Monday, 17 June 2019

‘Flawed expert testimonies’ led to mobiles blame in Italian tumour sufferer’s compensation case

  An Italian court sided with Innocente Marcolini who claimed his work related mobile phone use caused his benign brain tumour.
Experts from Italy’s National Centre of Epidemiology have criticised the ‘flawed expert testimonies’ that led to an Italian court granting worker's compensation to a businessman who blamed a benign tumour he developed on his work related cell phone use.

Global media attention was sparked in October last year when a final appeal in the Supreme Court of Italy to have the case thrown out was rejected because the court could not fault the legal processes followed by the lower courts, despite the questionable credibility of the court’s expert witnesses.
Innocente Marcolini, a financial manager at an industrial plant in northern Italy, claimed he used his cell and cordless phones for five to six hours a day for 12 years.  In 2002 he was diagnosed as having a benign tumour on the trigeminal nerve, which controls facial muscles and sensations after noticing unusual tingling sensations on his face while shaving.
In 2007, he made a claim to the Italian Workers’ Compensation Authority (INAIL, Istituto Nazionale Assicurazione contro gli Infortuni sul Lavoro), which rejected his claim saying there was no proof his illness had been caused by his work.
In 2009 Marcolini appealed the INAIL’s decision in the Tribunal of Brescia and was awarded 80 per cent of his former salary as an invalidity pension.
In awarding in favour of Marcolini the Tribunal ruled that there might be a link based on court appointed expert witness testimony and there was a level of exposure to his mobile phone beyond normal usage patterns that was clearly work related.
However, the evidence from expert witnesses, Oncologist Professor Angelo Gino Levis and neurosurgeon Dr Giuseppe Grasso, relied on in the case have subsequently been heavily criticised in a paper by experts from the Italian National Centre of Epidemiology:
“Based on the motivations of the verdict, it appears that the judge relied on seriously flawed expert testimonies. The "experts" who served in this particular trial were clearly inexperienced in forensic epidemiology in general, as well as in the topic at hand,” the paper by the Italian research experts said.
“Selective overviews of scientific evidence concerning cancer risks from mobile phone use were provided, along with misleading interpretations of findings from relevant epidemiologic studies (including the dismissal of the Interphone study results on the grounds of purported bias resulting from industry funding). The necessary requirements to proceed to causal inferences at individual level were not taken into account and inappropriate methods to derive estimates of personal risk were used.”
INAIL appealed the 2009 ruling to the Supreme Court of Italy and it was this appeal that was ruled on in October 2012.
The Supreme Court rejected the reasons for appeal – not because a direct link between cell phone use and the tumour was established – but because it concluded that the earlier Tribunal correctly followed the necessary procedures required under Italian law.
As the printed judgement (in Italian) makes clear the Supreme Court was not permitted to undertake a new assessment of the facts of the case and no new scientific evidence was heard.
The Supreme Court did not have to question the substance of the 2009 decision but only whether the lower court followed proper legal protocol. 


Media reports around the world have incorrectly reported that the court ruled there was a causal link between cell phone use and tumours. For example the British newspaper The Sun ran a story entitled “Mobiles can give you a tumour, court rules.”
The media also incorrectly reported that the Supreme Court supported evidence from ‘independent’ research and that research that had been funded by the mobile phone industry was rejected.
The printed judgement makes it clear that the Supreme Court did not reconfirm a causal link or make any re-assessment of the expert witness evidence. In fact the Supreme Court rejected the INAIL’s reason for appeal on the grounds “another assessment was not permitted by the Supreme Court”.
In response to the media reports of the judgement in the UK, Professor Malcolm Sperrin, Director of Medical Physics and Clinical Engineering at the Royal Berkshire Hospital, said:
“Without knowing anything significant about this patient, what seems to be claimed is that the phone has been used a huge amount, and that the patient has developed a condition. The link is that the phone is present; but not necessarily that the phone has caused the effect.
“It may, for instance, be the case that nerve damage could have been caused by long-term localised pressure or that the local temperature has risen because of reduced heat transmission from the skin as a result of the phone being in place. The conclusion is that we don’t know – and hence the underlying premise of ‘more studies being needed’ simply reiterates what is already stated by the broader scientific community. It has also reasonably been clearly pointed out that very extended use of mobile telephones may be an elevated risk indicator, but there is no claim as to the mechanism.
“It is not clear what reliable scientific evidence has been submitted to justify a perceived link between mobile exposure and risk. Great caution is needed before we jump to conclusions about mobile phones and brain tumours.”
Dr Michael Repacholi, Visiting Professor at University of Rome “La Sapienza” and former coordinator of the World Health Organization’s Electromagnetic Fields Project, said:
“I have recently published a thorough, systematic and transparent review of all the scientific evidence on this topic along with 14 other international scientist co-authors. We all agree that there is no link between brain cancer and mobile phone use. This is in line the World Health Organization’s statement that ‘…an increased risk of brain cancer has not been established’.
“Of course we would always like to see more research. But this Italian court ruling has not, in my opinion, been based on sound scientific evidence. Furthermore the Italian Courts take little effort to ensure they obtain advice from established experts in the EMF area.”


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