The impact of HIV/AIDS on mortality at a South African platinum mine
Date
2008-05-14T11:37:50Z
Authors
Dowdeswell, Robert Joseph
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Abstract
ABSTRACT
Background: There is a paucity of empirical data on the impact of HIV/AIDS on mortality
in the mining industry in the pre-ART era. Such data will provide a baseline against which
the efficacy of antiretroviral treatment can be measured into the future.
Objectives: To measure all-cause mortality in a population of platinum miners between
1992 and 2002, the impact of HIV/AIDS on mortality in this group and to determine the
pattern of other cause-specific mortality.
Methods: This was a primary analysis of mortality in an open cohort of male semi- and
unskilled workers at a platinum mine. Using Poisson regression, all-cause, HIV/AIDSrelated
and other cause-specific mortality rates and rate ratios were calculated by age and
calendar year.
Results: There were 1986 deaths in the cohort of 29954 subjects who contributed
200657 person years of follow up over the 11 year period of the study. Crude all-cause
mortality increased from a base of 5.1 per 1000 person years at risk (pyar) (95% CI 4.2-
6.2) in 1992 to 20.4 per 1000 pyar (95% CI 18.3-22.8) in 2002. Age-adjusted all-cause
mortality increased more than three-fold from 1992 to 2002 (RR 3.2, 95% CI 2.5-4.0). The
excess mortality was attributed to HIV/AIDS-related deaths which increased from 0% in
1992-1994 to 5.1% of total deaths in 1995 and reached 63.3 % of deaths in 2002.
Mortality due to other communicable diseases, non-communicable diseases and injuries
remained stable throughout the study period.
Conclusion: The impact of the HIV/AIDS epidemic on mortality in this group of platinum
mine workers has been profound and comparable to that experienced by the general
South African population. The data reported here provide a baseline to measure the
impact of antiretroviral treatment on the future course of mortality due to the epidemic.
Description
Keywords
HIV/AIDS, mortality, mining, platinum