Source: International Congress 2015 – Occupational and environmental cohort investigations and population studies

Abstract

IntroductionSouth Africa (SA) mined asbestos for more than 100 years and was the leading producer of crocidolite and amosite; mining ceased in 2002. SA is now among the 10 countries with the highest burden of mesothelioma. SA law allows for autopsy examination of the lungs of miners for compensation. Data from these autopsies were analysed to describe mesothelioma cases and determine time trends .MethodsMesothelioma cases diagnosed from 1975 to 2013 were described by year of death, age and asbestos mining duration (a proxy for asbestos exposure in the absence of dust measurements). Mesothelioma trends and explanatory factors were estimated, using logistic regression.ResultsIn the 39 year study period, 860 mesothelioma cases were diagnosed (0.8% of total autopsies). Mean age at death was 59.2±12.5 years; 37 (4.3%) were younger than 40. Of the 379 miners with documented asbestos mining duration, 177 (46.7%) had less than five years' service. The proportion of mesothelioma cases averaged 0.5% from 1975 and increased three-fold from 1.1% to 3.3% from 2004 to 2013. The increasing trend was associated with increasing year of death and age.DiscussionMesothelioma in SA is diagnosed at younger ages than in many developed countries, and often after only a few years of exposure. This is probably due to the type of asbestos mined and the high intensities of exposure. Although 860 cases is probably an underestimate of the number of affected former asbestos miners, this analysis shows that mesothelioma continues to be a legacy of asbestos mining in SA. The increase from 2004 is likely due to the active case finding programme which was instituted by the Asbestos Relief Trusts under the provisions of a legal settlement.


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Jill Murray (Johannesburg, South Africa), Jill Murray, Ntombizodwa Ndlovu, Gill Nelson. Mesothelioma in South African miners 1975-2013. Eur Respir J 2015; 46: Suppl. 59, 1164

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