Background: Despite the close relation between occupational exposure to asbestos and malignant mesothelioma, the compensation of this disease is still far from being the rule. The objective of this study is to assess the compensation process of all the cases of occupational mesothelioma recorded by the regional mesothelioma registry between September 1995 and August 2002, and to make suggestions for improvement of the compensation of future cases.
Methods: Lifetime exposure to asbestos was assessed for each of the 141 mesothelioma cases observed in Lower Normandy during this time period, and 105 cases could be related to a possible, probable, or very probable occupational exposure to this mineral. Data about notification and compensation of these occupational diseases were gathered with the help of all health insurance organisms concerned.
Results: Except for five cases in which insurance conditions did not allow any compensation, compensation of occupational mesothelioma occurred in 85% of the cases. This high rate was probably the result of the existence of an early asbestos industry in this region, and of the particular awareness of the Norman population about asbestos-related diseases, as well as of the epidemiological follow-up of mesothelioma in Lower Normandy. When notified for compensation, all cases but one were actually compensated, and the lag-time between notification and compensation proved to decrease since 1995, with an average delay reaching 91,1 days in 2002. Patients who did not report their disease were older than those who did, and the lack of knowledge of medical practitioners about compensation procedures seems to be an important matter in this issue.
Conclusion: In order to improve the rate of compensation of occupational malignant mesothelioma cases, information about the usual occupational origin of the disease should be delivered systematically to the general practitioner of each patient. This could be done by pathologists, when they diagnose malignant mesothelioma, and/or by medical examiners when sickness benefits are sought, or even by the epidemiological center of death causes (INSERM, CépiDc), for the beneficiaries of patients who died from malignant mesothelioma.