Georgia vets with rare diseases deserve better healthcare: The development of a national mesothelioma registry

By Jonathan Sharp

Veterans were exposed to various hazards during military service, which now takes a toll on their lives and health. Mesothelioma, a rare cancer developed as a result of asbestos exposure, is one of the most severe and debilitating conditions, highly prevalent among veterans. This type of cancer has a significantly long period of development, often spanning decades. Hence, cases today result from exposure from the Second World War to the late 1980s, when asbestos was finally better regulated.

Although a serious condition, mesothelioma is very rare, with just 2804 cases diagnosed in America in 2021. As exposure in the U.S. Military, and the Navy in particular, was extensive, around 900 of these cases are now seen in Army veterans. The rest are attributed to industry workers, although veterans often served in the army and worked in asbestos-related industries after service.

Current diagnosis and treatment methods for mesothelioma are considerably limited due to a combination of factors. As this condition is rare, research interest is low, resulting in a less developed knowledge base that would inform practice. Clinical experience is also scarce, while the disease manifests with insidious and nonspecific symptoms during the early stages. Subsequently, most people will receive a diagnosis in the late stages, when options are limited to non-existent.

In 2019, the Centers for Disease Control and Prevention (CDC) attempted to address these issues by proposing the creation of aNational Mesothelioma Registry. While the registry would essentially function as a database, recording in real-time mesothelioma cases, thus bypassing the national cancer reporting system reliant on estimates, it also comes with other changes. Firstly, a considerable expansion of research sample pools would be achieved by shifting to real-time data reporting. Even when research interest in mesothelioma exists in the current system, very few patients participate in clinical trials.

Secondly, using a case-finding rather than symptom-based identification methodology was proposed. This implies regular screening of at-risk populations, especially veterans, and thus aims to improve early detection. Finally, patients would benefit from this registry in various ways. Other than early detection, diagnosed patients would get access to specialized services, where clinical expertise surpasses current general standards. By participating in clinical trials investigating new treatment methods, patients with a diagnosis would benefit from cutting-edge medication for mesothelioma.

Notably, while the proposition is solid, a registry for patients with mesothelioma has yet to be created. Creating civil pressure and advocating for institutional accountability is essential to transform this promising proposal into a functional reality. Grassroots organizations, veteran advocacy groups, healthcare professionals, and affected families should collaborate and force federal action.

Mesothelioma in Georgia’s Veterans

According to environmental health data, between 1999 and 2017, Georgia recorded over 4,000 deaths linked to asbestos exposure. Of these, 777 were attributed to mesothelioma, while 302 resulted from asbestosis, a chronic lung condition tied to the same material. In Clarke County alone, an estimated 57 lives were lost due to asbestos-related illnesses.

These numbers hold the legacy of Georgia’s shipbuilding industry, which expanded significantly during World War II, with significant operations in Brunswick and Savannah, where Liberty ships and other naval vessels were produced. These facilities employed thousands of workers, many exposed to asbestos-containing materials commonly used for insulation and fireproofing. Asbestos was considered a standard industrial material at the time, and safety protocols were limited or nonexistent. As a result, long-term occupational exposure became common among shipyard workers.

In 2022, 607,506 veterans lived in Georgia, many of whom served in the Army and Navy long before asbestos protection measures were implemented. Clarke County is home to 4,367 of these veterans, and many of them may be at risk of developing mesothelioma.  A dedicated mesothelioma registry is essential for these veterans to improve care and early detection. Therefore, implementing this tool is necessary for evidence-based policy and equitable healthcare for Georgia’s veteran population.

Jonathan Sharp is Financial Operations Director atEnvironmental Litigation Group, P.C. He specializes in managing compensation for individuals and families affected by hazardous substances.