Eight to fifteen per cent of lung cancer cases and nearly all mesothelioma cases are caused by asbestos. Problems in compensation issues ensue from strict legal requirements for eligibility and regulations of the corporate accident insurance institutions pertaining to eligibility for occupational disease benefits. The latter include:
- the unscientific requirement for set numbers of asbestos bodies or fibers to be found in lung tissue in order to "prove" disease causation if lung specimen are available.
Although the validity of such evidence has been discredited by independent scientists, it is still used as evidence by some US and German pathology departments. This means that denying a causal relationship, e.g. in a case with lung fibrosis (asbestosis) or lung cancer with an asbestos load of 25 fiber-years in the absence of identification of a significant concentration of asbestos fibers or asbestos bodies in the lung (see so-called ‘‘hit and run’’ phenomenon), contradicts the medical scientific knowledge.’’ See below for more details
- The main strategy that the Italian asbestos industry and their expert witnesses have employed to rebut claims of asbestos causation in cases of malignant mesothelioma has centered on the thesis they have developed that brief exposures to asbestos are sufficient to induce mesothelioma. See below for more details
- Frequently, epidemiological evidence regarding causal relationships and exposure histories is also often being ignored by insurance-affiliated medical experts.
1. Statement for a revision of the 2014 update of the Helsinki criteria
Asbestos, asbestosis, and cancer: The Helsinki criteria for diagnosis and attribution. Critical need for revision of the 2014 update. Baur X, Woitowitz HJ, Budnik LT, Egilman D, Oliver C, Frank A, Soskolne CL, Landrigan PJ, Lemen RA. Am J Ind Med. 2017 May;60(5):411-421. doi: 10.1002/ajim.22709. https://www.ncbi.nlm.nih.gov/pubmed/28409857
2. Controversies and Unsound Science in the Context of the Worldwide Asbestos Tragedy
- Unreliable proposed 'new standard' for assessing asbestos exposure. Egilman D, Baur X, Soskolne CL. Occup Environ Med. 2016 Oct;73(10):709. doi: 10.1136/oemed-2016-103704. https://www.ncbi.nlm.nih.gov/pubmed/27466612
- Asbestos: Socio-legal and Scientific Controversies and Unsound Science in the Context of the Worldwide Asbestos Tragedy - Lessons to be Learned. Baur X. Pneumologie. 2016 Jun;70(6):405-12. doi: 10.1055/s-0042-103580. https://www.ncbi.nlm.nih.gov/pubmed/27124367
- Comments on the causation of malignant mesothelioma: Rebutting the false concept that recent exposures to asbestos do not contribute to causation of mesothelioma. Terracini B, Mirabelli D, Baur X, Landrigan P; Collegium Ramazzini. Am J Ind Med. 2016 Jun;59(6):506-7. doi: 10.1002/ajim.22590. https://www.ncbi.nlm.nih.gov/pubmed/27785864
see also Collegium Ramazzini Statements:
The Collegium Ramazzini recognizes the work of the 2014 expert committee convened by the Finnish Institute of Occupational Health (FIOH) to update the 1997 and 2000 Helsinki criteria on Asbestos, Asbestosis and Cancer in light of new advances in research. The published consensus report of the Helsinki Committee (Wolff, Vehmas et
al. 2015) and its more extensive on-line version (Helsinki Criteria Update 2014 Asbestos, Asbestosis, and Cancer) provide a valuable synthesis of many aspects of current knowledge of the hazards of asbestos. The Collegium Ramazzini is, however, very concerned about the sections of the 2014 Helsinki consensus report that discuss criteria for pathological diagnosis of the diseases caused by asbestos.
Applying the 2014 Helsinki report recommendations on pathology diagnosis will lead to:
- Missed diagnoses of cases of disease caused by asbestos,
- Failure of workers’ compensation systems to properly compensate workers who have been exposed to asbestos, and
Lost opportunities for public health authorities to recognize asbestos hazards and to prevent asbestos-related disease.
According to Italian law, exposures leading to occupational disease not only determine liability for personal damage, but are also a potential criminal offence. In both civil and criminal trials, a key role is played by experts called to determine whether the relationship between exposure to asbestos and the occurrence of mesothelioma in a worker is a causal relationship. The Collegium Ramazzini is deeply concerned that acceptance of the false concept that recent exposures to asbestos do not contribute to causation of mesothelioma will contribute to the unjust denial of workers’ compensation and civil damages to affected workers, that it will hinder efforts to diagnose and prevent malignant mesothelioma, and that ultimately it will undermine the health of the public in Italy and in countries around the world.