Approach for Compensation System of Asbestos-Related Lung Cancer. (13th November 2019)

• Record Type: Journal Article
• Authors: Nishina, Y; Niino, M; Higashi, T
• Is Part Of: European journal of public health. Volume 29(2019)Supplement 4
• Publication Date: 2019-11-13
• Subjects: Epidemiology -- Europe -- Periodicals; Public health -- Europe -- Periodicals; 362.109405
• DOI: 10.1093/eurpub/ckz186.321
• Languages: English
• ISSNs: 1101-1262

Abstract

Abstract: Background: The health hazards of asbestos have been globally recognized, especially those among industrial workers with long-term exposure. Lung cancer is one such asbestos-related disease. It occurs not only among workers but also among residents with environmental exposure to asbestos. Patients with work-related exposure can receive occupational compensation, and patients with non-occupational exposure are supported by a separate compensation system in Japan. However, the latter is not well-known among clinicians, and a substantial number of patients may have been left out. We need an effective way to find patients eligible to receive benefits by better understanding the clinical conditions that characterize patients with asbestos-related lung cancer. Methods: We conducted two types of research: 1. Comparison of clinical characteristics between compensation system recipients (N = 65) and general lung cancer patients diagnosed in 2015, using Japan's National Database of Hospital-Based Cancer Registry. 2. Estimation of the frequency of pleural plaques among lung cancer patients by double-checking CT scan images of a random sample of lung cancer patients obtained from the HBCR national database (N = 3585). Results: Patients with squamous cell carcinoma are twice as likely asbestos-induced as patients with other histology overall after adjusting for age, sex and cancer stages, but not smoking status and history. As many as 20% of the CT images were read inconsistently between two radiologists or respiratory disease doctors and we could not obtain the accurate rate of candidacy for the compensation system. Conclusions: We require more accurate information about pathological characteristics by controlling for smoking status and history among compensation recipients. For radiologic interpretation, more effective education is needed for the radiologists and respiratory disease doctors who treat lung cancer patients. Key messages: Specific information about asbestos-related lung cancer would lead clinicians to correctly identify asbestos-related lung cancer. Educational system for clinicians would help patients to receive the benefit of compensation.