New cases of mesothelioma and asbestos-related lung cancer in one year cost $1.9B

First-ever estimate of the economic burden of asbestos looks at newly diagnosed cases in Canada in 2011

One year’s newly diagnosed cases of mesothelioma and lung cancer due to work-related asbestos exposures cost Canadians $1.9 billion.

This is according to a recent study led by Institute for Work & Health (IWH) Senior Scientist Dr. Emile Tompa, a health economist who assessed the costs to Canadian society of newly diagnosed cases in 2011. The study is the first to estimate the costs to society of illnesses associated with work-related asbestos exposures, including secondhand or “para-occupational” exposures (e.g. a family member’s exposure to fibres brought home on work clothing).

Although it may seem cold to attach a dollar value to outcomes associated with workers and their families who have suffered asbestos-related mesothelioma and lung cancer, economic burden studies such as this one can help policy-makers better understand the costs to society, pointing them to areas needing more prevention efforts and helping them set priorities, says Tompa.

For example, advocates are pressing the federal government to ban the import and export of asbestos and asbestos-containing products. Information on the economic burden to society of illnesses associated with asbestos exposure can help inform these efforts, Tompa adds.

2,331 new cases in 2011

Tompa and his team looked at the estimated total lifetime costs of 427 newly diagnosed cases in 2011 of mesothelioma, as well as 1,904 newly diagnosed cases in the same year of lung cancer. These were all cases attributed to occupational and para-occupational exposures to asbestos, for a total of 2,331 new cases in 2011. They considered costs in three areas: direct costs (e.g. health-care and family/community caregiver costs), indirect costs (e.g. productivity and output losses associated with lost paid work time) and quality-of-life costs (e.g. loss of engagement in social roles such as being a parent or spouse, loss of community engagement and leisure, and loss of enjoyment of life due to pain, suffering and premature mortality).

According to the study, the estimated total cost of these cases to Canadian society (including costs to individuals, as well as their families, communities and employers) is $1.9 billion, with an average cost of $816,000 per case (see sidebar). Eighty per cent of the costs are attributed to health-related quality-of-life losses. Health care and other direct costs account for 11 per cent; loss of productivity and other indirect costs account for the remaining nine per cent.

Survival rates are poor for mesothelioma and lung cancer, so health-care costs are relatively low, says Tompa. And most of the diagnosed cases in 2011—92 per cent—involved people 60 years of age or older, so lost labour-market output and productivity is also relatively low. It’s the health-related quality of life loss that carries the biggest price tag.

Tompa notes that the cost estimates are conservative. They only include costs related to cases newly diagnosed in a single year, not cases diagnosed in preceding or subsequent years. They do not include costs related to other illnesses known to be caused by asbestos, such as asbestosis, or costs associated with non-occupational exposures to asbestos.

For more, see Tompa’s June 2016 presentation to an EU-OSHA project on estimating work injury costs, or his November 2015 presentation to a stakeholder meeting of the Occupational Cancer Research Centre. (The former includes para-occupational costs, and the latter does not). Go to: www.iwh.on.ca/other-reports.

Economic burden of asbestos-related cancers due to work exposures

The tables here show the economic burden of mesothelioma due to occupational and para-occupational (i.e. secondhand) exposures to asbestos and of lung cancer due to occupational and para-occupational exposures to asbestos. The cases were diagnosed in 2011. All figures are in 2011 Canadian dollars.

Table 1: Mesothelioma (427 new cases in 2011)
Cost category All cases ($) Per case ($)
Health-care costs 19,542,452 45,794
Informal caregiving 5,665,353 13,276
Out-of-pocket costs 6,052,921 14,184
Workers' compensation administration 32,731,536 76,700
Lost productivity and output 30,212,135 70,796
Cost of replacing absent worker 2,324,633 5,447
Health-related quality of life 296,303,160 694,325
Total 392,832,191 920,521
Table 2: Lung cancer (1,904 new cases in 2011)
Cost category All cases ($) Per case ($)
Health-care costs 53,993,826 28,355
Informal caregiving 32,713,179 17,180
Out-of-pocket costs 35,539,487 18,664
Workers' compensation administration 26,134,338 13,725
Lost productivity and output 126,275,066 66,314
Cost of replacing absent worker 10,394,631 5,495
Health-related quality of life 1,224,370,103 642,986
Total 1,509,420,630 792,682

Source: At Work, Issue 85, Summer 2016: Institute for Work & Health, Toronto