South African data on malignant mesothelioma

Our plain-English summary of South African data on malignant mesothelioma, by J.I. Phillips, J. Murray (Industrial Health, 2009).

The study

• Authors: J.I. Phillips, J. Murray
• Journal: Industrial Health
• Published: 2009;47(2):198-9
• Type of article: Comment, Letter
• Read it: PubMed · Publisher

In plain English

This was a letter to the editor, not a research study. The authors wrote in response to a published review of 89 articles on mesothelioma worldwide, which had found no data from South Africa or Sub-Saharan Africa. They noted that chrysotile, amosite and crocidolite were all mined commercially in South Africa, and that mining stopped in 2002. They described Pathaut, a database of autopsies done since 1975 by the National Institute for Occupational Health in Johannesburg on deceased mine workers for compensation purposes. It holds some 100,000 cases. In 2007, 1,724 cases came to autopsy. Of these, 64 were ex-asbestos mine workers, and 52 of the 64 had asbestosis. The overall asbestosis rate was 30 per 1,000 autopsies. Across all autopsies there were 22 cases of malignant mesothelioma of the pleura in 2007 (13 per 1,000 autopsies). This compared with 23 in 2006 (13 per 1,000), 41 in 2005 (22 per 1,000) and 25 in 2004 (12 per 1,000). The authors believed the data were accurate because they came from autopsies and the diagnoses were confirmed by tissue examination under the microscope (histopathology). They noted that the database covers only workers from mining, quarrying and foundry industries. Disease caused by asbestos in buildings would therefore not be included.

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: Letter to the editor reporting summary figures from a national autopsy database (Pathaut)
• Who was studied: Deceased mine workers and retired mine workers autopsied by the National Institute for Occupational Health in Johannesburg, South Africa. The Pathaut database has held records since 1975 and contains some 100,000 cases. In 2007 there were 1,724 autopsies.
• Exposure: Work in South African mining, including asbestos mining, where chrysotile, amosite and crocidolite were all mined commercially. The database also covers quarrying and foundry workers. No fiber type is given for individual cases.
• Main results:
  • In 2007, 64 autopsies were on ex-asbestos mine workers, and 52 of these had asbestosis
  • In 2007, the overall asbestosis rate was 30 per 1,000 autopsies
  • In 2007, across all autopsies, there were 22 cases of malignant mesothelioma of the pleura (13 per 1,000 autopsies). This was similar to 23 cases in 2006 (13 per 1,000).
  • There were 41 pleural mesothelioma cases in 2005 (22 per 1,000 autopsies) and 25 in 2004 (12 per 1,000 autopsies)
• The authors' conclusion: The authors believed the Pathaut data were accurate because they are based on autopsies with diagnoses confirmed by histopathology. They hoped the database would help authors conducting global reviews.
• Limitations the authors state:
  • The database contains only deceased workers from the mining, quarrying and foundry industries
  • Health effects of environmental exposure, such as asbestos products in buildings affecting builders and renovators, would not be captured

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: Malignant Mesothelioma.

Related studies

• Relationships between simultaneous airborne dust samples taken with five types of instruments at South African asbestos mines and mills — R.S. Du Toit, L.W. Isserow, et al. (1983)
• Effects of commodity on the risk of emphysema in South African miners — S.L. Mabila, K.S. Almberg, et al. (2020)
• Asbestosis in South African asbestos miners — G.K. Sluis-Cremer (1970)
• Some investigations into the nature and cause of massive fibrosis (MF) in the lungs of South African gold, coal, and asbestos mine workers — M.C. Leibowitz, B. Goldstein (1987)
• Cape Plc: South African mineworkers' quest for justice — R. Meeran (2003)
• South African experience with asbestos related environmental mesothelioma: is asbestos fiber type important? — N. White, G. Nelson, et al. (2008)

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