General information on mesothelioma
Mesothelioma is a rare malignant tumor that affects the cells of the mesothelium, the protective membrane that covers most of the body's internal organs including the pleura, peritoneum and pericardium.
Its most common form is malignant pleural mesothelioma. It is a so-called primary form of cancer of the pleura, which is characterized by an increase in cancer cells in the tissue constituting the pleura. The pleura is a membrane that envelops the lungs, made up of two layers, one covers the lungs (inner layer or visceral pleura), the other covers the inside of the thoracic cavity (outer layer or parietal pleura). When the disease occurs, the pleura thickens, takes on a scalloped appearance and the space between these two layers (pleural cavity) can fill with fluid and cause breathing difficulties.
It is estimated that 906 new cases of cancer of the pleura in 2005 in France, 71% of which occur in humans. Six in 10 new cases are diagnosed in people over the age of 69. The most recent data show 1090 deaths per year.
Asbestos as the main cause
80% to 85% of mesotheliomas are linked to exposure to asbestos, mainly of occupational origin, but also environmental. This exposure could have occurred several decades before the development of the disease. Multiple parameters influence the appearance of mesothelioma:
- the time elapsed since the start of the exhibition
- the cumulative dose of asbestos: it is expressed in fibers per milliliter (mL) of air multiplied by the number of years of exposure for occupational exposures, and in fibers per liter of air multiplied by the number of years of exposure for exposures of the general population;
- peak exposure;
- the size and geometry of the fibers which determine the penetration of asbestos into the respiratory tract and their biopersistence : the most harmful fibers correspond to a length greater than 5 micrometers (μm) and to a diameter less than 0.5 μm
Asbestos is the only recognized risk factor for mesothelioma of the pleura (classified as group 1, certain carcinogen by the IARC ); apart from erionite, a natural mineral fiber from the zeolite family , which is also a recognized risk factor, which is only present in certain regions of Turkey.
The occurrence of mesothelioma, in the absence of exposure to asbestos, is also possible (it affects about one person in a million).
Other debated risk factors
Other potential factors are mentioned and need to be confirmed: certain artificial mineral fibers such as refractory ceramics, exposure to ionizing radiation , to the SV 40 virus or to chemical agents such as bromates, nitrosoureas, nitrosamines.
The role of individual factors of genetic susceptibility is probable, but no gene predisposing to mesothelioma has been identified. Unlike in the case of lung cancer, exposure to tobacco has not been demonstrated in the risk of developing mesothelioma.
Compensation as an occupational disease
In the event of suspicion of exposure to asbestos during professional activity, it is recommended to initiate a process of recognition as an occupational disease . The occupational disease tables No. 30 of the general system and No. 47 of the agricultural system provide for compensation for the victims.
Proof of exposure is not necessary, as the diagnosis of mesothelioma is authoritative . In the event of recognition as an occupational disease, the worker benefits from a right to prematurely cease his activity from the age of 50, and compensation from the FIVA which aims to repair the damage suffered by the worker or his assigns. This FIVA compensation is also granted to the self-employed, environmental victims and beneficiaries.
Strengthened public health policies
Mesotheliomas are the subject of a national surveillance program in 22 departments and the exhaustive registration of all incident mesotheliomas completes a specific national register called the national multicenter registry of pleural mesothelioma (Mesonat).
The 2005 - 2009 occupational health plan (and 2010 - 2014 under development), the second national health and environment plan and the 2009 - 2013 Cancer planinclude all policies and measures to prevent risks related to the general environment and work. Thus, improving the observation and monitoring of cancers linked to the professional environment is one of the measures of the 2009 - 2013 cancer plan, with in particular a measure aimed at making the notification of mesothelioma compulsory.
By decree n ° 2012-47 of January 16, 2012, mesotheliomas are added to the official list of diseases notifiable. This compulsory declaration is implemented by the French Institute for Public Health Surveillance (InVS) at the request of the Ministry of Health. Any new case of mesothelioma, whatever its anatomical site (pleura, peritoneum, pericardium ...), must now be notified to the doctor of the Regional Health Agency (ARS), by any doctor (pathologist or clinician) practicing in mainland France or ultramarine and who diagnoses it.
Note also that as part of the Cancer and Environment Unit of the Léon Bérard Center (Center for the fight against cancer in Lyon and Rhône-Alpes), a "professional cancer" consultation has been set up, in collaboration with the Professional Pathology Consultation Center of the Hospices Civils de Lyon, so that patients at the Léon Bérard Center can benefit from a systematic approach to researching occupational exposures for compensable cancers in occupational disease, and particularly with patients suffering from cancer lung and mesothelioma.
You have been exposed to asbestos in the course of your professional activity and you have contracted a disease (pleural plaques, asbestosis, primary bronchopulmonary cancer, mesothelioma, etc.).
As a victim of asbestos, you can obtain recognition of the professional nature of your disease and obtain compensation to repair all your damage.
As exposure to asbestos is a very technical subject, the lawyer will guide you on the procedure most suited to your situation and will help you in your efforts.
1 - Recognition of the professional nature of your illness
If your attending physician has given you a medical certificate describing an asbestos-related illness, you must send it to your caisse in order to request recognition of the professional nature of your illness (note, due to the latency period, it happens regularly that the illness manifests itself once the employee retires).
This recognition of the professional nature of your illness will allow you to take charge of your care and medical follow-up. You may also receive compensation for your permanent incapacity.
Upon receipt of your request, the caisse will carry out an administrative and medical investigation. She will ask you for additional documents and will question your employer in order to know his opinion on the reality of your exposure. The CPAM will render its decision within 3 months.
2 - Referral to FIVA
The mission of the Asbestos Victim Compensation Fund (FIVA) is to provide full compensation for the damage suffered by victims of an asbestos-related illness.
Victims and their beneficiaries can apply to FIVA by filling out a compensation request form which must be accompanied by a large number of documents, particularly medical documents.
Upon receipt of the request, FIVA will send an acknowledgment of receipt within 15 days. If the file is complete, FIVA will have to make an offer of compensation within 6 months.
The victim can be summoned to a medical expertise.
On receipt of the FIVA decision, it can be challenged before the Court of Appeal within 4 months (if the request is rejected or if the offer is not satisfactory).
3 - The inexcusable fault of your employer
Once the professional nature of your illness has been recognized by the CPAM, you can obtain the conviction of your employer for inexcusable fault in order to obtain additional compensation and the increase in your pension.
You must contact the social center of the Tribunal de Grande Instance through your lawyer.
4 - Anxiety damage
If you have been exposed to asbestos in the course of your work, you can obtain compensation for your anxiety damage under certain conditions.
Since a judgment of the Court of Cassation of April 5, 2019, all employees, even those who have not worked in an establishment classified ACAATA can obtain damages for their prejudice of anxiety.