Basic guide - reporting and diagnosing occupational diseases

SPONSORED ARTICLE

Dr Luvuyo Dzingwa

RMA Medical Manager

Early recognition, diagnosis and reporting of occupational diseases are vital steps in any occupational health (OH) surveillance system. This article provides frontline medical practitioners with a basic guide to assist them in the vital role they play in diagnosing occupational diseases. Their clinical findings and expertise are critical for establishing a high index of suspicion of an occupational event. 

 

Compensation legislation

Compensation for occupational diseases in South Africa is covered by two statutory systems, namely the Compensation for Occupational Injuries and Diseases Act (COIDA, Act No. 130 of 1993), and the Occupational Diseases in Mines and Works Amendment Act (ODMWA, Act No. 208 of 1993). ODMWA provides compensation for specific occupational lung diseases contracted by employees who work, or previously worked, in a controlled mine and related works.

COIDA covers all other occupational diseases not covered by ODMWA that arise out of, and in the course of, employment. Rand Mutual Assurance (RMA) is licensed to administer COIDA benefits on behalf of the Compensation Commissioner for the mining, iron, metal, steel and related industries.  

 

NOTIFIABLE OCCUPATIONAL DISEASES

Compensation legislation imposes a statutory notification requirement on the employer with regard to OH diseases. Thus medical practitioners must inform employers of the diagnosis of occupational diseases to enable them to notify the relevant compensation fund, mutual assurance or entity.

Reporting an occupational disease triggers investigations to establish causality and active case-finding to identify others who may also be at risk. This assists employers to take appropriate preventive measures, monitor trends and ensure early identification of emerging concerns. Moreover, accurate and prompt reporting enables employees to exercise their rights in claiming compensation and ensuring that their claims can be processed swiftly.

 

Diagnosis of occupational diseases

Occupational diseases are not easy to identify as the cause and effect (disease) are normally distantly related in time. An exposure or multiple exposures over a long period are more likely to be the cause, and the effect (disease) may be slow to manifest, so may not be attributed immediately to the exposure.

The proposed approach described in Table 1 simplifies diagnosing and reporting of occupational diseases.

Proper diagnosis and efficient reporting of occupational diseases will be beneficial in two respects: more eligible employees will be compensated, and this will result in effective vigilance that will lead to early detection of an occupational disease, and timely treatment.

 

Table 1. Stepwise approach for diagnosis of occupational diseases, adapted from Boschman et al. (2017)1

 

RESOURCES

1. Eurogip. Reporting of occupational diseases: issues and good practices in five European countries. 2015.  Available from http://www.eurogip.fr/_scripts_externe/pdf.php?a=e&f=../images/.../Report...pdf (accessed 30 Apr 2018).

2. Govender M, Ehrlich RI, Mohammed A. Notification of occupational disease by general practitioners in the Western Cape. S Afr.Med J. 2000; 90(10):1012-1014.

3. International Labour Organization (ILO). Identification and recognition of occupational diseases: criteria for incorporating diseases in the ILO list of occupational diseases.  Meeting of experts on the revision of the list of occupational diseases (recommendation no. 194). 27-30 Oct 2009. Available from http://www.ilo.org/wcmsp5/groups-public  (accessed 5 May 2018).

 

REFERENCE

1. Boschman JS, Brand T, Frings-Desen MH, Van der Molen HF.  Improving the assessment of occupational diseases by occupational physicians. Occup Med (London). 2017; 67(1):13-19.

 

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