Rapporteur?s Report Session III: Exposure To Grunerite (Amosite) Asbestos: Historical Perspectives Of The Health Effects

The development of information concerning mesothelioma in South Africa started with the 1959 finding of Dr. J. Christopher Wagner of cases of mesothelioma in persons living in the vicinity or working in crocidolite mines in Cape Province. After more than 40 years, the data from South Africa now provide important insights into the differences in mesothelioma risk associated with different asbestos fiber-types. Three case series reports and one analytical report were reviewed in this session. In total, information on 504 proven cases was presented. There were 28% of cases arising from occupational exposure in mining, 35% from non-mining occupations, 23% from environmental exposures; 14% where no exposure was established and 9% where the exposure was unknown. Among the 129 cases for which occupational exposure and asbestos fiber-type were established, 115 cases were associated with occupational exposure to Cape crocidolite; 1 case associated with occupational exposure to Transvaal crocidolite and 9 cases with occupational exposure to amosite (grunerite asbestos) and 4 cases with occupational exposure to mixed fiber-types. There were no cases associated with chrysotile asbestos. There were 33 cases of environmental mesothelioma linked to Cape crocidolite exposure and 2 to exposure to amosite and crocidolite but none to Transvaal amosite alone or to chrysotile. The evidence shows that amosite is capable of causing mesothelioma but that the major risk in South Africa is associated with Cape crocidolite.