Invisibility, disease, & race: asbestos mining in South Africa

The last South African asbestos mine didn’t close until 2002, decades after scientific research had established that asbestos causes fatal diseases including asbestosis (by 1928), lung cancer (1948), and mesothelioma (1960). Why did it take so long?

According to the late Lundy Braun, a Professor Emerita of both Medical Science and Africana Studies at Brown University in the United States, efforts by the asbestos industry to protect its business interests were a major factor.

“Many people had written very straightforwardly, ‘the industry is terrible’”, Braun told Confront. The asbestos industry suppressed information, manipulated research, and waged public relations campaigns downplaying the risks of asbestos for a century. But for Braun, “it wasn’t the whole story.”

Confront spoke with Professor Braun in 2024, a few months before she died in an accident. Braun trained as a pathologist and began incorporating social science perspectives into her later work on racialized health disparities. In 2018, her book, Breathing Race Into the Machine: The Surprising Career of the Spirometer From Plantation to Genetics, received the Ludwig Fleck Award from the Society for Social Studies of Science.

Braun studied the origins and impact of the asbestos industry on South African workers, often alongside Dr Sophia Kisting, the former executive director of the country’s National Institute for Occupational Health. Braun noticed an enormous disparity between what she read in scientific literature on the topic dating back to the 1920s, and what she saw and heard on the ground while speaking to dozens of people.

Much of the scientific debate around asbestos exposure centred on the length and types of asbestos fibres, and how much airborne dust could be ‘safely’ permitted (there is no safe threshold for working with asbestos, according to the World Health Organisation). Important research, but any mention of who was breathing in those fibres, what happened to their bodies over time, and what types of protection they were – or weren’t – given was largely omitted, Braun argued.

“Scientists who were in a position to do more were unable to incorporate the social context and the biological context” for those exposed to asbestos, said Braun. “I’m not arguing for leaving out the biological, but for making a deep, deep connection between biological and social. I think we failed at that miserably.”

Clouds of dust

Asbestos emerged as an in-demand material, particularly in Western Europe and North America, during the rapid industrialisation of the late 19th and early 20th centuries. South Africa became the world’s major supplier of blue asbestos (crocidolite) and the sole supplier of brown asbestos (amosite). These two types of asbestos are rarer and even more toxic than the more commonly used white asbestos (chrysotile).

At the same time as the nascent asbestos industry emerged, South Africa was enacting the racialised policies which defined much of the century’s politics and economics. “One important part of the social context is that the land was basically being taken away from black farmers and workers, and they were only allowed to do certain kinds of work,” said Braun. The percentage of land the country’s majority-black population could own was limited to just 7% in 1913. This limit was expanded to 13% in 1936.

Needing to find work, the early era of asbestos mining allowed families to stay together and work as a unit. Meanwhile, men were able to do more skilled jobs than those available in gold mining, though conditions and pay were still dire.

The industry evolved and formalised over time as demand grew; peaking in the 1970s, when over 20,000 workers laboured in asbestos mining. Even more people worked informally alongside the asbestos industry, or in other jobs heavily exposed to asbestos, like construction work. The asbestos exported from South Africa to the rest of the world would be used in everything from fake snow and textiles to insulation and brake linings.

Several of the largest South African mines were owned for long periods by British and European companies, including Turner & Newall, Cape, and Eternit. All were aware asbestos dust causes potentially fatal, and incurable, asbestosis by the 1920s, and cancer by the 1940s.

Braun said workers were faced with a choice, “Do they have jobs at all, or do they destroy their health?”

Nevertheless, for decades, people in South Africa were exposed to extraordinary risks. Child labour was rife. One practice, observed in the 1950s, had children stamping on the fluffy asbestos in large shipping bags. Some of these children were noted to have developed asbestosis and cardiac failure from this practice later in life.

Even after research confirmed in 1960 that asbestos dust also causes mesothelioma, a terminal cancer, South African workforces continued labouring in and around asbestos mines for years, unaware of the risks and with few protective measures. Braun heard of workers coming out of the mines “covered in a white dust” of asbestos. To be able to breathe and protect their nose and mouth, they had to use their own handkerchiefs, which were known to be utterly ineffective against asbestos due to the diminutive size of the fibres.

In some areas, women continued cobbing – breaking up the “host” rock, which contains the asbestos, into pieces – generating significant asbestos dust. Younger children were often carried on their mother’s back while they worked. The unique nature of this work, and with people living close to the mines, meant the risk to families from asbestos exposure was extremely high.

In apartheid South Africa, Braun noted, black asbestos miners earned far less pay than whites and weren’t covered by the same health and safety regulations. “Black workers had worse jobs, more dangerous jobs, in whatever industry you are talking about.”

“This racialisation is often very invisible, and then people want to deny it,” said Braun, adding that the same problem exists in the United States.

“There were pretty large campaigns to deny the dangers of asbestos, and the black workers didn’t have a lot of power in that context.” Braun said workers were faced with a choice, “Do they have jobs at all, or do they destroy their health?” Not that the white workers Braun encountered were safe from asbestos diseases, either. Their exposure was less, but still sufficient to cause mesotheliomas due to the potency of asbestos.

Dumping

What happened to workers when they fell ill from asbestos? Braun kept hearing the same story while conducting field research in former mining towns in the early 2000s. In a practice dubbed “dumping,” companies would fire them and leave them to die in the countryside when they got sick.

“They were either dumped in rural areas or it was just routine that they went back to where they came from and died there or had to be cared for in that area,” Braun said. These poorer, rural communities were thoroughly unequipped to help the “horrendous and painful” terminal or disabling diseases caused by asbestos, she observed. This practice continued up until the 1980s.

“I saw what counted as cemeteries for workers who were dumped. There were little humps in the ground, and that was a routine practice that I heard over and over and over,” said Braun. “We tend to not believe workers more often than management, but workers repeatedly were terrified of this because burial practices were really important to black workers and they wanted to be with their families.”

This practice also ensured workers remained unaware of how deadly their work was. Even among those who did return to their hometowns after leaving the mines apparently in good health, they were still at high risk of developing an incurable or fatal asbestos disease later in life.

Some workers attempted to improve conditions, but they faced an uphill struggle. “Any kind of [union] activity was brutally suppressed,” she said. It ultimately took international pressure and a stubborn trade union movement in the 1980s to force modest improvements in working conditions and raise awareness among workers of why they were dying.

Braun argued that these labour policies, working conditions, and the racialised nature of work in South Africa, were largely omitted from the public-health conversation. “This just wasn’t something that science did. It looked purely at this fibre and its interaction in the lungs in particular. Once you look at the labour practices and the general social practices in South Africa, you start to see the story very differently.”

In particular, Braun saw the impact of sidelining the social context in patient care. “The workers didn’t get any of the kind of attention that they needed in order to avoid the extreme disease burden that they bore.” Braun described an “invisible epidemic” of asbestos-related diseases which ravaged South Africans. Tens of thousands of people are estimated to have died.

Who absorbs risk?

An argument Braun often heard is that we need to accept an element of risk in certain types of work that are seen to benefit society at large. She said, “Who determines who will absorb that risk? And who’s not involved in the discussion? Risk is social, it’s not scientific. It’s not this number that a statistician gives to a particular danger, if you will…

“If you can determine socially that certain workers, just for the society to function, need to absorb that risk, you could make a different kind of decision then. Anything that’s social can be undone.”

The last South African mine shut in 2002 after a steady decline from its peak in the 1970s. But the industry’s legacy remains, and the death count continues to mount.

The asbestos mining region, which stretched for hundreds of kilometres across South Africa, is still littered with exposed asbestos. Alongside the old mines, asbestos was widely used as a building material in schools, homes, gardens, and roads. Residents of some of these areas are still waiting for the government to rehabilitate the land and reduce the ongoing risk of this asbestos exposure. In the interim, tens of thousands of South Africans – once again, primarily black and in rural areas, are still being asked to absorb these risks from asbestos today.