Epidemiology of mesothelioma--a South African perspective

Our plain-English summary of Epidemiology of mesothelioma--a South African perspective, by R.P. Abratt, N.W. White, D.A. Vorobiof (Lung Cancer, 2005).

The study

• Authors: R.P. Abratt, N.W. White, D.A. Vorobiof
• Journal: Lung Cancer
• Published: 2005;49 Suppl 1:S13-5
• Cited by: 6 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Summary of the article

This narrative review described the epidemiology of mesothelioma from a South African perspective. The authors recounted how, in the 1950s, Dr C.A. Sleggs, a tuberculosis physician in the Kimberley district of the Northern Cape, noticed patients with pleural effusions that did not respond to anti-tuberculosis drugs. All came from an area of crocidolite deposits, and many, but not all, had worked in the mines. With a thoracic surgeon and a pathologist, he assembled 33 mesothelioma cases in 4 years, and their 1960 paper led to recognition that asbestos causes mesothelioma. The authors stated that asbestos companies deliberately tried to obscure this link. They reviewed the asbestos fibre types and reported that crocidolite is about ten times more potent than amosite, which is about ten times more potent than chrysotile. They described occupational, bystander, household (for example, laundering work clothes) and environmental exposures. They cited 1993 WHO data showing male mesothelioma mortality of 10–50 per million and female mortality of 5–10 per million in most Western European countries. They described three waves of the epidemic: miners, millers and transport workers; wider industrial use of amphibole asbestos; and exposure to asbestos remaining in buildings or during its removal. The authors noted that South Africa's last asbestos mine had closed and that a settlement for South African claimants had been reached with Cape Asbestos PLC in London.

PubMed has no abstract for this study, and the article doesn't print one. We wrote this summary from the full article with the help of AI. It is not the authors' wording.

In plain English

This short article was a review, not a new study. The authors summarized published work on the history, causes and occurrence of mesothelioma from a South African perspective. They recounted how, in the 1950s, Dr. C.A. Sleggs and colleagues near Kimberley assembled 33 cases of the then-rare pleural tumor in 4 years, among patients from the area of the crocidolite-bearing Asbestos Mountains. Citing other studies, the authors reported that crocidolite was about ten times worse than amosite at inducing mesothelioma, and amosite ten times worse than chrysotile. They also reported that only 9% of the crocidolite lung burden is cleared each year. They described exposure at work, exposure of family members who laundered work clothes, and exposure of people living near mines, mills or factories. Citing WHO 1993 data, they gave mesothelioma death rates in most Western European countries of 10 to 50 per million for males and 5 to 10 per million for females. In their conclusion, the authors noted that South Africa's last functioning asbestos mine, Msauli, had closed.

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: Narrative review of published literature (no new data collected)
• Who was studied: No study population of its own. The article reviewed published work on mesothelioma, focusing on South Africa, including the 1950s series of 33 cases collected in the Northern Cape around Kimberley.
• Exposure: Asbestos in general, comparing crocidolite (written 'crocodilite' in much of the article), amosite and chrysotile. Exposures discussed were mining and milling, secondary industry (shipping, locomotive and construction industries), transport of raw fiber, household exposure from laundering work clothes, residential exposure near mines, mills and factories (including an anthophyllite mine in Finland), and removal of asbestos from buildings.
• Main results:
  • Historical finding reported: Sleggs and colleagues assembled 33 cases of pleural mesothelioma in 4 years, published in 1960. The patients came from the area of the crocidolite-bearing Asbestos Mountains, and many, but not all, had worked in the mines.
  • Citing another study: crocidolite was approximately ten times worse than amosite at inducing mesothelioma, and amosite 10 times worse than chrysotile.
  • Citing another study: only 9% of the crocidolite lung burden is cleared each year, with a half-life of about 7 years.
  • The authors stated that wives and other family members were exposed to enough asbestos fiber to cause mesothelioma when workers took their work clothes home for laundering.
  • The authors stated that it has been repeatedly documented that people living close to mines, mills or factories processing asbestos have an increased risk of mesothelioma.
  • Citing WHO 1993 mortality data: in most Western European countries, mesothelioma death rates (per million population, all ages) were about 10 to 50 for males and 5 to 10 for females. The authors attributed the sex difference mainly to differences in exposure.
  • Citing another source: worldwide, mesothelioma occurrence parallels the use of amphibole asbestos, with a lag of 20 to 40 years.
  • The authors described the epidemic as three waves: first, miners, millers and transport workers; second, wider industrial use of amphiboles after the Second World War; third, exposure to residual asbestos or exposure during its removal.
  • Citing another source: South African crocidolite and amosite exports peaked in the late 1970s and ceased in the mid 1990s.
• The authors' conclusion: In their conclusion, the authors noted that the South African legislature had focused on asbestos matters and that the last functioning asbestos mine in South Africa (Msauli) had closed. They also noted that Cape Asbestos PLC had reached a settlement in favour of South Africans with asbestos-related diseases in a London court case, and expressed hope for future prevention and treatment.

Topics

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

Medical terms in this study, explained in our Lexicon: Epidemiology, Mesothelioma, Kimberley, Pleural Effusion, Crocidolite, Amosite, Chrysotile, Environmental Exposure.

Related studies

• South African data on malignant mesothelioma — J.I. Phillips, J. Murray (2009)
• Risk of mesothelioma from exposure to crocidolite asbestos: a 1995 update of a South African mortality study — D. Kielkowski, G. Nelson, et al. (2000)
• Asbestosis in South African asbestos miners — G.K. Sluis-Cremer (1970)
• South African asbestos: production, exports, and destinations, 1959-1993 — J.S. Harington, N.D. McGlashan (1998)
• A respiratory epidemiological study of stevedores intermittently exposed to asbestos in a South African port — J.E. Myers, D. Garisch, et al. (1985)
• Lung cancer, tobacco, and environmental factors in the African population of the Northern Province, South Africa — O. Mzileni, F. Sitas, et al. (1999)

Browse more research in Lung Cancer, or return to medical research.