Mesothelioma and Social Security Benefits in Brazil: 2019 to 2021

Our plain-English summary of Mesothelioma and Social Security Benefits in Brazil: 2019 to 2021, by L.E.F.E. Gomes, N.S.S. Souza (Revista Brasileira de Medicina Do Trabalho, 2025).

The study

• Authors: L.E.F.E. Gomes, N.S.S. Souza
• Journal: Revista Brasileira de Medicina Do Trabalho
• Published: 2025;23(4):e20251448
• Type of article: Review
• Read it: PubMed · Publisher · Free full text

Abstract

Introduction: Asbestos is carcinogenic to humans, according to the International Agency for Research on Cancer of the World Health Organization, and can cause several diseases, including mesothelioma, a malignant tumor of the pleura and peritoneum, mainly.

Objectives: Analysis of disability pension benefits with mesothelioma diagnosis in Brazil from 2019 to 2021.

Methods: Descriptive study using records of benefits granted by the Social Security National Institute (Instituto Nacional do Seguro Social) in Brazil to insured workers under the Regime Geral da Previdência Social with a diagnosis of mesothelioma or pleural cancer. Later, cases were identified as mesothelioma after reviewing medical-pericial reports. Two Instituto Nacional do Seguro Social data sources were used: Unified Benefits Information System, providing sociodemographic data of the insured and benefit information, and Disability Benefits Administration System (SABI), where the medical-pericial report is prepared, providing information on the insured's occupation and the type of mesothelioma.

Results: During the study period, 109 benefits were granted by Instituto Nacional do Seguro Social with a mesothelioma diagnosis, and six with a pleural cancer diagnosis, which upon review of the medical-pericial report were identified as mesothelioma. Of the total 115 benefits granted, only one was characterized as occupational.

Conclusions: Only one benefit was characterized as occupational disease, contrary to the literature evidence of mesothelioma being associated with occupational or environmental asbestos exposure in 80% of cases.

In plain English

This descriptive study reviewed disability benefits that Brazil's National Social Security Institute (INSS) granted to insured workers with mesothelioma, with benefits starting from 2019 to 2021. Diagnoses were checked against the 'clinical history' in medical-expert reports. Of 123 benefits coded as mesothelioma, 14 were excluded because the diagnosis was not confirmed. Of 62 coded as pleural cancer, 6 were described as mesothelioma. That gave 115 benefits. Women received 56.5% of them, and the mean age was 53 years. Pleural (47.0%) and peritoneal (46.1%) mesothelioma were nearly equal. Most benefits were temporary disability benefits (83.5%). Only 1 benefit was classified as occupational (work-related). Of the 115, 42 were not evaluated for an occupational cause, leaving 73 assessed. The study did not measure asbestos exposure. The authors concluded this suggests substantial underreporting and gaps in recording occupational history and in clinical awareness of the disease. They noted the limits of administrative data and the overlap with the COVID-19 pandemic.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Descriptive study of administrative social-security benefit records
• Who was studied: Disability benefits granted by the INSS to insured workers covered by Brazil's General Social Security Regime with a diagnosis of mesothelioma (ICD-10 C45) or pleural cancer (ICD-10 C38.4), benefit start dates January 1, 2019 to December 31, 2021; 115 benefits included after review
• Exposure: Asbestos exposure was not measured and no fiber types were reported. The study recorded each insured worker's occupation as described in the 'clinical history' field of the medical-expert report.
• Main results:
  • 115 benefits were granted for mesothelioma: 109 coded as ICD-10 C45 (mesothelioma) and 6 coded as C38.4 (pleural cancer)
  • Of 123 benefits coded as mesothelioma, 14 were excluded because the clinical history did not confirm the diagnosis. Of 62 benefits coded as pleural cancer, 6 were described as mesothelioma.
  • Among the 115 benefits, females predominated (56.5%; 65 of 115) and the mean age was 53 years
  • The most common INSS affiliation was employee (44.3%), followed by self-employed (30.4%)
  • The most frequent occupations were drivers (7.0%), commercial manager and teacher (6.1% each). Occupation was not reported for 13.9% of benefits.
  • Pleural (47.0%) and peritoneal (46.1%) mesothelioma were almost equally frequent among benefits (54 vs 53)
  • Among workers with pleural mesothelioma, males predominated (51.9%). Among those with peritoneal mesothelioma, females predominated (62.3%).
  • 114 benefits were non-occupational. Temporary disability benefits made up 83.5% and permanent disability retirement 15.7%.
  • 42 of the 115 benefits were not evaluated for occupational causation because of the worker's affiliation category. Of the 73 benefits assessed for an occupational link, only 1 was classified as occupational.
  • Only 6 of the 62 benefits coded as pleural cancer (9.7%) were actually pleural mesothelioma
• The authors' conclusion: The authors concluded that only 1 benefit being classified as an occupational disease suggests substantial underreporting and gaps in documenting occupational history and in clinical awareness of mesothelioma. They suggested the near-equal pleural and peritoneal numbers may reflect longer survival among women with peritoneal mesothelioma, along with possible diagnostic error.
• Limitations the authors state:
  • The study used secondary data, so the researchers could not control data quality
  • Administrative data from INSS information systems have inherent limitations
  • Part of the study period overlapped with the COVID-19 pandemic, which may have restricted access to diagnosis and to social-security benefits

Topics

Medical terms in this study, explained in our Lexicon: Mesothelioma, Carcinogenic, Pleura, Peritoneum, Occupational Disease, Asbestos Exposure.

Related studies

• Case-control study of pleural mesothelioma in workers with social security in Mexico — G. Aguilar-Madrid, E. Robles-Pérez, et al. (2010)
• Asbestos bodies in routine necropsies on Tyneside: a pathological and social study — T. Ashcroft (1968)
• Community-level social support responses in a slow-motion technological disaster: the case of Libby, Montana — R.J. Cline, H. Orom, et al. (2010)
• Asbestos-related disease in South Africa: the social production of an invisible epidemic — L. Braun, S. Kisting (2006)
• Estimating the social cost of respiratory cancer cases attributable to occupational exposures in France — H. Serrier, H. Sultan-Taieb, et al. (2014)
• The social context of occupational disease: asbestos and South Africa — J. Myers (1981)

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