Background Gold mineworkers in South Africa are exposed to high levels of silica dust as a result of which they are at risk of developing silicosis, which is a compensable disease. The incidence of tuberculosis is also high. Methods To determine the prevalence of occupational lung disease and the previous compensation history in former migrant mineworkers, a study was undertaken in a random sample of men living in Libode, a rural district of Eastern Cape Province, South Africa. Two hundred thirty‐eight ex‐mineworkers were examined according to a protocol that included chest radiography and spirometry. Chest radiographs were read into the International Labour Organisation (ILO) classification for pneumoconioses by two readers. Results The mean age was 52.8 years, and the mean length of service was 12.15 years. The prevalence of pneumoconiosis (≥ILO 1/0) was 22% and 36% (variation by reader). For both readers, a significant association between length of service and pneumoconiosis and between pneumoconiosis and reduction in FVC and FEV was found. Twenty‐four percent of study subjects were eligible for compensation. Conclusion There is a high prevalence of previously undiagnosed, uncompensated pneumoconiosis in the study group. As a result of the failure to diagnose and compensate occupational lung disease, the social and economic burden of such disease is being borne by individuals, households, and the migrant labor‐sending communities as a whole. Am. J. Ind. Med. 34:305–313, 1998. © 1998 Wiley‐Liss, Inc.

Recommendations to address the inaccuracy of ART programme data include improving knowledge translation during training of ART programme staff, ensuring the implementation of established data verification policies and procedures, rethinking the design of the programme to reduce the burden on health facilities and personnel, and standardizing information management procedures amongst the various governmental and non-governmental stakeholders. The challenges with reporting in the Eastern Cape may be shared by other South African provinces as well as other low-middle income countries that require high quality data to inform well-designed and well-implemented interventions in the fight against HIV/AIDS.

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