Confronting the growing epidemic of silicosis and tuberculosis among small-scale miners.

An estimated 49·5 million small-scale miners worldwide are exposed to high concentrations of silica during their work. The substantial morbidity and mortality of silicosis and tuberculosis among workers exposed to such intensities have been documented. This Viewpoint raises concern at the failure to respond to a growing epidemic of lung disease (predominantly silicosis and tuberculosis) among small-scale miners. The Viewpoint is framed around four arguments: outlining the huge burden of lung disease among SSMs; critically examining these figures in the context of high silica exposures; illustrating the failure to support research; and examining historical, socioeconomic, and political factors influencing the epidemic. We then outline a strategy for response. An urgent and coordinated response is needed to address the devastating health effects of silicosis and tuberculosis in small-scale miners and their preventable workplace causes.