The Gazette 1990

GAZETTE

JANUARY/FEBRUARY 1990

has I believe, occurred with leukaemia occurring in nuclear power station workers. Chronic leukaemia is a disease which occurs spontaneously in some adults. The problem is which are the cases which are due to exposure to low levels of ionising radiation? Which Workplace? Quite a number of asbestos workers with asbestosis to whom I have spoken gave a history of working in a number of different small insulation companies. These small companies, often employing only two or three laggers, may stay in business for a number of years and then go out of business or reform under another name. A particular individual may have learned his trade on building sites in the United Kingdom, worked back in Ireland for a while, emi- grated again, and might now be working, still as a lagger, but is totally protected from any exposure to asbestos dust, either because of good hygiene measures or because the particular industry is using asbestos-free lagging. When he develops asbestosis or other

doesn't and why one asbestos worker goes on to develop lung cancer and another doesn't. These other causes may be rooted in the individual's lifestyle, temperament, and most of all, inherited characteristics. "An asbestos worker who is also a smoker has fifty times the risk of developing lung cancer." Specific Disease The problem of whether an occupational disease is a specific one such as asbestosis or meso- thelioma or a non-specific one such as cancer of the lung must be a constant problem for the legal profession when trying to attribute blame. I have the reasonable objective of preventing future cases from occurring; therefore, it is of little import to me whether a par- ticular case of lung cancer was due to exposure at work or not. What is of interest to me is that asbestos workers are dying from lung cancer in excess and the answer must surely be to reduce the levels of asbestos dust. This same problem

asbestos related disease which exposure was responsible? Occu- pational hygiene techniques for measuring levels of asbestos dust were not available in those far off days. Even if they were available they were often much more crude than methods used nowadays and therefore not reliable. When did the individual know? Does an individual become aware of his personal ill-health due to exposure to asbestos or another occupational hazard on the day he first develops breathlessness, on the day he has a routine chest x-ray and the physician askes him if he has ever worked with asbestos, or the day when a chest specialist finally confirms that he has definite asbestos related disease? Asbest- osis is not as easily diagnosable as I may have indicated in all cases. Other fibrotic diseases of the lung, many not due to any occupational exposure, may have been con- sidered as an initial diagnosis by the physician. I believe it is not un- known for a physician to notice some of the "non-disease" con- ditions on an x-ray and to decide it

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