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GAZETTE
JANUARY/FEBRUARY 1990
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
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
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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