Compensation for environmental asbestos-related diseases in South Africa: a neglected issue

Abstract

BackgroundEnvironmentally acquired asbestos-related diseases (ARDs) are of concern globally. In South Africa, there is widespread contamination of the environment due to historical asbestos mining operations that were poorly regulated. Although the law makes provision for the compensation of occupationally acquired ARDs, compensation for environmentally acquired ARDs is only available through the Asbestos Relief Trust (ART) and Kgalagadi Relief Trust, both of which are administered by the ART. This study assessed ARDs and compensation outcomes of environmental claims submitted to the Trusts.MethodsThe personal details, medical diagnoses, and exposure information of all environmental claims considered by the Trusts from their inception in 2003 to April 2010 were used to calculate the numbers and proportions of ARDs and compensation awards.ResultsThere were 146 environmental claimants of whom 35 (23.9%) had fibrotic pleural disease, 1 (0.7%) had lung cancer, and 77 (52.7%) had malignant mesothelioma. 53 (36.3%) claimants were compensated: 20 with fibrotic pleural disease and 33 with mesothelioma. Of the 93 (63.7%) claimants who were not compensated, 33 had no ARDs, 18 had fibrotic pleural disease, 1 had lung cancer, and 44 had mesothelioma. In addition to having ARDs, those that were compensated had qualifying domestic (33; 62.2%) or neighbourhood (20; 37.8%) exposures to asbestos. Most of the claimants who were not compensated had ARDs but their exposures did not meet the Trusts’ exposure criteria.ConclusionsThis study demonstrates the environmental impact of asbestos mining on the burden of ARDs. Mesothelioma was the most common disease diagnosed, but most cases were not compensated. This highlights that there is little redress for individuals with environmentally acquired ARDs in South Africa. To stop this ARD epidemic, there is a need for the rehabilitation of abandoned asbestos mines and the environment. These issues may not be unique to South Africa as many countries continue to mine and use asbestos.

Epidemiology of Environmental Exposure and Malignant Mesothelioma

“…Local hospital registries are another common source for identification of MM cases. In addition, one study used compensation data to identify MM cases 56 and one study used pooled data from existing wellestablished study cohorts. 60 Most of the studies used registry data to analyze the spatiotemporal trend of crude and/or adjusted incidence of MM diagnosis and/or mortality (see Table 1).…”

In vivo Optical Coherence Tomography Imaging of the Mesothelium Using Developed Window Models

“…The differential diagnosis of DPT and pleural plaques from a diagnostic view has become important. In addition, an asbestos compensation law has also been established [21]. Therefore, the TV window model with an advanced diagnostic tool to differentiate MM from tuberculosis needs to be further investigated.…”

Guest Editorial: Building new knowledge: Celebrating the Wits School of Public Health (WSPH)

“…Neat compartmentalisation into categories however does not describe reality. The article by Ndlovu et al (27) illustrates that commercial exploitation of mineral resources has health consequences for the surrounding communities. However, these communities are further disadvantaged by insufficient compensation and measures that address the source of the problem.…”