A recent post-mortem concluded that a former maintenance worker who regularly came into contact with asbestos throughout his working life would not have caught and, subsequently, died of bronchial pneumonia if he had also not contracted malignant mesothelioma.

Under the Coroner’s Act 1988, whenever death occurs from an industrial disease suspected of being asbestos-related, a Coroner’s inquest is required to investigate and report on whether the patient had died from ‘unnatural causes’. In order to positively identify the cause of death, it may be necessary to conduct a post- mortem examination of the body and samples of lung tissue are often taken for asbestosis disease analysis.

In the present case, prior to the victim dying from bronchial pneumonia, a diagnosis of malignant mesothelioma had been made and later confirmed by post-mortem, which revealed a large tumour covering the right lung and partially damaging the left lung.

Regularly inspect asbestos-lined air ducts

The 70 year old machine fitter, who had worked for just over 30 years for the same Berkshire company until 1993, would regularly inspect asbestos-lined air ducts and access heating pipes to asbestos lined boilers. As is so often reported by those employed during the 1960s and 70s peak period of UK asbestos use, the lack of asbestos awareness of potential risk, health information or protective equipment available at his workplace meant not even a face mask was issued to prevent the inhaling of fibre dust.

In a written statement it was related that hammers were the only tools / equipment used to “knock the thick white asbestos covering” off pipes for access during maintenance and repair. Even as recently as 1989, asbestos removal was being manually handled while access was created by using “an electric saw”, causing quantities of fibre dust to be released.

Asbestos exposure linked to other diseases

A number of recent clinical studies strongly suggest that those who worked in occupations involving asbestos may not only be at risk of asbestos-related diseases but there is also sufficient evidence linking exposure to increased risk of heart disease, thrombosis, blood clotting and other types of cancer, such as stomach cancer.

It is well documented that there can be an exceptionally long gestation period of 15 to 50 years from the first asbestos exposure and the inhalation of fibres until the appearance of asbestosis symptoms. Recognising the early warning signs of asbestosis disease is never straightforward and can sometimes be misdiagnosed as viral pneumonia. Pleural effusion associated with mesothelioma may, for example, be misdiagnosed as pneumonia, tuberculosis, lung infection or drug reaction.

Mesothelioma is also often misdiagnosed as a carcinoma of the lung and the two conditions are often quite difficult to distinguish. In addition, peritoneal mesothelioma often causes abdominal symptoms, which may be misdiagnosed as bowel disease or incorrectly diagnosed as ovarian cancer.

Reason to suspect mesothelioma was present

In a number of cases where the cause of death is less clearly defined, the coroner’s verdict may be recorded as an “industrial disease” even where there is a strong reason to suspect that mesothelioma was present and could have been actually responsible for causing eventual fatality.

According to the latest figures from the Health and Safety Executive, in 2010 there were 2,347 deaths from mesothelioma, an estimated 2,000 asbestos related lung cancer deaths and 412 deaths from asbestosis without mention of mesothelioma (asbestosis register).