by Linda Ensor

No warning signs

Even though the risk of mesothelioma is small, the disease is deadly

Even though the risk of mesothelioma is small, the disease is deadly
Asbestos exposure is linked to a deadly lung cancer

Adriaan Lombaard grew up in the small town of Rierees in the Northern Cape, where he and his brother passed their afternoons swimming in the dam and playing in the dumps from the local asbestos mine. They had no inkling of the dangers they were exposing themselves to.

Despite the fact that South Africa was the site of ground-breaking research linking asbestos exposure to an excruciatingly painful and deadly lung cancer called mesothelioma more than a decade before Mr Lombaard was born, there were no warning signs or fences to keep children away from the contaminated land they played on. South Africa was the world’s third-largest producer of asbestos at the industry’s peak.

Now 42, Mr Lombaard has mesothelioma. Asbestos has cut a swathe through his family: his older brother too is battling mesothelioma, and their father died of an asbestos-related disease in 1982.

Mr Lombaard has successfully sought compensation from the Asbestos Relief Trust (ART), which recently paid him R500,000. But for many other South Africans with environmentally-acquired asbestos-related diseases, there is nowhere to turn.

"Legislation just takes care of the worker but many other people were exposed to asbestos in the course of their everyday lives," says scientist Zodwa Ndlovu, National Health Laboratory Service.

"Miners came home from work with clothes covered in asbestos fibres that family members would inhale, and there was extensive neighbourhood exposure. People would even take blue asbestos from the dumps and build their houses from it," she says.

South Africa mined three types of asbestos — blue (crocidolite), brown (amosite) and white (chrysotile), of which blue is the most dangerous.

People who acquire asbestos-related diseases (ARDs) at work can claim financial assistance from the Compensation Commission for Occupational Diseases administered by the Department of Health.

But at present the only source of redress for people with environmentally-acquired ARDs are the ART and the Kgalagadi Relief Trust (KRT), which were established by legal settlements with mining companies.

Many barriers stand in the way of claimants seeking compensation from these trusts, says Dr Ndlovu, who published research on the Relief Trust’s payouts earlier this year in the journal Global Health Action. The trusts do not actively promote themselves to environmental claimants, and the onus is on patients to provide medical evidence of their illness at their own expense.

Claimants must have lived within 10km of qualifying mines or mills around Kuruman, or prove their home was polluted with asbestos by someone who worked at one of these sites. The ART only covers people exposed to asbestos between 1965 and 1988, while the KRT covers the period 1952 to 1981.

Dr Ndlovu found only 146 of the almost 15,500 claims submitted to the trusts were related to environmental exposure to asbestos, and only half of these got compensation. They were the "lucky" ones.

For patients who were exposed to asbestos outside this timeframe, or in a part of the country that falls outside the trusts’ parameters, there is nowhere left to turn.

Asbestos-related diseases have an unusually long latency period, and people exposed to the mineral as a child or young adult may become sick only 40 or 50 years later, says Jill Murray, former head of pathology at the Institute of Occupational Health (NIOH)  "We mined asbestos for nearly 100 years over large parts of the country, and in all that time the dust control was very poor. There are probably hundreds of thousands of people who have been and continue to be exposed to environmental asbestos," she says.

Asbestos mining stopped in South Africa in 2002, but it was not until 2008 that the import, export, manufacture and sale of asbestos products was banned.

Without an energetic activist movement campaigning on behalf of asbestos victims today, the government is under no pressure to clean up contaminated sites or look into the issue of financial assistance for people with environmentally acquired diseases. Nor is it in any hurry to assess how many people were exposed to asbestos in the past and what proportion of them are likely to fall ill in the future.

"Government simply lacks the will," says attorney Richard Spoor, who represented asbestos claimants in the class action lawsuit against Gencor that led to the establishment of the ART.

Mintek told Parliament last year that there were more than 250 asbestos mines that required rehabilitation at a cost of R3bn.

Department of Environmental Affairs director for land remediation, Mpho Tshitangoni, says his department conducted an assessment of "secondary" asbestos contamination of non-mining areas in 2009, but the information it contains has yet to be approved.

Despite the lack of data, Prof Murray says the future financial burden posed by people affected by environmental exposure to asbestos is unlikely to be too great for the government to stomach. "Although many hundreds of thousands of people were and are exposed to asbestos in the environment, the risk of mesothelioma is small. But the disease is deadly, and no one should say the state can’t afford compensation," she says.

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