IARC To Review Human Carcinogens-metals, arsenic, dusts & fibers (asbestos)

The International Agency for Research on Cancer (IARC) has met to reassessthe carcinogenicity of metals, arsenic, dusts, and fibres previously classified as “carcinogenic to humans” (Group 1) and to identify additional tumour sites and mechanisms of carcinogenesis. 

It reported that 125 million workers continue to be exposed to asbestos in the workplace. Lancet reports:

"Globally, an estimated 125 million people are still exposed to asbestos in the workplace.2 Although asbestos has been banned or restricted in most of the industrialised world, its use is increasing in parts of Asia, South America, and the former Soviet Union.3Naturally occurring sources of asbestos, its use in brake linings, and deterioration of asbestos-containing products all contribute to environmental exposure worldwide. Exposure may also come from fibres carried home on the clothing of asbestos workers.4

"Epidemiological evidence has increasingly shown an association of all forms of asbestos (chrysotile, crocidolite, amosite, tremolite, actinolite, and anthophyllite) with an increased risk of lung cancer and mesothelioma. Although the potency differences with respect to lung cancer or mesothelioma for fibres of various types and dimensions are debated, the fundamental conclusion is that all forms of asbestos are “carcinogenic to humans” (Group 1). Mineral substances (eg, talc or vermiculite) that contain asbestos should also be regarded as “carcinogenic to humans”.

"Sufficient evidence is now available to show that asbestos also causes cancer of the larynx and of the ovary. A meta-analysis of cohort studies reported a relative risk of cancer of the larynx of 1·4 (95% CI 1·2—1·6) for “any” exposure to asbestos. With different exposure metrics, the relative risk for “high” exposure versus “none” was at least 2·0 (1·6—2·5).5 Cohort studies of women who were heavily exposed to asbestos in the workplace consistently report increased risks of ovarian cancer, as in a study of women in the UK who manufactured gas masks during World War II.6 Studies suggest that asbestos can accumulate in the ovaries of women who are exposed to it.7

"The Working Group classified the evidence for an association between asbestos and colorectal cancer as “limited”, although members were evenly divided as to whetherx the evidence was strong enough to warrant classification as “sufficient”. Further, there is “limited” evidence in humans for cancers of the pharynx and of the stomach.

The Lancet Oncology, Volume 10, Issue 5, Pages 453 - 454, May 2009

A Brokered Marriage: Medicare and Workers’ Compensation

The problems of old age are now worrying are beginning to influence decision makers on what to do with two major delivery system in the United States. Both the Medicare system and the workers’ compensation medical delivery system are now ailing. The fiscal remedy maybe their marriage.

The Medicare Hospital Fund will be insolvent by 2017. The Trustees of the program have indicated that the program has been paying out more than it has collected in taxes and interest over the last two years. This estimated date of insolvency is two years ahead of schedule and the shortfall will necessitate a deposit of $13.4 trillion.

Robert Pear reported in the NY Times this week, “’The financial outlook for the hospital insurance trust fund is significantly less favorable than projected in last year's annual report,’ the trustees said, adding, ‘Actual payroll tax income in 2008 and projected future amounts are significantly lower than previously projected, due to lower levels of average wages and fewer covered workers.’”

The workers’ compensation medical delivery system has been plagued with a set of its own difficulties including: cost shifting to Medicare and reimbursement issues, rising costs that now exceed the indemnity aspect of the program, lack of uniformity and delay in delivery of medical benefits, staggering litigation and administrative costs and uncertainty as to future premiums because of a failing economy.

The voice of change is now being heard in Washington as health care takes the stage front and center on the issues of affordability and choice. David Axelrod has indicated that the Administration is committed to "fix what's broken in the system and preserve what's good."

When the Social Security system was initial enacted, the country faced similar economic troubles. Employee medical coverage was not a consideration of the original program. The geriatric nature of both the Social Security system and the multiple workers’ compensation programs are now evidencing the problems of old age. A marriage of convenience maybe just what the future holds.

Budget Crisis Triggers NJ DWC Closing

The NJ Division of Workers' Compensation will be closed on May 22, 2009. This closing is the result of a State mandated furlough because of the lack of revenue in the NJ State Treasury.

Hyper Technical Procedure Rejected

The NJ Appellate Division, while ruling against an injured worker in a claim where the worker exhibited "egregious conduct" in failing to keep numerous medical exams, in dicta, declared that hyper technical rules should not be enforced in workers' compensation. The Appellate forum declared that even though a notice of motion was "less than perfect," that alone should not be the basis for an adverse ruling.

Williams v, Family Choice, at al., Docket No. A-4474-07T3 (Decided May 2008) 2009 WL 1286895

RICO Case Goes to the US Supreme Court

A Petition for Certiorari has been filed in Brown v. Cassens Transport Co., 546 F.3d 347 (6th Cir. Oct 23, 2008) (NO. 05-2089), following the rehearing and rehearing en banc denied (Jan 05, 2009). 

NCCI Issues a “Guarded” Report of Health of Workers’ Compensation

A report that the short term was “guarded” and the long term “cautionary” was issued this week by NCCI Holdings, Inc. Medical care continues to lead the list of concerns as the costs continue to out pace wages. Medical continues to be problematic as CMS (The Centers for Medicare and Medicaid Services) continue to become more involved in the workers’ compensation process that the Sec. 111 Mandatory Registration process and the recovery efforts and monitoring of future care plans, ie. Workers’ compensation Medicare set aside arrangement.

Lead is Still Breaking the Learning Cycle

The book, "Lead Babies Breaking the Cycle of Learning Disabilities, Declining IQ, ADHD, Behavior Problems, and Autism" by Joanna Cerazy, MEd and Sandra Cottingham, PhD addresses this issue.

"This groundbreaking study reveals the continuing danger that lead contamination presents to health—particularly in the earliest stages of life. Disclosure about the lead content in house paint, gasoline, canned food, and tap water revolutionized the manufacturing of those products a generation ago, but lead-based products are still produced and pose a health hazard as lead remains in the environment years after its initial use."