A Silent Killer: Asbestos and Mesothelioma in Workers’ Compensation
Summary:
Asbestos exposure is the only known cause of mesothelioma—a rare but aggressive cancer with a 20–50 year latency. Despite a 2024 U.S. ban, millions of older buildings still contain asbestos, making exposure a current risk for workers. For payers and adjusters, mesothelioma claims remain high-cost, complex, and preventable with proactive education, oversight, and enforcement of safety protocols. Prodigy’s clinical lens helps ensure risks are identified early and managed appropriately to protect both patients and payers.
Asbestos was once hailed for its heat resistance, durability, and low cost. But decades later, its legacy is not construction—it’s cancer. Today, asbestos remains the leading cause of mesothelioma, a rare and aggressive malignancy with devastating consequences for patients and significant financial implications for payers and workers’ compensation systems alike【1】.
The Asbestos–Mesothelioma Connection
Mesothelioma affects the thin lining around the lungs (pleural), abdomen (peritoneal), or heart (pericardial). Unlike most cancers, mesothelioma’s only known cause is exposure to asbestos fibers【2】. When disturbed, asbestos releases microscopic particles that lodge in lung or abdominal tissue, leading to inflammation, scarring, and cancer decades later. Symptoms typically take 20–50 years to surface, meaning today’s cases often stem from exposures in the mid-20th century【1】.
Who’s at Risk?
Although asbestos use has been restricted in the U.S. since the late 1970s, it still lingers in older buildings, factories, shipyards, and homes. The highest-risk groups include【3,8】:
Construction and demolition workers
Shipyard workers
U.S. military veterans, particularly Navy personnel (1930s–1970s)
Electricians, pipefitters, and insulators
Brake mechanics and automotive workers
Firefighters and first responders
Secondary exposure also remains a concern, as workers can unknowingly bring fibers home on their clothing, skin, or tools, placing family members at risk【3】.
Mesothelioma in the U.S. – The Numbers
Despite regulatory progress, asbestos-related illness remains a significant public health and workers’ comp challenge:
~3,000 new U.S. mesothelioma cases annually【4】
~80% linked directly to occupational asbestos exposure【2】
Age-adjusted mortality: ~0.8 per 100,000, with older men disproportionately affected【5】
Highest incidence in industrial and shipbuilding states—California, Pennsylvania, Texas【4】
For adjusters and payers, this translates into complex claims, long latency windows, and costly care trajectories.
How It’s Managed
Mesothelioma is difficult to diagnose early and often presents with vague symptoms. Once confirmed, treatment may include【1,9,10】:
Surgery – most beneficial in early-stage pleural mesothelioma
Chemotherapy – cisplatin and pemetrexed combination is standard
Radiation therapy – targets localized tumor sites
Immunotherapy – agents like nivolumab and ipilimumab show promise in advanced disease
Palliative care – crucial for quality of life and symptom relief in late stages
Minimizing Exposure – A Regulatory Mandate
The Occupational Safety and Health Administration (OSHA) regulates asbestos under 29 CFR 1910.1001, requiring【6】:
Permissible exposure limits (0.1 fibers/cc over 8 hours)
Air monitoring and labeling of asbestos-containing materials (ACMs)
Mandatory PPE use (respirators, disposable suits)
Employee training and hazard communication
Strict removal and containment procedures
Employers are responsible for ensuring proper evaluation and abatement of ACMs. Workers should know their OSHA rights, request safety audits when concerns arise, and never disturb suspect materials without professional guidance.
Paving the Way Forward
In 2022, the EPA proposed a full ban on chrysotile asbestos—the last form legally imported into the U.S. That ban became law in March 2024【7】. Yet millions of older structures still harbor asbestos, making education and vigilance critical.
Why It Matters for Workers’ Comp
Mesothelioma may be rare, but it is almost entirely preventable. For payers and adjusters, early recognition of risk, careful claims review, and coordination of specialty care are essential. Prodigy’s clinical oversight model emphasizes both prevention and appropriate utilization, helping avoid delayed diagnoses, unnecessary treatment extensions, and missed safety opportunities.
By reinforcing education, enforcing protections, and supporting claims teams with clinical insight, we can ensure that asbestos remains a cautionary tale—not a continuing cost driver.
By Ema Morse
PharmD Candidate (P4)
For questions, e-mail pharmd@prodigyrx.com
Citations
American Cancer Society. (2023). What is Mesothelioma? https://www.cancer.org/cancer/malignant-mesothelioma/about/what-is-mesothelioma.html
American Lung Association. (2022). Learn About Mesothelioma. https://www.lung.org/lung-health-diseases/lung-disease-lookup/mesothelioma
National Institute for Occupational Safety and Health (NIOSH). (2020). Asbestos Exposure and Your Health.https://www.cdc.gov/niosh/topics/asbestos
Centers for Disease Control and Prevention (CDC). (2023). U.S. Cancer Statistics: Mesothelioma.https://www.cdc.gov/cancer/uscs
CDC WONDER. (2023). Underlying Cause of Death Database. https://wonder.cdc.gov/
U.S. Occupational Safety and Health Administration (OSHA). (2023). Asbestos Standards. https://www.osha.gov/asbestos
U.S. Environmental Protection Agency (EPA). (2022). Proposed Ban of Chrysotile Asbestos.https://www.epa.gov/asbestos/proposed-ban-chrysotile-asbestos
U.S. Department of Veterans Affairs (VA). (2023). Asbestos Exposure and VA Benefits. https://www.va.gov/disability/eligibility/hazardous-materials-exposure/asbestos
U.S. Food and Drug Administration (FDA). (2021). FDA Approves First Immunotherapy Regimen for Mesothelioma. https://www.fda.gov/news-events/press-announcements
National Cancer Institute (NCI), National Institutes of Health (NIH). (2022). Malignant Mesothelioma Treatment (PDQ®)–Patient Version. Retrieved from: https://www.cancer.gov/types/mesothelioma/patient/mesothelioma-treatment-pdq