Getting aid to asbestos victims / Govt has tough row to plow in identifying diseases to blame

Please provide any information you think may be helpful to mesothelioma victimd and their familiesMakoto Mitsui Yomiuri Shimbun Staff Writer
Following the enactment earlier this month of a law that provides financial support for victims of asbestos-linked diseases, the government now needs to establish standards to identify those eligible for financial aid.
The law provides for compensation for people who contracted such diseases while living near factories using asbestos, and for family members of employees at such factories, who are not covered by workers compensation. The government also will give 3 million yen in condolence money to the families of those who died of asbestos-linked diseases. In addition, victims of such diseases will have their medical bills covered and be entitled to benefits of 100,000 yen per month.
The government aims to establish the standards by the end of next month, and start accepting applications for compensation. However, it is unclear whether the system will provide compensation for all sufferers of asbestos-linked diseases.
Before establishing official recognition standards, a committee established by the Environment Ministry and the Health, Labor and Welfare Ministry drew up a list of medical criteria on Feb. 2. According to the criteria, mesothelioma sufferers will be eligible for relief, as more than 90 percent of mesothelioma patients are thought to have contracted the disease through exposure to asbestos.
But when it comes to lung cancer patients, it is much harder to make a decision. Out of the 60,000 people who die of lung cancer annually, only 1 percent to 3 percent of deaths are believed caused by asbestos. Identifying such cases is difficult because many other factors, such as smoking, can cause lung cancer.
The committee concluded that lung cancer cases in which the pleura, or membrane, was partially thickened and the lung tissues had become hardened could be considered as asbestos-induced.
However, a member of the committee said, "There are cases when hardened lung tissue is not obvious, even when the disease occurred from asbestos," which indicates that the committee's standards could fail to cover all victims. But relaxing the standards would be expensive, as it would throw open the gates to people who contracted lung cancer from causes other than asbestos.
The government has a hard task ahead of it in ensuring that all victims of asbestos-linked diseases get compensation, while at the same time ensuring that those not entitled to compensation are excluded.
One committee member, Prof. Koki Inai of Hiroshima University, said, "When it's hard to tell whether the lung tissue is hardened or not, it's important to be flexible and take into consideration whether the patient had lived in an environment with asbestos exposure."
Initially, the only victims likely to be covered under the new law are those with mesothelial tumors or lung cancer. Those with asbestos-induced pleural effusion are covered by workers' compensation and are not subject to the new law.
An Environment Ministry official explained, "There are no reports of asbestos-induced pleural effusion in general environments unless a person has been exposed to asbestos at work."
But some experts disagree with this statement. One said: "We can't tell if there are patients with asbestos-induced pleural effusion in a general environment. Perhaps we should do detailed research around asbestos-related factories, such as in Amagasaki in Hyogo Prefecture."
Without checking a person's work history, it is hard to say whether he or she is suffering from an asbestos-induced disease. If the government is to add undocumented patients to the list of beneficiaries, it will face difficulties in developing the standards.
Organizations of asbestos victims had claimed that the new relief plan is less favorable to victims compared to industrial accident compensation, which includes benefits for missed work or pensions for bereaved family members.
It is, however, a step forward in providing compensation to people who lived near factories using asbestos or families of these factory workers, considering that until now such people were not eligible for benefits.
The government must make a thorough investigation into industry-related diseases, including lung cancer, with the aim of identifying and providing to cover all victims of asbestos-linked diseases.
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Number of victims unknown
Asbestos-related diseases became a big issue in June after it was disclosed that people who lived near a factory operated by machinery manufacturer Kubota Corp. in Amagasaki had mesothelioma. Following the revelation, it was learned that people living near asbestos-related factories in Saga and Nara prefectures also had the disease.
However, the disease seems limited to people living near such factories, as there have not been many reports of people living in other environments contracting asbestos-linked disease.
Of mesothelioma sufferers, 70 percent to 80 percent of them contracted the disease from exposure to asbestos at work. However, only 10 percent of them are recognized as victims of occupational accidents.
Prof. Iwao Uchiyama of Kyoto University Graduate School said, "We need to find out how many people contracted the disease in a general environment, by looking at the result of epidemiologic investigations conducted by the government."
It takes 30 to 40 years after exposure to asbestos until the symptoms of a mesothelial tumor become noticeable. This means that those who inhaled asbestos in the early 1970s will now present symptoms of asbestos-related diseases.
Imports of asbestos peaked around the 1970s, but in 1975 the government started to take preventive measures, such as banning the use of sprayed asbestos.
It is unknown how many people will develop asbestos-related diseases. An Environment Ministry official said, "The number of future patients depends on how effective the preventive measures were."