Mesothelioma in South Africa 3 decades post peak of asbestos production an analysis of a claims database of asbestos ex-miners

Master Thesis


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University of Cape Town

The peak in production of the three forms of asbestos that were commercially mined in South Africa occurred in the years between 1970 and 1977. Given the latency period of 20-40 years, we should expect to observe a rise in the incidence of mesothelioma throughout this decade. However, all we may ever observe is just the surface of what may be an immeasurable burden of disease due to amongst other reasons, the lack of representative data and the nature of mesothelioma itself. As a result of the obstacles that impeded earlier research, South African studies that have been conducted since Wagner et al. first established the association between asbestos and mesothelioma in 1960, have reported under estimated measures of occurrence of the disease, especially amongst black examiners. It also due to the exploitation and injustice to former miners throughout the asbestos mining history that we remain with an unknown burden and epidemiology of disease as well as heavy costs towards healthcare and rehabilitation of mine dumps. The author sought to review the medical information of claimants registered on an asbestos compensation database hosting the largest number of black asbestos ex-miners of all case series published in South Africa to date. The aim was to describe the demography and the epidemiology of the disease amongst those who had been diagnosed with mesothelioma between 2003 and 2010. The protocol (PART A) describes a brief background of the two Trusts on which this study was based, and the methodology of the study. The literature review (PART B) illustrates the conditions that prevailed in the asbestos mining industry and how these have distorted the epidemiology of mesothelioma in South Africa. The manuscript of the article (PART C) illustrates the data analysis, the results, as well as the discussion of the results. The objective was to describe the proportions of mesothelioma cases within the database by various characteristics. We also described by race the investigations that the claimants underwent to reach the diagnosis. The results showed that out of the 15 461 claimants registered on the database, 295 (1.91%) had mesothelioma. Of these, 54.24 % were black, 7.80% coloured and 37.97% white. There were more men (76.69%) than women (23.39%).

Includes bibliographical references.