The Cancer Pattern in African Gold Miners

Summary In a case-control study of 84 multiple myeloma patients and 168 age-and sex-matched controls with tumours at other sites, reported prior allergies were associated with an elevated risk of myeloma (RR = 3.1, P<0.001). In addition, more myeloma patients than controls reported prior myxoedema (RR= 5.0 Incidence rates for multiple myeloma in British Columbia are 3.4 and 2.2 per 100,000 in males and females respectively (B.C. Ministry of Health, 1976). A recent study has indicated that the incidence has been increasing over the last 30 years (Velez et al., 1983). The highest reported incidence in the world is in U.S. black males (Waterhouse et al., 1976). Several occupational risks have been demonstrated, with Milham showing elevated mortality for myeloma among farmers, woodworkers, smeltermen and forgemen (Milham, 1976). Several studies have shown nuclear workers to be at high risk for myeloma (Dolphin, 1976;Lewis, 1963;Cuzick, 1981).Schafer and Miller in a study of 153 patients showed elevated risks of prior biliary disease and peptic ulcer in patients with IgA myeloma when compared to patients with all other myeloma types (Schafer & Miller 1979), and Allen found an elevated frequency among myeloma patients of individuals with group A blood (Allen, 1970). Familial occurrence of myeloma has been reported in spouses (Kyle et al., 1976) and in blood relatives (Maldonado & Kyle 1974 C) The

Section: Discussionmentioning

confidence: 99%

Allergies and agricultural exposure as risk factors for multiple myeloma

Gallagher¹,

Spinelli²,

Elwood³

et al. 1983

“…Early evidence had pointed to the Zulu being especially affected by this cancer (Robertson et al, 1971), whereas nowadays KwazuluNatal rates (CIR 4.8) fall well below the average rate for all miners (9.4) and below half their own rate of 12.7 in 196412.7 in -79 (McGlashan et al, 1982.…”

Section: Spatial and Temporal Distribution Of Cancer Sitesmentioning

confidence: 99%

Changes in the geographical and temporal patterns of cancer incidence among black gold miners working in South Africa, 1964–1996

Harington

Chelkowska

2003

Self Cite

We describe here the results of the final 8 years of geographical and temporal data of a 33-year study of the cancer experience of 12.8 million man-years of black miners working on the gold fields of South Africa over the period 1964 -96. These workers were recruited from 15 territories, the major areas during the most recent period being Lesotho (26.8%), Transkei (21.5%) and Mozambique (15%). The earliest analyses, 1964 -71 and 1972 -79, showed hepatocellular and oesophageal cancers to be the most frequent cancers. The final analysis, for 1989 -96, however, shows marked temporal changes in the relative position of four cancers or grouped malignancies: respiratory cancer up by 236%, hepatocellular carcinoma down to 32%, oesophageal holding steady, and lymphatic system cancers up by 420%, almost certainly because of association with HIV/AIDS infection. Significant geographical variations occurring between the home areas of the miners are important, as mining operations have little to do with the cancers that develop. The causes are essentially socio-environmental rather than occupational, and this means that the rates of the major cancers in the miners are surrogate measures of the same cancers in the home areas.

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Summary.-The 5-year study of cancer in black gold miners, 1964-68, previously reported (Robertson et al, 1971) has now been extended for a separate 8-year period, 1972-79. This allows analyses of all cancers together and of 6 less common sites of cancer severally: lymphosarcomas, colon and rectum, leukaemia, stomach, pancreas and buccal cavity and also of those too rare to classify.

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mentioning

confidence: 97%

“…Finally, temporal change over the years 1964-79 shows a significant decrease overall (P <0.01) in cases of lymphosarcomas and colo-rectal cancers and an increase (P<0.05) in stomach cancer. The rare tumour, Kaposi's sarcoma, has also decreased significantly between the 2 periods studied.ANALYSES published by Robertson et al, (1971), Harington et al (1975 and Bradshaw et al (1982) have considered the spatial and temporal patterns of the 4 most common sites of cancer recorded among black gold miners recruited from homes in, respectively, 11 and 10 territories in 2 consecutive 8-year periods, 1964-1971 and 1972-1979 (see Fig. 1 for total gold-mine labour force from each home territory).…”

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confidence: 99%

“…ANALYSES published by Robertson et al, (1971), Harington et al (1975) and Bradshaw et al (1982) have considered the spatial and temporal patterns of the 4 most common sites of cancer recorded among black gold miners recruited from homes in, respectively, 11 and 10 territories in 2 consecutive 8-year periods, 1964-1971 and 1972-1979 (see Fig. 1 for total gold-mine labour force from each home territory).…”

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confidence: 99%

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Eleven sites of cancer in black gold miners from Southern Africa: a geographic enquiry

Nd¹,

Harington²,

Bradshaw³

1982

Self Cite

Summary.-The 5-year study of cancer in black gold miners, 1964-68, previously reported (Robertson et al., 1971) has now been extended for a separate 8-year period, 1972-79. This allows analyses of all cancers together and of 6 less common sites of cancer severally: lymphosarcomas, colon and rectum, leukaemia, stomach, pancreas and buccal cavity and also of those too rare to classify. The malignancies are considered by territory of origin of the gold miners. Lesotho miners have significantly fewer (P < 0.05) tumours of the lymphatic and haemopoietic tissues and Natal miners have the highest incidence rates for 5 of the 6 sites (excluding leukaemia). A simple grouping method is applied to determine which of the 11 sites of cancer in the miners have similar distributions in their 10 territories of origin. The aetiological implications of clusters over space of certain sites of cancer are discussed. Finally, temporal change over the years 1964-79 shows a significant decrease overall (P <0.01) in cases of lymphosarcomas and colo-rectal cancers and an increase (P<0.05) in stomach cancer. The rare tumour, Kaposi's sarcoma, has also decreased significantly between the 2 periods studied.ANALYSES published by Robertson et al., (1971), Harington et al. (1975 and Bradshaw et al. (1982) have considered the spatial and temporal patterns of the 4 most common sites of cancer recorded among black gold miners recruited from homes in, respectively, 11 and 10 territories in 2 consecutive 8-year periods, 1964-1971 and 1972-1979 (see Fig. 1 for total gold-mine labour force from each home territory). METHODSThe methods of analysis and the limitations of the data-base, especially with regard to both age of recruitment and age of death, have been reported previously (Harington et al., 1975). Briefly, it should be stressed that recruiting was of fully medicallyexamined men of apparent age between 18 and 40, but in the absence of birth-certificate records, actual age was neither known nor recorded by the mines of employment. Although an estimated age of each death was recorded, it was not possible to calculate age-specific mortality rates. We have previously suggested that the crude death rates were probably equivalent to an agespecific rate for the age group 25-35 years (Harington et al., 1975). Diagnoses were made in the well equipped hospitals of the major mining groups, a high proportion being confirmed histologically in the laboratories of the South African Institute for Medical Research. The 4 most common sites (in rank order, primary liver, oesophagus, respiratory system and bladder) comprised 75*1 % of all cancers in the earlier period and 79-1% in the later period.The purpose of this paper is to examine the remaining data which refer to less common sites of cancer. These are sites of which, in an 8-year period, inadequate numbers of cases occurred for analysis but for which useful information emerges in a longer period of record. Unfortunately data are now extant t Correspondence: Dr J. S. Haringtoin.