Compensation of Occupational Diseases, Particularly Asbestos-Related Diseases, Among European Union (EU) Countries

Our plain-English summary of Compensation of Occupational Diseases, Particularly Asbestos-Related Diseases, Among European Union (EU) Countries, by E. Merler, S. Brizzi (New Solutions, 1995).

The study

• Authors: E. Merler, S. Brizzi
• Journal: New Solutions
• Published: 1995;6(1):21-30
• Cited by: 1 article, as counted by NIH iCite
• Read it: PubMed · Publisher

In plain English

This paper examined occupational disease compensation in European Union countries, focusing on asbestos-related diseases. The authors surveyed compensation institutes by questionnaire and compared mesothelioma compensations with World Health Organization pleural tumor death data, which excluded asbestosis. Asbestosis was compensable in every country surveyed. Mesothelioma was then not compensated in Greece and Italy, but a note added later reported a new Italian law admitting mesothelioma and lung cancer in asbestos-exposed workers. About 200 new asbestosis cases a year were compensated in each of France, Germany, the UK and Italy. In 1988, 11 people in France and 59 in the UK were compensated for asbestos-related lung cancer. The authors wrote that UK mesothelioma compensations (both sexes) had exceeded male pleural tumor deaths since 1986. Their tables show this for 1987 and 1988 but not 1986 (306 compensations, 362 deaths). Germany compensated fewer mesothelioma cases than male deaths over age 65, and France a few dozen a year against hundreds of deaths. The authors concluded that the EU's recommendation-based approach had been ineffective for asbestos-related diseases, and called their picture only partially reliable.

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: Questionnaire survey of national compensation institutes with a policy discussion. Mesothelioma compensations were compared with World Health Organization data on deaths from primary pleural tumors; asbestosis deaths could not be taken from that source.
• Who was studied: Occupational disease compensation institutes of EU member countries. The tables cover Belgium, Denmark, France, Germany, Greece, Ireland, Italy, Luxemburg, the Netherlands, Portugal, Spain and the UK, with compensation and mortality data mostly from the mid-1980s to 1991.
• Exposure: Compensation for occupational asbestos-related diseases: asbestosis, pleural plaques and thickening, pleural, peritoneal and pericardial mesothelioma, and lung tumors. Compensation for occupational diseases in general was also covered.
• Main results:
  • At the time of the survey, asbestosis was compensable in all countries surveyed. Mesotheliomas were not compensated in Greece and Italy. Pleural plaques and lung tumors were admitted for compensation in very few countries.
  • A note added after the paper was written reported a new Italian law. It admits mesotheliomas and lung cancers as occupational diseases when they occur in workers exposed to asbestos.
  • Six countries (Belgium, France, Greece, Ireland, UK, Spain) still used a 'closed' list of compensable diseases rather than the 'mixed' system recommended by the EU.
  • The minimum disability required for a benefit ranged from 1 percent (Ireland, Luxemburg, Portugal) to 33 percent (Spain, Greece).
  • Approximately 200 new cases of asbestosis a year were compensated in recent years in each of France, Germany, the UK and Italy.
  • In 1988, 11 people in France and 59 in the UK were compensated for lung cancer recognized as due to occupational asbestos exposure.
  • In 1988, 75 people in France and 117 in the UK were compensated for pleural plaques.
  • The authors wrote that since 1986, UK mesothelioma compensations (both sexes) had overtaken male deaths from primary pleural tumors.
  • The UK compensation table lists mesothelioma compensations (both sexes) of 306 in 1986, 399 in 1987 and 479 in 1988. These are the second column, after asbestosis.
  • Table 4 lists total male deaths from primary pleural tumors in England and Wales of 362 in 1986, 369 in 1987 and 429 in 1988. Compensations therefore exceeded these male deaths in 1987 and 1988, but not in 1986.
  • In Germany, mesothelioma compensations numbered fewer than male deaths over age 65, though they were increasing. In France, a few dozen mesotheliomas were compensated each year while hundreds of deaths occurred.
  • Lists of prescribed diseases were revised less often where the expert committee was not permanent but formed from time to time.
  • Introducing mixed systems had not increased the number of compensated cases.
• The authors' conclusion: The authors concluded that the EU recommendation's premise, that listing a disease as occupational leads to action, had proved ineffective for compensation of asbestos-related diseases in EU countries. They saw a gap between knowledge and action.
• Limitations the authors state:
  • Where countries did not reply, the authors could not tell whether no benefits were awarded or whether the countries simply could not count them.
  • Asbestosis deaths could not be assessed from WHO data, because asbestosis is not among the diseases in the files sent to the WHO.
  • Mortality data were considered an unreliable indicator for mesothelioma because of false positive and false negative death certifications.
  • The authors described the inquiry as giving only a partially reliable picture, because compensation institutes could not produce comparable statistics.

Topics

Medical terms in this study, explained in our Lexicon: Occupational Disease.

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