The Federal Government has moved to end confusion in the work health and safety market over what is and isn’t an occupational disease (including lung cancer due to asbestos exposure) by publishing an up-to-date “deemed-diseases” list.

Safe Work Australia’s (SWA) Deemed Diseases In Australia report lists diseases and associated work-related exposures to streamline identification and compensation of work-related disease in Australia.

The list provides information to help anyone involved in the prevention or compensation of occupational disease. Among other things, it will assist registered training organisations, including AlertForce, educate workers on WHS best practice in at risk occupations.

SWA chief executive officer Michelle Baxter said most Australian jurisdictions had special provisions in their workers’ compensation legislation deeming certain specified occupational diseases as being caused by specified work-related activities.

“In many cases, these lists have not been updated since they were introduced and therefore do not include some diseases for which there is now strong evidence of a causal link to work-related exposures.”

Ms Baxter said the Deemed Diseases in Australia report was the result of a “thorough review of the latest scientific evidence on the causal link between diseases and occupational exposure, by an independent consultant in epidemiology and occupational medicine, Professor Tim Driscoll”.

“While the report was developed primarily for use by jurisdictions, SWA agreed to publish the report as it provides useful evidence-based information for anyone involved in the prevention or compensation of occupational disease.”

The project involved consultation via the representative membership of SWA. SWA agreed that impact assessments and public consultation are more appropriately undertaken by those jurisdictions considering revising their own deemed diseases lists.

The effect of the deemed diseases list is to reverse the onus of proof. A worker with the disease who has been exposed to the relevant exposure in the course of their work is assumed to have developed that disease because of the exposure unless there is strong evidence to the contrary. Diseases that are not included on the list can still be the subject of a workers’ compensation claim through the normal approach, where the reverse onus of proof would not apply. The deemed diseases approach simplifies relevant claims on the assumption that there is a high likelihood that the disease has arisen as a result of work-related exposures.

The deemed diseases lists in use in Australia are not commonly used as the basis for claims. There are probably several reasons for this, particularly that the lists are not up to date and are not well structured to facilitate claims to be made under deemed diseases legislation. As a result of these issues, SWA undertook a project in 2013 to develop an up-to-date Australian list, based on the latest scientific evidence.

The criteria used to determine which diseases and associated exposures should be included on the list were:
1. Strong causal link between the disease and occupation exposure.
2. Clear diagnostic criteria.
3. The disease comprises a considerable proportion of the cases of that disease in the overall population or in an identifiable subset of the population.

Not every disease that is known to be caused by work should be included on a Deemed Disease list. Where the disease is very common in the community but only rarely caused by work, it would usually be inappropriate to include the disease on the List because the vast majority of cases would be expected to be due to non-work exposures. To include every disease that has ever been shown to be caused by an exposure that occurred in connection to occupation would make the List very unwieldy and not be consistent with the Deemed Diseases approach.

Equally, it would not be appropriate to only include diseases in which occupational exposures were the majority cause. Lung cancer is a good example. Lung cancer is known to be caused by exposure to asbestos, and the most common circumstance in which asbestos exposure occurs is through work. However, the most common cause of lung cancer in the community is smoking. Excluding lung cancer from consideration because the main cause is non-occupational would mean that many people whose cancer is actually caused by occupational exposure to asbestos will find it much more difficult to receive appropriate compensation for their illness. In many instances, people may have had several exposures,

There are some infections that are likely to usually or commonly result from work-related exposures. These are good candidates for inclusion on the list, because it is likely that any individual case would have arisen due to work-related exposures in the at-risk occupations. Leptospirosis is an example of this sort of infection. Leptospirosis is a zoonotic infection caused by a range of small organisms called leptospira. The main occupational source of infection is the urine of infected animals. Persons who appear particularly at increased risk of leptospirosis include farmers (especially dairy farmers), abattoir workers, forestry workers, hunters, veterinarians, plumbers, sewer worker and transport operators. It is recommended that leptospirosis in high-risk workers be included on the list.

For other infections, the majority of cases will occur not in relation to occupational exposure, which means the infection is not appropriate to include for workers in general. However, for some specific working groups, most cases of the infection in question will be due to occupational exposure, so the infection in that work group could be reasonably included on the list. Tuberculosis in health care workers is a good example. Infections where there is not a strong relationship between the infectious disease and a particular occupational group, but where occupationally-related cases do occur sporadically, are not recommended for inclusion on the list.

AlertForce offers training in asbestos awareness training, assessment and removal (http://alertforce.com.au/ohs-training-courses/asbestos-awareness/), and dealing with hazardous materials and substances (http://alertforce.com.au/ohs-training-courses/hazardous-materials/)

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