size="2">Spoor has out-of-court    settlements from asbestos mining h1ouses totalling R1.1 billion since 2003,    all of which precluded a ruling on the constitutionality of archaic mining legislation    that in some cases limited medical incapacity payouts to just R1 000 for every    year worked. The latest litigation is virgin legal territory and may well bring    substantial financial relief to those injured or to relatives of those killed    by mining-acquired silicosis.</font></p>     ]]></body>
<body><![CDATA[<p><font face="Verdana, Arial, Helvetica, sans-serif" size="2">After meeting his    senior advocates on 9 April this year, Spoor told <i>Izindaba</i> that the final    form of the application would depend on the responses of the individual defendants,    AngloGold Ashanti, Gold Fields, Harmony Gold (South Africa's biggest gold miners),    and smaller producers, DRD Gold.</font></p>     <p><font face="Verdana, Arial, Helvetica, sans-serif" size="2">'We want to discuss    the process with them. Our court application includes a recommendation to the    judge on how the matter should be dealt with. This is something completely new    and we want the mining companies' input as to whether they think it's fair and    appropriate. At the core of our position is that if we don't deal with it on    a collective basis, people will not get justice. It's a crazy notion to think    that somebody in some remote Transkei, Lesotho or Mozambican village can bring    a civil action to recover damages - that just won't happen; that's why a class    action is appropriate.'</font></p>     <p><font face="Verdana, Arial, Helvetica, sans-serif" size="2">While each individual    miner will have to prove damages (via an independent medical panel), the basic    principles governing any award will be what the South Gauteng High Court adjudicates    on, paving the way for the setting up of a Silicosis Trust from which funds    would be disbursed. Actuaries will use the best epidemiological data to table    individual company award amounts (how many cases, of what severity, ages, life    expectancy and geographical information per respondent gold mine).</font></p>     <p><font face="Verdana, Arial, Helvetica, sans-serif" size="2">Based on his previous    out-of-court settlements with asbestos mining companies (Gencor, Hanova, Eternit,    <i>et al.)</i> in 2003 and 2006, Spoor is confident that the trust fund model    can be sufficiently enlarged and administered to handle what currently stands    at 15 times as many victims.</font></p>     <p>&nbsp;</p>     <p><font face="Verdana, Arial, Helvetica, sans-serif" size="3"><b>Mining executives    take a deep breath</b></font></p>     <p><font face="Verdana, Arial, Helvetica, sans-serif" size="2">A 2009 collaborative    study by the University of the Witwatersrand and University College, London,    estimates there to be 288 000 cases of compensable silicosis in South Africa,    which would put that unpaid liability at R10 billion in 1998 values (R27 billion    in today's values). This gives some indication of what even lesser settlements    could do to shareholder values on the Johannesburg Stock Exchange and how the    ConCourt ruling must be focusing the minds of senior mining company executives.</font></p>     <p>&nbsp;</p>     <p align="center"><img src="/img/revistas/samj/v102n6/09f02.jpg"></p>     <p>&nbsp;</p>     ]]></body>
<body><![CDATA[<p><font face="Verdana, Arial, Helvetica, sans-serif" size="2">Spoor said that    his estimate was of 'at least' 200 000 workers needing follow-up, screening    'and hopefully, treatment'. Identification of legitimate claimants is complicated    by geography, awareness and a dysfunctional public health system but the numbers    are already growing in their thousands every year (more than 7 500 in Lesotho    and over 2 000 in the Eastern Cape at the time of going to press). While there    had been no formal engagement of the gold mines at the time of writing, Spoor    said there was 'a fair amount of sounding out - we have a consultant encouraging    thinking and discussion to create a high-level awareness for the company to    make the right decisions'.</font></p>     <p>&nbsp;</p>     <p><font face="Verdana, Arial, Helvetica, sans-serif" size="3"><b>ConCourt ruling    the 'tipping point' for claimants</b></font></p>     <p><font face="Verdana, Arial, Helvetica, sans-serif" size="2">The tipping point    came in March last year when Spoor asked the Constitutional Court to declare    unconstitutional a section in the workman's compensation legislation prohibiting    workers from suing their employers. The case he used was that of a single R2.5    million claim turned down by both the High Court and the Court of Appeal on    the grounds that the State had set up a compensatory system and that the quid    pro quo was that this precluded the possibility of civil suits.<sup>1</sup>    The AngloGold Ashanti miner, Thembekile Mankayi (who died of lung disease two    weeks before the ConCourt ruling), was laid off for R16 000 (representing just    over R1 000 for every year he had worked). His payout was made in terms of the    Occupational Diseases in Mines and Works Act (ODIMWA), which specifically and    exclusively caters for (in limited terms) sick miners. AngloGold cited the relevant    section of ODIMWA which clearly states that compensable diseases are prohibited    under the Workman's Compensation Act. The ConCourt upheld Spoor's contention    that both laws trampled on Mankayi's common law rights.</font></p>     <p>&nbsp;</p>     <p align="center"><img src="/img/revistas/samj/v102n6/09f03.jpg"></p>     <p>&nbsp;</p>     <p><font face="Verdana, Arial, Helvetica, sans-serif" size="2">Ironically cabinet    resolved as far back as 1998 to re-align the two acts, but disagreement between    government and the Chamber of Mines over who would pay the costs associated    with lung-diseased mineworkers quickly snuffed out the initiative. Government    was reluctant to carry financial responsibility for laws it had no hand in making    while the mines cried foul over potentially carrying the financial can for mines    that had stopped operating. Spoor put it succinctly, 'Basically the laws acted    as a subsidy to the industry. The real cost is borne by the workers, their families    and the public health system. The "polluter pays" principle should apply to    occupational health - but it doesn't.'</font></p>     <p>&nbsp;</p>     <p><font face="Verdana, Arial, Helvetica, sans-serif" size="3"><b>Track record    of medical panel</b></font></p>     ]]></body>
<body><![CDATA[<p><font face="Verdana, Arial, Helvetica, sans-serif" size="2">Cape Town medical    specialist in public health, Jim Te Water Naude, one of Spoor's large team currently    assessing claimants in preparation for the South Gauteng Court application,    gave some idea of how 'recruitment' might go by citing previous experience.    He said his occupational medicine panel screened 14 000 ex-asbestos miners over    the last 7 years, working mainly with rural GPs. Numbers peaked at 3 000 people    annually in 2007 before tailing off. Some 4 000 were found to be compensable.    Three per cent of them (420) had mesothelioma which, along with lung cancer,    meant they lived on average for about a year.</font></p>     <p>&nbsp;</p>     <p align="center"><img src="/img/revistas/samj/v102n6/09f04.jpg"></p>     <p>&nbsp;</p>     <p><font face="Verdana, Arial, Helvetica, sans-serif" size="2">The Asbestos Relief    Trust (2003) and the Kgalagadi Relief Trust (2006) paid individual miners about    R280 000 for mesothelioma and about R210 000 for lung cancer while severely    lung-impaired workers received about R60 000 (half this for moderate or mild    lung impairment).</font></p>     <p><font face="Verdana, Arial, Helvetica, sans-serif" size="2">'This new case    is going to be a lot of hard work with a whole lot of challenges, not the least    of which is the triple epidemic on the mines of HIV, TB and silicosis. In the    90s the gold mines downsized from about 800 000 workers to 400 000 and the triple    epidemic was (more quickly) exported to where the miners came from.' Te Water    Naude said the relationship between silicosis and TB (owing to the macrophage    system being overwhelmed by small particles of crystalline silica which comes    co-compounded with gold ore) was well known.</font></p>     <p><font face="Verdana, Arial, Helvetica, sans-serif" size="2">Tina da Cruz, a    legal associate of Spoor's co-ordinating claims in Maseru, said she was working    with the Mineworkers Development Agency (MDA)'s Lesotho Country Office identifying    potential claimants for the class action. The MDA's experience in helping the    Asbestos Relief and Kgalagadi Relief trusts find former asbestos miners was    proving invaluable. Field teams of former miners and lawyers created awareness    among former gold miners and their communities in all districts of Lesotho while    similar teams were working in the Bizana area of the Eastern Cape.</font></p>     <p><font face="Verdana, Arial, Helvetica, sans-serif" size="2">Te Water Naude    said once claimants were found, the project's potential for improving public    healthcare delivery was huge, citing the vastly improved Kuruman postmortem    service via their efforts on behalf of asbestos victims. 'Basically we introduce    a high-quality management system, making sure that we communicate well upstream    and downstream' (again, using private healthcare practitioners whom he said    produced work of excellent quality in 85% of cases). His team was by mid-to-late    April inspecting doctors' reports of 30 lung-impaired gold miners examined in    Maseru and another 45 examined in Mthatha. The reports include lung function,    chest radiography and a clinical evaluation.</font></p>     <p><font face="Verdana, Arial, Helvetica, sans-serif" size="2">In an aside, Te    Water Naude said the glaring lack of continuing medical education in far flung    towns was best illustrated by one GP in Prieska who attended their team's talk    on asbestos-related diseases in November last year. The doctor said it was the    first time in two decades he'd seen any kind of external continuing professional    development activity.</font></p>     <p>&nbsp;</p>     ]]></body>
<body><![CDATA[<p><font face="Verdana, Arial, Helvetica, sans-serif" size="3"><b>Major potential    to boost public healthcare</b></font></p>     <p><font face="Verdana, Arial, Helvetica, sans-serif" size="2">Other exciting    developments included channelling PEPFAR funding (via a Yale University initiative)    into their programme to help treat ex-miners with HIV and TB and looking further    afield to 'see what there is beyond compensation; we want to use a future settlement    to bring more synergy,' he added.</font></p>     <p><font face="Verdana, Arial, Helvetica, sans-serif" size="2">Spoor said the    clinical work was not an attempt to duplicate the dysfunctional state system    which had no proper monitoring or surveillance, but to complement and improve    it by linking into the statutory system.</font></p>     <p><font face="Verdana, Arial, Helvetica, sans-serif" size="2">He said that a    'significant' percentage of lung-impaired miners died without being diagnosed,    mainly because of inadequate and inexpert postmortem services (cardiorespiratory    organs need harvesting and in most cases, storing and transport). This meant    that, in the main, only the organs of those who died in service (mostly black    miners) and most white miners (with access to facilities) were examined.</font></p>     <p><font face="Verdana, Arial, Helvetica, sans-serif" size="2">Asked whether he'd    be asking the court for an order preventing or minimising future lung impairment,    Spoor said the settlement would have to make provision for wherever mine inadequacies    were found. Medical monitoring and surveillance and treatment, especially for    TB, were the two major issues.</font></p>     <p><font face="Verdana, Arial, Helvetica, sans-serif" size="2">'This is about    holding people to account and once that's done you can expect substantial improvements    in the workplace. Silicosis is a preventable disease. If you can kill and maim    people without consequences there's obviously no reason to stop. I must say    the State's role as policeman of safe and healthy environments has not been    much to write home about, in fact the State has proved itself incapable of policing    the mines. The criminal justice system is not working, so civil accountability    is the only model left to us.'</font></p>     <p><font face="Verdana, Arial, Helvetica, sans-serif" size="2">Asked how long    it could take to settle the class action, Spoor said that based on his past    experience, anything from 18 months to 5 years; it will all depend on the attitude    of the gold mine executives and how well they recognised the inadequacy of existing    compensation regimens and their moral obligations. 'It comes down to the CEO    and the kinds of lawyers they get - this is not a game for bluffers.'</font></p>     <p><font face="Verdana, Arial, Helvetica, sans-serif" size="2">He said the role    of actuaries was crucial because, if the settlement proved inadequate, claimants    could 'come after me' - which is why a senior advocate was retained exclusively    to ensure the payout mechanism and the kitty were adequate, providing him with    what was legally termed, a 'comfort note'.</font></p>     <p><font face="Verdana, Arial, Helvetica, sans-serif" size="2">Asked what his    fee was, Spoor said it could either be built into the overall settlement or    established by agreement with individual clients not to exceed 15% of their    award.</font></p>     <p><font face="Verdana, Arial, Helvetica, sans-serif" size="2">'As a point of    reference the Gencor (asbestos) settlement was worth R450 million and my fee    was R2 million for what amounted to 5 years of work. I'm saving up for a new    car,' he quipped.</font></p>     ]]></body>
<body><![CDATA[<p><font face="Verdana, Arial, Helvetica, sans-serif" size="2">One of his senior    legal colleagues told him that the silicosis claim, when compared with famous    historical mining claims in Australia and the USA, the Chernobyl and Fukushima    nuclear meltdowns, and the Bhopal chemical leak in India (in terms of numbers    killed and injured) 'outnumbers them all - it's basically the world's biggest    and longest running industrial disaster.'</font></p>     <p>&nbsp;</p>     <p><font face="Verdana, Arial, Helvetica, sans-serif" size="3"><b>References</b></font></p>     <!-- ref --><p><font face="Verdana, Arial, Helvetica, sans-serif" size="2">1. Bateman C. A    better deal for lung-diseased miners? S Afr Med J 2010;100;10:626-628.</font>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;[&#160;<a href="javascript:void(0);" onclick="javascript: window.open('/scielo.php?script=sci_nlinks&ref=539900&pid=S0256-9574201200060000900001&lng=','','width=640,height=500,resizable=yes,scrollbars=1,menubar=yes,');">Links</a>&#160;]<!-- end-ref --><p>&nbsp;</p>     <p>&nbsp;</p>     <p><font face="Verdana, Arial, Helvetica, sans-serif" size="2"><b>Chris Bateman    <br>   </b> <i><a href="mailto:chrisb@hmpg.co.za">chrisb@hmpg.co.za</a></i></font></p>      ]]></body>
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<person-group person-group-type="author">
<name>
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<given-names><![CDATA[C]]></given-names>
</name>
</person-group>
<article-title xml:lang="en"><![CDATA[A better deal for lung-diseased miners?]]></article-title>
<source><![CDATA[S Afr Med J]]></source>
<year>2010</year>
<volume>100</volume>
<numero>10</numero>
<issue>10</issue>
<page-range>626-628</page-range></nlm-citation>
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