Veracity Of Disability Claimants' Self-Reports Of Current Smoking Status: Comparison Of Carboxyhemoglobin Levels From Disability Claimant And Reference Population - (1988)

Understanding Smoking and Asbestos Exposure: How a Key Study Strengthens Legal Claims for Asbestos-Related Diseases

Abstract The study "Veracity of Disability Claimants’ Self-Reports of Current Smoking Status: Comparison of Carboxyhemoglobin Levels from Disability Claimant and Reference Population" by Harber, Tashkin, Shimozaki, and Hathaway, published in Chest (1988), investigates the accuracy of self-reported smoking status among asbestos disability claimants. By measuring carboxyhemoglobin (%COHB) levels, an objective marker of recent smoking, the study compares 492 male asbestos disability applicants with 157 routine clinical patients. Findings reveal that both groups had similar mean %COHB levels, but many self-reported ex-smokers showed elevated %COHB, indicating recent smoking. The study concludes that disability claimants are as truthful as clinical patients in reporting smoking status, but self-reported smoking cessation may not always be accurate.

Legal Relevance This study is highly relevant in asbestos-related legal cases, particularly when defendants attempt to attribute lung diseases to smoking rather than asbestos exposure. The findings provide evidence that self-reported smoking histories may be unreliable, emphasizing the need for objective measures like %COHB to assess smoking status. This is critical in countering defense arguments that downplay asbestos exposure by focusing on smoking as the primary cause of disease. The study also highlights that smoking and asbestos exposure often coexist, and both contribute to disease risk, reinforcing the argument that asbestos exposure remains a significant factor in disease causation.

Occupation Groups at Risk The study’s findings are particularly relevant to individuals in high-risk occupations where asbestos exposure was prevalent. These include:

• Shipyard Workers: Frequent exposure to asbestos insulation and materials.
• Construction Workers: Regular handling of asbestos-containing products like cement and tiles.
• Industrial Workers: Exposure in manufacturing plants using asbestos for heat resistance.
• Insulation Installers: Direct contact with asbestos fibers during installation and removal.
• Power Plant Workers: Prolonged exposure to asbestos in machinery and insulation. These groups are at heightened risk due to prolonged and intense asbestos exposure, often compounded by smoking habits.

Current Medical Understanding The study aligns with current medical knowledge that both smoking and asbestos exposure significantly increase the risk of lung diseases, including lung cancer and asbestosis. It underscores the importance of objective measures like %COHB in evaluating smoking status, as self-reports may be unreliable. This reinforces the need to consider asbestos exposure as a primary factor in disease causation, even in individuals with a smoking history.

Citation Harber, P., Tashkin, D., Shimozaki, S., & Hathaway, E. (1988). Veracity of disability claimants' self-reports of current smoking status: Comparison of carboxyhemoglobin levels from disability claimant and reference population. Chest, 93(3), 561-564. https://doi.org/10.1378/chest.93.3.561

National Library of Medicine Link For more details, visit the National Library of Medicine’s page for the study: https://pubmed.ncbi.nlm.nih.gov/3342666/

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