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Occupational Health Perspective - Hazel Armstrong Law


									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
   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
   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
   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
ACC - claims for occupational disease -
   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
   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
       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-
   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
   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
   Publicising the fact that workers can be covered for occupational
   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
Challenges to workers if the scheme is administered by private

   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

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