The Facts
Pleural plaques are described as discrete localised areas of fbrosis which can be
found in the lining of the inner chest wall and are caused by exposure to asbestos.
Often referred to as ‘lung scarring’ and ‘thickening of the linings of the lung’ they
represent the most common of all asbestos-related conditions for which no treatment
is required. Plaques are benign and do not develop into anything cancerous but their
existence represents a future risk of lung cancer and mesothelioma because they are a marker of exposure to asbestos.
Generally associated to workplace settings where asbestos materials were produced,
used or handled plaques evolve slowly over time and tend to be detected many years
later after they have increased in size. Plaques can arise from low as well as high levels
of exposure and are diagnosed by means of a chest x-ray or CT scan and often
incidentally found during investigations into other health issues. Over time, the plaques
might become calcifed taking on a chalky appearance which makes them more
obvious than non-calcifed plaques.
Whilst recognised as a potential source of distress and anxiety pleural plaques rarely
cause any signifcant impairment of lung function or other symptoms and are not
therefore recognised by the Industrial Injuries Advisory Council as a prescribed
condition for the purposes of Industrial Injuries Disablement Beneft (IIDB).
Other asbestos-related diseases include pleural thickening, asbestosis, pleural effusion,
lung cancer and mesothelioma which are similarly caused by inhalation of asbestos
fbres. Compensation for these conditions remains unchanged as too is the position in
terms of IIDB whereby an award is made to a claimant in line with the severity of their
disability.
Compensation for pleural plaques had been a long standing right for the many
thousands of former workers’ which was challenged by the insurance industry through
a series of court cases which culminated in October 2007 by a landmark decision of
the Appellate Committee of the House of Lords (now the Supreme Court) in the case of
Johnstone v NEI International Combustion Ltd and conjoined cases who ruled to
remove compensation for pleural plaques. The basis of their decision was due to the
fact that plaques cause no symptoms therefore no damage had been caused which
is an essential element in a negligence claim for damages. This ruling prompted wide
debate and led to the Ministry of Justice introducing a short term no fault payment
scheme in England and Wales known as the ‘pleural plaques former claimants
payment scheme’.
The purpose of that scheme was to recognise those people who had started
compensation claims for their pleural plaque condition which had not settled prior to
17th October 2007 (date of ruling in Johnstone). Payments to successful applicants was
then limited to £5000.
Scotland and Northern Ireland legislated and reversed the decision but in England and Wales the situation remains unchanged in that compensation is not available for
asymptomatic pleural plaques.
In order to make a compensation claim in Scotland or Ireland for pleural plaques
action should normally be taken within three years of diagnosis. Instances do arise
where a historical diagnosis was never mentioned to a patient and in these
circumstances it is important to understand why this might have been the case. If a
person was not previously aware of such a diagnosis it might still be possible to bring a
claim for compensation providing action is taken within three years of learning of the
condition.
Pleural plaques, what pleural plaques?
There are instances where pleural plaques are not routinely commented upon in x-ray
fndings which otherwise state ‘the lungs are clear’. One reason behind this is due to the
fact that plaques (sometimes calcifed) are found within the lining of the lungs and not
in the lungs themselves. Depending upon the clinical question being asked it appears
pleural plaques are not regarded as an asbestos-related lung disease or pleural
disease by the medical fraternity and therefore it is important to seek reassurance by
asking the question of your GP/Consultant; Do my lungs show any features in keeping
with asbestos exposure?
Mr Jeffery Perkins contacted the Scottish Asbestos Helpline to speak of his personal
experience following a discussion with his GP in 2014. At that time Mr Perkins was told
about pleural plaques which had frst been diagnosed several years earlier albeit he
had not been told of the condition. Once he had come to terms with the shock of
learning of his asbestos-related condition he requested his x-rays be reviewed only to
learn an initial diagnosis of pleural plaques had frst been made in 2003. A subsequent
chest x-ray in 2010 also failed to mention his pleural plaques and when commented
upon in a chest x-ray of 2011, and disclosed to him, he found himself ‘technically out of
time’ to make a claim for compensation under the Ministry of Justice scheme former
claimant payment scheme.
He further commented, “Given the benign nature of pleural plaques I believe many GP’s
and Consultant’s also avoid telling elderly patients of their diagnosis for fear of causing
them unnecessary worries, particularly if they are dealing with far worse health issues. If
the condition is harmless and without treatment why would you upset somebody?
That said, I was disappointed not to have been told of my diagnosis after it had been
identifed on a chest x-ray and believe in the right to know everything about my health. People in Scotland and Northern Ireland who have been exposed to asbestos need to
be made aware that pleural plaques might not always be commented upon in a
chest x-ray. From my personal experience it is important to discuss your x-ray results
fully and seek clarifcation that there are no pleural plaques or other evidence of
asbestos exposure within your lungs”.
What should I do about my pleural plaques then?
Sufferers of pleural plaques are advised to be vigilant in terms of monitoring their
health and are encouraged to discuss any health concerns or changes in their
condition or symptoms with their GP. Further investigations including a repeat chest xray or CT scan are not helpful unless there are symptoms which might include
shortness of breath, persistent cough, chest pains, fatigue and weight loss. In any event
a GP must make a decision balancing the risk of any harmful radiation associated to
chest x-rays and CT scans. When visiting your GP it is important you outline details of
your work, exposure to asbestos and those health issues which might be worrying you.
Having pleural plaques does NOT put an individual at any greater risk of developing a
serious lung disease than those individuals who have had the same level of asbestos
exposure.
Compensation for pleural plaques in England and Wales was removed in 2007 but
reinstated in Scotland and Northern Ireland. Importantly if you have worked for a
Scottish or Northern Ireland registered company or been exposed to asbestos whilst
working in Scotland or Northern Ireland and have been diagnosed with pleural plaques
within the last three years it is important you seek legal advice immediately. The Scottish
Asbestos Helpline will ensure you get the right advice. Call us on 0141 333 6750 If you have been diagnosed with pleural plaques and you fail to take any action it
is likely you will be legally barred from other compensation in the future should you
develop a more serious asbestos-related lung disease such as pleural thickening,
pleural effusion, asbestosis, lung cancer or mesothelioma.
