OCCUPATIONAL ASTHMA Part Two

STATISTICAL DISHARMONY
In a September 1985 publication, the HSE reported the same number of awards in the Scheme's opening year, 95, as that given in the ministerial reply the following spring - a rare statistical harmony among government agencies. ⁽¹⁵⁾ This provisional figure was later set at 112 ^(16)(17) - but in a subsequent report it is once again listed as 95. ⁽¹⁸⁾
   The number of awards (or nowadays, cases diagnosed by the medical boards) recorded by the HSC and HSE from DHSS and DSS sources is: ⁽¹⁹⁾

1982 - 95 cases/awards 1987 - 220 cases 124 awards
1983 - 183 cases/awards 1988 - 222 cases 166 awards
1984 - 137 cases/awards 1989 - 220 cases 165 awards
1985 - 166 cases/awards 1990 - 216 cases 175 awards
1986 - 166 cases/awards 1991 - 293 cases 227 awards
(since 1-10-86 only those with 14% and more gain benefits)

Despite these 1,918 recorded cases (probably 1,604 benefit awards), the DSS Analytical Services Division (DSS/ASD) tables show only 550 current beneficiaries at March 31st, 1990 ⁽²⁰⁾ of which only 20 had been awarded in the latest statistical year ⁽²¹⁾, although the HSC/HSE statistics relying on DSS sources suggest there were about 170 awards in that year. Certainly some beneficiaries will have died but it would seem many of those awarded provisional benefits have failed to satisfy the medical boards on their reviews.
   The HSE has reported 70% of all cases are assessed at 10% and less, and very few at more than 50%. ⁽²²⁾ Elsewhere the DSS/ASD tables record just 10 cases of less than 14%; and 70 of the 550 current beneficiaries with more than 50% disability assessment. Most frequently assessments are between 20 and 44% (340 cases) but the 20 assessments first made in the year to March 31st; 1990 had all been between 15 and 24%. ^{(23) (24)}
   Disturbingly the HSE tables show between 1983 and 1991 there were 1,823 cases of occupational asthma diagnosed by medical boards of which 766 would not have qualified for a benefit payment under the present day 14% cut-off rule. ⁽²⁵⁾
   Of the 550 current beneficiaries, 450 are men and 100 women, and the average disability assessment is 30% PAYING £26.52 A WEEK IN 1992. ^{(26) (27)}

REPORTING - RIDDOR & SWORD
Employers are required to report certified cases of occupational asthma among their workforce to the enforcing agencies (i.e. the HSE or local authority Environmental Health Departments). During the first four years of these provisions under the Reporting of Injuries, Diseases, and Dangerous Occurrence Regulations, 1985 (RIDDOR) there were just 215 cases reported but even so it was the second most frequently reported occupational disease. ⁽²⁸⁾ There were only 65 further new cases reported in the following year - so clearly employers admit to even less cases than the official agencies. ⁽²⁹⁾ Again, there are differences in figures among the various HSC and HSE reports. A September 1992 Employment Gazette supplement has a total of 233 cases for the first four years and 70 for 1990/91. ⁽³⁰⁾
   A new HSE funded medical surveillance scheme indicates over 500 new cases of occupational asthma are seen each year by specialist chest and occupational physicians. In 1989, the first year of the Surveillance of Work Related and Occupational Respiratory Disease (SWORD) scheme, 554 new cases were diagnosed by physicians employed at 90% of the country's chest clinics. Of these new cases 282 (51%) were attributed to sensitising agents on the DSS benefits scheme schedule. This survey suggests and occupational asthma rate of 22 per million of the general population.

High risk occupations were listed as:-

• Coach and spray painters 35 cases/ 639 million in the trade.
• Chemical Processors 31 / 424
• Bakers 29 / 409
• Plastics making and processing 27 / 409
• Metal making and treating 14 / 249
• Laboratory technicians 26 / 204
• Welders/solderers/electronics assemblers 35 / 159
• Other painters 21 / 104

The regional rates of occupational asthma ranged from 8 million in West Yorkshire to 63 per million in the West Midlands. With increasing numbers of occupational physicians reporting to the SWORD scheme, it was believed there would be a rise of 50% or more in the reported incidence of occupational asthma in future years but it was clear already that occupational respiratory diseases were more common than official statistics suggested. ⁽³¹⁾

DOUBLE OR SEXTUPLE
Contrasting with the optimism that more cases would be discovered, later reports from the HSE on the SWORD scheme show an overall fall from the 554 cases in 1989, though 564 in 1990 to only 436 in 1991. The HSC and HSE, having said two years earlier that the relatively small number of over 500 new cases a year was "inevitably incomplete" and that "it can be drawn the incidence of occupational asthma is at least double that represented by the compensated claims " (in the DSS scheme), now suggest in September 1992 that the SWORD scheme can be interpreted to "imply a national incidence rate...up to six times the number of compensated cases". ^{(32) (33) (34)}

FINAL WORD FROM THE IIAC
When recommending to the Minister that the scheme could be widened, the IIAC said they did not anticipate the more open system of prescription, with the catch-all 'any other sensitising agent, would lead to a great increase in the number of those claiming benefit. By analogy, they wrote, the number of claimants for dermatitis, which is prescribed in similar terms, is not excessive. ⁽³⁵⁾
Doubtless they were aware the HSE has said "the numbers of cases of occupational dermatitis are probably greater than have ever received benefit from the Industrial Injuries scheme. Data from three separate surveys (including the Labour Force Survey) all produce estimates of the annual number of cases between 50,000 and 100,000". ⁽³⁶⁾ Today only 1,030 people receive benefits for this condition and in the last year less than 20 new awards were made. ⁽³⁷⁾ But that's another story....

If any union wishes to make comments or obtain greater details of references or copies of any documents (including the limited circulation DSS/ASD tables) contact the Research Service.
 

REFERENCES

1. DHSS/IIAC 'Occupational Asthma' Cmnd 8121 Jan 1981.
2. Office of population, Censuses & Surveys (OPCS) Labour Force Survey 1990 in HSE 'Health & Safety Statistics 1990-91' Employment Gazette Vol. 100 No. 9 Sept 1992 Occasional Supplement No. 3 p75.
3. Univ. of Birmingham Institute of Occupational Health Bulletin No. 12, March 1992; P. Blanc 'Occupational Asthma in a al Disability Survey' Chest Vol. 92 4 Oct 1987 pp613-7; Sheffield Occupational Health Project 'Community Survey of Occupational Health prevalence' (unpublished) in Hazards 39 June 1992 pp6-7.
4. Anon 'Asthma Benefit - no one told us' Hazards Bulletin 37 Oct 1983 p5.
5. RoSPA 'Safety Representative - keep them posters' Mar 1985 p12.  
6. A. Morris MP H. of Commons 29-7-83 HSIB (IRS) No. 124.
7. Social Security Commissioners' Decisions 52/53; CVG 2/49 (KL); R(G) 3/53 & R(P) 1/79.
8. DHSS 'Occupational Asthma' leaflet N1237.
9. DHSS 'Occupational Asthma' poster IB2/84.
10. See Section 11 'Occ'l Health - Industrial Injuries Scheme/background' in Employment Gazette Occ'l Supp. No. 3 Sept 1992 p76.
11. ditto p76 & Table 46 p90 and Table 49 p94.
12. HSE 'Draft Approved Code of Practice - control of respiratory sensitisers: COSHH Regs 1988' Consultative Document CD50 1992.
13. Hansard 19-3-86 col.27.
14. DSS/IIAC 'Occupational Asthma' Cmnd 1244 Oct 1990.
15. See ref. 9.
16. HSE Statistics Health & Safety 1981-2' Sept 1985 Table 10.2 p59.
17. HSC 'Annual Report 1988-90' Table 15 p102.
18. HSE 'Health & Safety Statistics 1988-90' in Emp. Gazette Vol. 98 No. 11, Nov 1990 Occ'l. Supp. No. 1 Table 33 p57.
19. HSE 'Health & Safety Statistics 1990-91' as above Table 46 p88 and Table 49 p64.
20. HSE 'Health & Safety Statistics 1990-91' as above Table 46 p88 and Table 49 p94.
21. DSS/ASD 'Industrial Disablement Pensions & Reduced Earnings Allowances Statistics 1989-90' Mar 1991 Tables Dis. Ben. 2 & 8.
22. DSS/ASD as above '1989-91' Table Dis. Ben 14.
23. As ref. 18 Section 11: 'Occupational Health - Occupational Asthma' p80.
24. As ref. 21 Tables 2 & 8.
25. As ref. 21 Table 14.
26. As ref. 18 Table 94 p94.
27. DSS 'Social Security Benefit Rates' leaflet NI 196.
28. HSC 'Annual Report 1989-90' Table 17 p104.
29. HSC 'Annual Report 1990-91' in Hazards 39 June 1992 pp6-7.
30. As ref. 18 Table 51 p95.
31. Meredith, Taylor & McDonald 'Occupational Respiratory Disease in the UK 1989; a report to the British Thoracic Society & the society of Occupational Medicine SWORD project group' British Journal of Industrial Medicine Vol.48 No. 5 May 1991 pp292-8.
32. As ref. 17 p49.
33. As ref. 28 para 35 and Table 19 p80.
34. As ref. 22.
35. As ref. 13 para 12 p3.
36. As ref. 22 but Section 1: 'The overall picture' p7.
37. As ref. 23 Table dis. Ben. 14.

This paper was drawn up by Bill Lawrence who has long assisted the GFTU on Health & Safety matters. He has contributed major work to the Federation on industrial deafness and has assisted a number of our unions on industrial health matters.

It is important that unions see the opportunities for assisting members with asthma problems. The Research Service is available to help any action a union wishes to take.

This paper began as part of a submission to a North Shields Social Security Appeal Tribunal on behalf of a 29 years old former baker awarded 17% for asthma. At the Appeal the DSS agreed to review the case and asked for an adjournment. A week later the benefit was back dated to 1982, the claimant receiving around £6000 in arrears of benefit having shown ignorance of the scheme and inability to claim before November 1992.

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