Studies on the Nature and Aetiology of Respiratory Disability in Witwatersrand Gold-Miners Free of Radiological Silicosis

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Abstract
In an investigation into the cause of symptoms in gold-miners who have no radiological silicosis, the relationship of dyspnoea and physiological disturbances to dust exposure was examined. Forty-five subjects, aged 41 to 45 years, with normal chest radiographs and long service underground were chosen for study from the population of miners past and present. Thirty-four men only were tested, but the validity of the sample was checked by comparison with a similar group of miners reported previously. Each individual's dust exposure was estimated in “particle-hours”. A detailed history, including smoking habits, was followed by a clinical examination and a battery of lung function tests in each case. No significant relationship was found between dyspnoea and dust exposure or smoking. However, a negative correlation was observed between dust exposure and effort tests, implying that exercise capacity appeared best in those men whose dust exposure was greatest. Possible reasons for this finding are discussed. On the other hand, dyspnoea did correlate with airway obstruction and hyperventilation on effort, indicating a physiological rather than a psychological basis for the symptoms. Further, the higher incidence of cough, sputum, and rhonchi in the more disabled subjects suggested that chronic bronchitis might be the basis of their symptoms, but the cause of the bronchitis remains to be identified. It seems that dust exposure alone was not the cause, but the findings do not exclude the possibility of its being related to the occupation of mining with stresses such as inhalation of fumes and rapid changes in temperature, humidity, and altitude.