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Medicals for the Mining Industry

Mining is well known as a potentially dangerous industry that poses many occupational health and safety risks to workers.

Every person working on a mine in South Africa is required to have a so-called Red Ticket – a valid medical certificate stating that he or she is fit to work – prior to entering a job site. This extends to short-term contract workers too.

Follow-up medicals will depend on a worker’s individual risk profile but will take place at least once a year.
And when a person leaves his or her position, for whatever reason, an exit medical is a legal requirement.

A mining medical generally consists of:

Full physical examination, including eye and audio tests
Blood and urine tests
Chest X-ray
Drug strip test

We will also do biological monitoring if a risk assessment shows that a mineworker is, for example, exposed to lead.

Medicals for Mineworkers

The risks mineworkers are exposed to vary widely and will depend on the type of mine and the commodity that is being mined. The most common health risks for mineworkers stem from:

Exposure to Respirable Coal Dust

Coal dust exposure is common among coal miners and drivers who transport coal. It is a health menace both underground and on the surface. If inhaled over a long period of time, it can cause pneumoconiosis, otherwise known as black lung disease.

Symptoms of black lung include shortness of breath and scarring of lung tissue, and have been known to appear in a five-year period, sometimes even less. The disease cannot be reversed and early detection is vital.

Both active and retired miners exposed to coal dust should undergo regular medical surveillance, including chest X-rays.

Another lung disease prevalent among South African miners is silicosis, which is caused by inhaling silica dust. Workers exposed to asbestos fibres can also get asbestosis or mesothelioma, both of which can be deadly.

Noise Exposure

Noise is an ever-present hazard at mines because of constant drilling, blasting, conveying and crushing, and the use of heavy machinery. Noise-induced hearing loss is therefore a real danger. It is permanent and irreversible, and often goes unnoticed until it is too late.

Symptoms of noise-induced hearing loss include tinnitus (ringing in the ears) and muffled hearing.

Every miner working in a designated noise zone should wear proper hearing protection, and an annual audiogram is a must for early detection of hearing loss.

Exposure to Harmful Chemicals

Harmful chemicals common in mining include cyanide, arsenic, lead, beryllium, diesel particulate matter, mercury and radon. Ingestion usually occurs through inhalation or skin exposure. It can lead to poisoning or, in the long term, respiratory problems and even cancer.

In addition to the annual mining medical, workers exposed to any harmful chemicals should undergo biological monitoring.

Whole-body and Hand-arm Vibration

Exposure to vibration is another health hazard common in mining. Workers sitting or standing on vibrating surfaces, such as the seat of a vehicle, are exposed to whole-body vibration (WBV). Miners such as rock drillers who operate vibrating hand tools are exposed to hand-arm vibration (HAV).

WBV can lead to lower back or sciatic pain or more serious musculoskeletal disorders, as well as vision impairment and digestive problems.

HAV can cause what is known as “vibration white finger”, which is tingling and numbness of the fingers. It can be painful and in severe cases lead to the loss of strength in the hands or fingers and the inability to do fine movements with the fingers, such as buttoning a shirt.

Thermal Stress

The heat and humidity found in deep underground mines can lead to thermal or heat stress. Risk factors for heat stress include high exertion, high temperatures, dehydration, certain medications, and alcohol use in the past 24 hours.

Workers with chronic conditions such as diabetes or heart disease and those who are overweight or obese may be excluded from working deep underground.

Medicals for Mineworkers

Did you know?

All mines must report each year on the number of initial, periodical and exit examinations that have been conducted as part of their medical surveillance system. This report goes to the Mine Health and Safety Inspectorate and must be compiled by a certified occupational medical practitioner (OMP).

Among other things, it should also include:

An analysis of the employees’ health based on their records of medical surveillance
Comments on the future direction of the medical surveillance system
The number of employees certified for compensation for occupational diseases
The total number of employees, including contract workers, who were subjected to medical surveillance in terms of the Mine Health and Safety Act 1996, as amended, during the reporting period and the total of hours worked by those employees

From the above, it is clear that mining companies need to maintain a good record-keeping system for their occupational health medicals. Read more about how our electronic reporting and management system, Care Net Online, can help you.


01. Which laws regulate the health and safety of workers in the mining industry?
The Occupational Health and Safety Act (1993) and Mine Health and Safety Act (1996) contain strict legislation and protocols that must be followed at all mines in South Africa.
02. What conditions could render a person unfit to work in the mining industry?
Conditions such as epilepsy, obesity, diabetes and high blood pressure could exclude one from working in a mine, or at least rule out certain types of jobs. For example, obesity could affect mobility and thus exclude a person from working underground because evacuation could be too difficult. Physical fitness is important in mining and if a person has cardiovascular disease, for example, he or she may not be able to undertake strenuous work.
03. What would be included in a mineworker’s exit medical?
An exit medical must include, but is not limited to, clinical comments on the chest X-ray, a lung function test, audiometry test, other biological monitoring by employer of the employee, the significant risk to which the employee was exposed, and occupational diseases past and present.

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