Why did South African mines become renowned for mine safety, while the mounting rate of silicosis in black migrant workers lay hidden for over a century? How complicit were regulating officers in the operation of the gold mines’ apartheid health and safety policies? Why and how was tuberculosis among black migrant miners not disclosed, perpetuating a cycle of disease (and death) and allowing the infection to spread to neighbouring states? This book reveals how the South African mining industry, abetted by a minority state, hid a pandemic of silicosis for almost a century, and allowed workers infected with tuberculosis to spread the potentially fatal disease to rural communities in South Africa and labour-sending states. The first crisis of 1896-1912 focused on the minority white workers and resulted in industry investing heavily on reducing dust levels. The second began in 2000 with mounting scientific evidence that the disease rate among black migrant miners is more than a hundred times higher than officially acknowledged. This has resulted in class actions against operating companies.