Abstract
South Africa's gold mines were the first to compensate for silicosis and tuberculosis as occupational diseases. They were also the first mines to introduce medical surveillance of a workforce. Despite those innovations, both employers and state authorities failed to identify the risk faced by underground workers, and the Rand mines remained among the most dangerous in the world. The reasons for that failure are found in the system of mine medicine, which hid rather than revealed the actual disease rates.
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