Asbestos Conference, Holland: The Polluter Pays
A two-day international asbestos symposium entitled The Polluter Pays was held in Amsterdam on May 13 & 14, 2004. Organized by the Committee for Dutch Asbestos Victims and held at the Free University, this bilingual event was the first international gathering on asbestos to be held in the Netherlands. Participation from European and American experts reflected the importance of this event while an exhibition of photographs of South African asbestos victims reinforced the message: asbestos is a killer. During the opening ceremony Bob Ruers, President of the Conference Committee, and Tinka de Bruin, President of the Committee for Asbestos Victims, discussed the epidemic of asbestos-related diseases currently raging in the Netherlands:
In 2000, mesothelioma cases numbered 350 cases a year; whereas the latest prediction shows a peak of 490 victims to be expected in 2017 The Committee for Asbestos Victims has established that the use of and the exposure to asbestos, which were originally concentrated in a few sectors of industry, slowly but surely spread to almost the whole of society (we have to ask) how far did this dispersion spread and to what extent does the polluter pay?1
The objectives of the conference included a discussion of environmental asbestos pollution in the Netherlands and abroad, the identification of victims, the possibility of compensation for non-occupational exposure and the exchange of international experience. Support for the conference was expressed in a video message from the Secretary of State for the Ministry of Social Affairs and Employment, Dr. M. Rutte.
|Delegates at the Symposium|
Kicking off the presentations, Laurie Kazan-Allen, Coordinator of the International Ban Asbestos Secretariat, described the current situation in which developed countries have banned or seriously restricted the use of asbestos while industrializing nations are increasing consumption with few, if any, safeguards to protect workers or the public. A series of photographs from Pakistan, India, Kazakhstan and Brazil illustrated the hazardous conditions in which workers are receiving potentially lethal exposures to asbestos. Having discussed the historical means by which asbestos producers have countered adverse publicity and protected the image of the magic mineral, Kazan-Allen surprised delegates by producing a copy of a document entitled The Situation in Holland, which was presented by Mr. A. R. Kolff van Oosterwijk at the International Conference of Asbestos Information Bodies in London in 1971. The four-page report reviewed the history of asbestos in Holland from 1934 and described the dangers of unfavorable publicity. Van Oosterwijk identified the growth in anti-asbestos sentiment amongst Dutch trade unions as a serious problem; trade unions have, he said:
contributed in no small way toward the adverse and often irresponsible publicity given to the biological effects of asbestos. It is their ultimate aim to obtain a complete ban on the use of asbestos and asbestos containing goods.
To neutralize the threats to the asbestos industry, van Oosterwijk proposed death by committee:
Perhaps, characteristically of Holland, is that in our country we feel that no problem can be tackled efficiently without forming as many committees as possible.
Besides the committee and organisations already mentioned there are the following committees (or organisations) which are also involved in some way or another in the problem of asbestos:
Asbestos Committee Netherlands Society of Safety Engineers.
Asbestos Committee of the Industries located in Amsterdam.
Asbestos Committee Society of Insulation Contractors.
Contact organisation of Workers in the Building Industry.
Safety Department of National health Administration.
The first speaker in Session 1 (Mesothelioma: Medical and Epidemiological Aspects) was Dr. Paul Baas; in his presentation on New Developments in Diagnostics and Treatment, Dr. Baas explained the challenge to find active compounds in the treatment of malignant mesothelioma. In the eighties and nineties, he said many single agent chemotherapeutic agents were tested as single agent or in combination therapy for their activity. So far, only modest responses have been obtained, with an unchanged median survival of 7 - 12 months. Two recent phase III studies on the effectiveness of new antifolates in combination with platinum compounds are encouraging. Baas said:
Although the response rates are very promising, the advantage in survival has evaporated within 2 years. It becomes more and more clear that the chemotherapy approach should be part of a more complex treatment schedule. Current studies deal with the introduction of biologicals as maintenance therapy or the use of combined modality treatments including induction chemotherapy, surgical resection and radiation therapy.
Speaking about the operations of the Dutch Mesothelioma Panel, Professor Mooi touched on the difficulties faced by pathologists in diagnosing mesothelioma. The Panel is responsible for the assessment of mesothelioma Dutch victims applying for government compensation. In the majority of cases, the Panel's assessment is in agreement with the applicant's primary diagnosis; significant discrepancies of medical opinion occur in less than 10% of cases. Dr. Lex Burdorf's discussion of Epidemiology and Prognoses placed the Dutch mesothelioma experience within the European context; during the period 1970-1994, the incidence of mesothelioma increased by 184% in the Netherlands, 109% in France and 264% in the UK:
Comparisons among six Western European countries have demonstrated a fourfold difference in lifetime risk of pleural mesothelioma among men born between 1945-1950 with the highest risk in the Netherlands (1.39%) and the lowest risks in Italy (0.35%) and Germany (0.31%).
In the Netherlands, occupational asbestos exposure in a number of industries has led to high levels of mesothelioma amongst former workers; the most hazardous sectors were: shipbuilding, construction and maintenance, insulation, the navy and army, coal mining, asbestos-cement and metal production.
Session II (Lung Cancer) began with a presentation by Professor Tjabe Smid on Multicausality and Lung Cancer. For every fiber year of occupational asbestos exposure, the risk of contracting lung cancer increases by 1%; 58 fiber years of exposure results in a 58% increase in lifetime risk. The Health Council Committee is attempting to develop an epidemiological model to establish the proportionate risk of lung cancer from asbestos exposure experienced by groups of workers. Proportional Liability was the subject discussed by Professor Arno Akkermans who illustrated how, in the Dutch legal system, compensation for asbestos-related lung cancer is assessed. Discussing the judgment (1999) in the Shrek case, Professor Akkermans said that from 1950-58 Mr. Shrek was occupationally exposed to asbestos during his employment as a mechanic; he had smoked since the age of 17. Two experts calculated that Shrek's asbestos exposure was 35 fiber years; this meant, they said, that there was a 26% probability that his lung cancer has been caused by asbestos. The Judge ordered Mr. Shrek's former employer to pay 26% of the damages. The concept of proportional damages is gaining ground in Dutch Courts.
An analysis by Dr. August Van of the types of compensation available in the Netherlands for victims of occupational, para-occupational and environmental exposure to asbestos started off Session III (Compensation). Unfortunately, certain provisions of the Dutch legal system, such as the 30 year statute of limitations on asbestos-related claims and small compensation payments awarded to surviving family members of a mesothelioma victim, continue to disadvantage Dutch asbestos plaintiffs.
|Dr. August Van|
The presentation Asbestos Map of the Netherlands by Machiel van der Woude, Director of the Dutch Institute for Asbestos Victims (IAV), detailed a remarkable initiative which assesses historical asbestos exposure levels in various industrial sectors and places of employment in Holland between 1945 and 1994. The IAV commissioned Dutch epidemiologists to undertake this project with a view to shortening the time required to process future claims for asbestos exposure. Using information gathered from the IAV caseload, a database was designed which can be searched by industrial sector, job or tasks undertaken; the system also includes the names of witnesses and reports of asbestos levels as well as asbestos types and products used in various places. From this data, a map of asbestos exposure in the Netherlands was produced. Since 2000, 1,200 claims have been settled by the IAV and 300 are pending; 80% of applications are processed within 8 weeks. 2
Mesothelioma 'Fast Track,' the title of the presentation by Master Steven Whitaker, detailed the pragmatic response by the judiciary to the UK mesothelioma epidemic. The 'fast track' system was set up in 2002 by the Senior Master of the Queen's Bench Division in concurrence with the Deputy Head of Civil Justice to streamline the processing of mesothelioma claims. Master Steven Whitaker, a procedural judge of the Supreme Court, was appointed to oversee the new system; he reports that since May 2002:
the majority of claims resolve into an assessment of damages on the date set at the CMC (Case Management Conference), and the large majority of those claims are compromised before that date. The level of co-operation from the profession has been tremendous. Most firms of claimant and defendant solicitors recognise the benefits of a fast track for the disposal of these claims, and accept that, in return, the court will expect the parties to 'self-regulate' the narrowing of issues, particularly those in relation to liability.
The principal objectives of the 'fast track' management of these claims are:
to settle claims for living plaintiffs within four months from issue of the claim form and for surviving relatives within eight months;
to reduce the grounds for dispute on liability and to proceed to trial as soon as possible;
to save expense and reduce the need for expensive expert advice by early admission of liability and the use of joint expert witnesses.
Defendants are expected, Master Whitaker said to demonstrate to me that they have a real prospect of success on at least one liability issue before I will allow a liability trial. Largely due to a more realistic approach by lawyers on both sides, progress is being made: The majority of claims in England and Wales are settled before they reach a trial.
Session IV (Position of Asbestos Victims) was introduced by Marius, a twenty-six year old assistant electrician from Utrecht who was diagnosed with mesothelioma in August 2003. In February 2004, Maris underwent a nine hour operation in Italy for the removal of a tumor from his peritoneum. He described the two weeks of chemotherapy treatment as hell. Paying tribute to the support from his family, he blamed the government for not doing more to prevent the lethal exposure which caused his illness. According to Evelien de Kezel, the amount of asbestos used in Belgium and Holland was similar, as is the number of victims. Unfortunately, access to compensation for asbestos victims in Belgium is far more difficult than for their neighbors. A 20 year statute of limitations for asbestos-related cases and the need to prove harmful intent by negligent employers has prevented all but a handful of asbestos personal injury cases from being brought; most Belgian asbestos victims do not receive compensation. The Belgian Occupational Diseases Fund, which only covers medical and pharmaceutical expenses, does not take account of moral or psychological distress; self-employed asbestos victims are excluded from this scheme as are civil servants and members of the armed forces. Public awareness of asbestos issues is low and companies, such as the asbestos multinational Eternit, continue to exploit legal loopholes to avoid paying compensation:
An Eternit worker in Belgium does not have the same right to compensation as one employed in an Eternit factory in France. Likewise the environmental victim of an Eternit asbestos cement plant in Belgium is denied access to the legal redress available to a Dutch victim on the other side of the border.3
Dr. Annie Thebaud-Mony, Director of Research at the National Institute for Health and Medical Research in France and a founding member of BAN Asbestos France and ANDEVA, a national group representing French asbestos victims, spoke about the status of asbestos victims in France. She said:
For many decades French society endured an 'invisible' epidemic of asbestos-related disease. Through a carefully designed strategy, the asbestos industry suceeded in hiding from the public the health consequences of asbestos use. The industry's efforts were bolstered by the pronouncements of its tame experts scientists, physicians, and lawyers. The truth only emerged through the perseverance of a social movement, which coalesced in the mid 1990s, that spoke out about the human toll asbestos had taken on French workers. This movement obtained two important victories: recognition of the suffering of the victims and their families and the prohibition of asbestos not only in France (1997) but in all European Union countries.
The National Association of Defence of the Asbestos Victims (ANDEVA), founded in 1995, coordinates the action of more than twenty-five local or regional groups and has been responsible for many improvements in the plight of asbestos victims in France. Before 1995, French victims of asbestos exposure rarely received compensation for their illnesses; subsequently, the number of asbestos compensations claims has increased dramatically. The creation in 2000 of FIVA, a central indemnification fund for asbestos victims, is a retrograde step. It is, Dr. Thebaud-Mony pointed out, an attempt to relieve negligent employers of their guilt for the hazardous exposures workers experienced:4
Responsible but not guilty such is the protection by which the asbestos industry executives and the employers' community prevailed against the penal complaints for manslaughter, poisoning, causing danger to other people
The official proceedings of the first day of the conference were rounded off by the presentation of Dr. Gregory Deleuil, the Medical Adviser of the Asbestos Diseases Society of Australia. Dr. Deleuil illustrated his talk on asbestos issues in Australia with a breathtaking collection of photographs depicting the reality of life in an Australian asbestos mining town. Although the Wittenoom (crocidolite: blue asbestos) Mine was operational for only 23 years, it has produced an epidemic of asbestos disease in Western Australia amongst former workers, their families and town residents. Many young adults, who had lived in Wittenoom as children, have died from asbestos-related diseases in their 20s and 30s. Greg's photos of race day in Wittenoom showed horses running on a blue track made from asbestos tailings. A photograph of children competing in sack races on the same track told its own story while the image of men competing to fill 50 gallon storage drums with asbestos tailings elicited gasps of disbelief from the audience. Dr. Deleuil informed us that the 1st and 2nd prize winners and the judge of the asbestos shovelling contest have all died from asbestos-related disease.
In recognition of the appalling human tragedy experienced by Australians, the Government set up The Asbestos Working Party in 2002 to identify research strategies aimed at reducing the incidence of asbestos-related cancer particularly mesothelioma, or curing these diseases.5 The budget for this program totals A$110 million over the next ten years. It is expected that this money will come from those with significant asbestos liabilities such as insurers, the national government and employers.
After the formal sessions of the day were adjourned, the photographic exhibition by Hein du Plessis was officially opened by Laurie Kazan-Allen who invited delegates to experience the drama and humanity of this collection of images revealing the devastating impact that the asbestos industry has had on workers and inhabitants in Prieska, a small town in the Northern Cape, South Africa.
The first presentation on Friday was made by Dr. Paul Swuste who opened Session V (Asbestos and the Environment) with his paper Asbestos, Environmental Pollution and Council Decision Making. By focusing on the situation which arose during the building of a new housing estate in the town of Goor, Dr. Swuste illustrated the lack of political will to tackle high levels of asbestos contamination stemming from years of asbestos-cement production at the Eternit factory. At its peak, the factory was generating 4,400 tons of asbestos-containing waste a year; between 1978-1987, hazardous emissions resulted in levels of asbestos ranging from 10-100 f/l near the factory and 1-10f/l in town. By 1992, asbestos contamination had become a political issue; when Holland banned asbestos one year later, Eternit pressed for exemption from its liability to clean up its mess using such excuses as: Belgium has not yet banned asbestos so it can't be that hazardous.
From 1969-2002, the incidence of male mesothelioma in the Netherlands rose from 70 to 325 a year; non-occupational exposure contributed to the death toll. A map showing the occurrence of environmental mesotheliomas in Goor pinpointed 5 cases in close proximity to the factory. Experience in England, Germany, Italy and Turkey confirms the hazards of environmental asbestos exposure. In Goor, the historical exposure to asbestos which people experienced will contribute to future mortality from asbestos cancer; the presence of asbestos in country roads constitutes a serious risk. Future building in areas where asbestos contamination exists creates the potential for hazardous exposures. In Goor, the financial and political clout of the multinational Eternit overwhelmed local government; national initiatives are required.
Anke Tiemens, a former employee of Eternit, discussed workers' experiences. From 1963, her husband was employed at the Eternit factory in Goor; in 1971, she became the first woman to work on the production of asbestos-cement pipes. From 1971-1982, crocidolite (blue asbestos) was used in the production of these pipes. Neither Mrs. Tiemens nor her colleagues had any knowledge about the hazards of working with asbestos. The company provided one liter of free milk a day to all the those working with crocidolite. One of the benefits of working for Eternit was the availability of ten asbestos panels a year; these panels were used throughout Goor and the surrounding areas. Free asbestos waste was used by farmers and many local farmyards are hardened with asbestos-cement waste. Although the Environment Minister has acknowledged the need for a public investigation into the possibility of getting Eternit to pay for decontamination, little has been done to achieve this goal.
Jim Fite, from the White Lung Association (US), spoke about Critical Techniques in Asbestos Removal. Faulty removal of asbestos has the potential to vastly increase exposure levels of asbestos removal workers and building users. Stressing the need for thorough worker training, clean working practices, use of wet methods and safe waste disposal, Mr. Fite listed the five standard abatement methodologies:
Purpose: to make the asbestos containing material (acm) non-friable.
Process: use of glue, plaster or other products to seal a broken floor tile, a cracked transite board, etc.
Purpose: to bond asbestos onto a surface or into a material thereby preventing fiber liberation.
Process: application of a liquid sealer over acm.
Purpose: to prevent liberation of fibers.
Process: use of an airtight and watertight barrier to prevent human exposure to asbestos dust.
Examples: used where asbestos cannot be removed such as in abandoned mines, factories, crawl spaces, boilers.
Purpose: recognition of damaged acms and hazardous conditions, minimization of risks for small jobs.
Purpose: final solution to asbestos contamination.
Process: location of and evaluation of asbestos, state-of-the-art removal and decontamination techniques (negative pressure, HEPA filtered equipment, etc.), constant monitoring, clearance with phase contrast microscopy or transmission electron microscopy.
|Jim Fite, White Lung Association (US)|
The concerted attempt made by US asbestos companies and their insurers to suppress adverse research findings on the links between asbestos exposure and disease were described by Dr. Barry Castleman, author of Asbestos: Medical and Legal Aspects. Currently, there are 10,000 asbestos-related deaths every year in the US; these deaths could have been prevented if warnings by factory inspectors, scientists and doctors had been heeded rather than buried by asbestos company executives.
|Dr. Barry Castleman|
Illustrating the lengths to which enterprises would go to find new uses for asbestos, Dr. Castleman displayed a series of advertisements for:
asbestos socks: protect your feet by wearing patent asbestos socks;
material made of asbestos combined with 80 per cent cotton (which) produces a fabric similar to linen (1947);
women's coats exported from Italy containing 8% asbestos;
a new dishtowel which contains 20 per cent asbestos comes out of the United States Rubber laboratories. The asbestos towel is made in six colors red, green, yellow, rose, blue and burgundy;
asbestos jewelry: a craft for schoolchildren.
The first asbestos-containing products banned in the US were imported Italian coats containing asbestos; although these were banned in 1972, the use of white (chrysotile) asbestos has not yet been banned by federal statute. A Congressional bill to ban asbestos, presented by Senator Murray in 2002, has not suceeded. The threat of litigation has, however, contributed to a climate in which asbestos is no longer used on a large scale but the effects of past usage are there for everyone to see. They include increasing numbers of victims and compensation cases. The business establishment, aggressively searching for ways of avoiding their liabilities, is backing legislative efforts to eliminate sympathetic juries, such as the proposals currently being supported by Senator Hatch.
The first speaker in Session VII (International Liability) was Erik Meijer, a Member of the European Parliament; his paper Towards Effective European Legislation for Victims of Asbestos described the process by which Directive 83/477/EEC was amended last year to increase protection for Europeans at risk of occupational exposure to asbestos. Issues mentioned during the various debates held on the amendments included:
protection for people who live near asbestos-contaminated sites or in asbestos-containing buildings;
the adoption of the precautionary principle when renovating or demolishing buildings lacking asbestos registers;
the extension of Commission regulations to include asbestos used in road construction, vehicles and equipment.
Attempts to gain EU backing for measures which empower asbestos victims failed; ideas which fell by the wayside during the legislative process included:
national registers of asbestos-related pathologies;
national health monitoring programs for all asbestos-exposed individuals;
adequate compensation for all asbestos victims;
the payment of compensation by public authorities when payment from negligent parties cannot be obtained.
Despite the dilution of the Directive, several new principles were established by Directive 2003/18 such as the extension of asbestos regulations to sea and air transport, the tightening of regulations pertaining to low-intensity exposure, an oblique recognition of the hazards of environmental asbestos contamination: employers must prevent the spread of (asbestos) dust outside the premises or site of action; the adoption of the precautionary principle: If there is any doubt about the presence of asbestos in a material or construction, demolition or maintenance, work shall proceed under the assumption that such material is present, observing the relevant requirements of the Directive.
Dr. Benedetto Terracini's subject was Asbestos Victims in Casale Monferrato (Italy). Between 1907 and 1985, asbestos cement was produced at the Eternit factory in Casale Monferrato. During the 1950s and 1960s asbestos concentrations in the plant were up to 100 ff/ml; in 1971 measurements of 20ff/ml in the plant were common; in the mixing area, concentrations of 200 ff/ml were reported. A mortality study of 3,4346 Eternit workers revealed the huge toll taken by asbestos-related diseases on the Italian workforce; where expected deaths from mesothelioma of the pleura for men and women in the general population of Piemonte were 3.0 and 0.6 respectively, fatalities for former Eternit workers were 96 and 39. Since the 1980s, 105 mesotheliomas from non-occupational exposure have been reported: the case-control study has shown a gradient of risk in relation to residence expressed in terms of distance of residence from the Eternit plant. In addition, a relatively high concentration of asbestos bodies were found at autopsy in residents of Casale Monferrato without occupational exposure and some asbestosis was found in two women who had never worked with asbestos.7
|Dr. Benedetto Terracini|
Richard Spoor's presentation Asbestos Victims in South Africa addressed the consequences of decades of asbestos mining in South Africa and discussed the attempt to obtain justice for thousands of injured miners and residents of asbestos communities:
At its peak in 1976 the (asbestos) industry employed over 60,000 persons. The prevalence of asbestosis amongst workers retrenched in the 1990s at date of retrenchment was approximately 30%. The percentage that go on to develop an asbestos related disease is well in excess of 40% or more. Extrapolating from studies into the prevalence of mesothelioma we believe that 15% to 20% of all miners employed in the crocidolite mines in the Northern Cape have died or will die from mesothelioma.
Vast areas of the Northern Cape are heavily contaminated with crocidolite fibre exposing tens of thousands of men, women and children on an ongoing basis. A very significant proportion of these are expected to die of the disease. There exists no statutory compensation scheme for persons who contract an asbestos related disease as a result of environmental exposure.
Multinational companies dominated the South African asbestos industry:
Cape PLC, a British company, mined crocidolite in the Northern Cape and amosite in the Limpopo Province until 1979;
Eternit, a Swiss multinational, mined crocidolite in the Northern Cape from 1960-1981 and, until the early 1990s, controlled Everite, South Africa's main asbestos cement manufacturer;
Gencor, a South African company, mined crocidolite in the Northern Cape and took over Cape and Eternit's crocidolite and amosite mining operations; Gencor mined chrysotile in the Mpumalanga Province.
The case against Cape PLC was the first legal action for asbestos compensation brought by injured South Africans. This action was launched in the UK Court by the London law firm of Leigh Day & Co in 1997; after seven years of litigation, money obtained in a negotiated settlement was received by thousands of plaintiffs. In 2002, a planned reorganization of Gencor's finances jeopardized the possibility of future asbestos claims against the company; to prevent the Gencor debundling, the law firm of Ntuli Noble & Spoor brought an action before the High Court to:
compel the company to make a provision to compensate asbestos victims before distributing its assets to shareholders... The matter was settled before judgment was given by the Court and Gencor undertook to pay an amount of approximately ZAR460 million (57.5 million Euros) into a fund to compensate persons who contracted asbestos related diseases as a result of their employment or exposure to the company's mining activities.
The Asbestos Relief Trust was set up as part of the Gencor agreement to process asbestos claims; information on this body can be found at http://www.asbestosclaims.co.za
The final presentation of Session VIII was by Bob Ruers who tied up many of the conference's recurring themes with his discussion of the double standards of Eternit. A week before the conference, a court in Arnheim ruled that by 1971, Eternit should have been aware of the risk of mesothelioma from exposure to asbestos and should therefore have placed warnings on asbestos-cement panels. After a long struggle, courts in the Netherlands, now compensate Eternit's victims of occupational, environmental and domestic exposure. It is unacceptable that this is not the case in Belgium, Brazil, Italy and elsewhere. In Nicaragua, 400 of Eternit's asbestos victims have registered their names with a victims' group; none of them has received compensation from the company. In the Netherlands, the Government, not Eternit, has paid for the clean-up of contaminated roads and rural areas. Eternit continues to avoid liability for its negligence; under the concept of the polluter pays, Eternit is morally and legally responsible for the people it has injured and the land it has contaminated. Like Eternit, other former asbestos multinationals:
refuse to bear any responsibility, especially where the third world is concerned, for the harm they have done. Therefore, it is of utmost importance that asbestos victims and their organisations support and inform each other worldwide. Only in that way can we make sure that all asbestos victims, wherever they live, can obtain adequate compensation for their damages.
The papers presented at the conference by Dutch speakers demonstrated how much can be achieved by the mobilization of asbestos victims; the personal ties between the Committee of Asbestos Victims, its lawyers, epidemiologists, researchers, civil servants and doctors has resulted in initiatives such as the Institute of Asbestos Victims and the Asbestos Map, both of which reduce the time required to process legal claims.
As the conference came to an end, Tinka de Bruin reflected on the experience of the two days: This international conference marks a new phase in the campaign by the Dutch Committee for Asbestos Victims. She pledged that the Committee would continue its campaign and work with global campaigners towards a universal ban on asbestos and justice for all asbestos victims. To this end, Bob Ruers announced that he would be presenting a paper entitled The International Operations of Eternit at the Global Asbestos Congress in Tokyo this Autumn. International delegates welcomed the opportunity of working with the Committee; there is much to be gained by closer cooperation in the global battle to ensure that the polluter does indeed pay.
August 2, 2004
1 The population of the Netherlands is approximately 16 million.
2 The IAV was set up four years ago after consultation with stakeholders such as victim support groups, insurers, politicians, employers and the Government to lessen the legal agony of asbestos victims, many of whom died before receiving compensation from the courts. It is an independent institute which mediates between workers with mesothelioma and employers on the basis of fixed amounts for damages and according to strict timetables.
3 Nay S. Asbestos in Belgium: Use and Abuse. Int J Occup Environ Health, Vol. 9, No. 3, July-Sept. 2003. p.287-293.
4 FIVA is 75% financed by the national fund for occupational injuries and illnesses to which all employers contribute and 25% by the State. Between July 2002 and May 2003, FIVA processed 5,433 applications for compensation, of which 95% were from victims of occupational exposure. The average amount of compensation awarded by FIVA was higher than the basic compensation awarded by the occupational disease compensation system but lower than that obtained in the most successful court cases for negligent asbestos exposure.
5 Document published by the Australian National Health and Medical Research Council, Asbestos Working Party.
6 This cohort included workers from 1950 onwards; 3657 men and 777 women.
7 Magnani C. Asbestos lung burden and asbestosis after occupational and environmental exposure in an asbestos cement manufacturing area: a necropsy study. Occup Environ Med 1998;55:840-846.