Mesothelioma is a rare and usually fatal cancer that signifies a person has been exposed to asbestos - the only known cause.
That is why mesothelioma is considered a special illness by the Ontario government. Contracting it is supposed to mean being placed on a fast track for compensation from the province's workplace insurance plan, since there is a presumption that the asbestos exposure came from being on the job.
Yet almost 1,000 of the 1,500 people who developed that cancer between 1980 and 2002 weren't compensated, according to a new research paper, which says this allowed the province's Workplace Safety and Insurance Board to shortchange victims of the disease, and taxpayers, out of hundreds of millions of dollars.
The paper, published in the current issue of the International Journal of Occupational and Environmental Health, provides some of the first estimates of the human and financial toll in Canada caused by exposure to asbestos, a mineral fibre widely used before the 1980s as an insulating material in construction and other industries.
Canada, unlike many developed countries, doesn't compile statistics on asbestos illnesses. Asbestos-caused diseases are continuing to show up now because many have a 20-to 50-year latency period.
The paper, written by a research team headed by Jim Brophy, one of Canada's top occupational health experts, said Ontario taxpayers have been covering huge medical bills for people with mesothelioma and thousands of other asbestos-caused cancers - costs that should have been covered by fees the WSIB charges employers to cover workplace diseases.
"In Ontario, the WSIB is legally obliged to reimburse the provincial health-care system for costs related to compensable diseases," the paper said. "Therefore the failure to recognize the work-relatedness of many mesothelioma cases has resulted in an economic loss to the provincial Ministry of Health."
The WSIB said in a statement to The Globe and Mail that most people with the disease don't apply for compensation and, out of those who do, about 90 per cent are compensated.
In an interview, Dr. Brophy, director of the Occupational Health Clinics for Ontario Workers in Sarnia, said doctors in Ontario are not required to notify the WSIB that they are dealing with mesothelioma cases. He said some of those who contracted mesothelioma lived with people who brought traces of asbestos home on their work clothes, and the WSIB refuses to compensate them. Others are having difficulty proving they worked with asbestos for two years or more.
Mesothelioma is a cancer affecting the lining of the chest wall, and because of its poor prognosis, almost all of the nearly 1,000 people who were not compensated are probably dead.
The incidence and compensation figures are based on data recently released by Cancer Care Ontario and the WSIB, which found from 1980 to 2002 nearly 1,500 men in Ontario were diagnosed with mesothelioma - but only about 550 claims were filed for the illness with the WSIB.
"It is an alarming statistic, and for the first time, reveals to the public the tragic consequences of poorly regulated and controlled asbestos exposures," the paper said.
Although asbestos also causes lung, head, neck and gastrointestinal cancers, mesothelioma is the most feared because the disease has few treatments and is almost always fatal, typically within four to 18 months of the diagnosis.
In Ontario, it is among only three occupational diseases - the others being asbestosis and a rare nasal cancer - for which those who contract it are assumed to have had a workplace exposure to a hazardous substance.
Canada continues to mine large quantities of asbestos, but the paper said about 95 per cent of the output is exported, mainly to poor, developing countries. This week, the Canadian Cancer Society called for the elimination of these exports, which have been heavily promoted by the federal government.