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Development of the International and Egyptian Occupational Diseases’ Lists - Review

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Development of the International and Egyptian Occupational Diseases’ Lists - Review Egyptian Journal of Occupational Medicine, 2012; 36 (2) : 215-237 DEVELOPMENT OF THE INTERNATIONAL AND EGYPTIAN OCCUPATIONAL DISEASES’ LISTS - REVIEW By Abo El-Ata GA Department of Occupational and Environmental Medicine, Faculty of Medicine, Cairo University. Abstract: An occupational disease is typically identified when it is shown that it is more prevalent in a given group of workers than in the general population, or in other worker populations. The present review study aims at eliciting development of the occupational diseases concepts and lists in Egypt and internationally, in order to anticipate the future trends in enhancing the supportive activities targeting healthcare activities of the Egyptian workers. The historical and present situation of occupational diseases are carefully reviewed and discussed, emphasizing the foot prints of related conceptions in Egypt and ILO. Future ambitions are expressed by the current study. Adopt the ILO list as well as its future amendments. In addition, re-formatting the schedule, in a similar way the ILO list is organized in three categories of occupational diseases: 1) Diseases caused by agents (chemical, physical, biological) ; 2) Diseases of target organ systems (respiratory, skin and mucous membranes, musculoskeletal, liver, kidney, endocrine, etc.) ; and 3) Occupational cancer. Restructure the basic occupational health services (BOHS) to insure provision of comprehensive and continuous benefits for every worker in his workplace. A series of guidelines and codes of practice should be issued to facilitate adoption of BOHS with detailed required procedures. The study recommended continued improving the Egyptian schedule, with establishment of proper guidelines and codes of practice to lead surveillance of the worker’s health and the workplace, an important item in basic occupational health services (BOHS). Key words: Occupational Diseases, List, Schedule, ILO, Egypt. 215 216 Abo El-Ata GA Introduction afford social justice, and presenting cultural At the beginning of the 21st century, the consciousness. The Occupational Diseases’ ILO/WHO Burden of occupational disease list has played a key role in harmonizing the – Worldwide – amount 1.9-2.3 million development of policies on occupational deaths attributed to occupation, 1.6 million diseases and in promoting their prevention deaths attributed to work-related diseases, at both the national and the international and 217 million cases of occupational levels. disease [ILO, 2013]. The present review aims at eliciting An occupational disease is any chronic synthesis and development of the ailment that occurs as a result of work or occupational diseases concepts and lists occupational activity. An occupational in Egypt and internationally, in order to disease is typically identified when it is expect the future trends in enhancing the shown that it is more prevalent in a given supportive activities targeting health and group of workers than in the general wellbeing of millions of Egyptian workers. population, or in other worker populations. Historical Perspective The first such disease to be recognized, squamous-cell carcinoma of the scrotum Egypt, Greece and Rome recognized, in was identified in chimney sweep boys ancient times, some forms of occupational by Sir Percival Pott in 1775 [Thompson, diseases affecting miners who were 1914]. Donald Hunter in his classic history engaged in one of the oldest industries. of occupational diseases discussed many It is known that miners used bags, sacks, examples of these diseases. They include: animal bladders as masks to decrease Phossy jaw among the London match-girls; dust exposure. During the middle ages, Radiation sickness among some persons feudalism emerged in Central Europe with who had been working in the nuclear appearance of feudal enterprises especially industry; and Radium jaw among the in mining activities with consequent need Radium Girls [Baxter et al., 2000]. of serf unskilled labour. At late middle ages, growth of trade with increased need Various countries are currently for money and capital for mines at the adopting lists of occupational diseases in Central Europe with consequent need for order to benefit their workforces exposed skilled labour in order to mine deeper with to various workplace health risks. Benefits worsened conditions (Linn, 2010). of the adopted lists are many: organize medical care and rehabilitation, provide Throughout the 16th and 17th century, economic and other types of compensation, mining, metal work and other trades Occupational Diseases’ Lists 217 were flourished with some improvement result of disability. These were sponsored by in ventilation happened and a shift from “Friendly Societies” that started to appear feudalism to capitalism. This was followed in the UK. Similar organizations sponsored by establishment of guilds, artisans who by workers, employers, townspeople, announced some sickness and funeral religious groups, physicians appeared in benefits. In the meantime, awareness of Scandinavia, Netherlands and Germany health hazards due to mined metals was (Occupational Diseases in 18th Century: A recognized by Agricola, a town physician Classic of Science, 1930). in Bohemia, who published in 1556 his During the 19th century, Europe treatise: De Re Metallica – hazards of metal witnessed a continual series of legislation mining. Eleven years later, Paracelsus, related to working conditions. The a town physician in Austria published “Factory Acts” in the United Kingdom his treatise on occupational diseases of (1878 to 1895) organized hours of work, mine and smelter workers. During the age of work, education for children, subsequent years, health hazards of some chemicals were documented: lead (1572), physician exams, safety inspectors, as carbon monoxide (1575), and arsenic well as other measures. This established (1630) (Baxter et al., 2000). principle of government intervention. As a part of the UK Factory Acts, statutory th During the 18 century, Bernardino medical service for factory workers was Ramazzini, a physician, professor of introduced in addition to factory inspectors, medicine in Modena and Padua published certifying surgeons, medical certification in 1700 his treatise on: “De Morbis for children. Periodic medical exams were Artificum Diatriba or Diseases of Workers” started for workers with exposure to lead, at which he wrote a systematic study of white phosphorus, explosives, and rubber. trade diseases. By this work, Ramazzini Notification of industrial disease started is considered the “Father of Occupational for lead, phosphorus, arsenic, and anthrax. Medicine”. He anchored the famous The 4 diseases, thus, constituted the first question: “what is your occupation?” At occupational diseases list set in Europe. In mid and late 18th century, Hale (1743) 1898,Thomas Legge was appointed as the pointed to the importance of ventilation and first Medical Inspector of Factories in the Von Humboldt (1790’s) designed the Gas UK (The Factory Acts, 2014). mask and safety lamps for miners. During 1750’s, the concept of insurance began to By the 20th century, continual develop in the form of payments of medical modifications to the “Workman’s care and replacement of income lost as Compensation” law necessitated additional 218 Abo El-Ata GA benefits and more coverage. By 1913 the industrial poisonings (lead and mercury) UK Schedule of “Industrial” diseases had and one infection (anthrax) [ILO: C18, 6 illnesses. More occupational diseases 1925], emphasized the workers’ right were consequently added: silicosis, to compensation. Then, years later, the pneumoconiosis (1926), cancer (1932). convention was revised to Convention By 1947, a generic definition of industrial No. 42 (C42) [ILO: C42, 1936]. The disease was issued, accompanied by a list new list of occupational diseases added of diseases appeared in the UK Schedule ( 7 additional diseases to the previous list Seaton, 2010). of lead poisoning, mercury poisoning, The International Labour Organization and anthrax infection. The newly added (ILO), declared anthrax an occupational diseases included 4 types of poisoning; disease at 1919, the same year of its phosphorus poisoning, arsenic poisoning, creation (ILO: R003, 1919). In 1925, poisoning by benzene, and poisoning by Workmen’s Compensation (Occupational halogen derivatives of hydrocarbons of the Diseases) Convention No. 18 (C18), which aliphatic series, and 3 diseases; silicosis, was established as the first ILO List of diseases due to radiation, and skin cancer Occupational Diseases, comprising two (Table 1). Table 1: Early Occupational disease list of the ILO ILO legislation R03, R04 C18 (1925) C42 (1934) (1919) Chemical 1) Lead 2) Mercury 3) Phosphorous, 4) arsenic, 5) Benzene or its homologues, their nitro- and amino-derivatives, 6) halogen derivatives of hydrocarbons of the aliphatic series Physical 1) Radium and other radioactive substances, 2) X-rays Biological 1) Anthrax No change No change Pulmonary 1) Silicosis with or without pulmonary tuberculosis, provided that silicosis is an essential factor in causing the resultant incapacity or death. Cancer 1) Primary epitheliomatous cancer of the skin. ILO: International Labour Organization, R03: ILO recommendation No.3, R04: ILO recommendation No. 4, C18: ILO convention No. 18, C42: ILO convention No. 42. Occupational Diseases’ Lists 219 The 10-item list was maintained for 30 that “unless proof to the contrary is years, until it was revised as Employment brought, there should be a
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