From 1916, South Africa gold mines were subject to the world’s first comprehensive system of state regulation, medical surveillance and compensation. Within less than a decade they were reputed to have conquered the oldest of the occupational lung diseases, silicosis. Dr A. J. Orenstein, who was the dominant figure in mine medicine, received much of the credit for making the mines safe. The transition to majority rule in 1994 has seen South Africa's gold mining companies face massive class actions by miners with occupational lung disease. The reasons for the litigation are in part to be found in the system of mine medicine Orenstein helped establish. That system hid rather than revealed the actual risks miners faced.
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