The provision of fair benefits for men and women injured in the workplace has everywhere depended upon the vigilance of trade unions, the presence of competent medical authorities and governments that maintain some critical distance from industry. On the surface South Africa, which was the first state to compensate for silicosis and tuberculosis as occupational diseases, appears to have met those criteria. Stonemasons and foundry workers in the UK facing similar risks had to wait for the Silicosis Act of 1918, which was narrower in scope and provided awards that were never as generous as those available to white miners in South Africa. In contrast to the situation in the UK, where compensation was awarded for demonstrable disability, under South African law compensation was awarded for silicosis even in the absence of physical impairment. The South African legislation has often been retrospective in reach and racialised in terms of medical review and the levels of awards. Whereas workmen's compensation legislation usually covers a number of industries that share a hazard such as exposure to silica dust, asbestos fibre or lead, until 1956 the South African laws applied only to gold mines.

The laws on miners' phthisis were woven around the binary pairing of miners (whites) and native labourers (blacks) – a linguistic sleight-of-hand that in the period of reconstruction after the South African War enabled legislators to racialise the labour laws without mentioning race.