Recent newspaper reports1,2 of mesothelioma occurring to two women have highlighted a particularly tragic outcome of the asbestos disease epidemic in New Zealand. An epidemic currently generating six or more cases of mesothelioma, lung cancer, asbestosis and pleural disease each week. An epidemic which has yet to plateau.
The unique feature of both these cases was that their mesothelioma was a consequence of exposure to asbestos in the home following transfer of the carcinogenic fibres from the workplace on the hair and clothes of family members who worked with asbestos.
Such ‘secondary’ cases usually occur unexpectedly in old age but not infrequently in middle age and predominantly affect women. A latency of 40 or more years after the initial exposure means that not only is the disease unexpected but often—at least initially—inexplicable both to the patient and to the doctor.
Asbestos disease occurring to family members in this manner was first reported in the medical literature in South Africa in 1960,3 in the UK, 1965,4 and later in the US,5–8 Italy9,10 and Denmark.11
In New Zealand, the first case was notified to the National Asbestos Disease Register in 1994. This occurred to a 43 year-old woman whose father and older brother were both employed for eight years at an asbestos cement manufacturing company from the time she was seven years old, thus illustrating a latency of 36 years.
As pointed out in the newspaper articles, these types of exposure do not comply with the New Zealand Accident Compensation Corporation law that requires exposure to have resulted from paid employment in New Zealand within the acceptable latency range. The consequence is that there is no entitlement for cover, lump sum payment, weekly compensation or funding for the most effective treatment. This illustrates both employment and gender discrimination affecting women who do unpaid homework.
While the primary focus of this viewpoint is to highlight the circumstances of transfer of a workplace hazard, asbestos, to the home, it does raise other questions such as “where is the workplace?” and “where are its boundaries?”.
If workplace hazards are transferred from work to home on the person (hair, clothes and boots) of the worker, so that the home becomes contaminated and family members suffer, does not that make the home a physical extension of the workplace? If that is the case, it places on the employer a duty of care to control and contain workplace hazards within the workplace, as well as ensuring the worker’s contaminated work clothes are retained and laundered on site.
Asbestos-related disease is of worldwide concern12 and was first brought to the attention of the medical profession, industry and government over 100 years ago.13 Its history is one of scientific conflict, industry denial, government inaction and inadequate recognition and care of the victims.
However, the immediate question is one of fairness for family members who contract asbestos-related diseases in the manner described. Is this too much to ask of a ‘no fault’ compensation system?