This Guidance Note has been issued by the Chief Inspector of Mines (Chief Inspector) in terms of his functions set out in section 49(6) of the Mine Health and Safety Act 29 of 1996, as amended (MHSA). However, the Chief Inspector has issued the Guidance Note with reference to sections 9(2) and 9(3) of the MHSA, which would indicate that the employer is under an obligation to prepare and implement a code of good practice to deal with the requirements of these guidelines.

Objective and scope

The primary objective of the Guidance Note is to help employers reduce the incidence of TB in mines by focusing on the prevention of latent TB progressing to active TB. It aims to enhance and upscale TB prevention programmes in the mining industry, particularly following the setbacks caused by the COVID-19 pandemic. The Guidance Note targets employees, mining communities, and peri-mining communities exposed to TB risks.

Application and key stakeholders

The Guidance Note is applicable not only to the employees employed by a mine and those in the employ of independent contractors, but also members of surrounding communities. It provides clear roles and responsibilities for relevant stakeholders involved in TB management, ensuring that the approach is collaborative and comprehensive.

Key risk populations

The Guidance Note identifies several groups at high risk of latent TB infection, including:

• Mine employees exposed to silica dust and those with silicosis.
• Individuals with compromised immune systems, such as those with HIV, cancer, or diabetes.
• Pregnant women with significant TB exposure.
• Healthcare workers exposed to employees with TB.
• Families of mine employees and members of mining and peri-mining communities who have had contact with individuals who have contracted TB.

Core components of the Guidance Note

The Guidance Note focuses on four core components: screening, management, treatment, and management of adverse health effects.

1. Screening: High-risk populations must be screened for active TB before latent TB testing and be considered eligible for TB preventive therapy (TPT). This is critical to identifying and managing such cases effectively.
2. Management: Employers are urged to scale up TPT programmes. Previously, TPT was limited to children under the age of five and individuals living with HIV. However, the Guidance Note emphasises the need to expand coverage to persons with significant TB exposure, particularly in a high-risk area of work.
3. Treatment: The Guidance Note provides treatment protocols for individuals who have tested positive for latent TB, to ensure they receive appropriate care to prevent a progression to active TB.
4. Monitoring of adverse health effects: Detailed protocols are provided for managing any adverse health effects associated with TPT.

Implementation plans and compliance

To ensure the effective rollout of this Guidance Note, mining companies must develop comprehensive implementation plans. These plans would outline the organisational structure, define the roles and responsibilities of those who will be part of the TB management efforts, and establish schedules and programmes for such TB management. Employers would be required to monitor and evaluate their TB control programmes annually, ensuring ongoing compliance with the Guidance Note.

Monitoring and evaluation

The Guidance Note emphasises the importance of continuous monitoring and evaluation. Employers must maintain thorough internal records of their TB management efforts and conduct annual evaluations to measure the effectiveness of their programmes.

Conclusion

The Guidance Note is an important instrument in the fight against TB. It highlights the importance of early detection and comprehensive treatment while also stressing the collaborative approach needed among employers, employees, and communities to address this health issue. By implementing the outlined practices and adhering to compliance measures, the mining industry can play a vital role in reducing TB rates and protecting vulnerable populations.