FINDINGS
5 At the hearing in the Compensation Court, medical specialists in the fields of pathology, radiation oncology, occupational medicine and respiratory medicine were called on behalf of Mr Scates. A chest physician with a particular interest in asbestos and its effects on the human body was called for the Board. Bishop CCJ carefully summarised the evidence and made findings including a finding that both asbestos and tobacco are recognised carcinogens. There is a synergistic relationship between these two carcinogens which is multiplicative. Although the radiological and pathological tests carried out on Mr Scates were neutral and revealed no evidence of asbestos bodies or any clinical signs of any reaction to the inhalation of asbestos, the evidence was overwhelming that such indications did not preclude the possibility of Mr Scates having been exposed to significant levels of asbestos.
6 Bishop CCJ regarded it as significant that Mr Scates's experts had expertise in a variety of disciplines. From the angle of their individual disciplines they all very firmly supported his case. The evidence of Mr Scates's exposure to asbestos was very thorough and detailed, there was no protection available and the latency period was statistically acceptable from the point of view of the identification of the tumour. Part of Mr Scates's duties of chipping away in an enclosed space asbestos that had been baked at a very high temperature involved very high danger. All experts accepted without qualification the Helsinki Criteria under which the evidence in the case established that Mr Scates underwent exposure to asbestos at a level more than enough to cause asbestosis. Mr Scates's witnesses were all firmly of the view that, on the probabilities, he would have a high fibre burden in his lungs. There was clear evidence that his smoking history would have impeded his clearance of asbestos fibres from his lungs. Bishop CCJ said:
"It is more probable than not that as a result of the synergistic effects of exposure to asbestos and tobacco smoke [Mr Scates's] employment at the Tamworth Power Station materially contributed to his carcinoma of the lung."
EVIDENCE
7 Before coming to the grounds of appeal there are particular matters in the evidence which can helpfully be referred to. On 20 - 22 January 1997 the International Expert Meeting On Asbestos, Asbestosis and Cancer was convened in Helsinki to discuss disorders of the lung and pleura in association with asbestos and to agree upon state of the art criteria for their diagnosis and attribution with respect to asbestos. A document was produced as a result and named the Helsinki Criteria. The document contained diagnostic criteria for conditions which included lung cancer. These criteria were related to periods of exposure relevantly described as one year of heavy exposure to asbestos (eg manufacture of asbestos products, asbestos spraying, insulation work with asbestos materials, demolition of old buildings) or five to ten years of moderate exposure (eg construction, shipbuilding) which might increase the lung cancer risk twofold or more over that of people not so exposed. Under the heading "Lung Cancer" it was said:
"Estimates of the relative risk for asbestos-associated lung cancer are based on different-sized population. Because of the high incidence of lung cancer in the general population, it is not possible to prove in precise deterministic terms that asbestos is the causative factor for an individual patient, even when asbestosis is present. However, attribution of causation requires reasonable medical certainty on a probability basis that the agent (asbestos) has caused or contributed materially to the disease. The likelihood that asbestos exposure has made a substantial contribution increases when the exposure increases. Cumulative exposure, on a probability basis, should thus be considered the main criterion for the attribution of a substantial contribution by asbestos to lung cancer risk. For example, relative risk is roughly doubled for cohorts exposed to asbestos fibres at a cumulative exposure of 25 fibre-years or with an equivalent occupational history, at which level asbestosis may or may not be present or detectable. Heavy exposure, in the absence of radiologically diagnosed asbestosis, is sufficient to increase the risk of lung cancer. Cumulative exposures below 25 fibre-years are also associated with an increased risk of lung cancer, but to a less extent. …. A minimum lag-time of 10 years from the first asbestos exposure is required to attribute the lung cancer to asbestos. …. Although tobacco smoking affects the total lung cancer risk, this effect does not detract from the risk of lung cancer attributable to asbestos exposure. No attempt has been made in this report to apportion the relative contributions of asbestos exposure and tobacco smoking."
8 A specialist pathologist, Professor Shilkin, was called on behalf of Mr Scates. Professor Shilkin referred to the occupational history of Mr Scates and the Helsinki Criteria and concluded that moderate exposure to asbestos over a five to ten year period might increase the risk of lung cancer twofold. The trial Judge said:
"Once that twofold risk is reached the Criteria suggest that it is more probable than not that the lung cancer is related to asbestos exposure. ….
With regard to smoking the doctor indicated there was a multiplicative effect with asbestos and tobacco in smokers. However, [Mr Scates's] smoking history, variable as it was, would probably be sufficient on its own to account for the development of lung cancer…..
On the basis of tests and research [Professor Shilkin] indicated that he was quite content in the present situation to simply accept the industrial history as an indicator of contribution without any confirmatory signs of asbestos induced clinical abnormality."
9 Another expert Mr Scates called was Dr Allan Langlands, a radiation oncologist with lengthy experience and qualifications. He concluded that the exposure at the power station very significantly contributed to the development of Mr Scates's carcinoma irrespective of whatever level of tobacco exposure might be accepted by the Court. Dr James Leigh, another witness called by Mr Scates, had specialist qualifications in a number of areas including medicine with particular interest in occupational medicine and asbestos related diseases. Despite the absence of tissue for testing and the absence of any abnormal findings on radiology or pathological testing, Dr Leigh considered that Mr Scates's exposure to asbestos had made, on the balance of probabilities, a material contribution to the cancer.
10 Dr Keay Foster, a specialist consultant in respiratory medicine with extensive experience and post-graduate qualifications and a special interest in asbestos related diseases, considered that the history as taken complied with the Helsinki Criteria and that the cause of Mr Scates's lung cancer was both his smoking and his occupational exposure to asbestos.
11 Such evidence led to and supported Bishop CCJ's finding that the asbestos exposure which Mr Scates endured while working at the Tamworth Power Station materially contributed to his carcinoma. The parties accepted that this was a correct statement of the necessary causative link between exposure and dust disease without any need to construe the language of the Act or the definition of dust diseases in Schedule 1 thereto.
12 This being so, the first matter raised on behalf of the respondent was that no appeal lay under s32 of the Compensation Court Act because the Board's challenge was to a finding of fact. The respondent relied upon the decision of this Court in Azzopardi v Tasman UEB Industries Limited (1985) 4 NSWLR 139 particularly at 155-157 in the judgment of Glass JA. Mr Hoeben SC, who appeared for the Board, sought to draw a distinction in this case by reference to a passage in that judgment at 156 in which Glass JA said: "…..that alleged insufficiency of evidence to prove a fact always raises a question of law". Mr Hoeben submitted that there was such an insufficiency of evidence in this case. He conceded, I think correctly, that the phrase "insufficiency of evidence" used in a judgment with which Samuels JA agreed and which has, since it was given, been taken in this State as authoritative upon the point, must be read to mean that the evidence led, even if accepted, is not capable of proving the fact. Whether the evidence, though capable of doing so, is, in the circumstances and particularly in the context of the other evidence, sufficient to prove the fact is a matter for the fact finder and raises no question of law.