The number of new cases of pleural thickening – scarring and fibrosis of the lung linings – have continued to rise over the last twenty years. Latest available figures from the Health and Safety Executive (HSE) show there were 430 new cases of pleural thickening assessed for Industrial Injuries Disablement Benefit in 2015 compared to 1991, when there were just 150 cases diagnosed.

Exposure to asbestos continues to cast a long and deadly shadow, often going back more than half a century. While those who are diagnosed with the fatal and incurable mesothelioma cancer tend to be the main focus of medical and legal attention, there is an increasing number of men and women who struggle to live with debilitating asbestosis diseases, such as pleural thickening.

In one recent case, a former telephone engineer who worked at a Royal Mail exchange during the 1960s and 70s was diagnosed with pleural thickening nearly half a century later.

Widespread in the insulation of electric cable and wiring

Asbestos was increasingly used to produce insulation and fireproofing products in British engineering and construction from the 1950s and 60s onwards, and imports soared to more than 180,000 tons in the early 1970s. One of the most widespread applications was in the insulation of electric cable and wiring, from the domestic, household fusebox to large-scale, commercial installations.

For ten years the electrical engineer worked at the telephone exchange directly stripping back the outer linings of electric cable, which included two layers of asbestos between copper foil and colour-coded silk wiring. Asbestos fibre dust particles would be released into the surrounding atmosphere whenever a layer was pulled back from the cables, and after every job when the asbestos waste was cleared away.

Neither protective equipment nor safety information

The absence of any asbestos awareness to the long term health risks during this time meant that often there was neither protective equipment, such as a breathing mask issued, nor safety information supplied. The engineer and his colleagues would also play football with the asbestos bags, which sometimes split open and release fibre dust into the air. How could the engineer possibly know that half a lifetime on that his daily work – and play – would lead to a debilitating respiratory condition?

It is now well-documented that an average of 30 to 40 years or even longer may pass from an initial period of exposure to the first appearance of asbestosis symptoms. The engineer was aged in his early 70s when he began to suffer a cough and chest discomfort on the left side, the early signs of the disease. A medical examination found there was no malignant cancer cells but did confirm a pleural effusion and diffuse pleural thickening caused by exposure to asbestos.

Defendant initially denied liability

Pleural thickening develops when asbestos fibre dust particles are inhaled into the lungs, which eventually embed in the pleura causing fibrosis, scarring, calcification and thickening of the membrane lining. Thickening reduces the elasticity and ability of the lung to function, producing symptoms such as shortness of breath, feeling of tightness across the chest and general chest pains. Although considered benign, potentially the condition can develop into more serious symptoms.

The medical examiners agreed that pleural thickening was responsible for a quarter of the former engineer’s overall respiratory disability who was only expected to survive for six years. The defendant had initially denied liability over whether asbestos exposure had caused the condition but did concede that they breached their duty of care. The case was set for another hearing for an assessment of damages, but the defendants finally settled with a five figure sum two months before the assessment date.

Higher degree of susceptibility before the age of 30

The engineer was in his early twenties when he was first exposed to asbestos. Medical evidence consistently finds a higher degree of susceptibility to contracting asbestos-related diseases when exposure occurs before the age of 30. Those young men who were in their late teens or early twenties when starting work in asbestos-using occupations from the 1960s onwards continue to be diagnosed for mesothelioma or asbestosis disease.

Around a half of all those who are exposed to asbestos will develop pleural plaques and in an estimated one in four of pleural thickening cases, the level of disability caused by a worsening of the condition will increase on and off in the first ten years after diagnosis.Today, an average of 20 tradesmen – mostly carpenters, electricians and plumbers – will lose their lives every week to asbestosis disease or mesothelioma due to asbestos exposure.

The number of asbestosis claim cases has more than doubled from 574 to 1,164, according to recent data released by the Royal Courts of Justice. The HSE also estimate that 564 new cases of non-malignant pleural disease reported by chest physicians in 2015 were mainly caused by exposure to asbestos and pleural thickening.