Royal Commission on Workers' Compensation in BC

Title:

Affiliation: WCB

Staff Present: TR, GG, OE, GS, SN, PL

Notetaker: Steven Noble

Date: Wednesday, April 8, 1998

 

 

JOHN STEEVES

Section 7: Compensation and Adjudication

BACKGROUND

  1. Health and Status of Work
  1. There is a powerful connection between health and the social and the physical environment, " In particular, the correlation between social status and health is well established. Higher status individuals live longer and healthier lives than lower status people". (page 6).
  2. The significance of this for workers' compensation is reflected in the Whitehall studies in Britain. The first study (starting in 1967 and tracking over a 10-year period) found that office workers in the highest employment category had about one-third of the mortality of office workers in the lowest category. In Whitehall II, twenty years later, the results were the same and they had other findings such as workers in lower status positions were more at risk for ischaemic heart disease, chronic bronchitis and chronic cough. (page 8). Another study has concluded that "there is something that powerfully influences health and that is correlated with hierarchy per se." (page 10)..
  3. These Studies counter the suggestion that factors external to the work are only responsible for certain diseases. Occupational position and job factors play a large role in disease causation. (page 13).
  1. Cardiovascular Disease
  1. "Workers who face high psychological demands, on the one hand, and who have low decision latitude and little control over job demands or how to use their skills, on the other hand, are at an elevated risk for cardiovascular disease" (page 16).
  2. The highest risk for heart disease for men in both blue and white-collar occupations has been found to be associated with hectic work, combined with few possibilities to learn new things and low influence on planning of work and working hours. (page 17).
  3. These findings suggest that systemic factors involving how the work is organized can be of causative significance in cardiovascular disease.
  1. Musculoskeletal Pain
  1. The authors note the pervasive nature of back pain, which affects 80% of adults some time in their life. In the United States, it is the second most common reason for work absenteeism, the third leading cause of total work disability and the leading cause of activity limitation in young adults. The rate of disability due to low back pain is increasing at a tremendous rate. (page 20).
  2. The tendency in workers' compensation is to seek discrete, precipitating events for personal injuries in order to establish causation. However, it is plain that back pain and other musculoskeletal diseases are multi-factorial in origin and, therefore, the search for a specific, precipitating event may be fruitless in the majority of cases. (page 21). We note that this may not be true in BC since back strain claims have been relatively constant since 1987 (taking into account claims volumes). (See 1996 Annual Report, page 53).
  3. One possibility is that the stress generated by high demand/low control jobs may affect an individual's ability to cope not only with the emotional pressures but also with the physical and mechanical loads of the workplace. Workplace features such as monotonous work, time pressure, perceived high workload and little control over one's job have been linked with musculoskeletal conditions such as back pain and other musculoskeletal injuries. (page 23).