Consultation questions - Bronchogenic Carcinoma in Asbestos-Exposed Workers

CONSULTATION QUESTIONS

Bronchogenic Carcinoma in Asbestos-Exposed Workers

WorkSafeBC is seeking input from stakeholders on EACH of the following FOUR key issues:

1.	ASBESTOSIS In the systematic review report, Dr. Finkelstein concludes that the asbestosis requirement in Schedule B is current and supportable based on the most current medical science.

Please rate the following and provide an explanation below:

	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree
1(a) Status Quo - Maintain Asbestosis Requirement in Schedule B

	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree
1(b) Delete Asbestosis Requirement in Schedule B

Please explain your response (required):

BILATERAL DIFFUSE PLEURAL THICKENING OR FIBROSIS REQUIREMENT

In the systematic review report, Dr. Finkelstein concludes that the presence of bilateral diffuse pleural thickening or fibrosis would not be an indicator of how much asbestos a worker was exposed to; rather, it would be an indicator of some amount of asbestos exposure.

Dr. Finkelstein refers to a study led by Dr. Mark Cullen where it was found that the risk of lung cancer was significantly higher among workers with the presence of bilateral diffuse pleural thickening greater than 2 mm thick.

Please rate the following and provide an explanation below:

	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree
2(a) Status Quo - Maintain Bilateral Diffuse Pleural Thickening or Fibrosis Requirement

	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree
2(b) Delete Bilateral Diffuse Pleural Thickening or Fibrosis Requirement

	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree
2(c) Modify Bilateral Diffuse Pleural Thickening or Fibrosis Requirement by Replacing 5mm with 2mm

Please explain your response (required):

CUMULATIVE EXPOSURE REQUIREMENT

In the systematic review report, Dr. Finkelstein concludes that there is an association between primary site lung cancer and significant exposure to asbestos for workers without radiographic asbestosis. These workers are likely to have been exposed to asbestos in industries or occupations where asbestos-associated lung cancer risks are known to be elevated.

Dr. Finkelstein recommends that WorkSafeBC adopt the cumulative exposure approach. Based on the study led by Dr. Mark Cullen, two options for exposure periods are 10 years and 20 years of cumulative exposure.

Please rate the following and provide an explanation below:

	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree
3(a) Status Quo - Do Not Add Cumulative Exposure Requirement

	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree
3(b) Add Cumulative Exposure Requirement of 10 Years

	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree
3(c) Add Cumulative Exposure Requirement of 20 Years

Please explain your response (required):

ADD CERTAIN PROCESSES/INDUSTRIES TO THE CUMULATIVE EXPOSURE REQUIREMENT

In the systematic review report, Dr. Finkelstein recommends the creation of a list of industries with elevated asbestos-associated lung cancer risks. Two jurisdictions with lists of industries have been examined. Saskatchewan has a list of specific industries and the UK has a list of broad industries.

Please rate the following and provide an explanation below:

	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree
4(a) Status Quo - Do Not Add Certain Processes/Industries to the Cumulative Exposure Requirement

	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree
4(b) Add Specific Processes/Industries to the Cumulative Exposure Requirement

	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree
4(c) Add Broad Processes/Industries to the Cumulative Exposure Requirement

Please explain your response (required):

5.	General Comments: Please provide us with your comments on any or all of the key issues addressed in this policy review.

Please enter your contact information. This information will allow WorkSafeBC staff to contact you should follow-up be required. Otherwise your identity will remain confidential.

Please note that anonymous submissions will not be considered. All comments become part of the Policy and Research Division's database and may be published, including the identity of organizations and those participating on behalf of organizations. The identity of those who have participated on their own behalf will be kept confidential according to the provisions of the Freedom of Information and Protection of Privacy Act.

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