Analysis of mortality patterns and workers' compensation awards among asbestos insulation workers in Ontario

Our plain-English summary of Analysis of mortality patterns and workers' compensation awards among asbestos insulation workers in Ontario, by M.M. Finkelstein (American Journal of Industrial Medicine, 1989).

The study

• Author: M.M. Finkelstein
• Journal: American Journal of Industrial Medicine
• Published: 1989;16(5):523-8
• Cited by: 11 articles, as counted by NIH iCite
• Read it: PubMed · Publisher
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 000879).

Abstract

Mortality and workers' compensation patterns were studied among 1,064 Ontario asbestos insulation workers. A proportional mortality analysis of 153 asbestos worker deaths found increased mortality from malignant diseases (65 deaths observed; 35.1 expected), cancers of the lungs and pleura (32 deaths observed; 11.5 expected), peritoneal mesothelioma (4 deaths), and respiratory diseases (14 deaths observed; 7.9 expected). Despite the publicity given to asbestos-associated diseases, dependents of many men potentially eligible for workers compensation awards have not received pensions because claims were not filed. These findings suggest that much occupationally related disease is not being recognized in Ontario.

In plain English

This study examined deaths and workers' compensation awards among 1,064 members of Local 95, the Ontario local of the asbestos insulation workers' union, followed to the end of 1985. Poor identifying information meant some deaths were probably missed. The author therefore used a proportional mortality analysis, comparing the causes of 153 deaths before age 85 with the pattern expected among Ontario men. Cancer caused 65 deaths against 35.1 expected: 42% of the insulators' deaths, compared with 23% among Ontario men of the same ages. Cancers of the lungs and pleura caused 32 deaths against 11.5 expected. There were 4 deaths from peritoneal mesothelioma, and respiratory diseases caused 14 deaths against 7.9 expected. Of 8 men with mesothelioma, 7 (88%) received fatal compensation awards. Of 30 men with potentially compensable lung cancer, 12 (40%) received awards. Twelve others may have left dependents, but no claim appears to have been filed. No claims were filed for 7 men with gastrointestinal cancers. The author wrote that these findings suggest much occupationally related disease is not being recognized in Ontario.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Proportional mortality ratio (PMR) analysis of deaths in a union membership group, compared with the general male population of Ontario, plus a review of workers' compensation fatal claim status for men who died of potentially compensable diseases
• Who was studied: 1,064 men who were members of Local 95, the Ontario local of the asbestos insulation workers' union. They were identified from Ontario Ministry of Labour medical examination cards and a list of 607 members from the Selikoff study, and followed by record linkage to the end of 1985. 155 were identified as deceased, of whom 153 died before age 85 and were analyzed.
• Exposure: Occupational asbestos exposure as asbestos insulation workers. Fiber types were not specified. Length of exposure was estimated as the time from first employment to the last X-ray examination, or from joining Local 95 to January 1, 1967 for men on the Selikoff list.
• Main results:
  • Malignant diseases: 65 deaths observed versus 35.1 expected among the insulators (PMR 185, statistically significant). 42% of insulator deaths were from cancer, versus 23% among Ontario men of the same ages.
  • Cancers of the lungs and pleura: 32 deaths observed versus 11.5 expected (PMR 278, statistically significant)
  • Peritoneal mesothelioma: 4 deaths. Respiratory diseases: 14 deaths observed versus 7.9 expected (PMR 177, statistically significant), including 5 asbestosis deaths versus 0.3 expected.
  • Of 8 men who had mesothelioma, 7 (88%) received fatal compensation awards for asbestos-related disease. The one who did not died in 1967.
  • Of 30 men with lung cancer and apparently at least 10 years of occupational asbestos exposure, 12 (40%) received fatal compensation awards
  • Of the 18 lung cancer cases without awards, 11 were married and one was divorced, suggesting 12 may have left dependents, yet apparently no claim was filed. In 9 of these 12, the death certificate gave the occupation as asbestos worker.
  • Seven men had gastrointestinal cancers: 6 died of them, and one with rectal cancer died of heart disease. There were no compensation claims for death from gastrointestinal cancers.
• The authors' conclusion: The author wrote that the analysis confirms Ontario asbestos insulation workers are at increased risk of death from malignancies and respiratory disease. The author also reported that many dependents went without pensions because claims were not filed, and wrote that these findings suggest much occupationally related disease is not being recognized in Ontario.
• Limitations the authors state:
  • Identifying information was often poor, so some deaths among Local 95 members were likely missed
  • The PMR method assumes that whether a death was found does not depend on its cause. The author said this assumption is probably reasonable except for mesothelioma deaths.
  • Exposure length estimates ignored breaks in employment and exposure after the assessment dates
  • The reasons claims were not filed could only be speculated about

Topics

The National Library of Medicine indexes this study under subjects our site covers: Asbestosis.

Medical terms in this study, explained in our Lexicon: Insulator, Proportional mortality, Pleura, Peritoneal Mesothelioma.

Related studies

• Filing for workers' compensation among Ontario cases of mesothelioma — J.I. Payne, E. Pichora (2009)
• Mortality among employees of an Ontario factory manufacturing insulation materials from amosite asbestos — M.M. Finkelstein (1989)
• Workers' compensation for nonmalignant asbestos-related lung disease — C. Nevitt, W. Daniell, et al. (1994)
• A cohort study of mortality among Ontario pipe trades workers — M.M. Finkelstein, D.K. Verma (2004)
• Occupational cancer: experience in Ontario — A.C. Chovil, W.J. McCracken, et al. (1981)
• French cohort of the uranium processing workers: mortality pattern after 30-year follow-up — I. Guseva Canu, E. Cardis, et al. (2010)

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