Mesothelioma in Curacao versus the Netherlands; incidence and advices for liability for compensation

Abstract

Introduction: The Caribbean island Curacao has a large oil refinery since decades. Exposure throughout years has caused asbestos related mesothelioma. However, the magnitude is unclear. The ‘Instituut Asbestslachtoffers (IAS)’ advices on liability for compensation for the Netherlands and Caribbean countries within the monastery. We studied incidences in Curacao and, based on equal accessibility, the proportion of cases presented to IAS, as compared to the Netherlands.

Methods: Open, retrospective descriptive study over 20 years (2000-2020). Patients were selected from a central pathology (PA) lab and were included if PA diagnosis was certain or if PA diagnosis was highly suspected in line with clinical-radiological course. Patients were excluded if PA diagnosis was unlikely or if no attempt to PA was performed. For the last 4 years the hospital electronic patient files (EPD) were screened for cases presentated to IAS. Family members were interviewed for their experiences

Results: 45 patients were found over 20 years; i.e. incidence 1.4/100.000 vs. 2.9/100.000 per year in the Netherlands. Eight patients were diagnosed in the last 4 years and were screened by EPD. Three of them had been presented to IAS, whereas in the Netherlands the vast majority is generally presented. Two families were satisfied by the process, whereas the process has failed in one patient.

Conclusion: Despite the presence of the refinery, mesothelioma incidence in Curacao is significantly lower than in the Netherlands. The number of cases presented for liability for compensation was also lower. Although mesothelioma is a rare disease in Curacao, effort should be made to improve awareness and the route to IAS.