Diffuse pleural mesothelioma and asbestos exposure in the North Western Cape Province

Our plain-English summary of Diffuse pleural mesothelioma and asbestos exposure in the North Western Cape Province, by J.C. Wagner, C.A. Sleggs, P. Marchand (British Journal of Industrial Medicine, 1960).

The study

• Authors: J.C. Wagner, C.A. Sleggs, P. Marchand
• Journal: British Journal of Industrial Medicine
• Published: 1960;17(4):260-71
• Type of article: Case report
• Cited by: 1,148 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 001607).

Abstract

Primary malignant tumours of the pleura are uncommon. Thirty-three cases (22 males, 11 females, ages 31 to 68) of diffuse pleural mesothelioma are described; all but one have a probable exposure to crocidolite asbestos (Cape blue). In a majority this exposure was in the Asbestos Hills which lie to the west of Kimberley in the north west of Cape Province. The tumour is rarely seen elsewhere in South Africa.

In plain English

This 1960 report described 33 people in South Africa with diffuse pleural mesothelioma, a cancer of the lining of the chest. All were confirmed under the microscope over about four years: 22 men and 11 women, aged 31 to 68. The authors traced each patient's past jobs and places of residence. Twenty-eight had some association with the Cape asbestos field in the North Western Cape, where crocidolite (Cape blue asbestos) was mined. Four had been exposed to asbestos in industry, for example lagging locomotive boilers or steam pipes. Relatives of one patient denied any exposure. Of 25 cases without pathological evidence of asbestos, 18 were born near the mines, and 11 of these reported definite childhood exposure to the dust. Lung tissue was available for 10 patients, and eight showed asbestosis. The authors stated that the pathological evidence linking the tumours to asbestos was not conclusive. They concluded that their findings tended to support asbestos as the common factor, and suggested the tumour occurs 20 to 40 years or more after exposure. By June 1960, 47 cases had been identified.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Case series (preliminary report) of histologically proven mesothelioma cases, with detailed histories for eight of them and a tracing of each patient's occupation and residence
• Who was studied: 33 people with diffuse pleural mesothelioma (22 males, 11 females, ages 31 to 68) seen in South Africa, most connected with the asbestos area of the North Western Cape; the first case was examined in February 1956
• Exposure: Crocidolite (Cape Blue Asbestos) from the North Western Cape asbestos field, through mining, transporting fibre, living or going to school near mines and mills, and childhood play on dumps; also industrial exposure from lagging boilers and steam pipes and from making fire-proof clothing
• Main results:
  • Of the 33 cases, 28 had some association with the Cape asbestos field and four had been exposed to asbestos in industry
  • In one case, relatives denied any visit to the asbestos mines or any exposure to asbestos
  • Histological evidence of asbestosis was found in eight of the 10 cases whose specimens included lung tissue
  • Of the eight cases with demonstrated asbestos evidence, six had a definite mining history and one had lagged steam pipes
  • Of the remaining 25 cases, 18 were born near the mines and two arrived in the district as infants; of those 18, 11 admitted definite childhood exposure to the dust
  • Among the four industrial cases, two lagged locomotive boilers and one lagged steam pipes; as far as could be ascertained, none had been in the Griqualand district
  • Apart from this series, no such tumour had been diagnosed among 10,000 lungs examined over the previous five years
  • No mesothelioma was seen in the lungs of 20 asbestos miners from the Cape Asbestos Field
  • The authors' findings suggested that mesothelioma occurs 20 to 40 years or more after dust exposure
  • In an addendum, 47 cases had been identified by the end of June 1960, 45 of them with a possible association with crocidolite exposure; one was a mesothelioma of the peritoneum
• The authors' conclusion: The authors concluded that the findings, especially the industrial cases from outside the region, tended to support asbestos as the common factor in these tumours and to counter the idea of some other environmental cause in Griqualand West
• Limitations the authors state:
  • The authors stated that the pathological evidence linking the tumours to asbestos was not conclusive; evidence of asbestos was demonstrated in only eight of the 33 cases
  • Apart from the first case, diagnoses were made on biopsy material, and other primary cancer sites had to be excluded by clinical and radiological examination
  • The biopsies from 23 cases contained no lung tissue
  • The authors described the paper as a preliminary publication

Mines named here

Asbestos mines this study is about. Each mine's page says who ran it, when it worked, and what it produced.

• Prieska and Kuruman districts, Cape Province

All asbestos mines

Topics

The National Library of Medicine indexes this study under subjects our site covers: Asbestosis, Lung cancer, Mesothelioma.

Medical terms in this study, explained in our Lexicon: Pleural Mesothelioma, Asbestos Exposure, Cape Province, Pleura, Crocidolite, Cape Blue, Asbestos Hill, Kimberley.

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