A report released Tuesday finds only a small fraction of those who get cancer on the job ever get workers’ compensation. Commissioned in April 2018 by the Ministry of Labour, the review, conducted by Dr Paul Demers of the Occupational Cancer Research Centre (OCRC), explored how scientific evidence can best be used in determining work-relatedness in an occupational cancer claim, particularly in cases with multiple exposures. Despite increased scientific knowledge of workplace carcinogens and chronic health effects of exposure to toxic substances, too many injured workers and their families still face an uphill battle to have their compensation claims accepted.
What are the numbers?
On average, the Workplace Safety and Insurance Board (WSIB) accepts 170 cancer claims per year (mostly those asbestos-related). As the report notes, this is only a small fraction of the 3,000 estimated occupational cancers diagnosed annually in Ontario that are due to workplace exposure to 16 of the most well-established cancer-causing substances. The acceptance rate of cancer claims of 2.9 cases per 100,000 workers falls well below that of many European countries.
Why so few?
Restrictive WSIB policy – the report recommends changes to reflect the current state of scientific knowledge including:
- greatly expanding the list of presumptions regarding cancer in Schedules 3 and 4 (O.Reg 175/98) based on 3 proposed criteria
- updating policies on adjudication, and adding new ones that clearly explain how exposure to multiple carcinogens is handled and how non-occupational exposures, particularly cigarette smoking, are weighted relative to occupational exposures
Lack of information gathering – in determining causation and work-relatedness of a claim, the WSIB relies on information that includes employment history, exposure history and medical history. However:
- Ontario’s Ministry of Labour stopped collecting its own exposure data in the 1990s. The report’s recommendations address improving collection and electronic exchange of exposure data with the WSIB, including digitization of historical data. Such information is considered vital also, in the absence of mandatory reporting or national registries, for the province to more easily identify disease clusters, emerging hazards and improve prevention
- Doctors can often fail to recognize and report occupational cancer. If the worker is to receive compensation benefits, the treating doctor taking a medical history must explore if disease is related to the patient’s employment. Yet in their medical education, Canadian doctors receive very little basic training in occupational health, including the need to ask about work exposures and collect an occupational history
As recommended also by the WSIB’s audit of its occupational disease program, the report points to the need for increased scientific capacity, in the WSIB internally and in its partnerships with external research centres. It calls on the WSIB to again create an independent standing Scientific Review Panel to review evolving science. (The Board’s former Industrial Disease Standards Panel, later renamed Occupational Disease Panel, was dismantled under Bill 99).
Families hope it brings changes
As cited in the Globe and Mail, Dr Demers said that “improving the rate of accepted claims is critical… because there’s a direct link between costs paid by the WSIB, which is funded by employers, and cancer prevention efforts. These cases cost the medical system many millions of dollars every year, costs that should instead be borne by the WSIB.”
He is optimistic that the political will exists to act on his report and implement the recommendations. The families of cancer victims, who have in many cases spent years of frustration struggling to have the WSIB acknowledge their cases, hope this is so.
Spokespersons for the Ministry and WSIB say they are reviewing the report and its recommendations.
- Demers, Paul A. 2020 Jan. 9. Using Scientific Evidence and Principles to Help Determine the Work-Relatedness of Cancer: Final Report. Toronto: Occupational Cancer Research Centre.
- Mercer, Greg. 2020 Jul. 11. “Claims system for workers with cancer outdated: study.” Globe & Mail (includes audio, available also in French and Mandarin)
- Jackson, James. 2020 Jul. 10. “Review calls for changes to WSIB and Ministry of Labour claims process.” The Record (Waterloo)
- Mojtahedzadeh, Sara. 2020 Jul. 9 . “Ontario’s ability to identify workplace cancer risk is ‘grossly inadequate,’ study finds.” Toronto Star
- Mercer, Greg. 2020 May 8. “The Uncounted” (investigative report on occupational disease and a broken system) Toronto Star/ The Record
- Ontario. Workplace Safety and Insurance Board / KPMG. 2019 Feb. 7. Value for Money Audit Report: Occupational Disease and Survivor Benefit Program (see historic development of occupational disease policy p. 9-10)
- Ontario. Ministry of Labour. 2018 Apr. 13. Ontario Launching Review of Work-Related Cancers to Ensure Workers Receive the Right Care.