Asbestos and the diseases it causes October 2013 Liz Darlison Mesothelioma UK University Hospitals of Leicester
Contents What is asbestos Why is it such an issue in the UK Disease Statistics Asbestos Related Diseases
What is asbestos? Fibrous mineral Silicate Highly Resistant to heat and fire Used widely since 19 th century 3 main types Blue (crocidolite) Brown (amosite) White (Chrysotile)
Asbestos Use Insulation, heat resistant, non-combustible Ubiquitous in mid 20th Century 6 million tonnes mined in 1977 Ship building, construction industry, mechanics, plumbers, carpenters, electricians, maintenance workers Asbestos use banned in USA in 1986 Chrysotile banned in UK 1999
Asbestos and Mesothelioma Doll 1955 asbestos and lung cancer Van der Schoot 1958 mesothelioma in asbestos workers Wagner 1960 33 cases in South Africa, crocidolite miners Keal 1960 East London factory workers
Brown Asbestos
Blue Asbestos
White Asbestos
http://www.hse.gov.uk/asbestos/gallery.htm
Diseases caused by exposure to asbestos Pleural Plaques Diffuse Pleural Thickening Asbestosis Mesothelioma Lung Cancer 4500 deaths per year
HSE data
Clinical Diagnosis of Asbestos Related Disease Detailed interview Occupational data Appropriate latency Signs and symptoms Radiological finding Respiratory physiology findings Cytology/histology Experience/professional judgement!
Pleural Plaques Circumscribed areas of fibrous thickening, typically of the parietal pleura.
Pleural Plaques
Diffuse Pleural Thickening Non-circumscribed fibrous thickening affecting both parietal and visceral pleura.
Pleural Thickening
Asbestosis Diffuse interstitial fibrosis of the lung as a consequence of exposure to asbestos dust.
Asbestosis
Malignant Mesothelioma Malignancy of serosal membrane. Pleural is the most common but can arise from peritoneum, pericardium and tunica vaginalis Universally fatal
CT Scan
Thoracoscopy
Lung Cancer 4 histological types 1 year of heavy or 5-10 year moderate asbestos exposure increases risk of lung cancer 2 fold. Synergistic effect with tobacco smoke.
Lung Cancer
Benefits Attendance Allowance 65 years + PIP up to 65 years Special Rules War pension Industrial Injuries Disablement Benefit Mesothelioma Diffuse pleural thickening (DFT) (medical) Primary lung cancer with DFT or asbestosis (medical) Post 1948 exposure
Pneumoconiosis and Workers Compensation Fund Lump sum payment IIDB pre-requisite Mesothelioma/diffuse pleural thickening/primary lung cancer with DFT or asbestosis No civil case
Civil Case If it likely that :- Caused by asbestos Identify an employer Who is legally at fault Can be pursued for Mesothelioma DPT Primary Lung cancer Asbestosis
Where to get advice? Local services Citizens advice bureau Macmillan Cancer Support Asbestos Support Groups Legal firm MESOTHELIOMA UK
Mesothelioma Key issues Increasing in incidence Patient expectation Fatal Short window of opportunity Highly Symptomatic Rare Complex investigations Medico legal issues No Guidelines Limited treatment options Variation in Practice/Opinion
A national nurse led initiative Provide high quality, impartial and up-to-date support and information Develop a national network of trained and experienced nurse specialists. Promote nurse-led research. Work in collaboration with charities, organisations and individuals interested in mesothelioma. Promote the development of mesothelioma support groups.
www.mesothelioma.uk.com
Average length of call 17 minutes Mesothelioma UK Help Line Free phone : 0800 169 2409 Open 08.30-4.30 Monday to Friday with answer phone out of hours 1500 calls per year 35% referred to RN 52% Patient and carers
Mesothelioma UK Newsletter Circulation = approx 5000+ 3500 Electronically & 1700 postal copies
Patient Information
Annual Mesothelioma UK Patient and Carer Day 1 st Saturday in October Manchester//Leeds/Newcastle/Londonx4/Leicester 2013 100-210 delegates Aim share experiences Provide up-to-date, unbiased information Opportunity to raise issues and ask questions Supported by JHMRF, GMAVSG & RMH
M-NAT Mesothelioma Nurse Action Team
Mesothelioma UK and RMH on-line Mesothelioma in practice module 45 completed to date Australian, USA, Japanese and South African Delegates Excellence in Oncology 2011 Award Winner Best Professional Educational Initiative
Publications
Mesothelioma CNS Posts Leicester Cambridge Cardiff Portsmouth Manchester London??
Global shift in asbestos use. 70% of global asbestos production originates in 3 Asian countries 10 million lives may be lost before asbestos is banned world wide. 50% of global asbestos consumption occurs in Asian countries (China, Thailand and Indonesia) 3 biggest global consumers are China, Russia, India www.ibasecretatiat.org
Thank you Liz Darlison Macmillan Nurse Consultant Mesothelioma UK University Hospitals of Leicester mesothelioma.uk@uhl=tr.nhs.uk 0800 169 2409