Asbestos-Related Disorders in Germany: Background, Politics, Incidence, Diagnostics and Compensation

Abstract

There was some limited use of asbestos at end of the 19th century in industrialized countries including Germany, but its consumption dramatically increased after World War II. The increase in use and exposure was followed by the discovery of high numbers of asbestos-related diseases with a mean latency period of about 38 years in Germany. The strong socio-political pressure from the asbestos industry, its affiliated scientists and physicians has successfully hindered regulatory measures and an asbestos ban for many years; a restrictive stance that is still being unravelled in compensation litigation. This national experience is compared with the situation in other industrialized countries and against the backdrop of the constant efforts of the WHO to eliminate asbestos-related diseases worldwide.

Keywords: asbestos; asbestos ban; asbestosis; compensation; litigation; mesothelioma; prevention; stakeholders; threshold limit values.

Figure 1

Asbestos consumption and recognized occupational diseases in West Germany (BRD), modified from [4]. In East Germany (DDR), the plateau of asbestos consumption was about 75,000 metric tons annually in 1975–1980. BK = occupational disease designation. Note, that past and current disease data were used for future estimates [4]. For evidence of underreporting of asbestos-related lung cancer see legend of Table 4.

Figure 2

Algorithm of medical expert examination for the diagnosis of asbestosis or asbestos-related pleural plaques/fibrosis according to the German guideline “Diagnostics and expert opinion of asbestos-related occupational diseases”.