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WebMD Live Chat Transcript: Asbestos Disease with Jonathan David, P.C.*
Transcribed by WebMD Staff
Jonathan David, P.C.*, is an attorney who has represented thousands of people with asbestos- related diseases. The Law Office of Jonathan David, P.C., is headquartered in Texas and has a network of local counsel around the country. They sponsor educational and medical screening programs for those exposed to asbestos and have helped clients recover millions of dollars in compensation.
In his course of representing victims of asbestos disease and their families, Mr. David has become outraged with the asbestos industry. For several decades these manufacturers exposed workers to asbestos, one of the most poisonous substances known to man. Although the asbestos insulation manufacturers knew asbestos was poisonous, they never warned the workers about the dangers of the dust they were breathing.
Asbestos diseases appears 20 to 40 years after exposure. Sadly, in the 1990s we see members of the generations who worked in the '40s, '50s and '60s coming down with a variety of diseases including fatal cancers such as mesothelioma, a rare disease in which cancer (malignant) cells are found in the sac lining of the chest or abdomen.
events_moderator Hello everyone and welcome to WebNM Live, a daily series of health chats! Today we have Jonathan David. He is a lawyer handling asbestos-related issues. Today he's talking about the negative effects of asbestos exposure. Submit your questions by typing them on a line beginning with "/ask".
events-moderator What kinds of diseases are caused by exposure to asbestos?
Jonathan_David Well there are several kinds of diseases caused by asbestos. It's easiest-to think of them in 2 general categories, those diseases that are malignant and those that are nonmalignant. On the nonmalignant side we have asbestosis and pleural disease. On malignant side we have mesothelioma, cancer of the lining of the lung. It's also seen in lining of the abdomen and even more rarely in lining of heart sac. Then we have lung cancer, esophageal cancer, laryngeal cancer and finally, colon cancer. Starting on the nonmalignant side, with asbestosis, asbestosis is a progressive scarring of lungs. It's found bilaterally which is on both sides of lower lung zones. Lung tissue gets scarred up from asbestosis fibers. It's a progressive disease. This scar tissue does not process oxygen, so a person finds himself getting progressively shorter of breath as years go on. The disease appears usually 25 or more years after one has had five or more years of occupational exposure to asbestosis. The lag time, which it takes disease to appear, is called the latency period. People who get very severe cases of asbestosis have to go on oxygen just to breathe. They carry around an oxygen canister. It can lead to death by suffocating a person to death. Pleural disease is a non-cancerous disease where asbestosis fibers have infested the lining of lung. Essentially the lining of the lung gets scarred up and thickens. Oftentimes it will calcify where there's calcified plaques on outside of lining of lung. This disease is not quite as symptomatic as asbestosis in terms of breathing problems. It increases your risk of cancer in future. The same applies with asbestosis. People with asbestosis have higher risk of lung cancer. Switching over to malignant asbestosis diseases, the most serious is mesothelioma. This is a cancer of the lining of the lung and lining of the abdomen primarily. When it is in the lining of lung, it's called malignant pleural mesothelioma and in the lining of the abdomen it's called peritoneal mesothelioma. There are about--the estimates vary-- somewhere in between 2500 and 3500 cases of mesothelioma in U.S. every year. It's a pretty rare disease. It has a number of distinctive characteristics. First of all, the consensus is that there is no other cause for mesothelioma besides asbestosis. Secondly, it is considered to be 100% fatal. Thirdly, it differs from all the other asbestosis diseases in that you don't need much asbestosis at all to get mesothelioma. Most of other diseases require significant occupational exposure to asbestosis. We've seen cases where people had a summer job and went on to have white-collar career and 30 years later came down with mesothelioma. What we also see more and more of these days are what we call household exposure cases. These are cases where a housewife was doing laundry and shaking out husband's clothes which contained asbestosis dust and 30 years later or so comes down with mesothelioma. Or we see people who are children and had contact with their father who came home with asbestosis dust on his clothes and 30 or more years later the children, who are now adults come down with mesothelioma. It's rather unique in that it does not require a great deal of exposure. Then we talked about lung cancer. Asbestosis and other things such as cigarette smoke can cause lung cancer. Asbestosis and cigarette smoke has a synergistic effect. What that means is that the two of them combined present a risk much higher than the sum of the two individual risks. So the bottom line is if you had a 10 times greater chance of getting cancer from just smoking and a 5 times greater risk from just asbestosis, the risk from the 2 combined would be more like 90 rather than just 15. Lung cancer though is not 100% fatal and, in many cases, it can be successfully treated if it's caught early. Of course, we mentioned esophageal and laryngeal and colon cancer. That's sort of a run-down of the diseases.
events_moderator How long does it take after you have been exposed for the disease-to show up?
Jonathan_David Usually asbestosis can be as little as 15 years after exposure but more typically about 25 or more years. Of course, with all these diseases, the longer you are away from your exposure, the higher the risk is. For any given disease you've got more of a chance of it showing up after 40 years than 30 years. With cancers, latency is a little longer. With lung cancer it might be 30 to 35 years later and with mesothelioma, 35 to 40 years later would be more common.
events-moderator What is your prognosis once you have been diagnosed?
Jonathan_David With mesothelioma, at least as of this moment in time, it's still considered 100% fatal. With lung cancer, depending on how early it was detected, it might or might not be treatable. Also depending on cell type and where it's spread. Typically if they catch lung cancer, they can usually go in and resect it out and do some follow up radiation or chemotherapy, and people can live many years and die of some other cause. With lung cancer, early detection is the key.
events-moderator what are some typical signs of lung cancer?
Jonathan_David Usually on x-ray it's going to show up as spot on lung. Unfortunately, some people aren't going to make it to a doctor until they're coughing up blood. That's usually a bad indication. It's highly recommended for people who have worked in trades where there was a lot of exposure, to have yearly chest x-rays.
chatbat how would you know if you or a relative had mesothelioma?
Jonathan_David With mesothelioma, it's actually--as far as symptoms, a person might feel that he has pain in side or chest area or he might feel himself getting short of breath. Mesothelioma causes people to have tremendous build up of fluid. Often times you'll see someone that has bloated abdomen where his stomach looks like he's pregnant. Mesothelioma often have to go in and have fluid drained out and literally they'll fill up several one liter bottles of fluid which, of course, will relieve them and allow them to breath easier. It usually shows up as a lot of fluid around the lining of lung on x-ray, they might see a tumor on lining of lung. Then they will go in and do a biopsy and have that examined by a pathologist, who will come back with a diagnosis. It's a complicated disease to diagnose even for pathologists. Oftentimes the pathologist will send the slides to national specialists to diagnose. For example, there's a panel of pathologists called the American Canadian Mesothelioma panel which contains some of the world's greatest experts on mesothelioma pathology.
events-moderator What are the treatment options for mesothelioma?
Jonathan -David There are a number of different approaches for treating mesothelioma and there are number of cancer centers around the country who are leading these different treatment approaches. First of all, radical surgery is one particular approach. On our Website, we have directory of different cancer centers and different approaches. The Website address is mesoth.com. You can reference that for a lot more detail but I can try and generally cover different approaches. Radical surgery is one approach and probably the most prominent doctor who has operating on patients in this manner for malignant pleural mesothelioma is Dr. David Sugarbaker at Brigham and Women's Hospital in Boston. He goes in and cuts out a large portion of the lining of the lung and, in some cases, portions of the lung itself. Then he follows that up with various cocktails of chemotherapy type drugs. He has several clinical trials going on which apply different regimens of drugs after this surgery. Within mesothelioma, there are different cell types and depending on what kind of cell type you have, your disease will be expected to progress more quickly or slowly. The slower progressive kind is called the epithelial cell type. The faster growing type is sarcomatous. With patients that have epithelial cell type and who are in the early stage of disease where the cancer has not spread to any of their nodes, Dr. Sugarbaker has a five-year survival rate approaching 40%. Of course, if those results are as he indicates, then this appears to be the most promising approach for people who qualify for his criteria. You have to have epithelial cell type, you have to be in early stage of disease. You have to be fairly young to where you could withstand surgery. I believe you also can not have had prior cancer of any type. Dr. Sugarbaker actually has a Website and that address is: www.chestsurg.org. That was the surgical approach and there are other doctors and hospitals around country that employ that as well. There's also an approach called photodynamic therapy, which is espoused by Dr. Harvey Pass in Detroit, and probably the best thing would be to contact him for details. Essentially what they do is apply doses of light with lasers into the pleural cavity and so that's an approach that they use. Then, the University of Pennsylvania has been associated with an approach called Gene Therapy where they inject genes with certain characteristics into the pleural areas and I guess have the genes try and kill cancer cells. That's an approach that they work with. There are various drugs that have been tried in clinical trials such as oncocase or onconase but that's a drug that's extracted from a certain kind of frog and it has certain tumor killing characteristics. Recently there was a study with a drug called lovastatin and this particular drug is actually on the market right now for cholesterol reduction. There was a study done that indicated that at least in the dish that lovastatin seemed to kill mesothelioma tumor cells. Research is still early on that and have not yet done animal studies or human studies that have been published. That may hold some promise in future. There have been other articles about this family of drugs that end in statis such as angiostatis for tumor suppressing characteristics. I think the idea is they choke off blood supply to tumors. Hopefully one or more of approaches will be refined and successful in future. Perhaps if a person can get onto a clinical program that at least prolongs life, maybe during that time period one of the new wonder drugs will become effective. I'm not a doctor or a medical expert, so this is sort of an overview. People can really talk to doctors and explore the various medical studies and resources more fully.
events-moderator Do you have any stories to share with us?
Jonathan David - First of all, l would just want to tell people that a positive attitude makes a big difference. I do have a story about a client of mine by name of Bob Harthcock. Bob worked for many years at a steel plant where they had high temperatures in manufacture of steel and there were large quantities of asbestosis to insulate equipment. In the course of his work over some 30 years, he came into contact with a lot of asbestos dust. Right as he reached the age of retirement and was looking forward to enjoying the golden years he was diagnosed with mesothelioma. This was in 1992. The doctors told Bob's wife, Jean, that Bob had about 6 to 8 months to live. Rather than despair and become depressed, Bob actually being a religious man took a positive attitude and decided that he was not going to let that death sentence affect him. So Bob and Jean traveled around the country and enjoyed themselves but what they also did in travels was they went to different hospitals and cancer centers and encouraged people with cancer and gave them support. They also went and helped people in Mexico that were devastated by hurricane to rebuild their homes. They did counseling with alcohol abuse programs on Indian reservations. They taught Sunday school and volunteered with the ambulance service at a local hospital. Bob Harthcock, last I heard which was about month ago was still alive. That's about 7 years after being diagnosed with mesothelioma. So even though the statistics might be grim, I believe that a positive attitude and optimism and willpower can make a difference for somebody. There are other stories similar to that and I think it's also important that people seek out information early on, research this disease, research options and take the bull by horns. They can make a difference in their life and in their life expectancy.
jeanbo Has Dateline or 20/20 or anyone done anything about asbestos diseases?
Jonathan_David Recently there was a series of articles in USA Today-week of February 8, 1999, 1 believe there was a 4 part series of informative articles about asbestos. Some things covered were the fact that although asbestos has killed so many Americans it is now almost never used anymore in the US. Unfortunately, it's' business as usual with asbestos in many other parts of world. For example, there were some stories about how in Eastern Europe, South Africa and Russia, asbestos is in widespread use. There's been an epidemic of asbestos disease among black populations. In China, to this day, they use prison labor to mine and process asbestos and a commonly used material in most of world as we speak. Even though it's a very deadly poison
events_moderator I recently worked in a building that had an asbestos warning sign on the front door. Why do some buildings STILL have asbestos in them?
Jonathan -David An enormous number of buildings still have asbestos in them because any building that was constructed before the mid 1970's is likely to have asbestos in it. We can talk about uses of asbestos over the years but just about every house, every commercial building, every industrial facility, every ship, every airplane and even the brakes and clutches in autos contain asbestos. So unless you're in a structure that was constructed from the late '70's onward, you're likely to be in a building that contains asbestos. It is being removed from a lot of buildings nationwide and has been over the last 10 to 20 years at a cost of about $50 billion. There are differences of opinion about whether it should be removed. Most people think that as long as asbestos is not being disturbed or cut or sawed or torn out, that it's not a hazard. Some people believe that removing the asbestos in some cases is worse than just leaving it there because by removing it you're disturbing the asbestos. Today, removal properly done is done with proper ventilation and respiratory protection and astronaut looking suits. People that worked in variety of trades prior to mid '70's worked without any protection and those are people now coming down with diseases.
events_moderator What trades are at most risk?
Jonathan_David There are a variety of trades that are high risk for asbestos exposure. Those who worked in shipyards, and industrial facilities such as power plants, refineries, paper mills or manufacturing plants where there was high temperature operations such as boilers, furnaces and things of that nature. We're talking about insulators, boilermakers, pipe fitters, welders, carpenters, electricians, steel workers, and shipyard workers, brick masons, aluminum plant employees and on and on.
jeanbo Have lawmakers had anything to say about asbestos?
Jonathan - David Unfortunately, what we've seen so far about what lawmakers have to say about asbestos is not particularly favorable to the people who have been exposed to it. There have been numerous efforts at tort reform where pieces of legislation are lobbied for by big business and industry. Insurance interest has attempted to restrict or all together cut off the rights of people to recover compensation for asbestos diseases and for that matter, other kinds of injuries. For example, recently in Alabama, they enacted a statute of repose that cuts off liability of a product manufacturer for injuries that occur more than ten years after the product has entered the marketplace. On it's face, that might sound like a reasonable law. However, when you think about an asbestos disease that doesn't show up until 30 years after product in marketplace is designed to automatically cut off recovery for anyone with an asbestos disease. In Alabama, there have been a huge number of people with asbestos diseases. Additionally, right now there's a bill pending in Congress that would on a national basis, restrict the right of a person with an asbestos disease to file a lawsuit in court system. It would relegate them to an administrative system which limited their remedies.
events- moderator Is there any financial compensation available for victims of these diseases and their families?
Jonathan_David Yes there are several routes a person might go for financial compensation. Usually the most beneficial is what we call a third party lawsuit which is filed against companies who manufactured asbestos insulation products and knew that these products were dangerous. We have evidence which can be found on our website asbestos-aftorney.com, which shows examples of internal company documents uncovered from the asbestos companies indicating that they have known about hazards of asbestos, in some cases, as far back as the 1920's and '30's. Yet for decades, they covered up this knowledge. There's also evidence that they formed an industry association which not only concealed the dangers of asbestos from public and workers, but also conspired to distort asbestos and its characteristics by funding medical studies and editing the results. For example, they had laboratory in Seranac Lake, NY where they funded studies on animals but then published incomplete results indicating asbestos to be safe.
jeanbo Sounds like the situation is similar to lawmakers and tobacco.
Jonathan_David It's actually very similar to this conspiracy where you had lawyers--perhaps the asbestos conspiracy is even worse than tobacco conspiracy--asbestos exposed workers all they did was show up for work every day. And worked with a poison and brought it home on clothes to families without being told but, with smoking, at least people made a choice to smoke and may have known about hazards. Of course, another remedy that people might have besides a third party lawsuit is a workers' compensation claim filed against their own employer. Then in addition, if a person is disabled, he might have social security claim or some other disability policy that would apply.
events_moderator Is the lawsuit worthwhile from a financial point of view?
Jonathan_David If you have a serious disease such as mesothelioma, lung cancer, or any other kind of serious disease which is impairing you, then such lawsuit is worthwhile. It is not uncommon for someone with mesothelioma to recover a high six figure of seven figure settlement, in excess of a million dollars. Certainly this is no substitute for someone's life but it does bring some measure of justice for a person who has been sentenced to death by an evil, unscrupulous company. It also does provide financial security for the family that such a person is leaving behind. So if someone knows they're going to die, if they die knowing that their husband or wife or children are taken care, at least they can get some measure of peace of mind.
events_moderator How can people find out more about medical and legal issues pertaining to asbestos? For someone who is focused on dealing with his or her disease would a lawsuit be a distraction?
Jonathan_David No it really wouldn't. Obviously a person with this disease wants to focus on medical treatment and he wants to focus on getting most out of his remaining life and being with family. There's very little time involvement for one of these lawsuits. It involves filling out questionnaire and video deposition where testimony and exposure can be preserved on video. If he's unable to make it for future legal proceedings, evidence is preserved. There's really very minor involvement on part of patient.
events_moderator Is there any reason for initiating legal action early on?
Jonathan -David Yes, the primary reason for initiating legal action early on is that most courts will expedite a case if the plaintiff is still alive so that they can resolve it during his lifetime. He gets to cut in line and not have to wait for years like rest of cases. He gets special setting which allows his case to be resolved quickly. It's a good idea to initiate action early on because while he's still feeling good, he can do video deposition.
events_moderator How can people find out more about medical and legal issues pertaining to asbestos? For someone who is focused on dealing with his or her disease would a lawsuit be a distraction?
Jonathan_David No it really wouldn't. Obviously a person with this disease wants to focus on medical treatment and he wants to focus on getting most out of his remaining life and being with family. There's very little time involvement for one of these lawsuits. It involves filling out questionnaire and video deposition where testimony and exposure can be preserved on video. If he's unable to make it for future legal proceedings, evidence is preserved. There's really very minor involvement on part of patient.
events_moderator Is there any reason for initiating legal action early on?
Jonathan_David Yes, the primary reason for initiating legal action early on is that most courts will expedite a case if the plaintiff is still alive so that they can resolve it during his lifetime. He gets to cut in line and not have to wait for years like rest of cases. He gets special setting which allows his case to be resolved quickly. It's a good idea to initiate action early on because while he's still feeling good, he can do video deposition.
events_moderator How can people find out more about medical and legal issues pertaining to asbestos?
Jonathan_David The medical Website that we have which is www.mesoth.com has links to many other medical resources including cancer centers and medical studies and lots of medical resource information for people with this disease to explore. Our legal site asbestos-attomey.com has more detailed legal information that people can inquire about. Finally they can reach us at 1-800-998-9729 for free consultations and more details about how to access medical and legal resources.
events_moderator thank you very much for joining us today.
Jonathan_David Thank you for calling attention to this subject.
* Licensed by the Supreme Court of Texas
Not Certified by the Texas Board of Legal Specialization
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