J. C. Wagner, C. A. Sleggs and Paul Marchand, Diffuse Pleural Mesothelioma and Asbestos Exposure in the North Western Cape Province (1960)

A 12-page article in the British Journal of Industrial Medicine (1960) by J. C. Wagner and Paul Marchand of the Pneumoconiosis Research Unit in Johannesburg and C. A. Sleggs, a doctor in the Northern Cape, describing 33 cases of diffuse pleural mesothelioma, a rare cancer of the lining of the chest, seen in four years. In all but one case the patient had a probable exposure to crocidolite (Cape blue asbestos), most often in the asbestos hills west of Kimberley. Many of the patients had never worked in the mines: they included "housewives, domestic servants, cattle herders, farmers, a water bailiff, an insurance agent, and an accountant" who had lived near the mines and mills or played on the dumps as children.

What it shows

This is the paper usually credited with establishing the link between asbestos and mesothelioma (see Wagner 1960 Study). Its table of cases shows how little exposure some victims had: a woman who lived on the asbestos fields only until she was five, children who played on mine dumps, people who lived along the wagon route the fiber traveled. The authors also note that the tumor appeared "20 to 40 years or more after exposure to dust," which explained why it had gone unnoticed. An addendum reports that by June 1960 the count had reached 47 cases, 45 of them possibly linked to crocidolite.

The article is still under copyright in the United States, so our copy of the file isn't shown. It can be read free on PubMed Central.

In Johns-Manville's chronology

Johns-Manville's own chronology of what the company knew describes this document as follows:

Wagner documents asbestos-mesothelioma link among South African miners, having occupational and/or environmental exposure to crocidolite. Found downwind mesothelioma.