Fiber Width as a Determinant of Mesothelioma Induction and Threshold*Bolivian Crocidolite: Epidemiological Evidence from Bolivia*Mesothelioma Demography and Exposure Pathways

Crocidolite is a well known causative agent for mesothelioma. Studies have shown that the pathogenicity of the fiber from different mines varies considerably and it has been postulated the parameter that appears most likely to account for this variation is fiber width. Epidemiological studies have shown that ‘thin’ fibers from mining areas of Western Australia and the Cape Province, in South Africa are associated with a high mesothelioma risk while exposure to ‘thick’ asbestiform amphibole fiber of the same fiber type are associated with little or no mesothelioma risk. This study is concerned with ‘thick’ Bolivian crocidolite but similar findings also probably explain the paucity of mesotheliomas in the Finnish anthophyllite, South African amosite and African Transvaal crocidolite mines. The findings from the present study suggest the incidence of mesothelioma in the three major cities of Bolivia is not significantly elevated above background even though Bolivian crocidolite has been used for the past 60 years commercially and residentially in all three cities. Although some cases of mesothelioma may have been missed due to a failure to reach hospital or a shortened natural lifespan, mesothelioma generally occurs after the age of 50, we cannot tell precisely the extent to which these were confounding. We suggest the most likely explanation for the lack of mesotheliomas despite the large populations at risk from the long and extensive residential and commercial use of crocidolite containing products, is related to an increased fiber width distribution and a concomitant reduction in the ‘Stanton fiber size’ fraction.