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Abuse Aware | February 2020
Asbestos Disease Trends and the HSE
The HSE issued its updated report on asbestos disease incidence at the end of October 2019. This indicates that mesothelioma cases have finally reached the peak that has been predicted for the last ten years. Behind that most important single statistic are some other straws in the wind for mesothelioma and other asbestos diseases.
To begin, as Dylan Thomas said, at the beginning - with the most important asbestos disease of mesothelioma. The HSE’s incidence statistics are up to date to 2017. In that year there were 2,526 cases of mesothelioma. This is a slight drop from the previous 12 months. The HSE expects a similar number of annual cases to the end of the decade i.e. about now. They then predict a reduction to 2,125 in 2025, 1,688 in 2030 and 1,261 in 20351. They advance the figures for post 2030 incidence with particular caution.
Mesothelioma incidence is now increasingly weighted towards the over 75’s, as would be expected given the disease’s latency period and the historic pattern of asbestos use in the UK. This should be good news
for insurers. Older sufferers are generally less likely to claim and (in England and Wales at least) usually have lower value cases.
There is one aspect of the report which might cause concern. Substantially more mesothelioma sufferers received Industrial Injuries Disability Benefit (IIDB) in 2018. This suggests that proportionally more cases were being linked with employment. This may be an anomaly (insurers should know by now if there had been a marked claims increase) but it is still worth keeping an eye on since it adds a nuance to predictions based on incidence. Static
mesothelioma numbers may not necessarily
mean static claim numbers.
Asbestos Lung Cancer (ALC)
The HSE thinks that ALC cases are around the same number as mesothelioma. It has thought this for some time. It expects incidence to diminish in line with the reduction in smoking. The multiplicative effect on risk of smoking and asbestos exposure is well known to insurers. Smoking is nearly always the most important risk factor in individual cases.
Even as things stand there are far fewer ALC claims than those for mesothelioma. On the defendant side we flatter ourselves that this is because of the technical quality of the defences we have quite properly mounted. The benefits data offers another clue. Only about 10% of ALC cases receive IIDB. This suggests that potential claims may be missed from the very outset. In turn this means that there could be an untapped resource for the claimant side. As ever ALC is the great unknown for insurers’ reserves. This is not to say that current reserves are at any greater risk. It does re-emphasise the need to watch ALC claims carefully.
Other Asbestos Cancers
The HSE says that there is now ‘good evidence’ to link asbestos to cancers of the larynx, pharynx and stomach. This ‘good evidence’ is not particularly new as it comes from a 2012 study. The numbers cited are modest – with only 50 cases of larynx and stomach cancer related to asbestos per year. No data is given for the other cancers. Again this is something to keep an eye on rather than to be concerned about.
This is the asbestos disease most closely associated with heavy occupational exposure – something which by and large ended earlier in the course of general asbestos use. It seems surprising then that the HSE records a marked increase in cases where asbestosis is recorded in the death certificate – almost doubling in the last ten years to 517 cases.
This incidence is heavily weighted towards the over 75’s. This would reflect an association with higher exposures. This combination suggests a rise in rates of detection (perhaps due to improved imaging techniques) and/or changes in diagnostic practice.
The overall picture is reassuring. There isn’t much in the HSE report to disturb insurers’ existing views. It looks like the mesothelioma peak has been reached and claims should shortly begin to reduce, if slowly at first. Mesothelioma cases still remain attractive for claimant lawyers. They continue to be exempt from QOCS and are still easy to win for claimants. This means that success uplifts are pretty easy to come by.
The great unknown is still what it always has been – asbestos lung cancer. A change in the legal approach or an increased tendency to identify such cases could make a big difference. So far, at least, there is little sign of that happening.