Written by Karen Selby, RN | Scientifically Reviewed By Arti Shukla, Ph.D. | Edited By Walter Pacheco | Last Update: December 6, 2024

The incidence of mesothelioma in South Africa ranks among the highest in the world.

South Africa reports approximately 200 cases of mesothelioma per year. A 2002 study cites that more than 2,700 South Africans have died of mesothelioma. Researchers say the cancer is underreported.

Environmental exposure accounts for 30% of mesothelioma cases in South Africa. Many are from the Northern Cape area. More than 70% of reported environmental cases affect women and children. Exposure happened when asbestos miners brought home fibers on their hair and clothes.

Diseases such as HIV and tuberculosis are serious health issues for the country. Exposed workers who die of these conditions before developing mesothelioma can skew statistics on the cancer’s true incidence.

South Africa was a global leader in asbestos production. The nation operated a thriving industry for more than a century. But South Africa banned asbestos in 2008.

The ban prohibits the importation and exportation of asbestos. It also bans the use and manufacturing of the mineral.

Cause of Mesothelioma

Africa ‘s asbestos mining and production for more than 100 years are the causes of mesothelioma.

Doctors around the world saw high rates of lung disease in workers exposed to asbestos in the early 1900s. Christopher Wagner, a South African pathologist, discovered a definitive link between the exposure and cancer in 1960.

South African miners drilling for asbestos without safety protection
South African miners suffered for decades from the hazards of asbestos exposure.

Wagner’s findings stemmed from a 1956 autopsy he performed on a South African man who worked at a gold mine. The autopsy revealed no signs of tuberculosis. Instead, he found a tumor in the patient’s right chest and a collapsed lung.

He gained further evidence for his study from Dr. C.A. Sleggs, the chief medical officer of Kimberley Tuberculosis Hospital.

Sleggs performed biopsies after collecting imaging scans from patients who lived near the mine. He found mesothelioma of the pleura in those biopsies. Shortly afterward, Wagner reported the link between the exposure and mesothelioma.

Manufacturers ignored the findings. The industry ramped up the output of crocidolite asbestos from 60,389 tons in 1960 to 155,477 tons in 1974.

Mesothelioma Treatment Centers in South Africa

Mesothelioma patients in South Africa can seek treatment at these cancer centers:

  • Sandton Oncology Centre (Johannesburg)
  • Chris Hani Baragwanath Hospital (Johannesburg)
  • Arwyp Medical Centre (Gauteng)
  • Wilmed Park Private Hospital (Klerksdorp)
  • Steve Biko Academic Hospital (Pretoria)
  • GVI Oncology (Bellville)
  • Netcare Unitas Hospital (Pretoria)
  • Lenmed Health (Johannesburg)

Leading centers in South Africa can provide cutting-edge therapies to cancer patients. But not all facilities have doctors who specialize in mesothelioma. This runs the risk of misdiagnosing patients.

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Who Is at Risk?

South Africans most at risk for developing mesothelioma are former asbestos miners. These workers excavated massive deposits of the mineral from the earth. And they released clouds of toxic dust into the air.

Workers and others who inhaled the dust increased their risk of developing mesothelioma. The disease’s lengthy latency period is 20-50 years after exposure.

Miners of gold, diamonds and other minerals were also at risk. Asbestos can form alongside these minerals. Miners sometimes disturbed these deposits and suffered dangerous exposures.

Even outside of the mines, it was hard for people to escape danger. While the risks to miners were significant, the majority of mesothelioma cases in South Africa have stemmed from asbestos use in secondary industry.

Three such industries known for high risks of exposure include:

  • Steam locomotive maintenance and other types of railway work
  • The asbestos cement industry
  • Artisans who used extensively used asbestos insulation, such as boilermakers

Workers in other professions in South Africa lost their lives after harmful exposures. Those occupations include::

  • Asbestos milling
  • Construction
  • Insulation installation, repair and removal
  • Asbestos product manufacturing
  • Brake pad manufacturing and repair
  • Textile manufacturing and repair
  • Power station maintenance
  • Shipbuilding and repair
  • Power station maintenance
  • Construction
  • Welding

Environmental Exposure

During the mining process, asbestos would become airborne and spread to nearby towns. When people inhaled the dust, they experienced environmental exposure.

Research published in 2021 studied the use of semi-quantitative X-ray powder diffraction (XRD). The technique would determine asbestos contamination levels in soils. The scientists also used this method to assess distribution patterns of asbestos mineral species in the surrounding soils.

The results from the 2021 study indicate that XRD is a useful tool for identifying target areas after rehabilitation efforts that may require more detailed, time-consuming, and costly analysis.

Asbestos has contaminated many parts of South Africa, most notably the Northern Cape Province. A report on Penge concluded that ongoing risks of environmental exposure make the town unfit for habitation. Northern Cape still struggles with exposure risks from the region’s 82 remaining asbestos mine dumps.

Asbestos Use in South Africa

South Africa is a country rich with minerals, known worldwide for its ample deposits of gold and diamonds. The nation also has a long history of mining and exporting asbestos, a toxic mineral fiber linked to the rare and aggressive cancer mesothelioma and various other diseases.

Although South Africa officially banned the use, processing and manufacturing of asbestos-containing products in 2008, past exposures from decades ago eventually raised the country’s incidence of mesothelioma to one of the highest rates in the world.

Out of the six types of asbestos minerals used commercially, South Africa has mined three on a large scale: amosite, chrysotile and crocidolite. While South Africa has used asbestos domestically for a variety of different purposes, the vast majority of its mined reserves were exported to other countries.

South Africa was the third largest asbestos producer in the 1970s, behind Canada and the USSR. The nation was once a global leader in the production of crocidolite and amosite, supplying approximately 97 percent of the world’s crocidolite and practically all of the world’s amosite.

The asbestos mining industry in South Africa reached its peak in 1977 when it employed 20,000 miners and achieved an output of 380,000 tons. Exports began to decline soon after, as evidence of serious health complications prompted countries around the world to enact restrictive legislation on asbestos use.

Between 1910 and 2002, South Africa mined more than 10 million tons of asbestos. The last of the nation’s asbestos mines ceased production in 2001 and closed down the following year. South Africa outlawed all types of asbestos by 2008, but the once-lucrative industry has left the environment polluted. Asbestos exposure risks continue to threaten the well-being of South Africans to this day.

Exposure in South Africa

South Africa once operated numerous mines that provided the bulk of the world’s supply of the mineral. Over the years, mining at these sites caused large-scale occupational and environmental exposures to toxic dust.

The South African asbestos mines were owned by subsidiaries of major European corporations, including Griqualand Exploration and Finance Company Ltd., Turner & Newall Ltd. and the Cape Asbestos Company. These corporations cared little about the welfare of their South African workers or the people who lived near the mines. Health and safety standards at the South African mines were incredibly poor, especially compared with the mines the companies operated in Europe.

Because many of the South African mine workers — including women and children — were largely undocumented, it is difficult to assess the true scope of harm the mines caused. The country reports about 200 cases of mesothelioma per year, but most likely this is an underestimate.

Products

Asbestos’s natural resistance to heat, chemicals, acid and electricity made it a highly desirable material that served a wide range of uses. Manufacturers primarily used the mineral for insulation and fireproofing applications, but it has more than 3,000 documented uses.

In South Africa and worldwide, asbestos was once a popular material in:

  • Boilers
  • Steam pipes
  • Asbestos cement
  • Roofing and other construction materials
  • Steel supports in buildings
  • Air conditioning ducts
  • Textiles
  • Brakes, gaskets and clutch pads

However, the main pathway of asbestos exposure for South Africans has historically been work-related, primarily in professions like mining, milling, construction, insulation work and asbestos cement manufacturing.

For example, in February 2019, the Ndlambe Municipality had to halt demolition and renovation work on a residential home because asbestos was found. A neighbor reported that the roof contained asbestos and that workers were not taking safety precautions to avoid exposure.

Legacy of Mining in South Africa

Many decades of asbestos mining and use in South Africa have taken a serious toll on the region and its people. And the spread of asbestos-related disease has extended far beyond the asbestos mines and mills. The mineral fiber contaminated many other areas as workers transported it by donkey, wagon, truck, train and ship.

Although South Africa has banned all mining, manufacture, import and export of asbestos and products that contain it, the toxic mineral persists in the environment. There are still massive asbestos deposits underground, and legal mining operations continue to unintentionally disturb them and stir up toxic dust.

Many older buildings and structures likely contain asbestos materials, which pose serious health risks to construction workers involved in demolition and repairs. Even though South Africa has outlawed the recycling of asbestos-containing materials, it still occurs because of a shortage of housing and building materials in the country. Additionally, the disposal of asbestos materials and the maintenance of asbestos dump sites continue to threaten the health of South Africans.

Litigation, class actions and out-of-court settlements have prompted some companies that once mined asbestos in South Africa to establish asbestos trust funds, including the Asbestos Relief Trust (ART) and the Kgalagadi Relief Trust (KRT). These trusts provide monetary compensation to qualified individuals who developed an asbestos-related condition after occupational exposures.

Access to the trust money is restricted to past employees of participating mines and people who lived near the mines who suffered environmental asbestos exposure. The trusts have also allocated some money to manage environmental contamination, but much more is needed to clean up the contaminated land, railways, mines and asbestos waste dumps that remain.

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