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FILE NAME Cape Asbestos CAPE DATE 2004 DOC CAPE020 DOCUMENT DESCRIPTION Journal Article - McCulloch & Tweedale Double Standards The Multinational Asbestos Industry & Asbestos Disease in South Africa The Politics of Environmental Health Policy The Politics ofEnvironmental Health Policy DOUBLE STANDARDS THE MULTINATIONAL ASBESTOS INDUSTRY AND ASBESTOS DISEASE IN SOUTH AFRICA Jock McCulloch and Geoffrey Tweedale This study documents and contrasts the development of knowledge about asbestos disease ARD in South Africa and the United Kingdom It also contributes to the globalization debate by exploring corporate decisionmaking in a multinational industry Between the 1930s and 1960s the leading U.K. asbestos companies developed a sophisticated knowledge of ARD though in South Africa where the leading companies such as Turner & Newall and Cape Asbestos owned mines there was little attempt to apply this knowledge Asbestos mines and their environments in South Africa were uniquely dusty and ARD was rife Social and political factors in South Africa especially apartheid allowed these companies to apply double standards even after 1960 when the much more serious hazard of mesothelioma was identified This shows the need for greater regulation of multinationals Because of the lack of such regulation in the early 1960s an opportunity was lost to prevent the current high morbidity and mortality of ARD both in South Africa and worldwide The purpose of this article is fold to document the development of knowledge about an occupational health hazard in a multinational industry and to contribute to the literature on globalization The chosen industry is asbestos the country is South Africa Asbestos is now one of the studied industrial and environmental health hazards reflecting the enormous current and projected mortality from asbestos disease ARD Brodeur 1 and Castleman 2 have documented the history of the American asbestos industry Flynn 3 and McCulloch 4 have studied South Africa Wikeley 5 Tweedale 6 and Johnston and McIvor 7 have explored the British experience International Journal of Health Services Volume 34 Number 4 Pages 663-679 2004 '2004 Baywood Publishing Co. Inc. 663 Receiver_00124637 664 / McCulloch and Tweedale These studies have sometimes examined the international ramifications of asbestos but as yet there has been no systematic attempt to link and contrast British and South African developments This article brings together for the first time research that we have undertaken since the 1990s This work was conducted and published independently but new insights have been gained by subsequent collaboration which has allowed a much closer scrutiny and comparison of the United Kingdom and South Africa This is important for several reasons It was in Britain that the hazards of asbestos manufacture were first appreciated and the first attempts were made to control dust and compensate workers It was also British firms that were most active in the South African asbestos mining industry Asbestos therefore provides an excellent case study of the behavior of multinationals in a major industry This is more than merely academic interest it also impinges on contemporary legal political and social issues 8 Many of the current concerns about globalization are reflected in the history of asbestos in South Africa Did multinational companies behave responsibly What was the extent of their knowledge about ARD To what extent did political and economic factors shape corporate decision Above all did multinational asbestos companies seek to apply as they claimed practice standards in health and safety abroad ECONOMIC AND MEDICAL CONTEXT Asbestos is a fibrous mineral which can be subdivided into three main types white chrysotile blue crocidolite and brown amosite The relative indestructibility high tensile strength and fireproof qualities of asbestos fiber made it a key engineering and building material in the 20th century World asbestos production became dominated by Manville in the United States and Turner & Newall N and Cape Asbestos in the United Kingdom These were multinational companies with mines in South Africa and Canada and factories in the United States and the Far East It was in South Africa and also in former southern Rhodesia now Zimbabwe and Swaziland that U.K. firms were most active Table 1 Blue asbestos was mined in the north and eastern Transvaal and western Cape of South Africa from 1893 until 1997. In Rhodesia the first chrysotile mines opened in 1917 and are still operating The major mines were owned and operated by three U.K. firms Cape Asbestos and its subsidiary Cape Asbestos South Africa Pty CASAP the Griqualand Exploration & Finance Company Ltd. GEFCO and N which operated a string of African mining subsidiaries such as Rhodesian & General Asbestos Corporation and New Amianthus Mines Ownership of the mines usually through a web of holding companies and cross directorships was often complex but although routine management was in the hands of the man they were directed from head office and frequently visited by U.K. managers and medical personnel This trio of companies exported fibers to more than 50 countries they also used 00124638 Asbestos Disease in South Africa / 665 Table 1 Cape Asbestos U.K. asbestos companies and South African mines Year established Headquarters South African mines Period operational under U.K. ownership 1893 London Egnep Penge Transvaal Amosa Penge Koegas Cape Province 1893-1979 Turner & Newall N 1920 = Rochdale Manchester Havelock Swaziland Shabanie S. Rhodesia Mashaba S. Rhodesia 1917-1995 Griqualand Exploration & Finance Company Ltd. GEFCO 1895 London Small mines in the 1897-1996 Northern Cape then Riries Northern Cape Whitebank Northern Cape Note Some of the mines continued operating after U.K. companies withdrew e.g. the former & chrysotile mines in Zimbabwe are still working The originating firm Turner Brothers Asbestos Rochdale began asbestos manufacture in 1879 fiber themselves to manufacture products at factories in the United Kingdom Italy France India and South Africa African regions where these U.K. firms were active became highly dependent upon asbestos and so state authorities and local white elites supported the industry In the absence of alternatives black and Colored labor accepted the conditions offered by employers Asbestos was therefore intrinsically bound up with apartheid This meant low wages and high profits Cape Asbestos's annual reports show that the major share of revenue always came from mining In 1953 when Cape celebrated its Diamond Jubilee the management paused to survey the company's achievements in building up a global sales organization Those in the London head office fully realise that the basic prosperity of the Company must depend on the efficiency and productive capacity of the mines 9 This was reflected in the company's employment structure in 1965 Cape had only 50 employees at its London head office but about 10,000 on the mines and another 3,000 or so in its U.K. factories 10 N was less dependent on mining In the late 1950s for example & employed about 16,500 in the United Kingdom and 20,000 worldwide about 11,000 of whom worked in the South African mines Nevertheless once N Receiver_00124639 666 / McCulloch and Tweedale had purchased two mines in the Mashaba district in 1917 and the Amianthus mine in 1924 its South African mines and the Bell mine in Canada were the linchpin of its global operations These mines were consistently sometimes extraordinarily so In 1957 for example N recorded a post profit of nearly 6 million of which more than half 3.2 million was from South African mining Raw fiber could be sold to other manufacturers while & could enjoy the benefits at cost price Even GEFCO which originally was much smaller than either & or Cape and produced insignificant amounts of fiber from the 1960s garnered substantial profits as it emerged as the world's largest producer of crocidolite and amosite 4 Given the huge input from South Africa toward the prosperity of these companies one would expect management to have shown some concern with overseas occupational health and safety issues After all they were aware of the mortal dangers of inhaling asbestos dust as early as 1899 when government Factory Inspectors singled out asbestos because of its easily demonstrated danger to the workers health 11 In the 1920s deaths at N's Rochdale factory and at Cape's London plant led to the first medical descriptions of asbestosis chronic fibrosis of the lungs which killed workers by suffocation or heart failure or pneumonia 12 Such was the prevalence of asbestosis that the British government launched an inquiry 13 which in 1931 resulted in government medical examinations workmen's compensation and dust regulations The carcinogenic potential of asbestos then began emerging 14 By the 1940s the company doctor at Cape Asbestos in London Hubert Wyers 15 accepted that there was a lung cancer risk for asbestos workers hazard confirmed by an epidemiological study of N's Rochdale workforce 16 By the end of the 1950s therefore U.K. asbestos companies operated under specific health and safety regulations for asbestosis and they also had scientific evidence of asbestos lung cancer Their compliance with these controls was often variable and so too was enforcement by the Factory Inspectorate 6 7 Nevertheless a basic regulatory framework of dust control medical surveillance and compensation existed in the United Kingdom from 1931. What was the situation in South Africa ASBESTOS DISEASE IN SOUTH AFRICA THE EMERGENCE OF ASBESTOSIS Compared with gold or diamonds asbestos mining in South Africa was a relatively small industry The mines were isolated and the workforce was overwhelmingly black or Colored South African scientists therefore had little incentive to study occupational disease among asbestos miners Public health authorities showed little interest and not until the 1950s did the issue of dust in asbestos mines appear with any regularity in official correspondence By contrast the dangers of working and breathing dust underground had been Receiver_00124640 Asbestos Disease in South Africa / 667 known for centuries 17 By 1900 South Africa's large gold mining industry was well aware of the dangers of silica dust and companies knew in theory how to prevent pneumoconiosis knowledge that could have been useful in the asbestos industry Consequently N GEFCO and Cape could draw upon the accumulated knowledge within the gold industry or the Department of Mines Asbestos mining proved particularly dusty Unlike other minerals asbestos was milled dry thereby increasing dust The host ore associated with crocidolite and chrysotile was particularly abrasive and would wear out ducting in hours Thus as production levels rose so did dust emissions The impact was soon noted by the mining companies and the Department of Mines with their access to local knowledge The first published study in 1928 of asbestosis among mine workers was written by F. W. Simson of the South African Institute for Medical Research SAIMR 18 He used mortem material from four men which had been forwarded by the chief medical officer at N's Shabanie mine in Southern Rhodesia 19 Simson described how exposure caused serious pulmonary disability but suggested that processing rather than mining was the major problem He was concerned that in South Africa asbestos was being used increasingly in cement products and that many factories were dusty In response the Chief Inspector of Factories approached the Miners Phthisis Bureau The bureau proposed a system of voluntary examinations for workers in the fabricating industry 20 Bureau officers then visited the Asbestos Products Ltd. factory in Johannesburg and examined eight black workers who were employed mixing cement and fiber in what was described as " dirty environment The only man to have been employed for more than one year was found to have some consolidation in the upper lung 21 There were no specific asbestos regulations and the inspectorate relied upon voluntary compliance to reduce dust Although no attempt was made to survey the mines the correspondence certainly shows that by 1928 the Department of Mines which was responsible for the Miners Phthisis Bureau had reason to be abreast of the current medical literature For example letters refer to a paper by I. G. Ross on asbestos mining and wet milling which was discussed at the Second Triennial Empire Mining and Metallurgical Congress in Quebec on September 5 1926 22 Even had the asbestos industry not been prompted by the government it had its own research and experience George Slade was a medical officer at a large chrysotile mine in the Transvaal almost certainly N's New Amianthus during the late 1920s The mill alone employed 100 workers making it one of the largest asbestos mills in the country Few asbestos mines in the 1930s had dressing stations to treat workers injured in accidents let alone a resident physician Having noticed what he believed was a high incidence of ARD among the mill workers Slade approached management about conducting research The company agreed perhaps with the blessing of head office in the United Kingdom and Slade began work on an M.D. thesis 23 Between 1926 and 1930 Slade examined the working conditions at the mine the incidence of disease and the Receiver_00124641 668 / McCulloch and Tweedale effects of continued inhalation of dust There were no ray facilities so Slade conducted a careful physical examination of each worker As Professor A. Davies formerly Director of the National Centre for Occupational Health in Johannesburg suggested to one of the authors J.M. the poor quality of contemporary ray equipment meant that Slade's method was probably more accurate He listened to each patient's chest and examined each subject for changes in weight and skin tone using illnesses such as bronchitis as indicators of ARD The highest rates of disease were in mill workers and the lowest among those employed in surface jobs The mill was choked with dust so that objects were indistinguishable . at a distance ofa few yards 23 The mill never stopped so the dust never settled and thick clouds of it spread throughout the building and clung to the hair face and clothing of the workers whom it eventually covers with a uniform white film 23 The men worked eight shifts and were continuously exposed to airborne fiber Not surprisingly the sputum of almost all mill workers contained asbestos bodies fibers coated with proteins by the lungs defense mechanisms 72 of the 100 had shortness of breath the classic symptom of asbestosis Most had lost weight 23 The only worker who wore a respirator in the mill a white miner had lung fibrosis The most frequent symptom was a persistent cough which was universal in the workers examined by Slade and was associated with fibrosis Of the 12 illustrative cases cited by Slade for which he had a work history and clinical profile 10 were migrant workers from Mozambique Swaziland or Malawi This suggests that most employees were migrants 23 We know from the later period that it was management policy in amosite and crocidolite mines to sack sick workers who would then be sent home to die Slade's thesis was notable in two respects it was the first M.D. thesis completed at Witwatersrand University and it was the first detailed study of occupational disease among asbestos miners Examining the bodies of black miners so carefully was unusual for a white physician in South Africa but then Slade seems to have been an unusual man He obviously wanted management to improve work conditions Having found evidence of ARD in 70 percent of mill workers Slade recommended periodic rays of any man who showed signs of disease The findings were potentially disastrous for & and had relevance to Cape and GEFCO The medical research community in Johannesburg at that time was very small and the thesis was readily available to officers from the Departments of Mines and Health both of which had a statutory responsibility for asbestos miners In 1931 Slade was the only trained specialist in South Africa working on ARD Yet having completed that work he left & almost immediately never published his research and spent the next 15 years in general practice in Johannesburg before retiring to the Channel Islands Possibly Slade's commercially damaging research proved unacceptable to his employers or he became disillusioned Faced with his thesis the evidence of Merewether and Price 13 in the United Kingdom and the beginnings of asbestosis litigation in the Receiver_00124642 Asbestos Disease in South Africa / 669 United States -T should have closed the New Amianthus mill or reduced dust and closely followed up Slade's pioneering work It did neither As South African occupational health experts have highlighted Incredibly Slade's study the first of any local asbestos mine or manufacturing operation was also the last study of chrysotile mines and mills in South Africa To this day 1994 no further study of disease in a local chrysotile mine has been published and the authors are unaware of any published studies 24 Consequently Slade's thesis in 1930 marks a divergence between two occupational health practices On the one side were conditions in the U.K. factories and lagging trades operated by & Cape and GEFCO the latter being linked to Central Asbestos a manufacturer in London Despite the introduction of government regulation in 1931 we know that these remained dangerous both in the factories and especially in the lagging trades where government regulation mostly did not apply But at least for some workers in the asbestos textile division such as N in Rochdale and Cape in Barking dust conditions were steadily improved and some monitoring of workers by the government continued On the other side conditions in South Africa remained appalling 4 The companies were fully aware of this But mining in South Africa was highly profitable because of the low labor costs and the industry's facility in avoiding legislation Like its U.K. competitors N wished to continue taking advantage of that situation From 1931 N decided to continue to run a filthy mill in South Africa a decision made with the tacit agreement of the Department of Mines Inspectorate It was not until 1968 almost 40 years after the Merewether and Price study and more than 70 years after asbestos mining began in South Africa that asbestosis was mentioned in a Department of Mines annual report 25 That decision in 1931 condemned successive generations of South African mine workers to disease and disability In contrast to the documentation about the industry's behavior and the extent of ARD in the United Kingdom and United States evidence on working conditions in the South African asbestos mines is sparse Most of N's South African records appear to have been destroyed 26 Cape Asbestos has never produced a substantial archive in litigation and most of its records including those of its South African operations are also apparently lost or destroyed Nevertheless the evidence that has survived is damning In 1949 as part of the first survey of the north Transvaal Dr. Gerrit Schepers of the Silicosis Medical Bureau visited Penge mine He later described how he found young children completely included within large shipping bags trampling down fluffy amosite asbestos which all day long came cascading down over their heads They were kept stepping lively by a burly supervisor with a hefty whip I believe these children to have had the ultimate of asbestos exposure ray revealed several to have radiologic asbestosis with cor pulmonale before the age of 12 27 CASAP which ran Penge was British owned and therefore in Schepers view knew about the dangers of asbestos Schepers was living in the United States when Receiver_00124643 670 / McCulloch and Tweedale he made these comments but he was immediately threatened with a libel action from Cape Asbestos 28 At the time the government responded by temporarily closing the mill but overall conditions in the industry did not improve Schepers found that asbestosis was almost universal in serving workers at the Barberton mill on the border between South Africa and Swaziland 28 This mill processed fiber from N's Havelock mine In 1950 N directors visiting the company's Rhodesian mines noted that asbestos tailings polluted the environment and that dust conditions in many mills left a lot to be desired 6 This was partly due to the rapid rise in demand for fiber worldwide which meant that the mines needed to operate at full capacity despite problems with shortages of labor and materials N's misgivings about working conditions were private ones its annual reports extolled the mines for their technical excellence harmonious race relations commitment to African advancement and a full social life with tennis courts and golf courses The various regulatory authorities were not impressed In June 1952 Dr. G. B. Peacock 29 an assistant health officer with the Department of Native Affairs reported on conditions in the Northern Transvaal Peacock was well informed about asbestosis and he believed that the main hazard came from small asbestos fibers rather than host rock dust He too found that the mills were filthy and he was shocked to see so many juveniles processing fiber Inadequate exhaust ventilation actually sucked the fiber past the faces of workers bent over sacks Peacock examined 26 black workers including five women he found lung disease in six of whom three had probably sustained their disability from their current employment The one of these three who had been employed on the asbestos mine for the shortest period wrote Peacock had been doing this kind of work for the past seven months 29 More than 20 years earlier Merewether and Price had found that in British factories it took at least eight years of heavy exposure to produce asbestosis Peacock also referred to the common practice of sacking employees once they showed signs of disease as despicable With no ray units on the fields employers made such decisions on the basis of symptoms such as shortness of breath and chronic coughing ASBESTOS DISEASE IN SOUTH AFRICA THE EMERGENCE OF THE CANCER THREAT Until the 1950s the United Kingdom and South African asbestos industries despite their close commercial links operated in isolation as regards ARD Medical and company knowledge in the United Kingdom counted for little in Africa while any health lessons that could be learned from the mines were ignored at head office For example there is no mention of Slade in & papers that survive from the 1930s However by 1960 the knowledge of ARD was becoming ' Schepers kindly provided his memoir 28 to one of the authors G.T. Receiver_00124644 Asbestos Disease in South Africa / 671 much more integrated This was partly due to the increasing closeness of the medical community facilitated by faster telecommunications and by jet travel But it was also due to the irresponsibility of the asbestos industry in South Africa which by providing a perfect test tube for asbestos cancers helped detonate an asbestos bomb in the 1960s ARD subsequently became a topic of world concern In the United Kingdom in the late 1950s the number of asbestosis cases began rising sharply term result of the industry's failure to control dust and the inadequacies of government regulation Lung cancer was also occurring more frequently among asbestos workers Increasingly these lung cancer cases involved malignancy of the pleura the lining of the chest type of cancer described in the early literature as endothelioma In the 1940s pleural cancers were observed in Germany 30 and in the United Kingdom where Cape Asbestos 31 and the Chief Inspector of Factories 32 logged cases More evidence accumulated during the early 1950s when the term mesothelioma was increasingly used and when peritoneal cancers in asbestos workers were also highlighted by N's consultant pathologist Matthew Stewart 33 The significance of pleural changes was also noted in South Africa Schepers found in a 1949 study of workers in the eastern Transvaal that several had marked pleural sclerosis Schepers saw several such mesotheliomas from North American workers when he was resident at the sponsored Saranac Lake facility in upstate New York in 1949 2 He later wrote After saw my first example of pleural mesothelioma I knew what had occurred 27 However mesothelioma excited little interest because it was still such a rare disease there was no appreciation that it could be caused by trivial exposure The events that forced mesothelioma into world prominence began in South Africa In 1954 the South African government appointed a young pathologist Dr. Christopher Wagner 1923-2000 as an asbestos research fellow to the Pneumoconiosis Research Unit PRU in Johannesburg Coincidentally mesothelioma cases were appearing in significant numbers at West End Hospital a chest diseases facility at Kimberly close to the asbestos fields of the northern Cape In 1929 Simson at the SAIMR had described a malignant pleural endothelioma 24 but Wagner was the first South African scientist in a generation to study asbestos and follow up this work Initially the industry was cooperative In September 1958 Wagner visited the head offices of CASAP in Johannesburg and was granted access to Cape's mine and mills 34 35 The material Wagner gathered proved invaluable in writing his Ph.D. thesis the results of which he soon shared with the industry While in the United Kingdom on sabbatical in 1958 Wagner visited & in Rochdale where he met the company physician Dr. John Knox and other managers and Cape Asbestos's Barking factory where he met with officials that almost certainly included Cape's senior medical officer Walter Smither 36 Wagner alerted them to the link between mesothelioma and crocidolite Receiver 672 / McCulloch and Tweedale In 1959 Wagner presented a paper to the Pneumoconiosis Conference in Johannesburg 37 in which he described how he had made a connection between mesothelioma and asbestos He ended his paper with the warning that a very serious hazard may exist on the asbestos fields Within days of the conference the asbestos industry approached the South African Council for Scientific and Industrial Research the major state scientific research body in South Africa to establish an asbestos research project While negotiations for the survey were in progress Wagner and his colleagues Kit Sleggs and Paul Marchand submitted a paper in April 1960 to the British Journal ofIndustrial Medicine 38 The article was based on an analysis of 30 cases of pleural mesothelioma with all but one patient having a proven exposure to Cape blue asbestos It became one of the classic occupational health studies of the 20th century The Government Mining Engineer accepted the link between asbestos and mesothelioma and asked Ian Webster from the PRU to coordinate a survey of the north Cape 39 According to Webster asbestos producers including Cape N and GEFCO provided 25,000 That is the figure cited many years later by Justin Mackeurtan of Cape Asbestos but is far in excess of the R8,000 about 4,000 acknowledged officially 39 According to the official estimates in the first year the project cost R12,000 of which the asbestos industry contributed R8,000 and the South African Cancer Association R4,000 40 41 Whatever the level of funding the industry's contribution enabled it to decide the PRU survey's fate after it was conducted between November 1960 and February 1962. The terms of reference were to study the incidence of mesothelioma and the possible relationship between asbestos dust mesothelioma and asbestosis In April 1962 the interim report was completed although the final version did not appear until July 1964 The survey covered a total of 2,389 residents drawn from the mining towns of Prieska Koegas Kuruman and Penge The PRU took 1,018 rays of adult residents only a minority of whom had worked in the mines The results identified a hazard for every person who lived in those towns and tests for fiber in the sputum also revealed high levels of exposure 42 The study identified four new cases of mesothelioma disturbing discovery in such a tiny population especially since the people of Prieska Koegas Kuruman and Penge were contracting asbestosis from environmental exposure The industry's response was decisive The Northern Cape Asbestos Producers Advisory Committee attacked the survey's methodology and protested that the whole survey appears to have been undertaken with the underlying object of implicating Crocidolite asbestos as being directly responsible for the comparatively rare tumour known as mesothelioma of the pleura 43 All funding by industry and the South African Cancer Association was canceled and the project was abruptly halted In his annual report in March 1962 the PRU director Dr. G. Walters noted that three factors had ended the survey the reaction by certain members of parliament and the subsequent scare campaign in the 00124646 Asbestos Disease in South Africa / 673 press the asbestos companies concern about recruiting labor and the industry's refusal to support further research 44 The existing results were then finalized under an arrangement whereby such a report would not be published or made available outside the Unit other than to sponsors and the various members of the working committees that had been concerned with the conduct of the survey 45 The results were then suppressed and all research in the north Cape ceased When a final report was completed in 1964 virtually all reference to mesothelioma was erased It is easy to demonstrate how successful the industry was in suppressing the PRU survey In 1974 Dr. Bill Harrison from the PRU began research with Dr. Jennifer Talent into mesothelioma in the northern Cape Ian Webster who was then the director and Bill Harrison both knew how much mining was harming those communities Webster had seen the PRU's research aborted in 1962 while Harrison's father Oliver Harrison who worked for Cape at Koegas and Pomfret had died from mesothelioma However what looks like a follow to the 1962 and 1964 report was nothing of the sort Neither Harrison nor Talent were shown the PRU's results or told of its existence 46 47 It was as if those reports had never existed They also had no impact in the United Kingdom Once South African pathologists had provided the flash of insight Cape and N were well placed to address mesothelioma in the United Kingdom Wagner knew little about the disease burden in Britain and stated in 1959 that he could find only one mesothelioma in the literature at & cited in 16 But he and his colleagues in their research published in 1960 had not cited Wyers or Stewart or Wedler or looked at published Factory Inspectorate data They also did not appreciate that by the early 1960s the asbestos companies themselves already had records of several pleural and peritoneal malignancies in their medical case files some dating from the 1930s 6 48 Moreover Cape and & had the resources to investigate the problem through the Asbestosis Research Council ARC a privately sponsored organization that had been launched in 1957 49 Their reaction to the PRU work is instructive In June 1962 within weeks of the completion of the PRU report Cape's medical officer Dr. Walter Smither was dispatched to South Africa He made a three visit to the mines and a four tour of game parks confirming the severe dust conditions in the mills and the ARD problem alongside other illnesses such as scurvy Having read the PRU report Smither saw clearly the financial stakes for his company and the whole industry as regards mesothelioma He did not recommend further research or a drastic improvement in dust conditions instead he belittled the PRU researchers and his only suggestion was that ten mesothelioma sufferers in Prieska should be removed from the area of conflict and taken some hundred miles away to Johannesburg 50 Within days of his return to the United Kingdom Smither met with the ARC yet the minutes of that meeting in July 1962 make no mention of mesothelioma or South Africa though Smither and his fellow scientists did Receiver_00124647 674 / McCulloch and Tweedale agree that labeling imported bags of fiber with a health warning was completely unnecessary impracticable and undesirable 51 It was another three years before mesothelioma hit the headlines in the United Kingdom when independent studies by Dr. Irving Selikoff in New York and Dr. Molly Newhouse 52 in London alerted the public to the threat of the killer dust Cape Asbestos had supplied some of the data for the Newhouse study but the findings were particularly damaging for the company Cape's Barking factory was in the heart of this London area and was clearly associated with many of the mesotheliomas listed which included nonoccupational cases Yet Cape told its shareholders as little about the dangers ofasbestos as it did its employees One can read Cape's annual reports between 1956 and 1966 and be oblivious to the darkening cloud of disease and litigation gathering over the industry Similarly N's published annual reports made no mention of the growing problems of ARD until 1968. To the public and its customers & denied that there was any proof that asbestos caused mesothelioma and dismissed Wagner's work as no more than statistical theory CONCLUSION Double standards continued to operate in the South African asbestos mines into the 1970s when the gap between U.K. and overseas safety practices was as wide as ever Aside from the fact that asbestos companies were obliged to comply with increasingly stringent fiber thresholds in the United Kingdom whereas there was little attempt even to count dust levels in South Africa it was in their policy toward crocidolite that the U.K. companies demonstrated their indifference to workers abroad The U.K. industry agreed to cease importing blue asbestos in 1970 because it was so dangerous yet it was mined in South Africa into the 1990s In the late 1970s a clean of sorts was launched with the introduction of the first ever dust counts and a number of modest epidemiological studies For example & sent its own physician Dr. Hilton Lewinsohn to the mines in 1976 His damning reports on dust conditions have survived in the N archives A study of ARD at the Havelock Mines completed by 1979 showed that asbestosis was rife throughout the community 53 Crocidolite mines and mills operated by Cape remained equally dusty and dangerous 54 This clean policy U.K. medical knowledge was at last made avail- able to South Africans not the result of any found concern for black workers It was largely a public relations exercise forced on the companies by the media and the respective governments which in turn reacted to pressure from labor and various nongovernmental organizations In London conscientious shareholders began asking searching questions about ARD at Cape's annual meetings and were staggered to learn that five black South Africans a week were being incapacitated by asbestosis 55 In 1974 a U.K. government inquiry confirmed that & and Cape were among several companies that paid Receiver Asbestos Disease in South Africa / 675 indigenous workers below the poverty level and operated wage discrimination 56 Television documentary makers then targeted the asbestos companies In 1981 one documentary Dust to Dust highlighted the mesothelioma problems in Cape Asbestos's South African mines 3 57 But the first major improvements in health standards came only with the emergence of black trade unions in the early 1980s by which time the industry was already in its twilight The U.K. companies were about to apply the most effective company medicine known for selling or closing the mines Cape N and GEFCO willingly abandoned their workings leaving a polluted environment and a legacy of ARD the scale of which is only now becoming apparent South Africa is a poor country and can ill afford to clean up the mining landscapes of the Northern Cape North West Province and Limpopo Province In November 1998 a National Parliamentary Asbestos Summit was held in Johannesburg to address the legacy of pollution and ARD bequeathed by British companies and their subsidiaries Since then more than R100 million of public money has been spent on reducing the risk to former miners and their families Much work remains to be done and whole communities and most especially children still live daily with the risk of mesothelioma In retrospect two things appear important First as commentators have noted it is the application of such double standards by multinational companies that gives the lie to the efficacy ofregulation 24 The U.K. asbestos companies proved incapable or reluctant to apply even the most basic standards of hygiene in South Africa This was a particularly telling offense because these firms were not backstreet affairs but blue chip companies Ultimately only government regulation was capable of compelling them to adopt better health standards making the need for improved control of multinationals evident Increased accountability of these companies is also necessary because since leaving South Africa they have not hesitated to use complex and confusing corporate structures to distance themselves from legal liability It took a long legal battle before 7,500 South African plaintiffs and their lawyers succeeded in bringing a class action suit against Cape in London 58 Begun in 1997 the action resulted in a modest settlement in 2003 when the owners of Cape agreed to pay 7.5 million compensation after initial promises of a 21 million trust were broken The Cape settlement though may have ranging implications for multinationals based in the European Union The Brussels Convention on jurisdiction which applies to all based companies stipulates in article 2 that the place of jurisdiction of a case is the country of domicile the parent company By contrast the way in which Cape was able to argue for years in the English courts over where the case should be tried shows that many legal ambiguities await resolution and that the legal control of multinationals as regards health and safety is still in its infancy 59 Second the operation of double standards resulted in a tragic lost opportunity between 1955 and 1965. The South African mining communities were unique Receiver 676 / McCulloch and Tweedale because ARD could not be studied so easily elsewhere The only crocidolite mine outside South Africa at Wittenoom in Western Australia was small and operated for only 20 years until its closure in 1966 when the labor force dispersed and there was no community to study 60 By 1966 asbestos had been mined in the northern Cape for more than 70 years Large communities lived in the mile strip from Pomfret to Prieska It was the ideal place and time to research ARD and launch the PRU survey Levels of production were still modest and the heaviest investment in new mines and mills by GEFCO and Cape Asbestos had yet to happen If the mines had to close the industry's losses could have been minimized while the numbers of people exposed in mining processing transport and manufacture would have been relatively small It is worth reflecting upon what could have happened if the industry had not sabotaged the PRU research If the survey had been completed and made public the mining of crocidolite and amosite could have ended by the 1960s thereby pushing the global asbestos industry into terminal decline Consequently the burden of disease in South Africa itself and in every country that imported South African fiber would have been greatly reduced REFERENCES 1. Brodeur P. Outrageous Misconduct Pantheon Book New York 1985 2. 2. Castleman B. Asbestos Medical and Legal Aspects Ed 4. Aspen Law and Business Englewood Cliffs N.J. 1996 3. 3. Flynn L. Studded with Diamonds and Paved with Gold Miners Mining Companies and Human Rights in Southern Africa Bloomsbury London 1992 4. McCulloch J. Asbestos Blues Labour Capital Physicians and the State in South Africa James Currey Oxford 2002 5. Wikeley N. Compensation for Industrial Disease Dartmouth Publishing Aldershot U.K. 1993 6. Tweedale G. Magic Mineral to Killer Dust Turner & Newall and the Asbestos Hazard Oxford University Press Oxford 2000 7. Johnston R. and McIvor A. Lethal Work A History of the Asbestos Tragedy in Scotland Tuckwell Glasgow 2000 8. Hertz N. The Silent Takeover Global Capitalism and the Death of Democracy Free Press New York 2001 9. Cape Asbestos Company Ltd. Diamond Jubilee Asbestos July 1953 pp 7--8 10. Deposition of Geoffrey Higham In re asbestos personal injury cases Arrington lead No. 93-9-114 Civil Action no 93-9-1114 167-8 London October 24 1996 11. Chief Inspector of Factories Annual Report for the Year 1898 Part 2 p 171 HMSO London 1899 12. Greenberg M. Cape Asbestos Barking health and environment 1928-1946 Am J. Ind Med 43 109-119 2003 13. Merewether R. A. and Price C. W. Report on Effects ofAsbestos Dust on the Lungs and Dust Suppression in the Asbestos Industry HMSO London 1930 14. Tweedale G. Asbestos and its lethal legacy Nature Cancer 2 311-315 2002 15. Wyers H. That Legislative Measures Have Proved Generally Effective in the Control of Asbestosis pp 89-90 M.D. thesis Glasgow University 1946 Receiver_00124650 Asbestos Disease in South Africa / 677 16. Doll R. Mortality from lung cancer in asbestos workers Br J. Ind Med 12 81-86 1955 17. Morgan W. K. C. and Seaton A. Occupational Lung Diseases Ed 3 p 1. W. B. Saunders Philadelphia 1975 18. Simson F. W. 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