Abstract

An autopsy survey of 1,010 Bantu South African coal-miners has been carried out in order to ascertain the commonest causes of death and the incidence of cardiorespiratory tuberculosis and of coal-workers' pneumoconiosis. These are consecutive autopsy cases. By law, all miners who die from any cause whatsoever, while still employed by the mines immediately before death, must be autopsied, but few autopsies are performed on repatriated miners who die in their homes. For this reason a serious bias has taken place and this limits the possibility of generalizing from this paper. The commonest cause of death was multiple injuries. Primary carcinoma of the liver was the commonest malignancy and the incidence of bronchogenic carcinoma was low. These are the usual findings in the Bantu. Active tuberculosis of the respiratory organs was found in 12% of cases. Coal-workers' pneumoconiosis was present in 26·8%, and 94% of these cases were of the simple type. There were only 17 cases of progressive massive fibrosis, and this is due to the fact that few autopsies were carried out on such cases. Active tuberculosis of the respiratory organs was present in 21% of cases with simple coal-workers' pneumoconiosis. The commonest cardiac lesion was chronic non-specific adhesive pericarditis. Myocardial infarction was absent in this series but this is not unusual as infarction of the heart is rare in the Bantu.