Program > Saturday > 14:00 > Session symposium. Symposium: Asbestos

Paper: Evaluation of a physician letter to increase awareness of workers’ compensation benefits for individuals with mesothelioma
Author(s) and Affiliation(s):
Chris McLeod, Center for Health Services and Policy Research, University of British Columbia; College for Interdisciplinary Studies, University of British Columbia
Mieke Koehoorn (presenting author), School of Population and Public Health, University of British Columbia; Center for Health Services and Policy Research, University of British Columbia
Lillian Tamburic, Center for Health Services and Policy Research, University of British Columbia
Paul Demers, School of Environmental Health, University of British Columbia; School of Population and Public Health, University of British Columbia
Session : symposium. Symposium: Asbestos
Day/Time: Saturday at 14:00
Room: Armoury Suite, 2nd Floor
Objectives:

Prior research by the investigators found that less than 50% of individuals with mesothelioma in British Columbia have a workers’ compensation claim. Several factors may influence compensation status including awareness of mesothelioma as a work-related compensable disease and eligibility for benefits. In collaboration with the BC Cancer Agency and WorkSafeBC, an educational letter is now sent to the most responsible physician of mesothelioma patients in the BC Cancer Registry. This project evaluated the effect of the letter on compensation status.

Methods:

Mesothelioma cases in the provincial cancer registry were linked with accepted mesothelioma claims in the provincial workers’ compensation database at the individual-level. The proportion of compensation cases in the pre-intervention letter period (Jan 2002 to Oct 2004) was compared to the proportion in the post intervention letter period (Nov 2004 to Dec 2006), by demographic, clinical and geographic characteristics. Incidence rate ratios investigated the effect of the letter on compensation status, adjusted for covariates.

Results:

A total of 342 mesothelioma cases were diagnosed in BC between 2002 and 2006. During the intervention period, 94 of 160 cases received a physician letter. Those with a longer survival time were more likely to receive the letter. The overall proportion of compensation was 43 claims per 100 cases during the pre-intervention period compared to 59 claims per 100 cases during the post intervention period among those who received the letter (adjusted IRR=1.14, 95% CI 0.72, 1.80). Compensation status increased among females, and for younger (45-54 years) and older workers (65+).

Conclusions:

The letter intervention was effective in increasing mesothelioma compensation and among groups with historically low compensation status (e.g. females). However, the effect was not as high as expected because the intervention was not fully implemented - the physician letter was not mailed to all cases, the letter was batch-mailed rather than mailed immediately following registration, and letters were only sent to histological confirmed cases. The intervention has been modified to address the preceding issues to reach as many cases as early as possible. Also, the BC Cancer Agency is investigating mailing letters directly to individuals with mesothelioma and their families.