Mesothelioma in South Africa

The incidence of mesothelioma in South Africa ranks among the highest in the world. The hefty mesothelioma count stems from the country’s extensive history of asbestos mining and production over more than a century.


South Africa reports approximately 200 cases of mesothelioma per year. One 2002 study cites that more than 2,700 South Africans have died of mesothelioma, and researchers believe the cancer is vastly underreported.

Nearly 30 percent of mesothelioma cases in South Africa are tied to environmental exposure, most commonly in the Northern Cape area. More than 70 percent of reported environmental cases affect women and children, who most likely were exposed when miners brought home the fibers on their hair and clothes. Diseases like HIV and tuberculosis are serious health issues for the country, so exposed workers who die of these conditions before developing mesothelioma can skew statistics on the rare cancer’s true incidence.

A former global leader in asbestos production, South Africa once operated a thriving industry for more than a century. Extensive mining and use of the mineral in the past have resulted in thousands of deaths from mesothelioma, a rare and aggressive cancer almost exclusively caused by asbestos exposure.

Cause of Mesothelioma


Although doctors around the world noticed unusually high rates of lung disease in asbestos-exposed workers as far back as the early 1900s, Christopher Wagner, a South African pathologist, did not discover a definitive link between the exposure and cancer until 1960.

His journal article on the subject, “Diffuse Pleural Mesothelioma and Asbestos Exposure in the North Western Cape Province,” became the most quoted paper in occupational medicine and triggered a massive wave of research on related disease.

Wagner’s findings stemmed from a 1956 autopsy he performed on a South African man who worked at a gold mine — the setting for many harmful exposures. Tuberculosis was a serious endemic disease at the time, but doctors struggled to explain why patients living and working west of South Africa’s Kimberley area did not respond to treatment as well as those living elsewhere.

Wagner’s autopsy revealed no signs of tuberculosis, but instead 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.

After collecting imaging scans from 14 patients who lived near an asbestos mine, Sleggs performed biopsies and confirmed the presence of mesothelioma. Shortly after, Wagner reported the link between the exposure and mesothelioma.

Many were shocked at South Africa’s response to Wagner’s findings. Senior officers of the Department of Health demanded industry review of future research papers. Despite evidence of serious risks to workers, the industry ramped up the output of crocidolite asbestos from 60,389 tons in 1960 to 155,477 tons in 1974.


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