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Occupational Health Perspective - Hazel Armstrong Law

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					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.

				
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