South African data on malignant mesothelioma.

Mesothelioma: Global Incidence and Relationship with Asbestos 1). The authors conclude that for very large parts of the world, data on mesothelioma incidence/mortality are not available and this constitutes a serious obstacle to the progress of knowledge of mesothelioma. No data was available from South Africa or Sub-Saharan Africa. The African continent was represented with data from Morocco and Tunisia only. Chrysotile, amosite and crocidolite were all mined on a large commercial scale in South Africa, which was the world's largest producer of both crocidolite and amosite asbestos. The mining of asbestos in South Africa ceased in 2002. The association between crocidolite and malignant mesothelioma was first described by Wagner et al 2). This study of 33 cases of pleural mesothelioma from the Cape, crocidolite, asbestos fields, has become a citation classic. It is the most cited paper in prominent occupational medicine journals 3). Wagner worked at what is now called the National Institute for Occupational Health (NIOH) in Johannesburg, South Africa. Currently, one function of the NIOH is to perform an autopsy service on behalf of the families of deceased mine workers and retired mine workers for compensation purposes. In South African law, pneumoconiosis, tuberculosis and asbestos related diseases are compensable in terms of the Occupational Diseases in Mines & Works Act: Act 78 of 1973. The autopsy service is utilized by 80% of families of miners who die while in mining service. Since 1975, computerized records of these autopsies have been stored in a database called Pathaut. The NIOH Pathaut database is a national resource and is used to monitor disease trends and has been the basis of many local and international collaborative research projects, including asbestos related research 4–6). There are some 100,000 cases in the database and histopathology slides and wax blocks of the cases are archived. The diseases seen in mine workers include pulmonary tuberculosis, emphysema, silicosis, lung cancer, massive fibrosis, coal workers pneumoconiosis, mixed dust pneumoconiosis as well as asbestosis, pleural plaques and mesothelioma. A Pathaut report is produced annually and is in the public domain. It can be accessed through the NIOH web site at the following address: We believe the information is accurate as it is based on autopsy data and diagnoses are confirmed by histopathology. During 2007, 1,724 cases came to autopsy at the NIOH. 64 autopsies were performed on ex-asbestos mine workers and 52 of these had asbestosis. The overall …