882 New Asbestos Cases in 2024. One Illinois County. More Than Any Other US Venue.

Madison County, Illinois is the most active asbestos litigation venue in the United States. In 2024, the county’s Circuit Court received 882 new asbestos civil cases per KCIC’s 2024 Year in Review. St. Clair County, Illinois ranked second nationally with 820 filings, meaning two adjacent Illinois counties together accounted for roughly 43% of all US asbestos filings.

People with mesothelioma and their families file cases here from across the country. The disease has no cure and an average survival of 12 to 21 months after diagnosis. Filing decisions carry real consequences. Understanding why this county handles roughly one in five US asbestos filings (22% per KCIC) matters to anyone navigating that decision.

Why One County Handles This Much

Madison County sits in southwestern Illinois, directly across the Mississippi River from St. Louis. The industrial base that surrounded the area, shipyards, steel mills, power plants, railroad yards, created decades of asbestos exposure among workers. That history gave the county a legitimate local connection to asbestos disease.

But the filing volume now reflects more than geography. Illinois venue law under 735 ILCS 5/2-101 permits filing in any county where any defendant has its principal place of business or has committed the tort. Major asbestos defendants, including product manufacturers that sold nationally, have Illinois contacts. That means a plaintiff from Texas or Ohio can file in Madison County if a defendant sold products into Illinois.

Defense attorneys have challenged this venue repeatedly. Illinois appellate courts have consistently upheld the venue rules as written. Until the legislature acts or the Illinois Supreme Court reverses course, Madison County remains a valid filing destination for mesothelioma cases nationally.

The Dedicated Docket Structure

Most courts assign civil cases to a rotating docket. Madison County runs a dedicated asbestos docket. One judge. One courtroom. One case management system built around the specific procedural demands of asbestos litigation.

The practical effect is substantial. The assigned judge knows the medical literature on pleural mesothelioma, peritoneal mesothelioma, and asbestos-related lung cancer. Standard expert witnesses have testified here before. The judge has ruled on the main evidentiary disputes, admissibility of fiber-type evidence, causation standards, and standard of care in industrial settings. There’s no learning curve.

For people with mesothelioma, this matters. Mesothelioma cases qualify for expedited scheduling in many jurisdictions because of the plaintiff’s life expectancy. Madison County’s docket moves these cases faster than comparable venues with general civil calendars.

The 2024 National Venue Concentration

Two adjacent Illinois counties handled roughly 43% of all US asbestos filings in 2024. The remaining 57% spread across every other US venue combined.

Who Files Here and Why

People with mesothelioma make up the majority of new filings. Asbestos-related lung cancer cases are the second-largest category. Pleural disease cases without cancer represent a smaller share.

Plaintiff firms with the highest Madison County volume include Simmons Hanly Conroy and other specialty asbestos firms that maintain full-time staff familiar with Madison County procedure and established relationships with local counsel.

Defendants in 2024 filings include the same group that has appeared in asbestos dockets nationally for decades: legacy product manufacturers, brake and gasket companies, insulation manufacturers, and distributors. Many defendants who have gone through bankruptcy and established trusts are named for evidence preservation but not as active litigation targets. The live targets are solvent defendants.

What the 2024 Data Shows About Trends

The 882 figure is below the 2022 peak of 1,201 (and the recent decade peak around 1,168 in 2020) but national asbestos filings have also declined. Madison County’s share remains stable. Several factors shape the annual count.

The latency period for mesothelioma is 20 to 50 years after exposure. Workers exposed in the 1970s, the decade of heaviest industrial asbestos use before EPA restrictions, are now in their 70s and 80s. The population of newly diagnosed people reflects the exposure cohort from that era. As that cohort ages through, new case counts will eventually decline, but that inflection point has not arrived in the filing data.

Improved diagnosis has the opposite effect. Mesothelioma is frequently misdiagnosed as lung cancer or pleural effusion. Better imaging and biopsy techniques, plus greater physician awareness, bring people to accurate diagnosis who previously died without it. Each accurate diagnosis is a potential filing.

Settlement Dynamics in Madison County

Cases filed in Madison County don’t all go to verdict. Most settle. But the shadow of trial affects what defendants offer.

Madison County juries have returned substantial verdicts in mesothelioma cases. Defense firms evaluate settlement ranges in part by trial risk in the filing jurisdiction. A county with a track record of plaintiff-favorable verdicts is a different negotiating environment than a venue where asbestos cases rarely reach a jury.

For people with mesothelioma, the decision about venue is one piece of a complex calculation. The strength of the exposure evidence, the specific defendants named, the plaintiff’s occupation and work history, and the available trust fund claims all affect case value. An attorney who handles mesothelioma cases can assess whether Madison County is the optimal forum for a specific fact pattern.