Document 4QoN56xGQM5nX0Naz5eZgbbKV
FILE NAME Insurance Industry INS
DATE 1937 DOC INS052
DOCUMENT DESCRIPTION Western Safety Conference Presentation - The Problem of Occupational Diseases in Industry with Cover Letter
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4.MY.NGL INEE S
4.M.NGINES PRESIDENT PRESIDENT
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Association of Casualty and Surety Executives
Number One Park Avenue
New York
August August 31 1937
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The it vne treated to for for the se cent
annual meeting on the subject Industry Industry
of the Tretorn Snity Conference at sland ate Problem of Organizational Cisnare in
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THE PROBLEM OF OCCUPATIONAL DISEASES IN INDUSTRY
Pacific by REGINALD MOSS
Coast Manager Association of Casualty and Surety Executives
An address before the third annual meeting of the Western
Safety Conference at
Portland Oragon August 20th
As a preface to this
discussion of The Problem of
Industry I would like to
explain briefly the interest
Occupational Diseases in
Association of
in the subject of the
Casualty and Surety Executives which I
The Association is
have the honor to represent
composed of some 60 of the
companies of the country the
leading casualty Insurance and surety
majority of which write a
men's
substantial volume of work-
compensation insurance Its
activities are
studying problema
largely along research lines --
and situations that are of
mutual interest to its member
companies
recent years and the bringing of
such diseases under the
laws of the
workmen's workmen's compensation
various Stateo with a
bonefits to such
resultant increase in the coat of compansation compansation
a problem and
consequently has received the
Association
careful study of the
It is recognized that where
a workman's death or
disease that arises out of his
disability resulte from a
employment he or his dependents
compensation Just as if
are entitlad to
the calamity had resulted from
employment At the same time it is felt
an gccident in the coures of
that socipational disease
ba
carefully studied and drafted so that
first
any abuses
coverage should
outset and
will be obviated at the
second that the costs of
place too
compensating such disabilities will not
heavy burden on industry Hence the research work
has done on the
which my Association
subject
This is a Safety Conference On first thought safety donates
dent prevention and
only acci-
nearly all the workmen's
compensation laws -- with a few
ceptions in this country ALL-
originally covered only injuries by
ex
otherwise called accidental injuries But from
accident
calla for just as much protection against diseases
the social standpoint safety
included
as against accidants and to be
as safety measures are all the
campaigns that have been or
for the
are being waged
prevention of yellow fever smallpox
diphtheria scourges of
tuberculosis and other
humanity Now the workmen a
compensation laws are being brought into
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same category by being amended or liberally construed to cover occupational
v7,thediscanos thereby placing the burden upon industry of preventing such diseases or of
compensating for their consequeDQNS In principle occupational diseases mean only those diseases for which indus-
try in the person of the employer can rightly be held responsible that is diasands which are peculiar to and characteristic of particular processes occupations
or employmento as distinguished from those diseases which are more or less comman
to humanity or to the community regardless of differences in occupation
number of the a workmen compensation laws in this country cover occupation-
al disenten implicitly by including all injuries
and not merely accidental
injuries {. arising out of the employment or by expressly covering occupational diseases but without defining them or by covering occupational diseases as do-
fined in general terms But a majority of our compensation laws that cover occupe-
tional diseases and nearly all of such laws abroad define such diseases by
listing them in a schedule
schedule "
The great weight of expert opinion I believe is in favor of this pien It not only avoids much uncertainty and wasteful litigation including pos-
sible abuse of power by Industrial Commissions Commissions but by directing the attention of
employers specifically to the diseases for which they will be held responsible it is also most conducive to prevention The experience in California in my opinion confirms the merits of the schedule plan Ever since 1918 our woziomen's compon
aation law has implicitly covered silicosis as well as other industrial disensen but hardly anybody ever heard of silicosis and Zew ployera had any idea of its seriousness or of means of preventing 10 until in 1930 and 1933 a series of decisions validating long belated claims surprised them and their insurance curriers
with a mass of liabilition for coems of a disease contracted years before and of
which they had had no warning
In connection with compensation for occupational diseases prevention is of
first importance Experience indicates that the standard occupational dise8806
that is as lead
those which have longest been or zow are more generally recognized nach sine mercury and phosphorus poisoning the beads or compressed air ill
5893 sto
can be almost sutirely prevented or greatly reduced by practicable
means. But as to that more lately recognized occupational disease siliconia
there are doubts and difficulties In Great Britain and New South Wales where
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vA anywhere they have had longer experience with compensation for silicosis than
in
this country the lossos therefrom as represented by the cost of compensation
still show increasing tendencias
It is true according to reports that in the mines of South Africa where
measures for prevention of and compensation for silicosis originated and where tha most elaborate methods for elimination of harmful silica dust have been most
thoroughly tried out the losses are being reduced But such favorable results I an informed may be ascribed in large part to paculiar labor conditions In those mines the common labor most exposed to silica dust is almost entirely negro the
negroes are medically examined monthly and are laid off at the first indication of
bronchial affection or loss of weight and their employment is only temporary seldom for longer than three years Manifestly such moans of prevention ere hardly
practicable with white labor Declarations by public authorities in some of our
compensation States that ailicosis therein is already on the way to extinction may
bs accepted as a pious hope but has no adequate basis in experience to support it as a prediction
true
The peculiar difficulties of asbestosis and any other
about silicosis
dust disesse of
and the samo is the lungs arina
approximately from the facts
that it is a disease of gradual contraction the average period of contraction being
said to be between seven and twelve years that it is incurable though it may be
arrested in its earlier stages but thereafter becomes progresdive that by itself
it seldom causes
silicotics being
disability especially
or death but is commonly complicated with tuberculosis
susceptible to tuberculosis and the tubercular being
especially susceptible to siliceais that traces of silicosle may be thought to
aggravate or accelerate disability or death from diseases of ordinary life or old
age and finally that silicosia with its complicatione is extremely difficult to
diagnose correctly
^ danger that amployers and their insurers have good reason to fear from these characteristics of silicosia is that they may be held responsible for the entiro results wherever disability or death from some ordinary disease or the infirmities of old cen be found - upon the opinion evidence of one partial
physician -- to have been accelerated or otherwise contributed to by more traces of silicosis This means expanding the payment of compensation for silicosis beyond its legitimate purpose and intent far in the direction of level health old
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bd and life insurance for the goneral run of workmen in the dusty trades
That would
a
entail a cost which would be utterly unendurable To avoid this danger it is ea-
sential that on claims for compensation medical questions shall be determined by
impartial medical experts and that where some other disease or infirmity is the principal cause of disability or death the employer shall not be held liable for
compensation for more than the degree to which siliconis has contributed to the
result
There are other safeguards against abuses that I believe need to be incorporated in any statute extending the compensation law to cover silicosis but I have not time to enumerate and discuse them now However I feel that I should not
omit to point out that such safeguards against abuses have also a bearing on pre-
vention The more clear and definite the responsibility for silicosia and obligations for its prevention that are placed upon the employer the greater are the probabilities of successful prevention To hold the employer responsible for evory aggravation of ill health to hia umployees which a jury or commission of laymon may choose to attribute to dust exposure in his plant affords no practicable standard of duty for him and is discouraging to reasonable efforts for prevention
An especially sorious difficulty in the way of compensating for silicosis
arises from the fact that the disease is of such slow contraction Whenever conditions are first studied there are found in nearly every plant in the dusty trades a substantial proportion of the workman who are affected with silicosis in various stages resulting from various periods of past exposures These men are not yet disabled same even may never be disabled by the disease but inevitably many of them will eventually became prematurely disablod thereby and the employer or bis insurance carrier of the date when the disabilities occur may have to pay compensation for the consequences of the past years of contraction These contingent im pending liabilities for past events are in insurance parlance termed accrued
liabilities and in the aggregate they may amount to immense s 'ms The problem
of meeting such charges may be handled though not without difficulties if employars and insurance carriers ba long forewarned However the accrued liabilities constitute practically a barrier to the sudden imposition of a novel liability to
compensata for silicosis without special provisions to reduce the burden from tho
ex post facto imposition of the called accrued liabilities for subsequent disablements and deaths resulting from a disease largely contracted in the past
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This difficulty is illustrated by experience in New York Workmen's Compensation Law of New York was extended by amendment
In 1935 the
to cover disable-
ment or death from silicosia on practically the same terms and conditions as acci
dontal injuries Thereupon the insurence carriers proposed rates for such coverage with loadings for the accrued liabilities that aroused a loud protest from the
industries affected even when reduced by the Superintendent of Insurance whose
approval was necessary for the premium rates of private companies The approved
rates were then so far below actuarial estimates of the probable loss of the
accrued liabilities that the private companies quite generally refused to provide
the insurance When application was made to the competitive New York State Insur-
ance Fund -- which is required to accept all risks offered but is permitted to make
its own rates -- that institution fixed its rates higher and in some cases vory
much higher then the maximum rates permitted to the private carriors The result
was that many in some cases
of the industrial establishments or the branches sending their work to other States and thousands
affected shut down
of workmen were
laid off
^ sa consequence at the next session of the New York Legislature with al-
most unanimous approval
pensation law was amended
including that of organized labor to limit compensation for silicosis
the workmen's com-|
to 500 in cases where
disability should result in the first month thereafter to 550 where disability or death should result in the second month and so on increasing the limit 50 from month to month until a final limit of 3000 should be reached That amendment re-
duced the cost of silicosis coverage to endurable rates the down industries
promptly resumed and the workmen who had bean laid off were promptly taken back A similar provision for reduced compensation benefit~ during a transitory period is included in the occupational diseases law recently adopted in Michigan I believe that some such provision is essential in every measure that may be enacted newly providing for compensation for silicosis asbestosis or other dust disease of the
lungs
In another way and another sense accrued liabilities cause trouble especially for insurance carriers in the field of compensation for silicosis
Experience in Wisconsin and to some extent also in California ind oates that
claims for silicosis do not eventuate from year to year fairly regularly in proportion to the exposures incurred as do claims for accidents and the majority of
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occupational diseases Instead they come in waves in periods of depression when workmen are laid off from other causes and then first feel that they are disabled
As long as employment is good workmen affected with silicosia hang on and the ac-
crued liabilities keep piling up to mature in the indefinite future Under present
employment conditions there are relatively few claims made for compensation for
silicosis But the loss cost of claims under such conditions affords no basis for premium rates adequate to build up reserves to meet the losses from silicosis that will eventually result from exposures during the good times The rates must be specifically loaded for that purpose and if the loadings be not adequate it means ruin for insurance carriers -- whether private companies or State funds That rates adequate therefor will not be obtainable under the public pressure for cheap insurance is an imminent peril affecting most directly insurance carriers but indirectly all concerned
I have said that in regard to occupational diseases prevention comes first
compensation second Therefore I would wish to impress it upon you that the matters relative to compensation Just discussed are all pertinent to prevention I believe that the imposition upon employers of a liability to compensate for occupational diverses is a most effective incentive to their prevention -- but only I would emphasize upon condition that such llability be reasonable and practically endurable and that the insurance provided be at adequate rates proportionate to the risks covered by individual policies If the liability for occupational diseases imposed by law be unendurable in any respect or degras it will in that respect or to that degr^'emerely kill the goose that lays the golden egg -- as happened in
New York
And if the insurance be so provided that industry may shift any material pro-
portion of its losses onto insurance carriers or that the bad risks may diatribue their excess lasens among the good risks the incentive for prevention will be greatly reduced where not entirely eliminated Purther and in my opinion mont reasonably it is contended that if employers be made liable for compensation for all known occupational diseases regardless of fault such liability should as between employer and his employees be exclusive of all other liability for injuries to the health of employess alleged to arise out of the employment otherwise than by accident
Reasonable standards of sanitary conditions in all industrial employments 6
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should be enforced by the State Beyond that to hold the employer liable for com pensation for such occupational diseases as may nevertheless result and yet to leave
him liable to damages in speculative litigation based upon his alleged negligence
wherever there is some speculative casual relation between the working conditions
and an employee's illness would be intolerable
primary purpose of the workmen
compensation law is to eliminata the wasteful litigation and uncertainties of the old employers liability system Whatever law for the compensation of occupational
diseases may be adopted it should be so drawn as to fulfill that purpose
Turning now to the direct methods and means for occupational disease preven
tion Manifestly these are matters for formulation by specialista Julemande by anginoera
chemists biologists and industrial physiciens Given a compensation law such as I
have advocated the more highly organiced industries may bo relied upon to meet the
problems of prevention by methods dictated by their own experts But the general
run of industries will need authoritative advice And the merginal establishments will need to be whipped up to the maintenance of minian~-m standards Moreover if the schedule plan of defining occupational diseases be gonerally adopted as I hope it will bo there will be need of appropriate procedure to determine additions to
the schedule as new industrial diseases are developed
As to the public machinery best adapted to promote prevention there may be
reasonable differences of opinion but the experts upon whom I rely recommend the
creation of a Bureau of Industrial Hygiene in the State Health Department or Labor
Department -- preferably since more appropriately in the Health Department -- with
a poraonnel of highly qualified specialista and adequately equipped to perform the following functions
First To study the causes of diseases occurring among employees in industry
to instruct and advise as to the means for their avoidance and prevention and to
recommend to the Legislature additions to the schedule of occupational diseases
along with such amendments to the law relative to occupational disease compensation
as experience may demonstrate to be noedod It may be advisable to go even further and to empower the Bureau of Industrial Hygiene itself to add to the schedule of
occupational diseasee subject to special regulations
Second Such Bureau of Industrial Hygiene should be empowered to mako amend and enforce reasonable rules for the protection of the health of employons in in-
dustry Such rules should be clear plain intelligible and practicable so as to
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establish stendards that all persons affected can understand and live up to in
certainty Juch rules should replace all existing statutes that are arbitrary
out
of date or that impose upon employers obligations ignorantly intended for the pro-
tection of the health of employees but which are so indefinite that compliance can
neldom be certain leaving it open for ignorent juries to find the employer at fault
and to mulet him for damages whatever he may do Such rules -- which would naturally take the form of codes for various indus-
tries - should be adopted or amended only after ample public notice and hearings
opon to all parties affected and should be subject to review by the courts as to
their reasonablene68 A modal for provisions to regulate the making power to
be delegated to such a bureau as here advocated may be found in the Illinois Heal
and Safety Act as enacted in 1936. Finally the rules to formulated should be en-
forced by appropriate penalties and it should be provided that they shall not serve
as bases for damage suits for alleged compliance
One of the most difficult features to agree upon in a program for occupation-
al disease prevention relates to the practiass of employment and periodical
medical examinations of workmen
that line that may be proposed
Organized labor is inclined to oppose anything in In the New York law labor succeeded in having in-
sortod a declaration to the ^ffect that employment sraminations are against the
public policy of the State But some such examinations are necessary I believe
that the difficulties in the way of gonaral agreement upon essential practices in
this respect can be ironed out and the necessary examinations made under public
regulation to avold the abuses that labor fears But I can not venture to predict
how this can or will be worked out
It will doubtless interest you to know how the eight States in what is com
monly known as the Pacific Coast field treat occupational diseases under their
respective workmen compensation lawa The Arizona act specifically excludes acqupational and other diseases except
as they result from injuries by accident In California the law was amended by the 1917 Legislature to cover occupa-
tional diseases by enacteunt of the provision nighe term ' injury shall include sny
injury or disease arising out of the employment The present Idaho law does not cover occupational diseases except cases re-
sulting from injuries by accident but the 1937 Legislature paused a bill creating
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an Occupational Disease Commission which is to work with the State Department of
Health in making a survey of the industrial disease problem and report its findings
to the next Legislature
The Montana Legislature likewise this year adopted legislation ta provide
for a survey of the occupational disease situation as a possible basis for future
legislation The commission has been appointed and is at work
In Nevada where the business ployers is a State monopoly the law
they are caused by accident
of insuring the compensation liability of an
uxcludes occupational disonses exc^ptwhere
Oregon likewise does not cover
occupational diseases under its workmen'sworkmen's
compensation act but a resolution was
adopted by the Legislature this year for
appointment of a commission to
prepare an amendment for submission to the
1939 Legis-
lature that would extend
compensation to include industrial diseases
The Utah workmen's workmen's such cases as result from
compensation act excludes injurios by accident
occupational
diseases
except
In Washington the compensation
act was amended by this yearLegislature so
as to include under compensation benefits a schedule of 21 specific industrial
diseases The shall be borne
szendment provides that equally by the employer
the and
cost of occupational
the employse
disease
coverage
Taking the country as a whole it is found that there are nine States in-
cluding the District of Columbia that provide compensation for occupational dia-
essen under general provisions These
Illinois Indiana Missouri Nebraska
States require employers to compensate
status include California California Connecticut
North Dakota and Wisconsin Twelve otl^r for occupatimal diseases under a schedule
provision which specifies the diseases for which benefits shall be paid
other States notably Massachusetts have by court decisions extended the
Several scope of
compensation laws to include at least certain occupational diseases
I have now outlined the subject assigned to me as comprehensively as I am
able The particular program that I have advocated follows
generally the Sugges
tions for Provisions for a Workmen's Compensation Plan for Occupational Diseases " formulated by an Advisory Committee of the
Association of Casualty and Surety Executives Copine of this brochure may be obtained upon request addressed to the
Association at No. 1 Park Avanue New York City Such program it is recognized would need some variations to adapt it to local
conditions in any particular Stato
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It is also to be understood that many of the features of such program may not be
,
generally agreed to But I hope that by presenting what I am led to believe is a
consistent and practicable program for dealing with occupational diseases I have
aroused your interest in the subject sufficiently to incite you to a detailed study of the problem with all its complexitias
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