Cancer describes more than 100 types of diseases characterized by development of abnormal cells which can divide uncontrollably and infiltrate and destroy normal body tissue. There are many causes of cancer, but it is estimated that approximately 5% of cases are the result of occupational exposure. Determining causation in a workplace is a complex endeavor since there may be multiple factors contributing to the diagnosis, some unrelated to the workplace. Expert witnesses may be essential in these cases in order to explain and opine on the science supporting each party’s position. Determining causation of cancer in the workplace requires consideration of issues including:
- Existence and level of exposure. The details of exposure are critical to the case. Was the plaintiff truly exposed and, if so, to which specific substances? How did the exposure occur in terms of mechanism, duration, and concentration? Among the relevant facts are compliance (employer and employee) with safety procedures, hazard controls, and the use of personal protective equipment (PPE) to minimize exposure.
- Association between exposure and cancer. Evidence is also needed to demonstrate whether the substance is a known or suspected carcinogen and that the plaintiff’s specific cancer is one of the cancer types associated with the implicated substance. Epidemiology and toxicology studies and laboratory tests are useful to establish or refute a causal link. While federal and international agencies may have identified and regulated a particular substance as an occupational and environmental carcinogen, evidence is still necessary to prove that the exposure caused or contributed to the development of cancer in a specific claimant. Scientific studies will always be questioned during litigation, so expert witnesses are required to testify regarding the strengths and weaknesses of the research and its applicability to the case at hand. When there is no definitive research, parties may seek to provide novel theories which are subject to Daubert standards for admissibility of expert testimony.
- Contributing plaintiff-specific factors. The plaintiff may have risk factors that would make the cancer more or less likely to occur including his or her medical history, age, gender, race, family history, genetic predisposition, alcohol and smoking history, and other exposures outside of work. These may be contributing factors or “confounders” that represent another reasonable hypothesis to explain the cancer.
In any litigation involving workplace exposure to possible carcinogens, it is important for both parties to have a comprehensive understanding of the science and the weaknesses and strengths of the science. Expert witnesses in various specialties provide valuable insight to support or refute various positions. For example, Medical Toxicologists are experts in the treatment of poisoning, drug overdose, and exposure to toxins or biological agents. They understand not only the effects of various toxins, but also have the expertise to determine whether patients have suffered from medically verifiable consequences of alleged exposure. Occupational and Environmental Medicine (“OEM”) physicians focus on the diagnosis and treatment of work-related illness, injury, and toxic exposures. They provide essential testimony regarding regulatory requirements for Occupational Health, OSHA compliance, epidemiology, and causal links between work-related exposure and illness. Both Medical Toxicologists and OEM experts can explain scientific research on the health effects of exposure as well as the impact on the plaintiff. In addition, Oncologists and other specialists may be effective in providing clinical information and scientific expertise on specific types of cancer which may be important in causation arguments as well as understanding the nature and severity of the plaintiff’s injury.
If you are considering filing a claim or must defend against one involving workplace exposure to carcinogens, please contact Elite Medical Experts for help with finding nationally recognized expert witnesses for your case.