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SILICOSIS - Diagnosing for Dollars
A court battle over silicosis shines a harsh light on mass medical screeners—the same people whose diagnoses have cost asbestos defendants billions.
By Roger Parloff
Severe silicosis is a ghastly disease. Caused by prolonged inhalation of tiny sand particles, it slowly scars and contracts the lungs until the victim suffocates. A sandblaster who comes down with an acute case may need a lung transplant before he's 40.
Severe asbestosis, which is caused by inhaling minute, spearlike asbestos fibers, is just as bad. It has nearly identical symptoms, and it can lead to lung cancer or mesothelioma, the dreaded, inevitably fatal cancer of the lung lining.
Perhaps the only consolation in having one of these diseases is that you almost certainly won't get the other. The massive, protracted dust exposure required to come down with either makes it extremely rare for a worker to get both, even in their mildest forms. And despite their outward similarities, the two diseases are readily distinguishable on X-rays. A panel of four eminent occupational-disease experts agreed on these points in February testimony before a Senate committee.
How, then, to account for this: Of 8,629 people diagnosed with silicosis now suing in federal court in Corpus Christi, 5,174—or 60%—are "asbestos retreads," i.e., people who have previously filed claims for asbestos-related disease.
That anomaly turns out to be just one of many in the Corpus Christi case that sorely challenge medical explanation. At a hearing in February, U.S. District Judge Janis Graham Jack characterized the evidence before her as raising "great red flags of fraud," and a federal grand jury in Manhattan is now looking into the situation, according to two people who have been subpoenaed.
The real importance of those proceedings, however, is not what they reveal about possible fraud in silica litigation but what they suggest about a possible fraud of vastly greater dimensions. It's one that may have been afflicting asbestos litigation for almost 20 years, resulting in billions of dollars of payments to claimants who weren't sick and to the attorneys who represented them. Asbestos litigation—the original mass tort—has bankrupted more than 60 companies and is expected to eventually cost defendants and their insurers more than $200 billion, of which $70 billion has already been paid.
The odor around asbestosis diagnosis has been so foul for so long that by 1999, professor Lester Brickman of the Benjamin N. Cardozo School of Law was referring to asbestos litigation as a "massively fraudulent enterprise." At the request of his defamation lawyer, Brickman says, he toned that down to "massive, specious claiming".
Gujarat quartz factories kill MP tribals, slowly
Abhilash Khandekar
December 24, 2005 - BHOPAL: Kamlibai, a tribal living on the MP-Gujarat border is about 38 years. She lost her husband Ditaliya to a glass factory. Now, both she and her 10-year old son Ramesh are suffering from fibrosis. And Kamlibai is not alone in her suffering.
A large number of quartz crushing units in the towns of Balasindhur and Godhra in Gujarat are wreaking havoc in the tribal belt of Jhabua in Madhya Pradesh. Hundreds of tribals who work in these factories are suffering from silicosis and fibrosis.
Both the diseases are said to be incurable and ensure slow, silent and painful death.
The grim picture is painted by a recent medical survey done by a team of doctors from Pune, Indore and Jhabua. “Over 400 tribals between the age of 15 and 35 have died due to these diseases in the past 4-5 years,” the survey says. Quartz powder, used to make glass, when inhaled affects human lungs beyond repair. The workers, who are made to work here without any protective gear are exposed to extremely unhygienic conditions.
Government officials in Jhabua told DNA that such a problem existed in the area but for want of any complaint, none of the officials took it seriously.
A senior official also said that it was an inter-state problem as the people work in Gujarat but suffer in MP. The other reason given was that since of those affected are daily wagers with no service record, which makes it difficult for the authorities to address the problem.
A former Jhabua collector, Arun Bhat, had once written to the then Godhra collector about the problem. The case was not followed up after he was transferred.
Dr Abhay Shukla of Pune and Dr Ashish Gupta of Indore, who have conducted the survey in 20 of the tribal villages say that the symptoms are slow to develop but when full grown, have a lethat effect.
“Working in the environment of a quartz factory, without protection for long periods can result in breathlessness as the stone and quartz particles block the alveolux ( air pockets inside the lungs of a human body). This results in death,” they said. “In one family of Thandla, 11 persons suffered from this fatal disease and died in the past few years,” Dr Shukla claimed.
A team of Jan Sawsthya Abhiyan, a national campaign for people’s health care has also expressed concern about the state of the tribal workers.
“Tribals from Alirajpur, Thandla and Ranapur blocks of Jhabua district go there to earn a livelihood, suffer from silicosis and fibrosis and come back in MP to die,” said Bijoy Bhai, the convenor of the campaign, demanding immediate action against the factory owners. He said that the local government hospitals in the area keep receiving patients suffering from chronic lung diseases.
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