Occupational Health Perspective Hazel Armstrong Chair of the Gradual Process and

Occupational Disease Panel Lawyer working in employment and personal

injury law

Outline of Presentation

The assumption in this presentation is that everyone wants workers to be healthy, but those workers who suffer occupational disease ought be covered and compensated by the NZ accident compensation scheme.

The Gradual Process Panel was established by the IPRC Act 2001 to address issues concerning GP conditions, and occupational disease.

This presentation focuses on one aspect of ACC’s work: occupational disease.

Outline of Presentation

We will identify the Law Commission approach to extension of the scheme to cover sickness and disease.

We will look at how the scheme has evolved over the last 50+ years .

We will identify the areas where NZers are failing to makes claims.

We will look at the challenges for ACC under the existing scheme.

How NZers would be affected if private insurers administered work cover.

The Woodhouse Report: 1967

Proposed to retain cover for certain industrial diseases as provided for in the WC Act.

Deafness from noise should be included. Deaf persons should have the advantage of a rebuttable presumption.

Personal Injury: prevention and recovery Report of the Law Commission 1988

Authored by Sir Owen Woodhouse and Sir Ken Keith

The Law Commission recommended:

Extension of the scheme in stages Phasing in through acceptance of industrial disease Adding a detailed specification of injury causes as a schedule

to the legislation Using the International Classification of Diseases – WHO That classes could be added or reduced That the requirement of relevant employment within 2 years

be removed; and That all incapacity (within scope of legislation) arising after 1

April 1974 should be covered.

The scheme has evolved

The accident compensation scheme is adaptable.

This presentation shows how the Law Commission recommendation of phasing or staging the extension of scheme by extending cover for occupational diseases has occurred over the last 50+ years.

Timeline of changes to the scheme

1956 – prescribed period – 2 years from date of employment

1972 – prescribed period – 2 years 1982 – exposures from employment after 1.4.74 1988 – Law Commission Report 1992 – incapacity arises after 1.4.74 1998 – incapacity arises after 1.4.74 and presumptive

schedule lists 11 diseases 2001 – presumptive schedule lists 17 diseases 2008 – presumptive schedule lists 41 diseases 2008 – legislation changes to ease burden of proof on claimants,

provide greater flexibility to amend schedule 2, clarifies ACC’s responsibility to pay for the investigation of claims

2009- What happens if National gives the scheme to private insurers?

ACC - claims for occupational disease - 2006 25,014 claims lodged 17,103 claims accepted 7911 (32% declined) $130 m spent per annum

Most common claims accepted: hearing loss, musculoskeletal, skin disorders

NOHSAC: How many work related diseases and injuries occur in NZ each year?

700- 1,000 people die from work related disease

100 die from injuries received at work 20,000 new cases of work related disease

and injury occur Speculation that there is under claiming for

occupational disease claims

Why are NZers not claiming for occupational disease cover? The DOL says: NZers lack of awareness of occupational

disease; and There is a lack of awareness that the scheme

covers occupational disease; and Are reluctant to make a work injury claim

Reluctance to claim because it will require disclosure of personal details/life style/health information

Cost, time, effort

What are the occupational diseases in NZ?

NOHSAC says: Noise induced hearing loss – noise Dermatitis – hazardous substances – skin Cancers – hazardous substances – carcinogens Musculoskeletal disorders – physical and

psychosocial disorders Respiratory disease – hazardous substances

What occupational diseases should ACC focus on in order to raise awareness?

Cancers Heart/circulatory disease Respiratory disease

Occupational Cancer

Of the 700-1,000 workers who die – 30-40% are caused by cancer – mainly lung cancer

Lung cancer due to asbestos, diesel fumes, environmental tobacco…

Mesothelioma due to asbestos Leukaemia from benzene.. Bladder cancer from dyes, paints, solvents….

Circulatory system

Work strain, e.g. shift work Carbon monoxide from engine exhausts Environmental tobacco smoke

Respiratory Disease

Exposures to dusts Occupational asthma Asbestosis

What is being done?

Two workplace surveys are underway (Massey – 5,000 workers) & Uni of Otago – smaller number but more detailed).

Some of the larger employers collect information about occupational disease.

Some Govt agencies collect data.

What should we be doing better? Overall – information is: fragmented, under

resourced, lacks strategic direction and co-ordination.

Surveys have not routinely or systematically been done across NZ.

Therefore surveying of workers, workplaces and specific exposures is a priority.

Measurement of personal and area exposures is required.

If we want to improve knowledge in NZ We need to describe the hazards by

occupation, industry, geography and worker demographics.

Describe hazard controls. Identify new and emerging hazards.

Changing Workforce: some challenges

Casual and part time workers The Self employed Ageing workforce Mobile workforce Workers less unionised

The Challenges to ACC

Getting information out to the medical fraternity, workers, unions, employers and the self employed about occupational disease.

Co-ordinating the surveys and data collection of workers and workplaces.

Publicising the fact that workers can be covered for occupational disease.

Giving effect to the 2008 amendments in the IPRC Act. Understanding the purpose of a presumptive schedule. Reducing barriers to access by claimants to ACC cover and

entitlements.

Challenges to workers if the scheme is administered by private insurers

Risk rating will discourage employers from participating in surveys – why would you identify problem areas in your industry?

Culture of ignorance about occupational disease will continue to prevail

No incentive on insurers to ensure claimants are covered for occupational disease

Difficulties proving cause will be magnified

Conclusion

The Law Commission recommendation to phase in an extension of the scheme through coverage of occupational disease remains sound.

ACC has many challenges ahead. If private insurers are involved we will not see

improvement in the coverage and delivery of entitlements for NZ workers who suffer from occupational disease.