South Africa faces an asbestos epidemic. Thousands of people across the nation currently suffer from ARDs, and hundreds continue to die each year in what is arguably South Africa's single largest environmental and industrial health catastrophe.
In areas where asbestos was mined for decades, the disease burden is staggering. In some areas, over 30% of the population is sick from a mineral dust that is highly persistent and sometimes not even visible(1, 2). Men who spent years as miners without even the most basic protection now struggle to breath as asbestos fibres scar their lungs. Women who "cobbed" asbestos (separated the fibres from the host rock) from iron ore for transport to local mills die of lung cancer thirty years later. A nurse who never worked with asbestos, but spent her life caring for patients downwind from her town's mill and surrounding mines, has lost a difficult battle with mesothelioma, a deadly cancer of the pleura surrounding the lung. People exposed as children are faced with the onset of disease in their twenties and thirties, a development not usually seen until after age 50 among workers exposed through their occupations.
How could such a public health catastrophe happen? For years asbestos was mined, milled, and used across South Africa and exported around the world. Yet as early as the 1920s there was evidence that asbestos was not only dangerous, but deadly. This body of evidence, ironically much of it South African, grew during the 1960s - yet individuals continued to become sick and areas continued to be contaminated. Mining companies and the apartheid government required few safety precautions even for workers classified as white, while almost completely ignoring dangers to workers classified as blacks and coloureds, most of whom worked the riskiest jobs with the lowest pay. The effects of secondary environmental exposure, that is exposure through industrial contamination of the environment, in nearby villages were hardly considered. And while the rest of the world began discouraging and even banning asbestos use amid the increasing burden of occupational and environmental cancers, South African companies continued to insist that their product was safe, while achieving their largest production levels and profit margins of the century(3, 4).
Although all the mines and mills in South Africa are now effectively closed, their legacy lives on. Because of the long latency periods for ARDs, public health researchers expect to see the effects of occupational mining exposure for at least the next thirty to forty years. More importantly, environmental exposure continues. Despite efforts by the government, no more than half of the nation's former mines are adequately rehabilitated. Fibres can travel up to 100km in the wind, and most mines are well within 20km of settlements. In many of these villages, asbestos continues to contaminate houses, streets, gardens, schools and playgrounds. Yet with limited resources for cleanup, health education, surveillance and treatment, the burden of ARDs continues.
In these circumstances, many place their hope in the legal case against Cape Plc., which is currently being heard in London on behalf of thousands of people. But the Cape Plc. case, even if successful in bringing some compensation to over 6,000 individuals, is not a panacea or a solution to the continued problem of asbestos contamination. The indestructibility of asbestos fibres requires us to commit to a long-term effort to rid living spaces and workplaces of these fibres and ensure that those already exposed receive treatment and compensation. Moreover, because more people are exposed and affected each day, the asbestos problem requires rapid response to minimise and eliminate risks.