Literature Review 

by Laurie Kazan-Allen



Under-Reporting of Compensable Mesothelioma in Alberta published in volume 52 (2009) of the American Journal of Industrial Medicine,1 concludes that “Patient under-reporting of compensable mesothelioma is a problem and raises larger questions regarding under-reporting of other asbestos-related cancers in Alberta.” The authors highlight the challenge Alberta faces to implement strategies:

“to increase filing rates and consequently alleviate some of the economic hardship burdening workers diagnosed with occupational cancer by compensating for wage losses and paying survivor benefits as well as treatment costs that are not covered under insurance plans, such as prescriptions, for example.”

In the same issue of this journal was another paper: Asbestos-Related Disease Among Sheet Metal Workers 1986-2004: Radiographic Changes Over Time. The study conducted by L. Welch and E. Haile confirmed a conclusion reached by researchers Cookson et al. in 1986 that “asbestosis should be considered an active disease three decades after exposure ends.” In the 21st century, the risk of contracting asbestos-related disease amongst U.S. construction workers persists even though the national use of asbestos has decreased dramatically. The authors conclude that:

“Workers exposed to asbestos in the construction industry need continued medical surveillance for early detection of disease and prevention of cancer… Tailored efforts to reach these workers with information on smoking cessation is essential, given the increased risk of lung cancer from asbestos exposure and an additional increased risk with asbestosis; specific programs for construction workers exist and are successful.”2

Mesothelioma in Australia Incidence 1982-2005, Deaths 1997-20063 was published by Safe Work Australia in June 2009. Australia has one of the worst incidences of asbestos-related disease due to the widespread and uncontrolled use of asbestos which took place post-World War II:

“Exposures to asbestos in the past were very high in some industries and occupations: as much as 25 million particles per cubic foot (150 fibres/ml) in asbestos pulverisers and disintegrators in the asbestos cement industry, and up to 6000 fibres/ml among baggers at Wittenoom.”

Epidemiologists predict that the Australian incidence of mesothelioma could peak some time between 2010 and 2021: “The overall number of deaths resulting from mesothelioma generally increased over the period between 1997 and 2006: reaching a maximum of 545 in 2004.”

The current issue of the International Journal of Occupational and Environmental Health contains two articles on asbestos issues. In Fiber Types, Asbestos Potency, and Environmental Causation author David Egilman attempts to peer review “the use of certain scientific methods in tort litigation and in testimony before regulatory agencies.” Section headings include:

  • SEER data cannot be used to establish a threshold for asbestos induction of mesothelioma;
  • available cohort epidemiologic studies cannot establish a “safe” threshold for asbestos exposure and cannot be used to establish reliable relative fiber potency assessments;
  • the use of fiber analysis: a case study of how bad science can contribute to bad public policy and erroneous courtroom and regulatory testimony.4

The authors of Mesothelioma Risk and Environmental Exposure to Asbestos calculate that due to Japanese environmental asbestos exposures “mesothelioma risks per year of exposure will reach peak levels in 2033… The number of deaths is estimated to range from 542-1276 in 2033. The cumulative number of deaths will reach around 17,000-37,000 in the years 1970-2070.”5

An electronic copy of the report Risk Assessment of Asbestos-Contaminated Soils: An International Perspective by Benjamin Hardaker was received in June 2009. Hardakar used the funds obtained in 2008 as a Churchill Fellow to conduct a comparative study of state-of-the-art techniques used in the United States, the United Kingdom and the Netherlands to calculate risks posed by asbestos-contaminated soils in order to suggest ways to improve Australian protocols.6 In his 50-page report, Hardakar highlights the need for an asbestos-specific regulatory document to provide “a standard assessment method with a defined end-point.”

June 30, 2009


1 Cree M.W, Lalji M, Jiang B, Carriere K.C. Under-Reporting of Compensable Mesothelioma in Alberta. Am. J. Ind. Med. 2009;52:526-533.

2 Welch L, Haile E. Asbestos-Related Disease Among Sheet Metal Workers 1986 2004: Radiographic Changes Over Time. Am. J. Ind. Med. 2009;52:519-525.


4 Int J Occup Environ Health 2009;15:202-228;

5 Azuma K, Uchiyama I, Chiba Y, Okumura J. Mesothelioma Risk and Environmental Exposure to Asbestos. Int J Occup Environ Health 2009;15:166-172;

6 The author can be emailed at:



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