Asbestos-related diseases-their aetiology and medico-legal issues: An overview

Abstract

The term “asbestos” refers to a group of naturally occurring fibrous hydrated silicates. Asbestos achieved wide popularity in the building and construction industry after World War II because of its physical properties. It is no longer used because of its deleterious effects on health. Asbestos exposure may cause a number of medical conditions, some of which are associated with significant morbidity and mortality. The detrimental effects of exposure on health have been recorded back to ancient times but more fully described over the last century. Despite the well-documented effects of asbestos as a health hazard, little was done to protect the exposed workforce. Governments and regulatory authorities in Australia have been exceptionally tardy in introducing legislation to prevent its ongoing use and to protect people who may be exposed. The last 20-30 years have seen an explosion of litigation against organizations mining and supplying asbestos or asbestos-containing products in Australia. Asbestos exposure causes a broad spectrum of diseases, for which there is no cure. These include pleural plaques, diffuse pleural thickening, benign pleural effusions, diffuse pulmonary fibrosis (asbestosis), carcinoma of the lung and upper airway, and pleural and peritoneal mesothelioma. The risk of asbestos-related disease is related to the degree of exposure, and a long period between first exposure and presentation of disease is a characteristic of this group of disorders. The greater the exposure the greater the risk, but there is no known lower protective threshold of exposure as exemplified by the occurrence of mesothelioma. The legal landscape, across Australia, varies from state to state and the substantive law of the state in which the exposure to asbestos occurred is the relevant law which governs a person’s claim. There are two broad categories of claims available to asbestos disease sufferers or their dependents, namely, common law (negligence) and workers’ compensation claims. Most people suffering from a mesothelioma or asbestosis are entitled to significant compensation and many of those with lung cancer will be successful if they can show that they have been exposed. Causation is the most significant legal hurdle and the relevant common law test is whether asbestos exposure has caused or materially contributed to the development of the disease. The causation tests in workers’ compensation claims vary from state to state but often contain a lower threshold requirement for causation. It is strongly recommended that legal advice be obtained as soon as possible after diagnosis.