"It is this characteristic of persistence in the body which gives rise to the long term risks associated with asbestos exposure."
"Following deposition in the alveolar regions 'scavenger cells' known as macrophages try to engulf the fibres. They succeed with shorter fibres but fail with larger fibres. The cells which fail in their attempts to engulf fibres die and release chemical mediators. These and chemicals generated at the surface of the asbestos fibres are responsible for producing inflammation. If this is sufficiently severe and long lasting fibrosis, i.e. the laying down of complex protein called collagen, may develop. Removal by macrophages and dissolution in situ succeeds in clearing some of the asbestos fibres from the lungs. Clearance occurs much more rapidly for chrysotile than for the amphiboles, probably at least partly accounting for the greater propensity of the latter to cause disease. Fibres which remain in the lungs commonly become coated with ferroprotein to form ferruginous bodies, also termed asbestos bodies."
"Pleural plaques are not thought to lead directly to any of the other benign varieties of asbestos-induced pleural disease, nor to pose any risk of malignant change leading to mesothelioma. Their presence may indicate, nevertheless, a cumulative level of asbestos exposure at which there is an increased risk of mesothelioma or other asbestos-related disorders. On average, in the absence of any other evidence about exposure it is reasonable to assume that subjects with plaques will have had higher exposure to asbestos than subjects without plaques. The frequency of development of other complications of asbestos exposure in persons with plaques is not a function of the presence of the plaques, but of the asbestos exposure that caused plaques. Since plaques may occur after a wide range of different exposures, the risks of other asbestos-related conditions may differ widely between different populations and individuals with plaques."
"There are pleural plaques overlying both diaphragms and the left mid zone. The appearance would be consistent with asbestos exposure"
"There is slight pleural thickening along the right chest wall and possibly slight mucosal thickening along the upper part of the left chest wall in keeping with previous asbestos exposure"
"very small bilateral pleural plaques formation". 23 rd July 2003 . Dr. Rudd advised: a. there is a 2% risk that he will develop diffuse pleural thickening sufficient to cause disablement due to breathlessness; b. there is a like risk of the future development of asbestosis; c. there is a 5% risk of the future development of a mesothelioma; and d. a risk of lung cancer reflecting early smoking was enhanced to 5%. 1 st December 2003. Having regard to his continuing mental state Mr. Grieves was referred to and was seen by Dr. Rajiv Menon, a consultant psychiatrist with a special interest in mental health problems arising out of asbestos exposure. By way of the consequent report (of the 16 th February 2004) Dr. Menon advises: "
"So when people like Mr. Grieves were diagnosed with asbestos disease both reality and folklore fuelled ….. fears and the psychological distress evoked by the diagnosis often outweighed the actual material risk of serious complications"
" ….. it can cause a condition called pleural plaques (scarring of the outside of the lung) which produces no disability but results in a perfectly valid claim against your former employers"
"There are bilateral chest wall and diaphragmatic pleural plaques with calcification in places. At the extreme right base there are a few small posterior opacities contiguous with the pleura which probably represent small areas of folded lung secondary to localised pleural thickening. There is no evidence of ….. asbestosis". 20 th November 2004. Dr. Rudd confirmed an earlier assessment of the risks: a. there is a 1% chance that he will develop diffuse pleural thickening sufficient to cause breathlessness; b. there is a similar chance of the future development of asbestosis; a. there is a 3% chance of the future development of mesothelioma; b. a 2% risk of lung cancer arising from smoking is enhanced by asbestos exposure to 3%; and c. asbestos exposure has reduced his life expectancy by 1 year. As to the impact of the new found knowledge of pleural plaques he said by way of his witness statement: "
"A few small calcified pleural plaques are noted bilaterally. Is there a history of previous asbestos exposure? No active lung disease"
"Appearances are probably due to the presence of pleural plaques. There are also calcified diaphragmatic plaques seen. The presence of pain is unusual in simple pleural plaques ….. appearances may be secondary to the development of mesothelioma"
"there are widespread pleural plaques some of which are calcified ….. the appearances are not that of asbestosis"
"I have no doubt whatever that the Plaintiff ….. has suffered material damage. It consists of the symptom – free pleural changes, the risk of pleural thickening deteriorating with the consequences I have indicated, the risk of mesothelioma developing and the understandable worry attendant upon these matters."
"I therefore have to value in combination (a) the present symptom-free pleural changes; (b) the 5%-odd risk of further diffuse changes developing so as to aggravate the plaintiff's breathlessness, and (c) the anxiety which the plaintiff entirely understandably, and in my judgment reasonably, has hitherto suffered, in particular over the last two years, and to a far more limited degree, the worry he may still experience in the future, even though, as I have sought to emphasize, these future risks are really very small. Doing my best to arrive at a figure which accords reasonably with the scale established by Church and Sykes, both now 2 years old, and with my own views upon the particular facts of the instant case, I assess such damages in the sum of£1,250 . There will accordingly be judgment for the plaintiff for damages in that sum assessed on the assumption that the plaintiff will not develop mesothelioma at any future stage."
"I do not regard the plaques as any concern save as a pointer that I have been exposed to asbestos and it has had an effect on my lungs"
'The permanent physical penetration of the chest by asbestos fibres to such extent as to give rise to: a. the actual development of pleural plaques; b. the possible future onset of symptoms, even of a terminal condition; and c. consequent, potentially continuing anxiety.'
"What is a material contribution must be a question of degree. A contribution which comes within the exception de minimis non curat lex is not material, but I think that any contribution which does not fall within that exception must be material. I do not see how there can be something too large to come within the de minimis principle but yet too small to be material."
"I have deliberately refrained from expressing any view as to whether the implantation of fibres into the lung (which did occur in this case) or the development of pleural plaques (which did not occur), in neither case involving any immediate symptoms, could be described as a physical injury especially having regard to the definition of injury in the Civil Liability Acts. At the hearing of this appeal it was accepted that the damages were awarded for psychiatric injury only and I am approaching the appeal on that basis."
"Whether it is so barred depends on whether by that date, 4 th June 1954, he had suffered damage, because without damage a cause of action in either negligence or breach of statutory duty is incomplete. The damage which is required is damage which is real, something more than minimal; something beyond what can be regarded as negligible, even if it was then both unknown and undiscoverable: material damage; something more than that which the law will disregard."
"The Claimants do not contend that plaques simpliciter are actionable but that pleural plaques in conjunction with anxiety and future risks of other asbestos diseases combine to constitute an injury which is more than minimal and which is significant. Accordingly pleural plaques are actionable and set time running against a Claimant."
"The general principle embedded in the common law (is) that mental suffering caused by grief, fear, anguish and the like is not actionable."
"It is perfectly clear law that fear by itself, of whatever degree, is a normal human emotion for which no damage can be awarded ….. fear of impending death felt by the victim of a fatal injury before that injury is inflicted cannot by itself give rise to a cause of action which survives for the benefit of the victim's estate."
"Mere mental suffering, although reasonably foreseeable, if unaccompanied by physical injury, is not a basis for a claim for damages."
"There are those whose mental suffering was a concomitant of physical injury. This type of mental suffering is routinely recovered as 'pain and suffering'."
"The cause of action accrued when it reached a stage, whether then known or unknown, at which a judge could properly give damages for the harm that had been done."
'you can have an immediate sum reflecting at least 100% uplift if you are prepared to stand a risk assessed by the physicians as little more than minimal'
"I do not think I can rate the damages as being very substantial in this case; and it may well be that if the plaintiff is unfortunate, he may feel that the damages I have awarded are very inadequate. But after all, it was the choice of the plaintiff and his advisers to bring the matter before the court at this stage, and all I can do is really to compensate him for the risk which he undergoes in addition to the anxiety he has suffered. It would appear to me that a sum of£1,500 would be appropriate compensation."