Compensation of pleural mesothelioma in France: data from the French National Mesothelioma Surveillance Programme

Our plain-English summary of Compensation of pleural mesothelioma in France: data from the French National Mesothelioma Surveillance Programme, by S. Chamming's, B. Clin, P. Brochard, et al (American Journal of Industrial Medicine, 2013).

The study

• Authors: S. Chamming's, B. Clin, P. Brochard, P. Astoul, S. Ducamp, F. Galateau-Salle, A.G. Ilg, M. Goldberg, C. Gramond, E. Imbernon, P. Rolland, J.C. Pairon
• Journal: American Journal of Industrial Medicine
• Published: 2013;56(2):146-54
• Cited by: 12 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Background: The aim of this study was to determine the rates of compensation awarded to patients presenting with pleural mesothelioma and factors linked to such compensation in France.

Methods: The study population consisted of 2,407 patients presenting with pleural mesothelioma, recorded by the National Mesothelioma Surveillance Programme between January 1, 1999 and December 31, 2009. Analysis of claims for recognition as "occupational disease" (OD) and claims for compensation by the Compensation Fund for Asbestos Victims (FIVA) were analyzed.

Results: Approximately 30% of subjects presenting with pleural mesothelioma, affiliated to the General National Health Insurance fund, neither sought recognition as an OD nor claimed for FIVA compensation. Gender, age at diagnosis, type of health insurance, and socio-professional category influence the likelihood of patients presenting with mesothelioma seeking compensation for this disease.

Conclusions: Results show an under-compensation of pleural mesothelioma as OD and by the FIVA in France.

Copyright © 2012 Wiley Periodicals, Inc.

In plain English

This French study described how often people with pleural mesothelioma sought compensation. It covered 2,407 patients recorded by the National Mesothelioma Surveillance Programme from 1999 to 2009 in 21 départements. Of the 1,814 patients covered by the General National Health Insurance, 62% claimed recognition of their cancer as an occupational disease, and 91% of those claims were granted. Refusals were all for administrative reasons, essentially unconfirmed asbestos exposure. Among those who did not claim, 39% were judged to have been occupationally exposed to asbestos. Claims were more common in men (70%) than women (32%). Of 1,418 patients recorded from 2005, 51% sought compensation from the Compensation Fund for Asbestos Victims (FIVA). The fund offered compensation in every case once the diagnosis was confirmed. Among the 1,114 General National Health Insurance patients recorded from 2005 to 2009, 30% sought neither type of compensation. This was more common in women (47%) than men (24%), and in those over 75 (44%) than those under 65 (19%). The authors concluded that claims were largely lower than expected and that healthcare professionals need to be informed.

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: Descriptive study of compensation claims among pleural mesothelioma cases recorded by a national surveillance programme
• Who was studied: 2,407 patients with pleural mesothelioma recorded by the French National Mesothelioma Surveillance Programme (PNSM) between January 1, 1999 and December 31, 2009, in the 21 départements that recorded more than 15 cases
• Exposure: The study's main subject was compensation claims (recognition as occupational disease, and FIVA compensation), not exposure itself. Asbestos exposure was assessed from a standardized questionnaire, given face to face or as a shorter version to a relative, friend or doctor, and rated by industrial and environmental hygiene experts. No fiber types are named.
• Main results:
  • Of the 1,814 patients covered by the General National Health Insurance, 62% (n = 1,123) sought recognition as an occupational disease. Recognition was granted to 91% of claimants (n = 1,022).
  • All refusals were explained by failure to meet the administrative criteria, essentially failure to confirm asbestos exposure because records from since-closed plants were missing.
  • Among the 38% of General National Health Insurance patients who did not seek recognition, 39% were considered occupationally exposed to asbestos after expert review of the questionnaire.
  • Occupational disease claims were significantly more frequent in men (70%) than in women (32%), P less than 0.001.
  • Occupational disease claims were more frequent among patients interviewed face to face than among those covered only by the shorter questionnaire (69% vs. 53%, P less than 0.001).
  • In the 15 départements in the programme since 1999, occupational disease claims showed a non-significant decrease, from 70% in 1999 to 66% in 2009.
  • Of 1,418 cases recorded since January 1, 2005, 51% (n = 723) sought FIVA compensation.
  • Once the mesothelioma diagnosis was confirmed, FIVA proposed compensation in 100% of cases.
  • FIVA claims were significantly more frequent (P less than 0.001) among the 1,114 patients with General National Health Insurance (55%) than among the 304 with a different health insurance fund (37%).
  • FIVA claims varied by département, from 26% in Alpes Maritimes to 77% in Manche.
  • FIVA claims were more frequent in younger patients: 66% of those under 65 years vs. 36% of those over 75 years (P less than 0.001).
  • 30% of patients with General National Health Insurance (2005 to 2009 cases, n = 1,114 in Figure 2) sought neither occupational disease recognition nor FIVA compensation.
  • Seeking neither form of compensation was more common in women (47%) than men (24%), P less than 0.001.
  • Seeking neither form of compensation was more common in patients over 75 years (44%) than in those under 65 years (19%), P less than 0.001.
  • Among patients with identified asbestos exposure, laborers/workmen claimed occupational disease compensation more often than managers (OR = 3.0, 95% CI 1.8 to 4.9).
  • For FIVA claims, laborers/workmen tended to claim more often than managers, with a confidence interval that included 1 (OR = 1.4, 95% CI 0.9 to 2.2).
  • The authors compared the ratio of occupational disease recognitions to pleural mesothelioma deaths. In 74 départements outside the programme it was 32% (1999 to 2004) and 36% (2005 to 2009). In programme départements it was slightly but not significantly higher, at 40% and 45%.
• The authors' conclusion: The authors concluded that, despite general awareness of the occupational origin of most pleural mesothelioma and the existence of FIVA, claims for compensation as occupational disease and by FIVA were largely lower than expected. They said this suggests healthcare professionals need to be informed of the social stakes of the disease.
• Limitations the authors state:
  • The authors described the ratio of compensated cases to pleural mesothelioma deaths, used to compare départements inside and outside the programme, as a crude surrogate for a compensation rate.
  • Some cases registered before 2005 may have been compensated by FIVA between 2005 and 2009, overestimating the numerator of the FIVA compensation ratio. The authors state this would not differ between programme and non-programme départements.

Topics

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

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

Related studies

• Choice of rating method for assessing occupational asbestos exposure: study for compensation purposes in France — C. Gramond, P. Rolland, et al. (2012)
• Occupations and industries in France at high risk for pleural mesothelioma: A population-based case-control study (1998-2002) — P. Rolland, C. Gramond, et al. (2010)
• Attributable risk in men in two French case-control studies on mesothelioma and asbestos — A. Lacourt, P. Rolland, et al. (2010)
• Justice for asbestos victims and the politics of compensation: the French experience — A. Thébaud-Mony (2003)
• Programmed health surveillance and detection of emerging diseases in occupational health: contribution of the French national occupational disease surveillance and prevention network (RNV3P) — V. Bonneterre, L. Faisandier, et al. (2010)
• Mesothelioma incidence surveillance systems and claims for workers' compensation. Epidemiological evidence and prospects for an integrated framework — A. Marinaccio, A. Scarselli, et al. (2012)

Browse more research in American Journal of Industrial Medicine, or return to medical research.