103 - Tuberculosis management for underground miners: an overview of the literature, lessons from highly endemic areas, and opportunities for the future

Session Description: Mining professions have long been known to have unique dangers. However, their continued relevance and the growth in demand for extracted resources suggests that occupational physicians should be aware of their risks. For those practitioners specializing in the care of mining communities and cohorts, tuberculosis remains a constant threat and management dilemma. The tiny mycobacterium remains a danger even for those mining in advanced work places, and outbreaks can be devastating to community health. In highly endemic areas, mines are reservoirs of disease, and despite years of studies, we have struggled to vanquish this troublesome infection. Here, I will detail literature on the risk of this disease across mining workplaces, from advanced mining operations to artisanal and small scale mines. Additionally, I will address the risk of endemicity as a function of prevention and control strategies. I will also discuss recent studies on tuberculosis control in mines and considerations for those with medical comorbidities. Finally, I will detail interesting new directions in detection, surveillance and treatment that may portend practice change in the future.

Educational Gaps: Most OEM clinicians may use the yearly test and treat strategy for latent TB in high risk workplaces. However, OEM clinicians should think critically about their practice environments to address care gaps. Research in at risk populations suggest that yearly MTB testing or suppressive anti-tb meds may be preferred in patients with pneumoconiosis (cases of which are on the rise in the USA and worldwide).

Is this session being sponsored by an ACOEM Section or Component?: No

Has this session previously been presented?: No

The AOHC 2026 theme is Healthy workers. Healthy world: Tuberculosis is one of the worlds biggest killers. Those who see workers in mining should be cognizant of the ensuing risk of transmission. As we work to control tuberculosis, we have to be aware of how we can best manage individual risk and treatment as well as considering how the work environment can serve as a vector and reservoir of disease, and how we can contribute to global goals in disease control. OEM physicians must be cognizant of the two important facets of tuberculosis management in these patients ... preventative efforts to reduce tuberculosis spread in mining environments (and secondarily, in communities close to mining work), and treatment efforts for those diagnosed, which may require different strategies based on comorbidities and the rates of disease among the cohort.