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Book Review Asbestos Blues/Labour, Capital, Physicians and the State in South Africa by Jock McCulloch, Bloomington, IN: Indiana University Press, 2002. 223 pages. cCulloch, an Australian histo Mrian, is also the author of an workers was avoided for decades. All decisions costing more than 30 earlier book about asbestos miningBritish pounds had to be approved in his own country, Asbestos. Its by corporate headquarters (1947). Human Cost. He has searched out As late as 1962, Cape's medical what remains of the record of the director, Walter Smither, came down history of asbestos mining in South from Britain and observed that Africa and interviewed many there were many cases of what he people who were involved, locating called vitamin deficiency, but made surviving reports and correspon no recommendations to the Board. dence of government health offi State health officials reported scurvy cials, mine engineers, Native Affairs on many occasions and also found officials, and a diverse array of pub plague, tuberculosis, and typhus; in lished sources which, added to one case, the Cape manager lied to material obtained in interviews, he a government official, claiming the uses to tell this detailed and company had built a hospital in the uniquely South African story. town of Prieska. For decades, the Many government records and state looked the other way on Cape's photographs had been destroyed, gross abuse of the working people, including thousands of pages of its utter lack of willingness to pro reports of thrice-annual inspections vide housing, sanitation, or medical required by law between 1960 and care. The mining was poor people's 1980. Asbestosis was not mentioned work; men blasted and extracted the in a Department of Mines annual ore, their wives hammered the report until 1968, 75 years after the asbestos fiber free of the hard host start of asbestos mining in South rock with their babies beside them. Africa. In the 1960s, publications by Workers practically starved, while the government's Pneumoconiosis mine management cheated them in Research Unit had to be sent first weighing the fiber brought in and to the asbestos industry for prior Cape's company stores overcharged approval. them for cornmeal. The annals of toxic corporate Cape operated a mill in the crime are replete with horrific sto center of the town of Prieska to sep ries of inhumanity, but the story of arate the deadly blue (crocidolite) asbestos mining in South Africa is asbestos from its host rock. Mine in a class by itself. A central player tailing wastes were strewn all in the story is Cape Asbestos, a around the town, and the contami British multinational corporation nation remains a mortal threat to that managed contract mining the people there to this day. employment under conditions that Wanton environmental contamina were unusually harsh even for tion from mining included the sur South Africa. facing of roads with mine tailings, Cape was subject to asbestos reg children playing on tailings dumps, ulations in its British plants after the women washing clothes in the early 1930s, but in South Africa even Orange River beside tailings the modest cost of preventing scurvy dumps, infants sleeping on asbestos by providing some citrus fruits to its sacks, and the common use of tail ings and mud to make bricks and plaster walls of homes. Chest X-ray abnormalities typical of asbestos exposure are widespread in Prieska's adult population. This is particularly alarming because of the high associated risk of mesothe lioma documented by Drs. Kit Sleggs, Chris Wagner, and Paul Marchand in this region starting in the 1950s. Their 1960 report of 33 South African cases of rare pleural mesothelioma, 32 with occupa tional and/or environmental asbestos exposure histories, trig gered worldwide investigations, and mesothelioma would become recognized as a signal tumor for asbestos exposure. In 1962, Cape's most senior medical officer, Walter Smither, tried to transfer 10 mesothelioma victims hundreds of miles from Prieska to Johannes burg, a difficult journey for termi nal cancer patients, to remove them from what Smither called "the area of conflict." He did this to defuse local discontent over "the mesothelioma scare" and ensure that they died out of sight of their relatives and members of the Prieska community. A government report on mesothelioma and envi ronmental asbestosis at Prieska was suppressed that year. At the cabinet level, the Secretary of Mines sent a crisis memo to his counterpart in the Treasury in 1963, laying out the overview of asbestos' hazards as a devastating threat from both the health and economic points of view. This bad news was tightly held, McCulloch reports: Over the next 15 years, asbestos production continued to rise, 242 but no further research was done into the impact of asbestos on human health. Industry and the state were allies with a common interest to protect the foreign exchange generated by South African asbestos. There was no disclosure to consumers or to the general public. In its place was a studied silence, which protected the mining industry and its mar kets. We will never know how many people died as a result. The apartheid system in South Africa was freely exploited by the British multinational asbestos com panies. With no trade unions or gov ernmental protection in South Africa, it was easy for mining compa nies to hide the deadly truth, while at the same time avoiding pressure on the government to do research that would further explore the threat to human life. Even mid-level officers of Cape's South African enterprises were not told about mesothelioma. The South African government's failure to do research on human health effects in the 1960s and 1970s deprived unions and gov ernments in Europe and North America of additional information to counter the prolonged growth of markets for asbestos. The initial failure to find mesothelioma cases in the amosite asbestos mining area in the north east of South Africa was a result of the poverty and isolation, the utter lack of medical services there, and the very high proportion of migrant workers from Mozambique. This lack of data was nonetheless seized upon by asbestos interests as a reason for questioning whether there was a relationship between amosite and mesothelioma. Well after the capacity of amosite to cause mesothelioma was docu mented, the risk was downplayed in a 1991 publication by Dr. Wagner; it was not disclosed at that time that Wagner was a paid consultant to Owens-Illinois (O-I), a company with large liabilities from having sold an insulation product contain ing amosite asbestos. Wagner's retention by O-I (for "$6,000 per month for some period of time irrespective of whether Dr. Wagner did any work for O-I . . . paid by OI to a bank account in the US in the name of a third party") was publicly revealed in an affidavit filed in a Texas court in January 2000, in a lawsuit between O-I and the domi nant U.K. asbestos company, T&N. The author was the senior lawyer for T&N in the United States; T&N and O-I had shared secrets as co defendants in damage suits prior to their falling out. This sworn state ment was at first withheld from public disclosure by the court, and it is not possible to know what Wagner would have said if asked about it; he died in July 2000. Asbestos Blues contains the first pub lished account of this story. McCulloch made a prodigious effort to understand and explain not only the big picture but also the conduct of the individual doctors, government officials, and man agers, conducting lengthy inter views with many of the participants and their family members. BarryI. Castleman, D.Sc. Environmental Consultant P.O. Box 188 Garrett Park, MD 20896 (301) 933-9097 VOL 10/NO 2, APR/JUN 2004 www.ijoeh.com Book Review 243