MARCH 2009
Exposure to Particulate Air Pollution from Diesel Exhaust at Work may Cause Heart Disease
A scholarly medical article from the Journal of Occupational and Environmental Medicine has reported that there is a growing number of studies showing that exposure to particulate matter (fine particles in the air) is a risk factor for cardiovascular disease. The understanding of the underlying mechanisms remains limited, but it has been proposed that inhalation of small particles induces an inflammatory reaction in the airways and subsequent induction of systemic inflammation and coagulation disturbances.
The article also reports increasing evidence of an association between ambient particulate air pollution and disturbances of the cardiac autonomic nervous system. Several groups have reported changes in heart rate variability associated with ambient particulate air pollution.
To establish the effect of occupational exposure to particulate air pollution and the risk for cardiovascular disease there is a need for a large study which, in addition to exposure information, would also include information about relevant confounders. In the following we report the results of a prospective cohort study of 179 309 Swedish made construction workers exposed to inorganic dust, wood dust, fumes and gases and 71 778 unexposed Swedish construction workers. The specific aim of the study was to elucidate whether occupational exposure to dust, fumes and gases increases the risk for death from cardiovascular disease - that is, ischaemic heart disease and cerebrovascular disease.
Diesel exhaust consists of two parts; first is the particulate after that are fine bits of carbon and the second consists of complex chemicals that are attached to the particulate matter. These chemicals contain various known carcinogens. The article concluded that occupational exposure to particulate air pollution, especially from diesel exhaust and among construction workers increases the risk of heart disease. If you have suffered from heart disease after long term exposure to diesel exhaust and want to know more about your potential rights, contact Gavin Law Firm.
Excerpts taken from Occup Environ Med 2007; 64:515-519
Illinois Tort Reform?: Let's Meet a Malpractice Victim
The following letter to the editor by ITLA President Philip H. Corboy, Jr. appeared in the Wall Street Journal on Monday, December 8, 2008.
In your Dec. 1 editorial "Messing With Malpractice Reform," you urge the Illinois Supreme Court to "side with patients and the rule of law" in considering a case that could overturn the state's cap on damage awards. Yet the editorial never mentions the patient who is at the center of that case.
She is a three-year-old little girl named Abigaile LeBron, whose life has been forever changed by the sever brain damage she suffered as a result of medical negligence. It is likely that Abigaile will have to be fed through a tube for the rest of her life. She will never develop cognitively or physically as her peers do. And she will likely never live independently. It is inarguably a very painful tragedy for Abigaile and all who know and love her.
the insurance industry and its brethren in the tort reform world have argued that Abigaile's compensation for lifelong disability, pain and suffering should be arbitrarily limited, despite what a jury of the average citizens may decide. The question before the Illinois Supreme court is whether the Illinois Constitution allows Abigaile's rights to be limited in this fashion to the benefit of insurance company profits. Twice before, our state’s highest court has decided in favor of patients and against the insurance companies that would limit these rights to protect their own profits. No new arguments have been offered by the insurance industry.
You argue that a reduction in malpractice premiums and the return of doctors to the state have resulted from the law containing caps. Nothing could be further from the truth. Not one case has been litigated under the new cap in Illinois. The simple fact is that those positive developments have resulted from strong, long-suppressed insurance reforms in the legislation. That law has now forced malpractice insurance companies to provide greater transparency on rate-setting and pay outs that has in turn spurred competition, motivated more companies to enter the marketplace, and lowered premiums for doctors. Important to the discussion for your readers is the additional fact that Illinois’ largest malpractice insurer has reported that payouts have remained flat for the past 13 years. By the way, it’s the same insurance carrier that admitted during the run-up to this legislation in 2005 that capping awards would not guarantee lower premiums for its doctors.
The Illinois Constitution was put in place to ensure individual rights and freedoms. While corporations and profit-hungry executives often stack the decks against individuals in the marketplace and the halls of government, the courtroom can still provide all parties with a level playing field. The Illinois Supreme Court will now decide whether that standard remains in place for patients like Abigaile LeBron. You should let it do its job.
Philip Harnett Corboy, Jr.
President Illinois Trial Lawyers Association
New Evidence shows that Long Term Use of Cellular Phones cause Increased risk of Brain Tumors
Since the middle 1980s, the use of cellular telephones and other wireless telephones has increased dramatically. Cellular telephones and wireless telephones are widely and frequently used by Americans and cellular telephones may someday completely replace traditional "land line telephones" in the average American home. The increasing use of cellular telephones and other wireless technology has caused physicians, scientists, and researchers to be concerned about whether there is an increased risk of brain tumors caused by radiation from the cellular telephone antenna. The manner in which cellular and wireless telephones are and have been constructed and used result in the brain absorbing a relatively large amount of electromagnetic energy.
An increased risk for brain tumors could be an indication of other potential health effects, but it would also imply that the current guidelines for microwave exposure during phone calls are inappropriate. Initial studies on brain tumor risk had insufficiently long latency periods to give a meaningful interpretation of long-term risk.
In recent years, studies have been published that enable an evaluation of the risks associated with the use of cellular and wireless telephones for more than ten years. A 10-year latency period for development of tumors seems to be a reasonable minimum period to indicate long-term carcinogenic risks from exposure to radio frequency (RF) fields during use of cellular or cordless phones.
In a recent scholarly medical article published in the Journal of Occupational and Environmental Medicine the authors presented the results of studies published to date on the topic of increased brain tumors in long term cellular and wireless telephone users. The article presented the results of the review of published studies and predicts an increasing incidence of brain tumors because of the wide use of cellular telephones among almost all age groups in the population.
The Nordic countries were among the first to introduce new cellular telephone technology.
The analog system has been used from the early 1980s using 450 or 900 MHz RF fields. The digital system has been increasingly used since the beginning of the 1990s and currently dominates the market. This system uses dual-band, 900 and 1800 MHz frequencies for communication. Over recent years the third generation of mobile phones, 3G or universal mobile telecommunication system (UMTS), using 1900 MHz RF fields has been introduced worldwide.
Desktop cordless phones (digital enhanced cordless telecommunications; DECT) also use wireless technology. Initially, in the late 1980s, analogue 800-900 MHz was used but since the early 1990s, the digital 1900 MHz system has been used. The research group also assessed the use of DECT telephones in all of its tumor investigations, but other published articles have not.
The authors of the article concluded that results from the published studies show that there is a consistent pattern of an increased risk of brain tumors among those who have used mobile telephones for more than 10 years. The risk is greatest for tumors developing on the same side of the brain that receives that exposure from the telephones.
Excerpts taken from Occup Environ Med 2007;64:626-632
Seat Belts and Shoulder Harnesses in the Accident Patient
By: Dr. Kathleen Roche
Injury/Fatality Prevention NHTSA has reported that shoulder and lap belts reduce the risk of fatal injury by 45% and the risk of moderate to critical injury by 50%. The risk of fatality in a crash is approximately five times higher for an unbelted occupant. But, while seat belt and shoulder harness use has decreased the number of fatalities and serious facial and chest trauma, it has significantly increased the number or minor and sometimes disabling cervical, thoracic, and lumbar injuries, as well as numerous types of abdominal injuries. In frontal crashes, occupant neck and head loading has been found to be affected to the greatest degree by the restraining effect of the shoulder harness and seat belt.
Children Children are particularly prone to seat belt injury because neither the car seat nor the seat belt/shoulder harness was designed to fit them optimally. Numerous pediatric injuries have been reported and often the most serious are spinal injuries, with the most common lumbar injuries occurring at the L2-L4 segments during deceleration (frontal collisions). Perhaps owing the more elastic and pliable pediatric cervical spine, with its more horizontally oriented facet joints and underdeveloped uncovertebral joints, spinal cord injuries may present without radiographic evidence of trauma, i.e. the SCIWORLA syndrome (spinal cord injury without radiographic abnormality) hours or days after initial trauma. Some of these cases, although initially asymptomatic, end in paraplegia or quadriplegia. As a precaution, pediatric patients demonstrating the seat belt sign (visible bruising from the diagonal or horizontal belt webbing) or complaining of extremity pain should be evaluated carefully. This would include peritoneal lavage or MRI. In recent reports, blunt intestinal trauma was found in 5-10% of pediatric MVC trauma; and in 64% of pediatric cases in which the seat belt sign is present.
Pregnancy A 1993 study by Wolf et al. provided reassurance to pregnant women that the use of seat belts does not place them or their fetus at significantly greater risk in the event of a crash. However, it is advisable to recommend fetal monitoring and ultrasound for all third trimester pregnant crash victims. This confidence is echoed in a more recent study which also mentioned that proper restraint use, with and without airbag deployment, generally leads to acceptable fetal outcomes in lower severity crashes, while it does not affect fetal outcome in high severity crashes.
Use It is difficult to estimate the precise contribution of seat belts and shoulder harnesses to neck and head injury due to the tendency towards over reporting as a result of medicolegal claims. For example, most non-crash use studies show current use to be about 65% in the U.S., while data at SRISD shows an observed use of 74% in San Diego county and reported use of 96% in those injured in motor vehicle crashes. Others have reported similar figures of 97.3% use and 95% use in reported crashes. Lange and Voas have reported a sharp increase in the use of safety belts following California” enactment of primary use laws, with 55% of persons reporting increased use of belts. In a secondary use law, drivers can only be cited for not wearing seat belts if pulled over for another violation. In a primary law, one can be pulled over and cited merely for not wearing safety belts.
Advertising and Organized Jury Tampering
You may have seen the U. S. Chamber of Commerce advertisements that state: “What is lawsuit abuse costing your family?” The advertisements refer to and rely on a study by Tillinghast Towers Parrin and claim that “lawsuit abuse” is costing the average American family over $3,000 per year. The advertising has two obvious purposes: 1) to convince potential jurors that the United States is overly litigious; and 2) to convince potential jurors that this Tillinghast report has determined that “abuse” of lawsuits costs each American family over $3,200 per year.
Unless the U.S. Chamber of Commerce is not just blatantly lying to the public in its advertisements, the Tillinghast report must have really found that lawsuit “abuse” is costing the public. A few facts about the Tillinghast report follow.
The authors of the Tillinghast report have admitted that the costs tabulated in the study are not reflective of litigated claims or of the legal system. Rather, the costs assessed in the Tillinghast report consist of the following: 22 percent of the Tillinghast “tort costs” are what the insurance industry calls “administrative expenses.” These include salaries of executives such as the $29-million-a-year salary received by AIG’s CEO, Hank Greenberg, rent, utilities for insurance company headquarters, commissions paid to agents, advertising and other sales costs. One logical question might be, “How did our legal system make AIG pay Hank Greenberg $29 million and how is our legal system responsible for State Farm’s promise of neighborly service or Allstate’s promise of holding you in good hands or Geico’s insistence that its gecko can come to your aid in times of need?” These advertising costs arise solely from the business decision to try and get more business to make more money. These costs are not caused by America’s legal system.
A further breakdown of the Tillinghast “litigation costs” show that a very large percentage of the “costs” have no relation to litigated claims at all. Rather, they are payments by insurance companies pursuant to contract. Included within the Tillinghast report are claims involving property damage to automobiles. Claims that are handled without lawsuits, without lawyers, payments that are simply a carrier paying benefits pursuant to its insurance contract. Since when did honoring a contract without litigation become lawsuit abuse?
Furthermore, Tillinghast claims that it should include all liability insurance costs in its assessment because without tort exposure, these costs would not be necessary. Professor Theodore Isenberg of Cornell University Law School points out the falsity of this assertion by pointing out that 61 percent of all compensation paid for tort claims involves automobile accidents. Insurance for auto-related injuries is not optional; it is required by each state. It is, of course, required because each state feels that negligent drivers should have responsibility for accidents that they cause and injuries that their negligence causes. A state’s requirement of liability is not “lawsuit abuse.”
What the Tillinghast study does show is that, even using its figures, well over half of the counted “costs” are not costs from “abuse” but rather represent payment for medical expenses, wage loss and other tangible losses caused by the wrongful conduct that led to injury or death. How payment by a wrongdoer responsible for causing damage can be described as abuse is not clear. Furthermore, there is no showing that these costs are passed on to the consumer in that some costs are borne by the business to remain competitive with its “safer” competition.
The Tillinghast report does nothing to calculate expenses caused by the insurance industry itself. What one may call “Insurance Abuse.” It has not looked at the cost incurred when an insurance company denies a valid claim and forces their victim to hire a lawyer and file suit. It does consider the expense of frivolous defenses often asserted by insurers in the lawsuits that follow denials of valid claims.
The report made no attempt whatsoever to calculate the benefits to society from our compensation system, including safer products, the receipt of good medical care by innocent victims or the ability of an innocent victim who can no longer work to educate his children. The report does begrudgingly concede that awards for pain and suffering are “beneficial to society as a whole.”
While it is certainly a valid observation that an attorney who represents those injured by the wrongful conduct of others may attack the report upon which the U.S. Chamber of Commerce rests its advertising, conservative media sources have likewise criticized the study. Business Week has called the Tillinghast report “wildly exaggerated.” The Wall Street Journal has challenged the report and asked “How is that evidence of a system run amuck?” The Congressional Quarterly has questioned the report as not reflecting tort cases and The Washington Monthly, likewise, has found that the report is more of an assessment of the insurance industry than of the legal system.
It is true that, as a civilized nation, the United States has a system of compensation for those that are injured and the families of those that are killed by the neglect and wrongdoing of others. This system is based on the principle that those whose neglect cause death, injury and suffering should be responsible for the damages caused. Every civilized nation in the world adheres to this principle. Are we litigious? Not according to court filings which that show injury lawsuits declining. Not according to research showing that litigation per capita is less now than it was in 1960. Not when our society is compared with others. The United States, in fact, is considerably less litigious than Germany, Sweden, Israel, and Australia and is on par with Denmark and England.
Do not be deceived, the use of the Tillinghast report by those who claim lawsuit abuse is simply dishonest and a threat to an injured party’s right to a fair trial by the long term influence of those citizens who come to serve as jurors.
Written by Steve Garner, The Strong Law Firm, Springfield, Missouri
Federal Regulations Limits Lawsuits
"Faced with an unfriendly Congress, the Bush administration found another, quieter way to make it more difficult to consumers to sue businesses over faulty products. It re-wrote the bureaucratic rulebook. Lawsuit limits were included in 51 rules proposed or adopted since 2005 by agency bureaucrats governing just about everything Americans use: drugs, cars, railroads, medical devices, and food. The agencies' use of the government's rule-making authority represents the administrations final act in a longstanding drive to shield companies from lawsuits. Underlying this bureaucratic version of lawsuit reform is the concept of federal preemption-the legal idea that is hard to build widespread panic.
AP – May 14, 2008
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