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The 2004 GIRO Conference UK Asbestos Working Party. 12-15 October 2004, Hotel Europe, Killarney . UK Asbestos Working Party. What’s the plan ? What have we done? Main observations Some information about asbestos A bit about the HSE mesothelioma model A bit about our model

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The 2004 GIRO Conference UK Asbestos Working Party

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the 2004 giro conference uk asbestos working party

The 2004 GIRO ConferenceUK Asbestos Working Party

12-15 October 2004, Hotel Europe, Killarney

uk asbestos working party
UK Asbestos Working Party

What’s the plan ?

  • What have we done? Main observations
  • Some information about asbestos
  • A bit about the HSE mesothelioma model
  • A bit about our model
  • Recent experience / current developments
  • Brief US update
  • Workshop / copies of our model(s)
  • Andrew Darnton / Senior Statistician HSE
what have we done
What have we done ?
  • Lots !!
  • Definitive reference source on UK asbestos
  • Collected industry-wide UK asbestos data
  • Surveyed practitioners about methodology
  • Replicated HSE model
  • Extend HSE-type model to other diseases/costs
  • Projected UK industry-wide costs
  • Practical spreadsheet model & benchmarks
headline observations from the paper
Headline observations from the paper
  • Future cost to UK insurance industry is £4-10b
  • Over half of this relates to mesothelioma
  • Mesothelioma projections very uncertain
  • Future numbers very dependent on the over 80’s
  • Asbestosis numbers peaking ?
  • Pleural plaques mushrooming
  • Poor data capture and limited disclosure
  • Continued worldwide use
some information about asbestos
Some information about asbestos
  • Types of asbestos
  • Use of asbestos
  • Types of disease
types of asbestos
Types of asbestos
  • Chrysotile: “White asbestos” (Serpentine minerals)
  • Amosite: “Brown asbestos” (Amphibole)
  • Crocidolite: “Blue asbestos” (Amphibole)
uses of asbestos
Uses of asbestos
  • Insulation (pipes and boilers)
  • Fire-proofing (fire doors)
  • Asbestos cement (roof and wall cladding)
  • Friction materials (brake linings)
  • Textiles (clothes, fire blankets)
  • Other !! (socks, phone boxes, gas masks, cigarette filters, gaskets on space shuttle, broomstick in Wizard of Oz)
types of disease
Types of disease
  • (Pleural plaques)
  • Pleural Thickening
  • Asbestosis
  • Lung Cancer
  • Mesothelioma
types of disease1
Types of disease
  • Cue Video Clip 2
a bit about our model
A bit about our model
  • Mesothelioma based on HSE model
  • Asbestosis based on exposure / latency model
  • Lung cancer based on HSE model / judgement
  • Pleural plaques based on hand-waving
  • Average costs based on survey data / judgement
  • Average cost inflation based on survey data / judgement and age-adjusted allowance
  • Overall “level” based on survey data (£1.3b paid)
current developments
Current developments
  • CAWR regulations: May 2004
  • T&N / RSA court case(s)
  • T&N pension scheme / Federal-Mogul
  • Pleural Plaques test case: 8/11/04
  • Continued worldwide consumption
brief us update
Brief US update
  • Recent US claims experience
  • Increases in insured costs
  • Update on the “FAIR” Act
  • Recent legislation / developments
recent us claims experience
Recent US claims experience
  • Number of claims continues to grow
  • Average size of awards has increased
  • Number of defendants grown lots (~ 8,400)
  • Number of companies filing for bankruptcy has also grown (now in excess of 70)
recent us claims experience2
Recent US claims experience
  • 730,000+ claimants filed to date
  • Estimate ultimate number 1-3m
  • Manville Trust 100,000+ claims filed in 2003
  • Most of increase from unimpaired lives
  • Increase in ultimate or just an acceleration?
  • Claim filings in 2004 show sharp decline
increases in insured costs
Increases in insured costs
  • Coverage block expansion
  • Reclassification of products claims as non-products claims
  • US carriers increased Gross reserves by $12b+ since the start of 2003 (Net $8b+)
  • Follows significant increases in 2001 and 2002
  • Equitas increased its reserves by £0.3b for the year ending 31 March 2004
update on the fair act
Update on the “FAIR” Act
  • No-fault “trust fund”
  • Remove claims from tort system
  • Privately funded, companies and insurers (US and non-US)
  • Defined set of medical criteria and award levels
  • Considerable disagreement over fund size and who contributes what
  • Concerns if the fund runs out of money - sunset clause means claims revert to tort system
update on the fair act1
Update on the “FAIR” Act
  • Not all key stakeholders supported: Labor, Unions, Democrats, Plaintiff Attorneys
  • Insurance community divided
  • Cloture vote failed 22 April 2004
  • Negotiations have continued but significant compromises are still needed
  • Size of fund converging around $140b
  • Disagreement over pending claims, funding levels and return to tort system
  • So continue to watch this space ….
recent legislation developments
Recent Legislation / Developments
  • May 2004: Ohio first state to establish medical criteria (subject to a referendum in November)
  • June 2004: Mississippi tort reform: limits on where can sue, cap damages, protects some
workshop copies of our model s
Workshop / copies of our model(s)

What’s the plan ?

  • Discussion of the HSE model
  • Our model and industry estimates
  • Recent experience and our survey
  • Court cases - and potential impacts
  • Questions/discussion on the paper
  • Model(s) from or e-mail
the expected burden of mesothelioma in great britain from 2002 to 2050

The expected burden of mesothelioma in Great Britain from 2002 to 2050


JT Hodgson, HSE

DM McElvenny, HSE

AJ Darnton, HSE

MJ Price, HSE


previous predictions of mesothelioma deaths in gb
Previous predictions of mesothelioma deaths in GB
  • Published in 1995 (Peto et al) and 1997 (Hodgson et al)
  • Based on simple birth cohort model
  • Suggest peak of 2700 to 3300 deaths around 2020
  • Data conformed to this model well up to 1991, but departed from it thereafter (visual inspection, confirmed by modelling – see later)
modelling approach 1
Modelling approach (1)
  • Adopts HEI/Peto model: an individual’s additional meso risk caused by single year’s exposure is proportional to exposure in that year multiplied by the 2nd or 3rd power of time since the exposure lagged by 10 years
  • Assumes effect of successive years are additive
  • Assumes individual exposure can be adequately approximated by the product of 2 factors, one defined by year (DT), the other by age (WA)
modelling approach 2
Modelling approach (2)
  • Choose factor values, DT and WA (and k) to achieve best fit to observed mortality for males 1968-2001 aged 20-89
  • The implied exposure (given by the factor DT) reduced rapidly after a peak in the mid-1960s, but estimates become increasingly uncertain, and effectively undetermined (under this model) from the early 1980s onwards
  • Assumed from indirect evidence that exposure from 2000 was 4% of peak and by 2050 will be 0.75% of peak (RIA for recent regs)
poisson regression modelling
Poisson regression modelling
  • Two alternative models pursued
    • No clearance model (half-life assumed 1000 years)
    • Clearance model (half-life of 15 years – from Berry’s modelling of Wittenoom workforce)
  • Model adequacy examined via deviance residuals and by comparing observed versus fitted deaths
age cohort model
Age-cohort model
  • Fit significantly worse than models with more parameters
  • However, two possible alternatives with similar fits, but different future implications
  • Which is closest to the truth?
differences between models
Differences between models
  • One key difference (apart from clearance/non-clearance distinction) is that they imply different time paths for population exposure to asbestos. Profiles similar up to 1950.
  • One way of assessing which is best is to compare their implied exposure patterns with the actual patterns of asbestos imports, taking account of differences between fibre type.
Fitted import index for non-clearance and clearance models with best approximate weighting of actual imports
model preference
Model Preference
  • Better correspondence between implied exposure pattern and imports data for no-clearance model?
  • Data for the year 2001 is a more significant outlier in the clearance model than the no-clearance model.
  • Slight (but not definitive) preference for non-clearance model!
results from non clearance model
Results from non-clearance model
  • Peak of around 2150 (approx 95% CI: 1950 to 2450) deaths per year some time around 2013 (approx 95% CI: 2011 to 2015).
  • Total estimated mesothelioma deaths to 2050 – around 90,000, with 65,000 occurring from 2002 onwards.
further work
Further work
  • 2002 data now available (no. deaths approx. equal to 2001)
  • Sensitivity of predicted future burden to choice of similarly plausible models needs further exploration
the 2004 giro conference

The 2004 GIRO Conference

12-15 October 2004, Hotel Europe, Killarney

types of disease2
Types of disease
  • Cue Video Clip 3