With the wide application of new technologies, new materials and new processes, the occupational environment and hazards to which workers are exposed are more complex and diverse. Can the occupational disease catalogue keep pace with the times?
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At the 22nd Publicity Week of the Law on the Prevention and Control of Occupational Diseases, professionals called for timely and flexible adjustment of the Classification and Catalogue of Occupational Diseases, proper simplification of the identification procedures for work-related injuries of workers with occupational diseases, and better protection of workers' occupational health rights.
From April 25 to May 1, it was the 22nd publicity week of the Law on Prevention and Control of Occupational Diseases in China. At present, focusing on improving workers' occupational health literacy and safeguarding their occupational health rights and interests, various forms of publicity activities are carried out everywhere.
"Are cervical spondylosis and low back pain occupational diseases?" "Why is it difficult to identify work-related injuries when they have been diagnosed as occupational diseases?" "Will the spectrum of occupational diseases change with the introduction of new technologies and processes?" When it comes to occupational diseases, some workers raise questions and others are troubled.
In this regard, a professional said to the reporter that with the economic transformation and upgrading, new types of work and modes of work continue to emerge, and the occupational environment and occupational hazards to which workers are exposed are more complex and diverse. The Classification and Catalogue of Occupational Diseases should be adjusted timely and flexibly, and the identification procedures for occupational injuries of workers with occupational diseases should be properly simplified to better protect the occupational health of workers.
Can cervical spondylosis be included in the list of occupational diseases
The reporter found that many office workers, including drivers, called for cervical spondylosis, periarthritis of shoulder, "mouse hand" and other diseases to be included in the list of occupational diseases. Master Jiang, who was "injured at work", is one of them.
Master Jiang has been driving a taxi in Shenzhen for nearly 20 years. He suffered from cervical spondylosis and lumbar disc herniation due to sitting for a long time
"I sit on the bus for 12 hours every day. Sometimes when I get off the bus, my legs are numb and my waist is very tired." Jiang Shifu said that when I get sick with cervical spondylosis, my shoulders are numb and my head hurts badly; When the lumbar intervertebral disc protrudes, it may be painful in light, but difficult to get up in heavy.
In response to the call of many workers to include cervical spondylosis, lumbar spondylosis and other diseases in the list of occupational diseases, Ren Guoyou, vice president and professor of the School of Safety Engineering, China Institute of Labor Relations, said frankly: "It is a positive measure to include musculoskeletal diseases in the list of occupational diseases, but there is currently no operable technical means to identify diseases caused by work, which needs to be promoted scientifically and carefully."
Guan Tieliu, senior partner of Guangdong Huashang (Longgang) Law Firm, told reporters that diagnosis would be a big problem if musculoskeletal diseases were included in the list of occupational diseases. "The diagnosis of occupational disease requires the determination of the causal relationship between the disease and work to prove that there are no other hazardous factors in daily life. In addition, even if the occupational disease can be diagnosed, the subsequent disability rating is not easy to carry out."
"More importantly, once an occupational disease is diagnosed, reemployment will inevitably be affected." Guan Tieliu said frankly that the Law on the Prevention and Control of Occupational Diseases stipulates that employers should transfer the occupational disease patients who are not suitable to continue their original work from their original posts and properly settle them. "The damage caused by most occupational diseases is irreversible, while musculoskeletal diseases are reversible. In addition, occupational disease diagnosis books are connected to the national network. If cervical spondylosis and lumbar spondylosis are confirmed as occupational diseases, then the workers who are confirmed as occupational diseases will be transferred from their posts, and even in the future it will be difficult to work from their original posts."
Whether the identification procedure of work-related injury can be properly simplified
"Unexpectedly, my industrial injury identification card is on the confirmation of labor relations." Since the early 1990s, Mr. Hua has been mining in a gold mine in Zhangjiakou City, Hebei Province. In 2014, Mr. Hua sought occupational disease diagnosis due to lung discomfort. However, after being diagnosed as an occupational disease, he could not be identified as an industrial injury because he could not prove the labor relationship. Up to now, they still fail to enjoy the treatment of work-related injuries.
The reporter learned that in 2005, the gold mine that Mr. Hua worked for was a collective enterprise, and now it has gone bankrupt and has been restructured into a mining company. He continued to mine at the original site and resigned at the end of the year.
In September 2016, the occupational disease diagnosis institution issued a diagnosis certificate confirming that Mr. Hua was suffering from occupational pneumoconiosis, but the employer was a collective gold mine, not a reformed mining company. In May 2019, he applied for labor arbitration to confirm the existence of labor relations with the mining company in 2005, which was not accepted. After he filed a lawsuit to the court, the court ruled that both parties had labor relations after the establishment of the mining company and before Mr. Zhihua left his job.
However, when Mr. Hua applied for industrial injury, it was proved that the employer was a collective enterprise before bankruptcy due to occupational disease diagnosis, and the local human resources and social security department decided not to accept the application on the ground that the gold mine was bankrupt and cancelled. In desperation, Mr. Hua had to apply for occupational disease diagnosis again to the local occupational disease diagnosis institution, requesting it to change the employer into a mining company. The agency clearly stated that it was impossible to diagnose again, and the change of employer must be confirmed and approved by the mining company with seal.
In 2023, Mr. Hua applied for industrial injury with the mining company as the employer, which was not accepted by the human resources and social security department. For this reason, he filed a lawsuit again
"After nearly 10 years and 10 lawsuits, the identification of work-related injuries could not be completed and occupational disease insurance and work-related injury benefits could not be enjoyed due to labor relations, employer confirmation and other problems." Guan Tieliu believes that the root cause of the problem is that when employees suffering from occupational diseases are identified as work-related injuries, it must be confirmed that there is a labor relationship with the employer.
Guan Tieliu revealed that Mr. Hua's experience was not an individual case. After some employees were diagnosed with occupational diseases, they were often stuck in proving their labor relations in the subsequent identification of work-related injuries. The occupational diseases are different from the industrial injuries caused by mechanical external forces. Most of them have an incubation period and need continuous or even lifelong treatment.
"Occupational causes are caused by occupational activities. Occupational history, contact history and clinical manifestations are enough to diagnose occupational diseases. Therefore, specific labor relations do not constitute a decisive factor in determining whether to identify work-related injuries. In this way, it is difficult for workers to identify work-related injuries by proving the existence of labor relations." Guan Tieliu called on whether the procedures could be properly simplified. At the same time, it is suggested that workers should know as soon as possible whether their posts are exposed to occupational disease inductive factors. In case of complicated employment relations or changes in the main body of the employer, they should consciously preserve the evidence related to their work.
Establish a dynamic updating mechanism of occupational disease catalogue
The reporter found that since 1957, when China first issued the Provisions on the Trial Implementation of the "Scope of Occupational Diseases and the Measures for the Treatment of Occupational Disease Patients", the list of occupational diseases has been adjusted three times, and the types of diseases have also increased from 14 to 132 in 10 categories. The last adjustment was in 2013.
At present, new technologies, new materials and new processes are constantly updated, new occupations, new types of work and new business types are constantly emerging, and some new occupational hazard factors are beginning to appear.
"With the wide application of new materials, workers may be exposed to more new chemical substances, some of which may cause potential harm to human health." Ren Guoyou cited the hazards of electromagnetic radiation, non ionizing radiation and other physical factors as examples. Emerging industries such as biological medicine and gene editing may expose workers to new biological hazards such as viruses Bacteria, etc.
Ren Guoyou believed that the list of occupational diseases should not only maintain a certain stability, but also establish a dynamic updating mechanism to make the list more flexible and applicable. He suggested that we focus on the newly generated occupational hazard factors, assess their impact on the health of employees, and timely include related diseases in the list.
Guan Tieliu feels the same way. For the new occupational disease inductive factors, he suggested that the list of occupational diseases should be supplemented with open clauses, "for example, the open clauses on occupational chemical poisoning in the current list - other chemical poisoning not mentioned above that have direct causal links with the exposure to occupational harmful factors."
How to improve the flexibility of occupational disease catalogue? Ren Guoyou believed that the scientific and professional nature should be strengthened, new occupational hazard factors should be found and evaluated in time, and the dynamic adjustment mechanism of the catalogue should be further improved to better adapt to the changing occupational environment. At the same time, establish the occupational disease monitoring and early warning system to provide timely and accurate information support. (Reporter Liu Youting)
