Development of a Comprehensive Occupational Disease Surveillance System for the Nigerian Mining Sector: Design, Piloting, and Policy Framework

Occupational disease remains systematically underreported and underdiagnosed in Nigeria's mining sector due to the absence of a functioning surveillance infrastructure, creating critical information gaps that prevent evidence-based prevention policy. This dissertation develops, pilots, and evaluates a comprehensive occupational disease surveillance system (ODSS) for the Nigerian mining sector. The research adopts a health systems design methodology, beginning with a systematic review of global mining occupational disease surveillance models and a stakeholder needs assessment involving regulatory agencies, medical professionals, mine operators, and worker representatives. An original ODSS framework is designed, incorporating mandatory case reporting, periodic prevalence surveys, biological monitoring protocols, and a national mining disease registry. The system was piloted over 18 months across 24 mining operations in Enugu, Ogun, Plateau, and Kebbi states, covering a workforce of 6,200 workers. Pilot data reveal an occupational disease prevalence of 14.2 per 1,000 workers per year, dominated by silicosis (4.1), noise-induced hearing loss (5.8), and musculoskeletal disorders (3.2), with substantial additional suspected burden from dermatological and respiratory conditions. Reporting completeness achieved in the pilot (67 percent) is substantially higher than the estimated baseline completeness of the existing fragmented system (below 8 percent). A legislative framework for mandating ODSS participation as a condition of mining licence renewal is drafted and evaluated through legal expert review. The dissertation delivers a scalable, implementable surveillance system with an evidence base for national adoption. Keywords: occupational disease surveillance, mining sector, Nigeria, silicosis, health policy.