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4/19/2018 By Elizabeth Hanke

In August, I wrote about how the incidence of mesothelioma in the nine regions reported by the National Cancer Institute’s SEER program is starting to diverge from the often-used “Nicholson Curve”— a widely used tool in forecasting asbestos liabilities for individual corporations.

This divergence is not necessarily a surprising development considering that Nicholson’s analysis was specifically on workers in the 13 industries considered at-risk for asbestos exposure. In contrast, the SEER program records incidence of mesothelioma for the entire population in those nine regions, not just for workers likely exposed to asbestos. In November, my colleague Megan Shockley, KCIC Senior Manager, wrote about mesothelioma in younger females, as discussed during a panel at the 2017 DRI Asbestos Medicine Conference. Specifically, the panel discussed recent studies indicating alternate causes of mesothelioma.

Mesothelioma Incidence Data

Recently I was introduced to Dr. Bertram Price, who has done extensive statistical analysis of mesothelioma incidence in females as part of his work on projecting future cases of mesothelioma. Dr. Price has been applying mathematical and statistical modeling methods to analyze risk for over 30 years.  He has testified in state and federal courts and before regulatory agencies on health risk and contributing causes. He first began studying and reporting on asbestos exposure in 1979 when he was a consultant in the EPA’s Asbestos-in-Schools Program. Dr. Price has written articles on mesothelioma incidence, served as an expert witness for asbestos defendants, and is a thought leader in the area of projecting future asbestos claims. His article “Time trend of mesothelioma incidence in the United States and projection of future cases: An update based on SEER data for 1973-2005” published in Critical Reviews in Toxicology (2009) addressed the incidence of future mesotheliomas. It was an update of projections he published in the American Journal of Epidemiology in 1997 and again in 2004.

Dr. Price has since updated his statistical analysis using more recent SEER data, but his conclusion remains essentially the same. He has written an article about that most recent analysis exclusively for KCIC, and we are pleased to make it available for download here.

“Background” Mesothelioma

In the article — titled “Mesothelioma: The Long Tail of Asbestos Personal Injury Litigation in the U.S.” — Dr. Price summarizes his analysis and observations specifically of mesothelioma cases not likely caused by exposure to asbestos, i.e., “background cases”. The premise is simple: use a time trend analysis of the incidence of mesothelioma in women to demonstrate the relationship between mesothelioma risk and levels of asbestos exposure. The statistical model itself is, well, sophisticated! But in plain English, what Dr. Price’s model shows is that despite increasing exposure to asbestos through take-home, environmental, and general product use, the probability of women developing mesothelioma has remained basically constant since the SEER program began in 1973. He uses the observed rate of mesothelioma in females to estimate a background rate for the entire US population.

Dr. Price has since updated his statistical analysis again using more recent SEER data, but his conclusion remains essentially the same. He has written an article about that most recent analysis exclusively for KCIC, and we are pleased to make it available for download here.

As discussed further in the article, background mesothelioma refers to medical cases of mesothelioma resulting from spontaneous tumor formation that are not a consequence of asbestos exposure or any other identifiable risk factor for the disease. 

Dr. Price’s analysis shows that during the five-year period from 2012 through 2016, an estimated 55% of all mesothelioma medical cases diagnosed in the U.S. were background cases; 37% of male mesotheliomas were background cases, as were approximately 99% of all female mesothelioma cases.   Furthermore, in approximately 20 years — starting around 2040 — most, if not all, mesotheliomas will be background cases. Leading up to and after 2040, there will be between 1,500 and 1,600 mesothelioma cases per year, virtually all background cases. 

Background cases, although not asbestos-related, are the pool of potential future lawsuits or claims for asbestos defendants. Any individual among the 1,500 to 1,600 background mesothelioma cases, after being diagnosed with the disease, may recall one or more previous circumstances in which he or she came in contact with or was near a product that contained asbestos, even though the asbestos exposure, if any, would have been extremely low and, therefore, unlikely to be the cause of their mesothelioma.

The corollary to the background cases are the non-background cases, or the cases more likely to be related to asbestos exposure. Comparing Dr. Price’s forecast of asbestos-related mesothelioma with Nicholson’s analysis, beginning in 2025, the projected numbers of cases are very similar.

If the idea of around 1,500 mesothelioma cases a year not being related to asbestos interests you, I encourage you to download and read Dr. Price’s article. 

Implications for Defendants

It is Dr. Price’s opinion that to minimize unjustified damage or settlement payments to plaintiffs, asbestos defendants need to:

  • Help courts and trusts understand that one fiber will kill and each and every exposure is a substantial factor are flawed causal theories

  • Show courts and trusts that low-level asbestos exposures are unlikely to cause mesothelioma

KCIC’s recent "Asbestos Litigation: Year in Review" report shows a slight decrease in asbestos-related personal injury filings in 2017, but mesothelioma claims continue to comprise almost 50% of all filings.  Acknowledging the increasing proportion of background mesothelioma cases relative to all mesothelioma cases is essential for asbestos defendants. This is especially true for those whose product has been out of circulation for over 30 years but who continue to be named in lawsuits. At least one of the top 10 most-named defendants was named on 98% of received lawsuits and the most frequently named defendant was named on 87% of lawsuits. 

Stay tuned for my next post, where I will discuss the importance of incorporating defendant specific data, the epidemiologic models, and the realities of what is happening today in asbestos-related litigation. 




Elizabeth Hanke

About Elizabeth Hanke

For nearly 25 years, Elizabeth Hanke has been a trusted advisor in both the settlement and litigation arenas, and KCIC clients can always expect her to work passionately on their behalf.

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