The Madison County Record Mar. 18, 2014, 3:26pm

To the Editor:

Heather Isringhausen Gvillo’s March 6, 2014 article, “Lung Cancer Cases Push Madison County’s Asbestos Docket to New Record,” quotes a local attorney as saying that while asbestos cases filed in Madison County were traditionally mesothelioma cases, recent advertising has led to a “a new lung cancer trend [that] has ‘significantly increased this docket.’” The attorney goes on to state that “if it wasn’t for lung cancer cases, Madison County would probably be seeing docket numbers near the 2009 and 2010 new case numbers.”

The implicit suggestion appears to be that these claims for lung cancer arising from asbestos exposure are somehow caused by attorney advertising and less valid than claims for mesothelioma, with “huge numbers in Madison County put[ting] a burden on the courts and tax payers.” In fact, asbestos causes lung cancer, not lawyers and not attorney advertising.

Documentation of the causal link between asbestos exposure and lung cancer appeared in medical literature as early as 1935, when a British physician documented lung cancer deaths concurrent with asbestosis and postulated a causal link between asbestos exposure and lung cancer.

 Gloyne, S.R. “Two Cases of Squamous Carcinoma of the Lung Occurring in Asbestosis,” Tubercle, Oct. 1935. Two American physicians documented similar findings the same year, noting a connection between the chronic bronchial irritation resulting from asbestos exposure and the development of the lung cancer. Lynch, K.M. & Smith, W.A. (1935) “Pulmonary Asbestosis III: Carcinoma of Lung in Asbesto-Silicosis”, The Am. Jour. of Cancer, Vol. XXIV, No. 1, p. 50. A 1948 article found cancer in a population of asbestos workers at seven times the expected frequency. Lynch, K.M. & Cannon, W.M. (1948) “Asbestosis: IV. Analysis of Forty Necropsied Cases,” CHEST, 1948 14(6):874. Similarly, a 1955 study found that men exposed to asbestos dust suffered increased mortality from lung cancer, the increased risk being “on the order [of] 10 times that experienced by the general population.” Doll, R., (1955) “Mortality from Lung Cancer Among Asbestos Workers,” British Journal of Industrial Medicine, Vol. 12, p. 81.

In the early 1960s, Dr. Irving Selikoff at the Mount Sinai Hospital published a landmark study of over 1500 asbestos workers, demonstrating a link between asbestos exposure and lung cancer. In an article in the Journal of the American Medical Association, Dr. Selikoff wrote that:

“The results with regard to carcinoma of the lung are clear… exposure to asbestos [r]esult[ed] in a marked increase in the incidence of cancer of the lung, approximately six to seven times the expected incidence.” Dr. Selikoff stated:

Asbestos exposure in industry will not be limited to the particular craft that utilizes the material. The floating fibers do not respect job classifications.

…[W]orkers undoubtedly share their exposure with their workmates in other trades; intimate contact with asbestos is possible for electricians, plumbers, sheet-metal workers, steamfitters, laborers, carpenters, boiler makers, and foreman; perhaps even the supervising architect should be included. Selikoff, I.J, Churg, J. & Hammond, E.C. (1964) “Asbestos Exposure And Neoplasia,” The Journal Of The American Medical Association,” Vol. 188, No. 1, p. 22.

In addition to the link between asbestos exposures and lung cancer, scientists have documented a synergistic relationship between asbestos, smoking and lung cancer. Dr. Selikoff stated: “clearly, the smoking habits of the asbestos workers cannot account for the fact that their lung cancer death rate was 6.8 times as high as that of white males in the general population.” It is uncontroverted that the two risks (smoking and asbestos exposure) did not act independently; rather, one study concluded (and similar findings have been documented in multiple subsequent studies) that there was “a strong synergistic effect between the two types of exposure (asbestos dust and cigarette smoking) in respect to risk of lung cancer.” E.C. Hammond, I.J. Selikoff & H. Seidmann, (1979) “Asbestos Exposure, Cigarette Smoking and Death Rates”, Annals of the New York Academy of Sciences, Dec. 1979, Vol. 330, pp. 473-740.

The latest study, in 2013, was led by Dr. Stephen Markowitz of the Center for the Biology of Natural Systems, Queens College, City University of New York. Markowitz found that for non-smokers exposed to asbestos (working as insulators), the rate of lung cancer deaths increased 5.2 times. The increased risk was nearly three times more for smokers exposed to asbestos (28.4) versus the control group of smokers with no asbestos exposure (10.3). Markowitz, S.B., Levin, S.M., Miller, A. & Morabia, A., (2013) “Asbestos, Asbestosis, Smoking and Lung Cancer; New Finding from the North American Insulator Cohort,” American Journal of Respiratory and Critical Care Medicine, 13-April-2013 as 10.1164/ rccm.201302-0257OC. There is undoubtedly a statistically significant relationship between smoking and asbestos exposure, moreover, Markowitz, et al., reported that a finding of asbestosis was not necessary to document this relationship.

Finally, it is important to note that Illinois law plainly does not require proof that asbestos exposure be the only cause of the lung cancer alleged. Illinois Pattern Jury Instruction 15.01, defining “proximate cause,” explains that the proximate cause of the injury complained of “need not be the only cause, nor the last or nearest cause. It is sufficient if it combines with another cause resulting in the injury.” (Emphasis added). The studies I’ve cited confirm that asbestos exposure is a cause of lung cancer and may act in concert with cigarette smoking to produce a higher incidence of lung cancer than would cigarette smoking alone.

While defense counsel may decry the increased volume of filings in Madison County, we suggest that these filings are anything but detrimental to the Court and the community. The community and its residents benefit from the increased business, jobs and tax revenues generated by new satellite law offices opening locally from large, out-of-state firms, as well as the increased business travel of out-of-state attorneys appearing before the Court. Revenues are increased for the court system in terms of filing fees and for the community in terms of restaurants, hotels, other businesses and vendors (court reporters, shippers, document management, office supplies, to name but a few) serving the local and transient legal community and the court system. Most of all, Madison County residents should be proud to know their community and Court system are helping those victims and their families whose malignancies, whether mesothelioma or lung cancer, will eventually lead to their death.

 Paul Napoli

Napoli, Been, Ripka, Shkolnik & Associates

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