Japan: Glacial help for asbestos victims

Masae Honma, Yomiuri Shimbun, October 14, 2006

Though six months have passed since legislation was passed to provide relief for sufferers of asbestos-related health problems, about 170 people have died while a decision on the validity of their condition was pending.
The law provides financial aid to victims of asbestos-linked diseases who are not covered by workers accident compensation, which provides aid to employees in plants producing or using asbestos only.
However, according to the Environmental Restoration and Conservation Agency, which accepts applications for the aid, as of the end of August screening of only 522 of 1,160 applicants had been completed.
The government recognized 242 of the 522 cases as mesothelioma or lung cancer caused by asbestos. But the figure is about one-fourth the annual death toll from mesothelioma alone.
In 271 of the cases in which the initial procedure was finished, final decisions were held up because of insufficient medical information. The government asked applicants to receive additional medical checks in which tissues of the affected organs were removed for examination.
In June, a 59-year-old man in Amagasaki, Hyogo Prefecture, asked, “Are they waiting for us to die?” on being advised that a decision on him remained outstanding three months after he made his application.
The house in which he lived until the age of 27 was located about 50 meters from a Kubota Corp. factory, which is believed to have caused asbestos-related diseases.
The man remembered seeing asbestos fibers floating and shimmering in the air when mud alongside a river running through the plant’s compound dried out.
Though he had been in good health, he started feeling constantly out of breath. In 2003, he was diagnosed with mesothelioma and had to have his left lung removed, forcing him to quit his job.
Due to the high cost of medical expenses, he applied for aid at the earliest opportunity but received a reserved judgment. He submitted the results of an additional medical checkup, but a final decision has yet to be made.
Another man in the city, aged 54, lost his left lung after being diagnosed with mesothelioma. He continued working as his child was in primary school.
His application was also given a reserved judgment, and the man died last month.
The number of applicants who died before their applications had been processed has reached about 170.
Prof. Takashi Nakano at Hyogo College of Medicine, which will establish in November a center for mesothelioma and other diseases caused by asbestos, said judgments are reserved in many cases because diagnosing a disease as being asbestos-linked is difficult.
“Lung cancer is caused by not only asbestos, but also smoking, air pollution and other factors. So it is difficult to pinpoint the cause of each patient’s disease. Concerning mesothelioma, nearly 70 percent of the patients have symptoms known as the epithelium type. The disease is very similar to that of lung cancer caused by factors other than asbestos,” he said.
In medical institutions, biopsies from affected organs in mesothelioma cases are often skipped because the process is not necessary for treatment, though the law requires that it be done.
However, many doctors said it was hard to perform such biopsies because many of the victims have deteriorating conditions.
In the coming five years, a total of 75.7 billion yen of relief funds are scheduled to be raised from not only budgets of the central and local governments but also donations by companies that have used asbestos in the past and other cooperative firms.
The amount was calculated based on the quantity of asbestos used in the nation and the estimated number of victims.
An estimated 10,000 people died from asbestos-related diseases before the law was enacted. Bereaved family members of a dead victim in this category will receive about 3 million yen in condolence money. There have been 1,514 applications for compensation.
It is also estimated that about 2,000 people will develop asbestos-related diseases every year. Each victim will receive about 100,000 yen a month for medical expenses, and about 200,000 yen will be provided for funeral expenses in the event of death.
Judging from the estimated figures, the current number of applications is too small.
Sufferers of asbestos-related diseases said the government puts too much emphasis on the formality of medical judgments and does not pay enough attention to the reality of the patients’ situation.
The victims and their family members are now suffering from heavy medical expenses and other burdens. Delay in recognizing them as victims makes the aid system itself meaningless.
Kazuko Furukawa, deputy president of the Japan Association of Mesothelioma and Asbestos Related Disease Victims and their Families, said, “We want the medical judgment process to be speeded up.”
“Also, patients of asbestos-related benign pleural effusion and lung asbestosis are not covered by the scheme, though these illnesses are also caused by asbestos. Relief should also be given to these patients,” she said.
It should be remembered that the law came into force only nine months after Kubota revealed that many ailments were caused by asbestos from the plant, and the government quickly began searching for victims.
But if the current situation remains unchanged, the relief process will become meaningless.
The government is still unable to settle disputes over recognizing victims of Minamata disease and itai-itai disease–poisoning from organic mercury and cadmium, respectively– as results of industrial pollution.
Will the government make the same mistake with the asbestos problem? It should manage the relief system more flexibly so that victims can reap the benefits to which they are entitled.

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