Litigation Management

Latest Statistical Report On Asbestos And Other Occupational Lung Diseases

Authors:	Elizabeth Juliano
	James Fell

Strategic planning for the long-term defense of occupational lung disorders is often challenged by the paucity of hard statistics on the current incidence and future projections for these conditions. Insurers are also confronted by the need to assess disease trends when attempting to establish monetary reserves for asbestos, silica, and other toxic torts where workplace respiratory exposures are implicated. For example, a review of the literature reveals that the majority of asbestos-related disease forecasts were developed in the late 1970’s and early 1980’s, and widely varied in their predictions of disease incidence and claims filing. Such dated analyses are of limited utility to corporate legal departments addressing optimal case resolution of mass toxic torts in Y2000 and beyond.

The 243-page Work-Related Lung Disease Surveillance Report 1999, published by the Centers for Disease Control and Prevention and the National Institute for Occupational Safety and Health, offers some welcome concrete data on mortality trends of respiratory diseases associated with exposures to various industrial agents. This analysis is the fifth report in a series, with previous evaluations being published in 1991, 1992, 1994, and 1996.

Section 1 of the report contains a number of tables and graphs examining asbestosis mortality from a variety of demographic perspectives. As Figure 1-1 illustrates, asbestosis fatalities have been on a continual upward slope over the years, although a plateau effect may be underway beginning in 1995. Figure 1-2 presents the geographic distribution of asbestosis crude mortality rates, with the highest rates noted for Delaware (first in the nation), New Jersey, West Virginia, Mississippi, and Washington.

From 1987 through 1992, the frequency of asbestosis mortality was greatest for the 65-74 age group. However, since 1993, deaths in the 75-84 age group have surpassed this age cohort. Although the report does not attempt to explain this finding, this observation may be attributed to such factors as the introduction of regulatory measures reducing workplace asbestos fiber exposure, as well as improved medical recognition and treatment of asbestosis. Asbestosis mortality was by far the highest for the construction trades, followed in descending order by deaths in shipyard, industrial and chemical, and railroad workers.

Section 7 addresses malignant neoplasm of the pleura, which the report notes is often associated with the asbestos-related occupations and industries. However, for the 1987-96 period, 142 deaths, or 10.6% of total mortality from malignant neoplasm of the pleura, occurred in homemakers, although some 792 deaths, representing 59.2% of the study population, were classified in the group "all other occupations." By industry group, the proportionate mortality ratio was highest for shipyard work. In the aggregate, yearly deaths from malignant neoplasm of the pleura have remained relatively stable, ranging from 491 in 1988 to 554 in 1992. See Figure 7-1. Geographic distribution for 1987-96 is illustrated in Figure 7-2 and differs from that seen with asbestosis mortality. In decreasing order Florida, California, New York, Texas, and Pennsylvania evidence the highest numbers of deaths from malignant neoplasm of the pleura.

The slope of annual mortality from silicosis is opposite that of asbestosis. See Figure 3-1. Silicosis deaths have declined from a high of 342 in 1987 to a low of 212 in 1996. The construction and mining industries accounted for 20.8% of the silicosis mortality for the period 1987-96.

The report notes that numbers of deaths from coal workers’ pneumoconiosis (CWP) have been on a steady decline since 1982. See Figure 2-1. Over 75% of CWP deaths are associated with just four states—Pennsylvania, West Virginia, Virginia, and Kentucky—where historically coal mining has been heavily concentrated.

Deaths from hypersensitivity pneumonitis have increased between 1979 and 1996 as depicted in Figure 8-1.

Although mortality is largely concentrated in the agricultural occupations, hypersensitivity pneumonitis is increasingly being recognized as a serious disorder among chemical workers engaged in work with compounds such as isocyanates and phthalic anhydride.

Other sections of this report present similar analyses for byssinosis and unspecified/other pneumoconioses. Mortality rates for these disorders have declined or flattened out for the recent study periods.

Note: The entire CDC NIOSH report is in the public domain and can be located at www.cdc.gov/niosh/pdfs/2000-105.pdf. All illustrations accompanying this review were taken directly from the National Institute for Occupational Safety and Health Work-Related Lung Disease Surveillance Report 1999 without modification.

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