Histological findings and lung dust analysis as the basis for occupational disease compensation in asbestos-related lung cancer in Germany

Abstract

Objectives: This study has researched the significance of histologically raised findings and lung dust analyses in the context of claiming the recognition of and thus compensation for an asbestos-associated occupational disease. Material and Methods: For this approach, all findings from the German Mesothelioma Register in 2015 that included lung dust analyses were evaluated and were compared with information on asbestos fiber exposure at work based on fiber years, and with the results of radiological findings. Results: For 68 insured persons, recognition of an asbestos-induced lung disease according to Section 4104 of the German Ordinance on Occupational Diseases (Berufskrankheitenverordnung -BKV) could be recommended solely on the basis of the histological examinations of lung tissues and complementary lung dust analyses. Neither did the calculation of the cumulative asbestos dust exposure at work yield 25 fiber years, nor could bridge findings (e.g., plaques) be identified. In addition, the autopsies of 12 patients revealed plaques that had not been diagnosed during radiological examinations. These results show that -irrespective of the prescribed working techniques and radiological diagnosis -pathological/anatomical and histological diagnostics are often the only way for the insureds to demonstrate the causal connection between asbestos and their disease. Even after long intervals of up to 40 years post last exposure, the asbestos fibers would still be easily detectable in the lung tissues evaluated. Conclusions: Whenever suitable tissue is available, it should be examined for mild asbestosis with the aid of a lung dust analysis. Otherwise there is a risk that an occupational disease is wrongfully rejected. In the context of health insurance, the lung dust analysis and the resulting proof of the presence of asbestosis often constitute one option of providing evidence of an occupational disease. Int J Occup Med Environ Health 2018;31(3):293 -305

Misleading “New Insights into the Chrysotile Debate”

“…This conclusion is not even congruent with their own website where they have stated "usually, chrysotile is cleared from the lungs very rapidly". It also contradicts the authors most recent publication [18] where their figures show a strong decline of asbestos bodies in the human lung after a latency period of 25 years and only a few remaining asbestos bodies after latency periods of more than 4 decades.…”

Occupational and Environmental Cancer

“…Since, information about occupational cancers and their causes can determine labor groups that require special attention. For example, workers exposed to harm can be assessed and considered for preventive interventions [34,109]. Other steps should be taken include: reducing tobacco use, controlling respiratory infectious diseases, and replacing inefficient energy sources with renewable energy sources [104].…”

Letter to the Editor (February 14, 2018) concerning the paper “Histological findings and lung dust analysis as the basis for occupational disease compensation in asbestos-related lung cancer in Germany”

“…In conclusion, we consider that the study by Feder et al [1] uses flawed methods to make the diagnosis of asbestosis grade 1 more difficult. It also misrepresents the low biopersistence of chrysotile asbestos in the human lung.…”

“…Dear Editor, Some key material presented in this article [1] is ambiguous, vague, and confusing. The conclusions are unsupportable.…”