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Following is a written reply by the Secretary for Labour and Welfare, Mr Matthew Cheung Kin-chung, to a question by the Hon Kwong Chi-kin on occupational diseases in the Legislative Council today (January 16):
Question:
Will the Government inform this Council:
(a) among the new cases received by occupational health clinics, of the respective numbers of cases confirmed and not confirmed as occupational diseases in each of the past five years, the age distribution of the patients concerned as well as the trades they were engaged in, broken down by the type of occupational disease (including silicosis, tenosynovitis of hand or forearm, occupational deafness, tuberculosis, occupational dermatitis, asbestosis, compressed air illness, gas poisoning and others);
(b) of the percentage of the confirmed cases in (a) in the total number of confirmed occupational disease cases in Hong Kong in the same year;
(c) of the current waiting time for the new cases of the above clinics; the average waiting time for patients suspected to be suffering from occupational diseases to receive necessary treatment after their first attendance, and the average time for them to recover after receiving treatment;
(d) how the current number of patients, the current number of new and old cases as well as the current workload of each doctor (e.g. the number of patients required to be treated per hour) of the above clinics compare with those of the orthopaedic and thoracic out-patient clinics of the Hospital Authority;
(e) of the criteria adopted by doctors at occupational health clinics for diagnosing whether a patient is suffering from occupational disease, and whether such criteria are consistent with those adopted by other medical institutions;
(f) whether occupational disease cases confirmed by specialists at public hospitals must eventually be referred to and verified by occupational health clinics; and
(g) whether, in the past three years, there were occupational disease cases confirmed by occupational health clinics in which the employers or insurance companies concerned had objected to or challenged the diagnoses concerned (including bringing the cases to the court for its ruling); if there were such cases, of the number of cases involved and whether, when such type of cases was brought to the court for its ruling, the attending doctors of occupational health clinics had responsibility for explaining the diagnosis results in court for the patients?
Reply:
Madam President,
There are altogether 51 occupational diseases prescribed under the Occupational Deafness (Compensation) Ordinance (ODCO) (Cap 469), the Pneumoconiosis (Compensation) Ordinance (PCO) (Cap 360) and the Employees' Compensation Ordinance (ECO) (Cap 282).
These three pieces of legislation provide for the different procedures for confirming occupational deafness, pneumoconiosis (including silicosis and asbestosis), and other 48 occupational diseases respectively. Under the ODCO, the Occupational Deafness Compensation Board is responsible for processing and determining applications, including determining whether the claimant has suffered from occupational deafness as prescribed in the Ordinance. One doctor from the Occupational Health Service (OHS) of the Labour Department (LD) is a member of that compensation board. The Pneumoconiosis Medical Board (PMB) is responsible for determining whether the claimant has suffered from pneumoconiosis in accordance with the PCO. The PMB consists of three members and one of them is a doctor from the OHS of LD.
As to the 48 occupational diseases prescribed in the Second Schedule of the ECO, LD is responsible for processing such claims. Where there is any dispute between the employer and employee on whether the disease is due to the nature of the occupation in which the employee is engaged, LD will, with the consent of the employee, collect relevant information and medical reports on the case and seek the professional advice of the LD's doctor from the OHS. LD will then give its view to both parties on whether the disease is one prescribed by law. If the employer and employee are unable to reach a settlement through the assistance of the department, the case shall be determined by the Court.
The two occupational health clinics of LD can provide treatment for employees who suspect their diseases to be work-related. Apart from treating patients, doctors in the occupational health clinics will take a comprehensive history from patients and may inspect the patient's workplace, depending on the circumstances and wish of the patient, to identify the existence or otherwise of hazards in the working environment relating to the diseases to facilitate the diagnosis of whether the patient has suffered from occupational diseases prescribed in the ECO. Moreover, the doctors will advise the patients to adopt appropriate preventive measures in order to avoid recurrence of the disease. They are also required to perform other duties such as inspection of the patients' workplaces, participate in the aforementioned boards relating to employees' compensation, and provide professional advice on cases of suspected occupational diseases, etc.
I will now reply to the seven parts of the question as follows:
(a) From 2002 to 2006, a total of 12,800 new patients sought consultation at LD's occupational health clinics. Of these, 12,574 (98.2%) were diagnosed as having diseases not prescribed in the ECO. The breakdown of these patients by age, industry and nature of illness is at Annex I.
During the same period, a total of 226 new patients were diagnosed as suffering from occupational diseases prescribed in the ECO, including 180 cases of tenosynovitis of hand or forearm and 46 cases of occupational dermatitis. The breakdown of these patients by age and industry is at Annex II.
(b) Between 2002 and 2006, the number of patients diagnosed by the occupational health clinics as having occupational diseases prescribed in the ECO as a percentage of all the confirmed occupational disease cases in the same year are as follows ¡V
2002 2003 2004 2005 2006
---- ---- ---- ---- ----
Number of cases 53 29 54 57 33
diagnosed by the
occupational health
clinics as having
prescribed
occupational
diseases in ECO
Total number of 364 258 251 256 264
confirmed
occupational
diseases (Note 1)
Percentage 14.6% 11.2% 21.5% 22.3% 12.5%
(Note 1: The patients confirmed to have occupational deafness and pneumoconiosis will be treated in the specialist clinics under the Hospital Authority and the Department of Health.)
(c) The waiting time for the first appointment in LD's two occupational health clinics is about two months on average. If some patients are required to have early treatment, LD will make special arrangements for them. As to the waiting time for the first appointment in the specialist clinics under the Hospital Authority (HA), the median is about seven weeks.
Doctors in the occupational health clinics will provide appropriate treatments to the patients having regard to their clinical condition in both initial and follow-up consultations in order to facilitate their recovery. If the treatments such as medication and wound dressing could be provided by the occupational health clinics, there will be arrangements immediately. Where referral to other services providers, such as physiotherapy and occupational therapy service under the HA, is required, the queuing time is determined by the general waiting time for such services. With regard to the time for the patients to recover, this varies individually, and is subject to many factors, including the nature of the disease and effectiveness of the treatment. LD does not keep the relevant statistics.
(d) In addition to general diagnostic procedures, doctors in the occupational health clinics will take a comprehensive occupational history from patients in the diagnosis of whether the patients have occupational diseases prescribed in the ECO. The time for each consultation is therefore longer than that of other specialist clinics. Doctors in the occupational health clinics will also inspect the patient's workplace to identify the existence or otherwise of hazards in the working environment relating to the diseases. In 2007, the two LD's occupational health clinics provided a total of 13,000 consultations. On average, each doctor can attend eleven patients in a half-day consultation session. As the nature of services provided by the occupational health clinics, including inspection of the patients' workplace, is different from that of orthopaedic and thoracic out-patient clinics of the HA, a direct comparison of their number of patients, new and old cases as well as workload of each doctor cannot be made.
(e) Doctors in occupational health clinics will, according to the requirements stipulated in the ECO, make diagnosis and provide professional advice to the patients on whether the cases involve occupational diseases prescribed in the Ordinance. The law provides that in order to qualify for seeking compensation for occupational disease, the diseases must be one specified under the Ordinance and have resulted from work in any occupation in which he was employed immediately preceding the total or partial incapacity caused.
¡@¡@LD has already published relevant publications such as "Guide to occupational diseases prescribed for compensation purposes" and "Guidance notes on the diagnosis of notifiable occupational diseases" (English version only) to explain the occupational diseases prescribed in ECO to the public and registered medical practitioners. These publications are available free of charge from offices of the Occupational Safety and Health Branch of LD, and may also be downloaded from LD's website. LD has also sent the "Guidance notes on the diagnosis of notifiable occupational diseases" to all registered medical practitioners to help familiarise them with the diagnostic criteria for occupational diseases.
(f) In reporting a case of occupational disease to LD in accordance with the ECO, the employer or the employee should also provide information on the occupational disease diagnosed by registered medical practitioners to facilitate LD in processing the case and calculate the amount of compensation. If comprehensive information is not provided in a reported case of occupational disease, or if there is a dispute between employer and employee on whether the disease is one due to the nature of the occupation in which the employee was engaged, LD will give its view to both parties. If the dispute is unable to reach a settlement, the case shall be determined by the Court.
(g) LD does not maintain statistics on the cases in which the employers and insurance companies concerned challenged the diagnosis of the occupational health clinics. If cases involving patients who had received treatment from the occupational health clinics are taken to the court for ruling, the attending doctors will, upon receipt of the Court summons, attend the Court to explain the diagnosis made and relevant documents such as medical reports and medical records.
Ends/Wednesday, January 16, 2008
Issued at HKT 16:49
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