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OCCUPATIONAL DISEASES Additional Responsibility Legislation Places On Industry By HENRY D. SAYER ASSOCIATION of CASUALTY AND SURETY EXECUTIVES, NEW YORK, N. Y. OT many years ago legislators and industrialists re doubtedly, another year will see legislative attempts in many Nsponded to the new doctrine of compensation for indus more states. In great part these efforts were not successful, trial accidents without regard to fault as a causative but a renewal of them is inevitable. factor. So familiar has this compensation principle becomEemployers will have to prepare to meet the added burden of that it is virtually unanimously accepted by employers, and such laws. Just as in time the cost of compensation for acci this idea that was so revolutionary only a short twenty years dents was absorbed, so too will the cost of compensation for ago is now an accepted rule of industry. Its burdens have not diseases in time be absorbed if right principles prevail and if beat lessened as time has passed. On the contrary, compensa the effort is not made under the guise of compensation to charge tion costs have steadily mounted. But industry long since employers with general health and life insurance of their learned to absorb those costs and to assume those burdens, even workers. though frequently at the cost of great hardship. But it is not certain that correct principles will always be Entirely aside from the monetary benefits to injured workers observed. The temptation is great to give to the oppressed and the dependents of deceased employees, the two great out and distressed--out of the other man's funds! To be the public standing benefits to workers through the compensation system almoner of industry's money must be a comforting thought to ate (1) the reduction of accident frequency brought about by some public officials--especially at election time. the promulgation of safety standards and by good engineering, and (2) the reduction of accident severity, by rhe requirement NECESSARY TO SAFEGUARD AGAINST ACCHUED LIAEIUTY for prompt medical and surgical care at the expense of the employer. These arc the positive sides of compensation for accidents, and employers may well take pride in the accom We must, therefore, be vigilantly on guard to demand in all such legislative efforts a recognition of sound principles and policies, and insist that such laws do not throttle the industry plishments of industry, of medicine, and of engineering in itself. It is essential that we insist on at least two safeguards: these lines. EBCENT LEGISLATION ON OCCUPATIONAL DISEASES WIDESPREAD (1) To guard against the already accrued liability, and (2) to make certain that compensation shall be payable only for diseases that are truly occupational. Just as twenty years ago there was the insistent demand for What is meant by the term accrued liability is illustrated compensation for accidental injuries, so now there is an ever by what has recently happened in New York. The New York growing demand for legislation for compensation for industrial diseases. This is no new thing to us here in New York, We have had an occupational-disease statute since 1920. Three or state law is what is known as a schedule law, that is, the law itself contains a list of diseases or poisonings with a parallel column listing the occupations or processes in which such con four Other states have rather full occupational-disease laws, ditions usually occur. Thus, to use a common illustration, lead while some others have laws of somewhat limited application. poisoning is listed as a disease, and is compensable when in But in the greater number of states, no provisions have been curred by a worker engaged in any work that causes him to use adopted for compensation for occupational diseases. The essence of the idea of compensation for occupational diseases is that disability or death from a truly occupational or be exposed to lead. This, it will readily be seen, is truly an occupational disease, readily recognizable as such, and is a definite pathological entity. Seldom is the disease found ex disease is just as much the responsibility of industry as is such cept among lead workers, painters, and the like. a condition resulting from industrial accident. With this principle it is hard to disagree. Few there are twho will say that the workman who suffers a disability, who is de prived of the means of a livelihood through a disease or sick ness that came upon him only because of his exposure in his The schedule in the New York act had been enlarged from time to time until it included practically all known occupa tional diseases with the exception of lung diseases attributable to dust. It is generally conceded that these dust diseases call for special provisions of law and for different procedures. work to the deleterious effects of some poison or some chemical, some dusts, gases;, or fumes, is not equally entitled to compensa tion with his brother whose disability came on him by reason of an accident. In principle both seem alike. So prevalent is; this idea that in the legislatures of 18 states The effort to provide such special provisions proved abor tive, and when the legislature passed a general all-inclusive provision to cover in broad terms "any and all occupational diseases," it swept in under the law all dust diseases along with the rest. bills were introduced last winter newly providing for occupa tional diseases or for enlarging the existing laws. In a number of states provision was made for the appointment of interim legislative committees to study and report on the subject of Some occupational diseases are or slow development Now by the very nature of these diseases they are of slow, progressive development. Silicosis, or a fibrous condition of occupational-disease legislation at the next sessions. Un Contributed by the Safety Committee and presented at a session on Occupational Diseases at the Annual Meeting, New York, N. Y., Dec. 2-6, 1935, of Thu American Society of Mechanical Engineers. Slightly abridged. the lungs resulting from the inhalation of silica dust, requires a minimum of five years of exposure to produce disability, and many authorities assert that the progression to disability takes from ten to fifteen years. In all these diseases, there comes a time when regular work is not possible. This is called in the 103 104 Mechanical Engineering Jaw "disablement." Tbe momenr the wide-open law went on the statute books, it created a liability for many years of expo sure that had already taken place among thousands of workers. Industry found itself faced with the problem of paving for con ditions that arose at a time when the law imposed no special duty on the employer to pay for the condition or to take effective measures to prevent the disease. While industry cannot assume safely such a burden, neither can insurance be asked to take it on. Payment for losses that accrued prior to the insurance contract is not in any sense in surance; insurance is the assumption of liability for a contin gency or for a fortuitous future happening. The result of the new law in New York has been disastrous. Premium rates were set at prohibfcive figures. Where dust exposures existed supplementary rates were added to the regu lar already high compensation rates. These supplemental rates ranged from the lowest at something more than a dollar per hundred dollars of payroll up to as high as twelve and thirteen dollars a hundred. The total compensation cost, therefore, for many industries has risen to more than twenty dollars. When this is compared to the comparatively low compensation cost in states where such liabilities have not been imposed on industry, it will be readily appreciated how difficult it is for New York industries to survive under competition. Since September I, 1955, the effective date of the new law, manv plants have utterly closed down, some have gone on part time, There is another, and to engineers a very important, con sideration in favor of the schedule method of covering occupa tional diseases, rather than the general all-inclusive method, and that is prevention. Prevention is the key to the occupa tional-disease situation. Just as the engineers took up the challenge in the field of industrial safety when accident-com pensation laws came into operation, and have done a magnifi cent job, so they will have to take over an intensive study of the means and methods of prevention of disease. They have learned that good results arc obtained onlv when thev can concentrate on some special problem or on some phase of a problem. How better can the engineer concentrate on occupationaldisease prevention than to start out with a named list of diseases set forth in the law? It is often necessary to appeal to employers or management to take certain steps in throwing up safeguards, and these cost money. If the engineer is dealing with a definite schedule of diseases he looks for the conditions in a plant from which those diseases may arise. He can tell management that if lead is used workers must be safeguarded from it. That is ele mentary. Buc without the law suggesting it, how many would think to guard against chrome ulceration, or adequately safeguard workers coming in contact with or using methyl chloride, or an)- of rhe other manv conditions included in the occupational-disease schedule? others arc contracting out to plants in other states chat part of SAFEGUARD AGAINST EVERYTHING their operations which arc involved in dust, and with it all, the worker may he said ro he rhe sufferer through unemployment. Any attempt anywhere to impose on employers by law a burden of responsibility for diseases of past contraction will lead inevitably to such a muddled situation as exists in New York today. It may he suggested: Safeguard against everything. How ever, no matter what attempts are made, no matter how willing the employer to go along with the plans, under any blanket plan some dangerous conditions will certainly be overlooked. And from the standpoint of bringing to the employer the necessity of spending money in disease prevention, it is hard COMPENSATION SHOUI.D HE CONFINED TO TRULY OCCUPATIONAL DISEASES The second principle is that compensation shall be provided only for diseases truly occupational. The term "occupational disease" is in common use, yet it lias no fixed definition nor definite limitations, The effort is sometimes made to define it as a "disease that arises out of and in the course of employ ment." Such a definition is thoroughly unsatisfactory. This terminology has been used probably because it has ample precedent in the field of accident compensation, but the condi tions surrounding accidents and those surrounding disease arc so radically different that the same terms will not do. Shall we say that heart disease, tuberculosis, pneumonia, pleurisy, head colds, and all the multitude of human ills shall be deemed occupational when they occur among workers and it is claimed that some act or incident of the employment caused or contributed to the disease? If so, it means nothing less than general health and life insurance for workers at the employer's expense. This is nor a burden that industry should or could bear. An occupational disease is not a disease of ordinary life, but a disease "characteristic of and peculiar to" the occupation. When speaking of disease, these words arc far more definite than is the phrase "arising out and in the course of" employment. They should he used wherever it is impossible to have a schedule or listing of diseases. This qualification has received the approval of the State In dustrial Board in New York. As yet there has not been suffi cient time for a case to arise under it and be passed on by the courts, but it is greatly to be hoped that the courts will follow this view ol occupational diseases. going to convince him that he has a disease hazard warranting the expenditure of large sums unless the law gives the clue to the diseases to be guarded against. Only by the slow laborious process of picking up diseases as they occur and are made com pensable over a period probably of years will we get effective prevention work, unless the scientific knowledge of diseases and industrial processes now possessed by public authorities in the field of industrial hygiene is made available to industry through writing it into the statute. That new burdens are being imposed on employers by recent legislation or are impending in the demand for new legislation must be recognized. There will he no turning back in this field, any more than there will be turning back in the field of compensation for accidents. If, however, we are wise, we will give heed to the lessons we have learned out of an abundant experience in accident compensation. The same motivating factors will be present in this new field; the same liberality, the same generosity with the employer's moneys. The cure for all tlie workers' ills will be attempted through these laws. Vagueness and lack of definition but play into the hands of the overlihcral. We should insistently demand that occupational-disease legislation be intelligent, certain in terms, and properly safe guarded against already incurred liabilities. Let the em ployer's responsibility be expressed in understandable terms and with a scrupulous regard for the ability of industry to carry the increased load. And above all insist that the law be so worded as to make effective prevention work possible. By so doing, and only by so doing, will industrial justice be done and effective steps taken to carry industry's part in the field of the true occupational disease.