Evaluation of the periodic examination in the South African mining industry.

The periodic examination in the South African mining industry was evaluated by determining the number and nature of abnormalities found in 7,758 consecutive examinations and the outcomes of these findings up to 3 years later. Separate analyses evaluated the examination in relation to its role as (1) a screening examination; (2) a means of assessing fitness for work, and (3) a means of identifying workers with compensable diseases. As a screening examination, very little benefit was realized, as only 132 examinations (1.7%) resulted in diagnoses considered significant according to specified criteria. As a means of assessing fitness for work, the examination appeared to be more useful. In 640 of the examinations (8.2%), conditions were discovered which were thought to have at least raised doubt about whether the certificate of fitness should be renewed unchanged. As a means of identifying workers with compensable diseases, the periodic examination was unproductive, with only 20 workers (0.26%) receiving compensation for conditions discovered during the periodic examination. It is suggested that the time between examinations can be extended, especially for the younger workers, and that follow-up of significant conditions can be undertaken more effectively if the examinations are conducted at the workplace.