Transcript Irena Manfredo PS III 17_15 Can unemployed persons.ppsx

Can unemployed persons have
an occupational disease?
prim. Irena Manfredo, MD, MSc,
OHS
EUMASS 2016, Ljubljana
No conflict of interests
prim. Irena Manfredo, MD, MSc,
OHS
EUMASS 2016, Ljubljana
V.B.‘s story
Frame = unemployment
10 years trend - SLO
10 YEARS TREND OF UNEMPLOYMENT
124015
110021
112754
JAN/11
JAN/12
118061
119,458
96672
92575
78303
JAN/06
JAN/07
68414
66239
JAN/08
JAN/09
JAN/10
JAN/13
JAN/14
JAN/15
Unemployed
Position = outsiders
• margins of the health-care
system
• outside the scope of
organisations for safety and
health at work
• outside trade unions
OHS at ESS
•
•
•
•
Cousellor
review medical records
no medical exam
assess workability
advise appropriate job
The /un/happy end of OHS role
Passepartout = asbestos
Legislation - part
• asbestos products have been
banned from the EU since
2005
•
Commision Directive of 26 July 1999 adapting to
technical progress Annex I to Council Directive
76/769/EEC on the approximation of the laws,
regulations and administrative provisions of the
Member States relating to restrictions on the
marketing and use of certain dangerous substances
and preparations (asbestos).
SLO- asbestos clusters
Source: prof. Metoda Dodic-Fikfak, Ph.D, OH specialist
Reality /show/
…
…to be continued..
…
…more legislation
• European Parliament resolution of 14 March
2013 on asbestos related occupational health
threats and prospects for abolishing all existing
asbestos (2012/2065 (INI)).
• Rules on conditions for designation of disease
because of exposure to asbestos and measures
for designation of height of indemnity (displayed
30 September 2008).
Picture = VB‘s story
• 60 years old carpenter
• 10 years unemployed
• reduced ability to work
….he felt well but "there is
something in my lungs supposedly
due to asbestos".
Accurate work history
• apprentice in a carpenter's
workshop: July 1971 - August 1974
• six months at school and six months of
practice
• over eight hours a day, six days a week
• carpenter:
until August 1975*
installing asbestos insulating boards
…after *continued to work with wood
as carpenter proper.
Asbestos insulating boards
Working on safety
• The boards were cut, sawed, and
screwed on walls without masks,
ventilation, or other safety
measures.
• The workers knew that the boards
were made of asbestos, but had no
idea of its harmful effects.
• They usually had their lunch breaks
at the workplace.
Medical history
• 2008: surgery of his right
shoulder pointed to pulmonary
embolism
• follow up lung X-ray once a year
• 2008 -2011: no suspicious
changes
• 2012: extensive pleural plaques
and atypical condensation
Pleural plaques
The causal relationship
• exposure at work
•
•
•
•
•
•
•
no paper evidence
no contracts
no environmental measurements
no risk assessment
master-carpenter died
the apprentice's working diaries were burnt
signed statement of the master-carpenter's collaborator
• effect on the worker
•
•
diagnosis
induction period: 41 years
1st submission…
…rejected as insufficient
PROOF?!
Proof : mineral analysis
SEM - electronic line microscopy
EDS-electronic dispersion spectroscopy
2nd submission…
• verified asbestos exposure
+
• extended diagnosis: bilateral
pleural plaques + asbestosis
Deja vu…
To conclude
• illustrates:the unemployed are
on the margins of the system
• gives guidelines: for
improvement (?)
The burden of proof should lie
with the system and not the
individual.
Thanks for attention!