[Regional differences in the compensation of pleural mesothelioma as occupational disease in France (1986-1993)]

Area of Science:

• Occupational Health
• Epidemiology
• Public Health Policy

Background:

• Asbestos exposure causes at least 80% of mesothelioma cases in developed nations.
• Significant regional variations in compensated mesothelioma rates exist in France, prompting investigation into risk differences.
• The study aims to quantify these regional differences in relation to risk levels.

Purpose of the Study:

• To quantify regional differences in mesothelioma compensation rates across France.
• To investigate potential links between regional mesothelioma compensation disparities and occupational risk levels.
• To assess the probability of mesothelioma being compensated as an occupational disease by region.

Main Methods:

• Comparative analysis of regional mesothelioma mortality and compensated occupational disease data (1986-1993).
• Calculation of expected compensated mesothelioma numbers based on national distributions.
• Computation of compensation rates, regional variations, and probability of compensation relative to the best-performing region.

Main Results:

• Significant regional differences in mesothelioma compensation rates were observed (p < 0.05).
• The ratio of observed to expected compensated mesothelioma varied widely, from 0.15 in Montpellier to 2.29 in Nantes.
• Compensation rates ranged from 5% in Montpellier/Clermont-Ferrand to 61.5% in Nantes for male cases, with a national average of 25%.

Conclusions:

• Substantial regional disparities in compensating mesothelioma as an occupational disease are evident in France.
• These differences are likely due to variations in physician judgment regarding occupational etiology, though system differences cannot be ruled out.
• Improvement of the national occupational disease statistical system is strongly recommended.