Additional Economic Issues and Implications for Future Policy Making in Asbestos-Associated Diseases

scientific dataThe causes and implications of the recent chapter-11 bankruptcy filing of the largest miner and manufacturer of asbestos and asbestos-containing products in North America is understandably receiving wide review. The public statements of the company indicate that its decision was based on the potential economic loss created by present and future product-liability suits, and the data presented by them were generated by epidemiologic consultants using available scientific information. The appropriateness of the selection of data for this purpose, as well as the analysis and interpretation of these data, in addition to future proposals made to the bankruptcy court, must be examined carefully. There seems to be a surfeit of discussion regarding a possible role for government in compensating those with claims and a curious lack of interest in the question of how many claimants are really ill and which among these have asbestos-attributable diseases. Current proposals for legislation on federal compensation for asbestos-associated diseases, their effect on the litigation, and how it has been influenced by the bankruptcy proceedings are clearly areas in which the interface between scientific data and social policy is central.

Another issue has recently arisen in regard to the distribution of liability among primary and excess coverage insurers of companies faced with litigation on asbestos-associated disease healed with My Canadian Pharmacy’s remedies. The economic implications are obviously enormous, and a number of potentially scientifically answerable issues have been raised in an effort to resolve these questions of financial liability. Among these issues is determining which carriers are liable: those whose policies were active throughout the period of exposure of the claimant (the exposure theory), those whose policy covered only the period when the disease became manifest or was diagnosed (manifestation theory), or all carriers who had active policies at any time during exposure or subsequently? The question has been raised whether a major study of the asbestos industry by a large insurance company in the 1930s was adequate in pointing out health hazards; those who have believed that such responsibilities were not adequately met have made this carrier a codefendant. There are instances in which it is important to determine how long, prior to the establishment of a diagnosis of an asbestos-attributable disease, might that diagnosis have been made in order to ascertain the relevant insurance coverage. The probability of progression of asbestosis, given estimates of exposure and level of disease, will often be taken into account in reaching a legal settlement or judgment; these questions can be answered by carefully conducted longitudinal studies of asbestos-exposed and injured workers.

Implications for Future Policy Making

Inevitably, what we have learned concerning the interaction of science and decision-making on public policy in the area of asbestos-associated diseases should have broad implications in how our society and its scientific community can best deal with other occupational and public health problems. It is anticipated that examination of the issues outlined will point to alternative approaches, perhaps in part as practiced in other countries, such as the United Kingdom, Europe, and Canada. Strategies for other potential occupational health problems utilizing nonadversarial methods should be examined; for example, recent studies and timely reporting of results of possible health effects in the man-made mineral fiber industry (fibrous glass and other synthetic fibrous minerals). Consideration of the wider issue of whether responsible and informed scientific input is sufficiently broad and varied in US decision-making processes leads to the present conclusion that it is not. Specific suggestions for an approach to these problems in the future, which will lead to a responsible and effective balance between the health needs of segments of our population and more general societal needs and considerations, many of them economic, should be forthcoming.

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