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Een proportioneel risicoverdelingsmodel voor mesothelioom

16-11-2005 00:00

Mensen die mesothelioom krijgen zijn vaak op meerdere plaatsen of aan meerdere asbestproducten blootgesteld geweest. Hoe kunnen het risico en de compensatie proportioneel over de verschillende blootstellingsoorzaken worden verdeeld? Price en Ware beschrijven een berekeningsmodel dat hiervoor kan worden toegepast. Het model is gebaseerd op medische informatie over de tumorgroei en neemt daarnaast variabelen mee als: de blootstellingsintensiteit, duur en het soort asbestvezel dat gebruikt werd. Bron: Price, B. & Waren, A. (2005). Mesothelioma: risk apportionment among asbestos exposure sources. Risk Analysis Aug:25(4):937-43.
Price B, Ware A. (2005). Mesothelioma: risk apportionment among asbestos exposure sources. Risk Analysis Aug:25(4):937-43.

Abstract


The mesothelioma epidemic in the United States, which peaked during the 2000-2004 period, can be traced to high-level asbestos exposures experienced by males in occupational settings prior to the full recognition of the disease-causing potential of asbestos and the establishment of enforceable asbestos exposure limits by the Occupational Safety and Health Administration (OSHA) in 1971. Many individuals diagnosed with mesothelioma where asbestos has been identified as a contributing cause of the disease have filed claims seeking compensation from asbestos settlement trusts or through the court system. An individual with mesothelioma typically has been exposed to asbestos in more than one setting and from more than one asbestos product. Apportioning risk for mesothelioma among contributing factors is an ongoing problem faced by occupational disease compensation boards, juries, parties responsible for paying damages, and currently by the U.S. Senate in its efforts to formulate a bill establishing an asbestos settlement trust. In this article we address the following question: If an individual with mesothelioma where asbestos has been identified as a contributing cause were to be compensated for his or her disease, how should that compensation be apportioned among those responsible for the asbestos exposures? For the purposes of apportionment, we assume that asbestos is the only cause of mesothelioma and that every asbestos exposure contributes, albeit differentially, to the risk. We use an extension of the mesothelioma risk model initially proposed in the early 1980s to quantify the contribution to risk of each exposure as a percentage of the total risk. The percentage for each specific discrete asbestos exposure depends on the start and end dates, the intensity, and the asbestos fiber type for the exposure. We provide justification for the use of the mesothelioma risk model for apportioning risk and discuss how to assess uncertainty associated with its application.