An October 2o, 2015  story in Carrier Management reports a payment to a nuke worker who developed AML at a young age. Overall, he is reported to be the 13th nuclear plant worker paid compensation after developing AML. Key parts of the story state the following:

“Japan’s health ministry confirmed for the first time that leukemia found in a worker at Tokyo Electric Power Co.’s Fukushima Dai-Ichi power plant is a result of the March 2011 atomic disaster.

The worker was in his 30s while employed at the Fukushima facility north of Tokyo between October 2012 and December 2013, according to a statement from the Ministry of Health, Labour and Welfare.

**** 

The worker received 15.7 millisieverts (mSv) of radiation during his time at the Fukushima facility, while workers compensation insurance is awarded after receiving 5 mSv in a year, according to the ministry. So far, 13 workers at nuclear power facilities have received compensation for cancer due to radiation exposure. There is still debate, however, as to whether low doses of radiation—below a threshold of 100 mSv—have a direct link to leukemia.

****

High-dose radiation exposure increases the risk of developing acute myeloid leukemia, according to the American Cancer Society. Japanese atomic bomb survivors had a greatly increased risk of developing acute leukemia, most often about six to eight years after exposure, the society says on its website.

A study published earlier this month by Toshihide Tsuda, a professor at Okayama University, found that cases of thyroid cancer have increased among children and adolescents in Fukushima Prefecture since the accident.”

Mesothelioma web sites continue to pick  up the pace of and quality of information disseminated regarding asbestos related diseases. A new example arises from the Surviving Mesothelioma site publishing this August 29, 2015 post about an August 24, 2015 medical article. The abstract is as follows:

“Abstract
OBJECTIVE:
The aim of our study was to estimate the incidence of digestive cancers within a cohort of asbestos-exposed workers.
METHODS:
Our study was based on a cohort of 2024 participants occupationally exposed to asbestos. The incidence of digestive cancers was calculated from 1 January 1978 to 31 December 2009 and compared with levels among the local general population using Standardised Incidence Ratios (SIRs). Asbestos exposure was assessed using the company’s job-exposure matrix.
RESULTS:
119 cases of digestive cancer were observed within our cohort, for an expected number of 77 (SIR=1.54 (1.28 to 1.85)). A significantly elevated incidence was observed for peritoneal mesothelioma, particularly in women. Significantly elevated incidences were also observed among men for: all digestive cancers, even when excluding peritoneal mesothelioma (SIR=1.50 (1.23 to 1.82)), oesophageal cancer (SIR=1.67 (1.08 to 2.47)) and liver cancer (SIR=1.85 (1.09 to 2.92)). Concerning colorectal cancer, a significant excess of risk was observed for men with exposure duration above 25 years (SIR=1.75 (1.05 to 2.73)).
CONCLUSIONS:
Our results are in favour of a link between long-duration asbestos exposure and colorectal cancer in men. They also suggest a relationship between asbestos exposure and cancer of the oesophagus in men. Finally, our results suggest a possible association with small intestine and liver cancers in men.”

M Boulanger, Morlais F, V Bouvier, Galateau-Room F, L Guittet, Marquignon MF, Paris C, C Raffaelli, Launoy G, Clin B., Digestive and occupational cancers
asbestos exposure: impact study in a cohort of asbestos plant workers, Occup Environ. Med. 2015 Aug 24. pii: OEMéd-2015-102871. doi: 10.1136 / OEMéd-2015-102871.

 

After various delays, the new, more detailed ICD-10 coding takes effect in October. The ICD-10 coding is more detailed than is current coding in terms of identifying cancers by type, subtype and location. New knowledge inevitably will follow from better data. This page provides examples of the new oncology coding in general.

Here are examples of ICD-10 coding for mesotheliomas. A comparative look at historic ICD mesothelioma codes is here; the new ones are more specific.

The use of ICD-10 codes helped to improve finding mesotheliomas in Scotland.  See D R Camidge, D L Stockton, M Bain, Factors affecting the mesothelioma detection rate within national and international epidemiological studies: insights from Scottish linked cancer registry-mortality data,  Br J Cancer. 2006 September 4; 95(5): 649–652. Published online 2006 August 29. doi: 10.1038/sj.bjc.6603293

 

Genetics and epigenetic issues continue to knock open doors in toxic tort litigation. An example? A recent federal MDL ruling rejected defense Daubert motions seeking to strike expert opinions that were based on the concept of a cancer arising less than 1 year. How could that happen? Think epigenetic actions that “turn on” a cell receptor and leave it generating proteins at full throttle, and putting the cell into an agitated state in which it more easily transforms into a malignant cell.

I will be covering those issues and more on a panel with Lenn Murelle, a smart scientist who runs a company known as Venebio Group.  Lenn  “gets” molecular science and toxic tort litigation.

2:15 p.m. – 3:15 p.m.

Molecular Epidemiology, Epigenetics, and Nutrigenomics Bioscience – Intersections with Toxic Tort Claims

• Molecular Epidemiology and Toxic Tort Intersections
• What is Happening in the Human Body with the Increases in Obesity?
• Mesothelioma – Seeing the Intersections with BAP1 Mutation and Epigenetic Factors
• Epigenetics and Multi-Generational Toxic Tort Claims

Edward L. Murrelle, MSPH, Ph.D., Co-Founder and CEO, Venebio Group, LLC, Richmond, VA
Kirk T. Hartley, LSP Group LLC

Other panels also include real scientists who are at the front edge and also “get” the changes that will transform litigation over the next 20 years. For example, Len van Zyl and his company (ArrayXpress) are way ahead of most and actually are doing genomic testing in toxic tort cases.

9:00 a.m. – 10:00 a.m.

The Rapid Evolution of Law With Quantitative Precision Science

Len van Zyl, Ph.D., CEO and CSO, ArrayXpress, Inc., Raleigh, NC
Michael Zapata III, Executive Chairman, ArrayXpress, Inc., Raleigh, NC

10:00 a.m. – 10:45 a.m.

Understanding The Application of Epidemiology to the Science of Genomics

David G. Hoel, Ph.D., Exponent, Inc., Alexandria, VA

11:00 a.m. – 12:00 p.m.

The Role of Medical Toxicology and Ethical Issues

D. Mark Jackson, Bassi Edlin Huie & Blum LLP, San Francisco
John B. Sullivan, M.D., MBA, University of Arizona, Department of Emergency Medicine/Medical Toxicology Division, Tucson, AZ (Retired)

Go here to see the rest of the agenda and register:  HarrisMartin’s DNA and Molecular Evidence in Toxic Torts Conference: The Time of Genomics Is Here

Researchers continue to seek out “fingerprint” patterns in tumor mutation patterns in order to look back towards causation and source of disease. A recent study in France looked at somatic mutation patterns in lung cancers in never smokers who may have been exposed to “passive” tobacco smoke.   See No impact of passive smoke on the somatic profile of lung cancers in never-smokers, pERJ March 5, 2015 ERJ-00973-201 (2014). 

The abstract states:

“Abstract

EGFR and HER2 mutations and ALK rearrangement are known to be related to lung cancer in never-smokers, while KRAS, BRAF andPIK3CA mutations are typically observed among smokers. There is still debate surrounding whether never-smokers exposed to passive smoke exhibit a “smoker-like” somatic profile compared with unexposed never-smokers.

Passive smoke exposure was assessed in the French BioCAST/IFCT-1002 never-smoker lung cancer cohort and routine molecular profiles analyses were compiled.

Of the 384 patients recruited into BioCAST, 319 were tested for at least one biomarker and provided data relating to passive smoking. Overall, 219 (66%) reported having been exposed to passive smoking. No significant difference was observed between mutation frequency and passive smoke exposure (EGFR mutation: 46% in never exposed versus 41% in ever exposed; KRAS: 7%versus 7%; ALK: 13% versus 11%; HER2: 4% versus 5%; BRAF: 6%versus 5%; PIK3CA: 4% versus 2%). We observed a nonsignificant trend for a negative association between EGFR mutation and cumulative duration of passive smoke exposure. No association was found for other biomarkers.

There is no clear association between passive smoke exposure and somatic profile in lifelong, never-smoker lung cancer.”

Some say that change is the predominant theme in asbestos litigation. For 2014, some of the change arrives in the form of at least five mesothelioma cases where the presence or absence of a germline  BAP1 mutation is becoming an issue. As it happens, the five cases are scattered around the country: California (3), Missouri, and New York. Thus, 2014 becomes the year mesothelioma litigation undeniably entered the age of precision scientific analysis aimed at a particular person’s genomics, and related molecular characteristics. The five cases are listed in an August 18, 2014 declaration of Ms. Andrea Huston – online here. Ms. Huston is an experienced lawyer with an Oakland based asbestos plaintiff’s firm – Kazan McClain et al.

Ms. Huston’s declaration indicates the five cases are the only known cases in which germline BAP1 issues are known to have emerged. The declaration of course is limited to Ms. Huston’s best knowledge, after some unspecified amount of communication among some members of the asbestos plaintiff’s bar. So, it is of course possible there are germline BAP1 issues emerging in some other cases. The cases identified by Ms. Huston are:

  • Ortwein v. CertainTeed Corp., et al., Alameda County Superior Court No. RG13701633
  • Perez v. ArvinMeritor, Inc., et al. , Alameda County Superior Court No. RG13689541
  • McCarthy v. Baltimore Aircoil Co., et al., Los Angeles County Superior Court No. BC464985
  • Bergstrom v. 84 Lumber, et al., Missouri Circuit Court (22nd Cir.) No. 1322-CC09325
  • Bernard v. Colgate-Palmolive Co., New York Supreme Ct., New York County, No. 107211/08

More ahead this week and next week on further specifics about the germline BAAP1 issues in these cases.

 

Some see lung cancer claiming as associated only with the Napoli Bern law firm. But that’s not correct.  More and more, members of the Motley Rice firm (and some other firms) are talking about and taking action regarding lung cancer claims, both in and out of  asbestos litigation. Consider, for example, that the Motley Rice firm and the Leiff Cabraser firm were plaintiff’s counsel for an Engle trial in Florida that recently produced a $27 million plaintiff’s verdict, as described in a September 25, 2014 post at PHAI.

The Motley Rice focus on lung cancer  continues with its very active role in an upcoming Harris Martin conference focused on lung cancer claims in asbestos litigation, with a major focus on some but much less than all of the science relevant to lung cancer claiming. The agenda is below; note the number of speakers from Motley Rice.

_________________________________

“HarrisMartin’s Asbestos Litigation Conference: Emerging Issues in Lung Cancer Cases Agenda”

 

Day 1, Friday, October 17, 2014

7:45 a.m. – 8:45 a.m.

Continental Breakfast and Registration

8:45 a.m. – 9:00 a.m.

Welcome By Co-Chairs

V. Brian Bevon, Motley Rice, Mt. Pleasant, SC
Louis P. Herns, Pierce, Herns, Sloan & Wilson, LLC, Charleston, SC

9:00 a.m. – 10:00 a.m.

What to Expect from Your Expert in Smoking Lung Cancer Cases and Non-Smoking Lung Cancer Cases

Allan Feingold, MD, FRCP(C), FCCP, Medical Director, Occupational & Environmental Medicine, South Miami Hospital, Miami

10:00 a.m. – 10:30 a.m.

“Cigarette Warnings” in the United States – You’ve Got To Be Kidding!

• Consumers Prior to Having Warning Labels
• The Federal Government and the Tobacco Industry
• The Use of New Graphic Warnings
Louis P. Herns, Pierce, Herns, Sloan & Wilson, LLC, Charleston, SC

10:30 a.m. – 10:45 a.m.

Refreshment Break

10:45 a.m. – 11:30 a.m.

Lung Cancer – Asbestos and Smoking Synergy

Thomas A. Sporn, M.D., Associate Professor of Pathology, Pathology/Pathology Clinical Services, Duke University School of Medicine, Durham, NC

11:30 a.m. – 12:30 p.m.

A Comparison of State Case Filing Criteria

• Current Filings and Trends: Focus on CA, FL, IL, NY, OH, PA and SC
• What Are the Similarities and Differences?
• Review of the Statutes, Case Law and CMOs Governing the Filing of Lung Cancer Cases
• Review and Implementation and Enforcement of Procedural Criteria that Must be Met Before Cases are Put on Trial Calendars

E. Elaine Shofner, Hawkins Parnell Thackston & Young, LLP, Atlanta
S. Christopher Collier, Hawkins Parnell Thackston & Young, LLP, Atlanta
Sara M. Salger, Gori Julian & Associates, P.C., Edwardsville, IL
Randy L. Gori, Gori Julian & Associates, P.C., Edwardsville, IL

12:30 p.m. – 1:30 p.m.

Lunch

1:30 p.m. – 2:15 p.m.

Alternative Causes of Lung Cancer

• Looking for Other Causes of Lung Cancer for Non-Smokers
• Second- and Third-Hand Smoke Exposures
• Other Potential Exposures – Radon, Chemical, Radiation, etc.
Michael J. Block, Wilbraham, Lawler & Buba, Philadelphia
V. Brian Bevon, Motley Rice, Mt. Pleasant, SC

2:15 p.m. – 2:30 p.m.

Refreshment Break

2:30 p.m. – 3:30 p.m.

Causation in Relation to Asbestos Exposure vs. Cigarette Smoking

• Duration and Concentration of Exposure
Patrick N. Haines, Napoli Bern Ripka Shkolnik, LLP, Austin, TX
Eric D. Cook, Willcox & Savage, P.C., Norfolk, VA

3:30 p.m. – 4:15 p.m.

Lung Cancer: Preparing for and Cross-Examining Experts

• What to Look for in Medical Records
• Individual Risk Factors
• Recent Developments
Susan J. Cole, Bice Cole Law Firm, P.L., Coral Gables, FL
David A. Jagolinzer, The Ferraro Law Firm, Miami
Richard D. Schuster, Vorys, Sater, Seymour and Pease LLP, Columbus, OH

4:15 p.m. – 5:00 p.m.

Maritime Law and Lung Cancer Cases

Robert P. Scott, Blank Rome LLP, Houston*
John E. Herrick, Motley Rice, Mt. Pleasant, SC

5:00 p.m. – 6:00 p.m.

Networking Cocktail Reception

 

The role of smoking in cancers is an increasingly litigated issue for cancers that are not lung cancer. For example, a current trial in a Takeda- Actos bladder cancer case is reported by LAW360 to include a defense expert assigning causation to “tobacco abuse,” diabetes and excess weight. According to the article:

“Mark Schoenberg, a urologic oncologist at the Albert Einstein College of Medicine at Yeshiva University, testified that his review of medical records and scientific literature had led him to conclude that there was no significant link between Actos and instances of bladder cancer, and that plaintiff Frances Wisniewski had a number of other factors putting her at greater risk.

“In reviewing Mrs. Wisniewski’s record, what I came to learn was that she has a number of risk factors which would completely explain the experience she’s had clinically,” Schoenberg said. “She’s a smoker with a long history of tobacco abuse, she’s older, and she has the additional features of excess weight and a history of diabetes. There a number of factors that exist independently of any presence of Actos that completely explain her situation.”

The key question, of course, is: what will the jury conclude?