title: [The effectiveness of compensation system for mesotheliomas due to occupational exposure to asbestos and determinants for requests and awards: an evaluation based on record-linkage between the Veneto Mesothelioma Register and the claims and compensations recorded by the National Insurance Institute (INAIL)].
abstract: OBJECTIVE
  To determine the rate of requests for compensation and of compensations awarded for mesothelioma cases due to occupational exposure to asbestos; to identify factors that may influence the outcome; to provide an appreciation of the amount of compensation.
  
  
  METHODS
  Record-linkage study at individual level between the new cases of mesothelioma occurred among the residents of the Veneto Region (Northern Italy) between 1999- 2007 and the file of the Insurance Institute, with individual data on all claims and compensations. Adjusted logistic regression models were used to estimated the association between submitting claims and obtaining an award and socio-demographic and other characteristics.
  
  
  RESULTS
  349 on 499 mesotheliomas considered to be due to occupational exposure to asbestos submitted a claim (70% of those of occupational origin) and 72%of claims were accepted. The welfare system covers only 35%of mesothelioma occurred. The probability of submitting and obtaining a claim was associated with gender, cancer site, age at diagnosis, vital status, and residence or local office in charge of the evaluation. A strong discrimination against women is observed. If exposure to asbestos at work was due to a direct manipulation of asbestos, claims were more easily accepted.As a consequence,mesothelioma occurred among construction workers, the occupational activity at the origin of the largest number of occurring mesotheliomas, are more frequently rejected.When submitted by a relative, the lag between a request for compensation and the decision is on average of about two years.
  
  
  CONCLUSIONS
  This is the first study in Italy using a record-linkage method and was made possible thanks to a population based mesothelioma Register and the availability of memorized information of the Insurance Institute.The welfare system shown clear limitations and there is the need for more appropriate strategies.
authors.affiliation: Registro regionale veneto dei casi di mesotelioma, Servizio prevenzione igiene sicurezza ambienti lavoro, Azienda unità locale socio-sanitaria locale 16, Padova. enzo.merler@sanita.padova.it
authors.forename: Enzo
authors.initials: E
authors.lastname: Merler
authors.forename: Vittoria
authors.initials: V
authors.lastname: Bressan
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Bilato
authors.forename: Alessandro
authors.initials: A
authors.lastname: Marinaccio
mesh_terms: D000047:Academies and Institutes / Q000706:statistics & numerical data; D000368:Aged; D001194:Asbestos / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007342:Insurance Benefits / Q000706:statistics & numerical data*; D007344:Insurance Claim Reporting / Q000706:statistics & numerical data; D007345:Insurance Claim Review; D007558:Italy / Q000453:epidemiology; D008297:Male; D008498:Medical Record Linkage; D008654:Mesothelioma / Q000191:economics* / Q000453:epidemiology / Q000209:etiology; D008875:Middle Aged; D016273:Occupational Exposure; D009790:Occupations; D010997:Pleural Neoplasms / Q000191:economics* / Q000453:epidemiology / Q000209:etiology; D011287:Prejudice; D015397:Program Evaluation; D012042:Registries / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D014942:Workers' Compensation / Q000191:economics / Q000592:standards / Q000706:statistics & numerical data*
chemical_list: D001194:Asbestos