Trends in compensation for deaths from occupational cancer in Canada: a descriptive study

Our plain-English summary of Trends in compensation for deaths from occupational cancer in Canada: a descriptive study, by A. Del Bianco, P.A. Demers (CMAJ Open, 2013).

The study

• Authors: A. Del Bianco, P.A. Demers
• Journal: CMAJ Open
• Published: 2013;1(3):E91-6
• Cited by: 14 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Background: Occupational cancer is the leading cause of work-related deaths, yet it is often unrecognized and under reported, and associated claims for compensation go unfiled. We sought to examine trends in deaths from occupational cancer, high-risk industries and exposures, and commonly compensated categories of occupational cancers. In addition, we compared deaths from occupational lung cancer for which compensation had been given with total deaths from lung cancer.

Methods: We used data from the Association of Workers' Compensation Boards of Canada pertaining to the nature and source of the injury or disease and the industry in which it occurred (by jurisdiction) to describe trends in compensated claims for deaths from occupational cancer in Canada for the period 1997-2010. We used data published by the Canadian Cancer Society in Canadian Cancer Statistics to compare compensated occupational lung cancer deaths with total estimated lung cancer deaths for the period between 2006 and 2010.

Results: Compensated claims for deaths from occupational cancer have increased in recent years and surpassed those for traumatic injuries and disorders in Canada, particularly in Ontario. Between 1997 and 2010, one-half of all compensated deaths from occupational cancer in Canada were from Ontario. High-risk industries for occupational cancer include manufacturing, construction, mining and, more recently, government services. Deaths from lung cancer and mesothelioma comprise most of the compensated claims for deaths from occupational cancer in Ontario and Canada. These diseases are usually the result of asbestos exposure. The burden of other occupational carcinogens is not reflected in claims data.

Interpretation: Although the number of accepted claims for deaths from occupational cancers has increased in recent years, these claims likely only represent a fraction of the true burden of this problem. Increased education of patients, workers at high risk of exposure and health care providers is needed to ensure that people with work-related cancer are identified and file a claim for compensation.

In plain English

This descriptive study examined workers' compensation claims accepted for work-related deaths in Canada from 1997 to 2010, using data from the Association of Workers' Compensation Boards of Canada. Accepted claims for deaths from occupational cancer rose and overtook claims for traumatic injuries and disorders. Ontario made up 52.5% to 65.0% of Canada's compensated cancer death claims each year except 1998 (46.2%). Manufacturing, construction and mining were the top industries. Claims from government services rose in the last five years, mainly because of firefighters. About 70.8% of accepted cancer death claims in Canada (70.6% in Ontario) involved asbestos exposure. In the last five years, about 93.0% of compensated asbestos-related death claims in Canada were for mesothelioma or lung cancer. From 2006 to 2010, 626 occupational lung cancer death claims were accepted in Canada and 402 in Ontario, equal to 0.6% and 1.2% of estimated lung cancer deaths. The authors concluded that these claims likely represent only a fraction of the true burden. They noted that claims are counted by the year accepted rather than the year of death, and that groups such as self-employed workers are not covered.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Descriptive study of accepted workers' compensation death claims, including time-trend analysis
• Who was studied: Accepted (compensated) death claims reported by all Canadian provincial and territorial workers' compensation boards to the Association of Workers' Compensation Boards of Canada, by jurisdiction and industry, 1997–2010. These were compared with estimated lung cancer deaths for 2006–2010.
• Exposure: Occupational exposures leading to compensated cancer deaths, with asbestos as the main exposure identified. Cancers were grouped as mesothelioma, asbestos-related lung cancer, non-asbestos-related lung cancer and all other cancers.
• Main results:
  • In Canada, compensated claims for deaths from occupational cancer increased in recent years and surpassed those for traumatic injuries and disorders.
  • Ontario accounted for 52.5%–65.0% of all compensated occupational cancer death claims in Canada from 1997 to 2010, except in 1998, when it accounted for 46.2%.
  • In Ontario, compensated occupational cancer death claims surpassed those for traumatic injuries and disorders from 2004 on.
  • In Ontario and nationwide, the top 3 industries were manufacturing, construction and mining. In the last 5 years of the study, claims from government services increased, mainly driven by claims for firefighters.
  • In Canada between 1997 and 2010, accepted claims rose by 216.4% for mesothelioma, 575.0% for lung cancer and 512.5% for other cancers.
  • In Ontario over the study period, accepted claims rose by 97.7% for mesothelioma, 383.3% for lung cancer and 1300.0% for other cancers.
  • From 1997 to 2010, about 70.8% of accepted occupational cancer death claims in Canada involved exposure to asbestos, and 70.6% in Ontario.
  • Mesothelioma and lung cancer combined accounted for up to 98.4% of compensated occupational cancer death claims in Ontario and up to 87.3% in Canada.
  • In the final 5 years, about 93.0% of compensated asbestos-related death claims in Canada, and 88.7% in Ontario, were attributed to mesothelioma or lung cancer.
  • As of 2010, asbestos-related lung cancer claims made up about 69.6% of compensated lung cancer deaths in Canada and about 73.6% in Ontario.
  • Between 2006 and 2010, 402 occupational lung cancer death claims were accepted in Ontario and 626 in all of Canada. These equalled 1.2% of the estimated lung cancer deaths in Ontario and 0.6% in Canada.
• The authors' conclusion: The authors concluded that compensated occupational cancer death claims have risen sharply since 1997 and now exceed those for traumatic injury deaths. In Ontario there are now more than 2 occupational cancer deaths for each traumatic injury death. They also concluded that these claims likely represent only a fraction of the true burden.
• Limitations the authors state:
  • The number of accepted death claims differs by jurisdiction because of variations in policies and legislation.
  • The data reflect the year a claim was accepted, not necessarily the year the death occurred.
  • The data do not cover the entire workforce. For example, in 2010 the Ontario data represented about 71.3% of the province's workforce.
  • Self-employed workers, employees of small businesses, military personnel and others not covered by provincial boards are not in the claims data.
  • Many other workplace carcinogen exposures are not captured in claims statistics.

Topics

Medical terms in this study, explained in our Lexicon: Lung Cancer, Jurisdiction, Mesothelioma, Asbestos Exposure.

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