Elsevier

Lung Cancer

Volume 45, Supplement, August 2004, Pages S3-S6
Lung Cancer

Asbestos and mesothelioma in South Africa

https://doi.org/10.1016/j.lungcan.2004.04.007Get rights and content

Abstract

Asbestos has been used by man since 4000 before the Christian era (BCE) in many different parts of the world and for a wide range of functions. Blue asbestos (crocidolite) was first discovered in South Africa in 1805 and within a few years was being mined there extensively. Mining reached its peak in 1977 with >380,000 tons being exported and 20,000 miners employed in the industry. South Africa also has large deposits of white asbestos (chrysotile) and brown asbestos (amosite) both of which have been mined extensively. At the turn of the 20th century, it was noted that those working with asbestos suffered lung disease and in 1960, the link between asbestosis and mesothelioma was established in the Kimberley area of South Africa. Further studies in the 1970s and 1980s showed an alarming incidence of mesothelioma based on pathology reports. The majority of the reported mesothelioma cases result from exposure to asbestos in its many uses in secondary industry although incidence of the condition among miners is also significant. A high proportion of mesothelioma in patients in South Africa is attributed to environmental origin with a high incidence of women and children affected.

Section snippets

History

Asbestos is a remarkable material and has been used by humans for many years.

4000 before the Christian era (BCE)Asbestos was used for wicks in lamps and candles. Asbestos means inextinguishable or unquenchable.
2000–3000 BCEEmbalmed bodies of Egyptian pharaohs were wrapped in asbestos clothes to offset the ravages of time.
2500 BCEUsed in Finland to strengthen clay pots.
800–900 ADAnecdotal evidence of Charlemagne’s table cloth made from woven asbestos.
1000Mediterranean people used chrysotile

South African mining

Blue asbestos (crocidolite) was first discovered in South Africa in 1805. It was originally named “Woolstone”. All commercial asbestos fibres were mined in South Africa. Mining reached its peak in 1977 with the export of >380,000 tons and 20,000 miners were employed in the asbestos mining industry.

Crocidolite

The name was coined in 1831 by Hausman, a German geologist, from the Greek “Krokis” meaning woolly and “lithos” meaning rock. It is also known as blue asbestos. South African mining of crocidolite began in the mid 1800s. Initially, the mining took place with many small digging operations—“outcrop mining”. The mining and milling are highly labour intensive, with the fibre cobbled from the rock by hand-held hammers, sieved by hand, sorted by a combination of manual and mechanised methods and

Asbestos and mesothelioma

In 1960, Wagner reported the link between asbestos and mesothelioma as described above. In 1960, Pneumoconiosis Research Unit undertook a survey of every 10th house in areas at risk. They found an alarming incidence of mesothelioma in and out of the industry. In addition, 4.8% of the population outside the industry had asbestos fibres in their sputum. The fibre concentration in the general ambient atmosphere was measured at 0.09 fibres/ml. Webster informed the mining houses. This had the

Mesothelioma and the mining industry

Four case series have been published in South Africa that detail the source of exposure in >500 cases of histologically proven malignant mesothelioma [5], [6], [7].

If we remove the unknown and no exposures, mining-related exposures represent 40% of those mesotheliomas for which exposure is known. The majority of them are related to crocidolite exposure, which is considered to be more carcinogenic than the other fibres. The biologically active or inhaleable particles are those with a diameter of

Mesothelioma and secondary industry

The majority of the reported mesothelioma cases result from exposure to asbestos in its many and varied uses in secondary industry. Three major occupations at risk stand out:

  • 1.

    the maintenance of steam locomotive and other railway-related procedures;

  • 2.

    the asbestos cement industry; and

  • 3.

    boilermakers and other artisans who use asbestos for insulation applications.

Mesothelioma from environmental exposure

A high proportion (26%) of mesothelioma in patients in South Africa is attributed to environmental origin, particularly in the Northern Cape area. Of all environmental cases in South Africa, 93% originate from exposure to crocidolite in that area. An interesting observation is the high incidence of women and children affected (>70% of all reported environmental cases). This is presumably due to asbestos brought home in the hair and clothes of the miners. The closure of the last mine is

Conclusion

The story of mesothelioma within South Africa is dismal indeed. More than 2700 South Africans have died of mesothelioma. Government officials have failed to prevent the disease and protect citizens. Mine owners have focussed excessively on profit. The legal system has offered no means of redress for patients with malignant mesothelioma resulting from environmental exposure. The medical community has had minimal impact on policy and/or practices.

Some recent developments are a little more

References (7)

  • J.C Wagner et al.

    Diffuse pleural mesotheliomas and asbestos exposure in the Northwestern Cape Province

    Br. J. Ind. Med.

    (1960)
  • I Webster

    Asbestosis and malignancy

    S. Afr. Med. J.

    (1973)
  • A.B Zwi et al.

    Mesothelioma in South Africa 1976–84: incidence and case characteristics

    Int. J. Epidemiol.

    (1989)
There are more references available in the full text version of this article.

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