Filing for workers' compensation among Ontario cases of mesothelioma

Our plain-English summary of Filing for workers' compensation among Ontario cases of mesothelioma, by J.I. Payne, E. Pichora (Canadian Respiratory Journal, 2009).

The study

• Authors: J.I. Payne, E. Pichora
• Journal: Canadian Respiratory Journal
• Published: 2009;16(5):148-52
• Cited by: 10 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Background/objective: For many types of cancer, disease attribution to occupational exposures is difficult. Mesothelioma, however, is a 'sentinel' occupational cancer associated with asbestos exposure. The present study linked workers' compensation claims data with cancer registry data to explore the completeness of reporting of mesothelioma to the Ontario Workplace Safety and Insurance Board (WSIB) according to characteristics of cases diagnosed among Ontario residents.

Methods: Two data sources were linked at the person level: the WSIB Occupational Disease Information and Surveillance System and the Ontario Cancer Registry. Filing rates were calculated as the proportion of Ontario Cancer Registry mesothelioma cases (International Classification of Diseases - Oncology code 905) that linked to a WSIB-filed cancer claim. Filing rates were calculated for the period 1980 to 2002, and trends were calculated by year, age and county of residence at diagnosis.

Results: The filing rate for compensation has increased little over the past 20 years, reaching a high of 43% in 2000. Overall, filing rates were highest among pleural mesothelioma cases among men (range 27% to 57%). Filing rates were highest among individuals 50 to 59 years of age and declined substantially throughout the retirement years. There was substantial variation in filing rates by area of residence, with the highest rate being in Lambton County, Ontario.

Conclusion: The filing rate for compensation in Ontario was much lower than the estimated proportion of cases eligible for compensation. The increased filing rate in Lambton County was likely related to this community's awareness of the association between asbestos and mesothelioma. Physicians can play an important role in educating patients of their potential entitlement to compensation benefits.

In plain English

This study linked, person by person, Ontario workers' compensation claims for cancer with the Ontario Cancer Registry. The claims were held by the Workplace Safety and Insurance Board (WSIB). It aimed to test how well the two databases could be linked for possible ongoing use, and to see how many people with mesothelioma filed a claim. Of 1855 mesothelioma cases diagnosed in Ontario between 1980 and 2002, 643 (35%) had filed a WSIB cancer claim, and 97.5% of those claims were for mesothelioma. The yearly filing rate ranged from 20% to 43% and rose only slightly over time. Among men with pleural mesothelioma the filing rate was 44% overall, ranging from 27% to 57% over the period. Filing was much higher among people diagnosed before retirement than after. Lambton County had the highest filing rate, 77%. The authors reported that more than 85% of the cases that filed were compensated. They concluded that filing rates were well below expected rates. They noted that the cancer registry under-reports mesothelioma and that some patients are not eligible for WSIB compensation.

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: Population-based record-linkage study of workers' compensation claims data and cancer registry data. It had two objectives: assessing whether the two databases could be linked successfully, and describing filing patterns for mesothelioma.
• Who was studied: 1855 mesothelioma cases (ICD-O code 905) diagnosed in Ontario between 1980 and 2002 and registered in the Ontario Cancer Registry, linked to 6499 WSIB cancer claim records
• Exposure: The study did not measure individual asbestos exposure or fiber type. What it measured was whether each registered mesothelioma case had filed a WSIB claim for any cancer (the 'filing rate').
• Main results:
  • Of the 6499 WSIB cancer claim records, 86% (5604 of 6499) linked to the cancer registry.
  • Of 821 WSIB claims compensated for mesothelioma, 93% (767 of 821) linked to a cancer registry record of any cancer.
  • Of the 1855 Ontario mesothelioma cases diagnosed 1980 to 2002, 643 (35%) filed a WSIB claim with a cancer diagnosis code.
  • Of those 643 claims, 97.5% were filed for mesothelioma and 1.4% for lung cancer.
  • Across years of diagnosis, the filing rate ranged from 20% to 43%, with a small increase in the linear trend.
  • Among men with pleural mesothelioma, the filing rate was 44% overall, ranging from 27% to 57% over the 20-year period.
  • Filing rates were much higher for cases diagnosed before retirement than after, although many cases were diagnosed after age 65.
  • Lambton County had the highest filing rate of all counties, 77%.
  • More than 85% of mesothelioma cases that filed for compensation in Ontario between 1980 and 2002 were compensated.
• The authors' conclusion: The authors concluded that observed filing rates for mesothelioma in Ontario were well below the rates expected from the attribution of the disease to occupational asbestos exposure.
• Limitations the authors state:
  • The cancer registry under-reports mesothelioma because its algorithm relies on cancer site coding rather than morphology coding.
  • Some compensated mesothelioma claims linked to registry cases not coded as mesothelioma, suggesting misclassification or miscoding in one or both databases.
  • Because morphology data were incomplete before 1980, the analysis was restricted to 1980 to 2002.
  • Not all Ontario mesothelioma patients are eligible for WSIB compensation. Some exposed workers are not WSIB-insured.
  • People exposed through contact with an asbestos worker or an environmental source are not eligible for WSIB compensation.

Topics

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

Medical terms in this study, explained in our Lexicon: Mesothelioma, Attribution, Occupational Exposure, Asbestos Exposure, Cancer Registry, Occupational Disease, Pleural Mesothelioma.

Related studies

• Analysis of mortality patterns and workers' compensation awards among asbestos insulation workers in Ontario — M.M. Finkelstein (1989)
• Surveillance of mesothelioma and workers' compensation in British Columbia, Canada — T.L. Kirkham, M.W. Koehoorn, et al. (2011)
• Exploring the usefulness of occupational exposure registries for surveillance: the case of the Ontario Asbestos Workers Registry (1986-2012) — A.J. Koné Pefoyo, L. Genesove, et al. (2014)
• Mesothelioma incidence surveillance systems and claims for workers' compensation. Epidemiological evidence and prospects for an integrated framework — A. Marinaccio, A. Scarselli, et al. (2012)
• Workers' compensation for nonmalignant asbestos-related lung disease — C. Nevitt, W. Daniell, et al. (1994)
• Approach to asbestos worker compensation plan alleged to be flawed — K.T. Kelsey, D.C. Christiani (1985)

Browse more research in Canadian Respiratory Journal, or return to medical research.