February 5, Louise S. Kim Senior Policy Analyst Policy and Research Division WorkSafeBC PO Box 5350 Station Terminal Vancouver, BC V6B 5L5

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1 February 5, 2010 Louise S. Kim Senior Policy Analyst Policy and Research Division WorkSafeBC PO Box 5350 Station Terminal Vancouver, BC V6B 5L5 Dear Ms. Kim, The BC Government and Service Employees' Union (BCGEU) represents over 60,000 public and private sector workers province-wide. Our workers have been exposed to asbestos in the past, and it is possible that they will face exposure in the future. These workers deserve fair compensation. We appreciate this opportunity to discuss the proposed policy changes that will affect our members and all workers that may suffer from asbestos-related diseases. Overview After examining the discussion paper and the report by Dr. Finklestein, the BCGEU concludes that we cannot support the recommended amendments to Schedule B of the Workers Compensation Act regarding lung cancer in asbestos-exposed workers. The BCGEU is concerned that the discussion paper took a narrow approach in reviewing the available scientific literature, as stated by the doctors that reviewed the paper. Additionally, some recommendations are based on convenience rather than a specific rationale. We do not believe that the proposed recommendations will do enough to increase the approval rate of legitimate compensation claims for workers with asbestos-related diseases. In some cases, the recommendations would decrease the number of successful claims. The BCGEU also believes that in order to better protect the rights of workers, Worksafe BC should take a precautionary approach rather than a strictly epidemiological approach to asbestos-related claims. We encourage Worksafe BC to use this initial review to develop a more thorough review process, and there needs to be further consultation on these matters.

2 A component of NUPGE (CLC) Page 2 Policy review The current Worksafe policy on lung cancer and asbestos-exposed workers, Schedule B of the Workers Compensation Act, "provides a presumption of work causation in favour of a worker who has developed primary lung cancer where one or both of the following diseases are present: Asbestosis, or Bilateral diffuse pleural thickening or fibrosis, over 5mm thick and extending over more than a quarter of the chest wall; and where there has been exposure to airborne asbestos dust." The discussion paper examines four questions regarding this current policy. Should Worksafe BC: 1. maintain or delete the current policy requirement that asbestosis be present? 2. maintain, delete or modify the current policy requirement that diffuse bilateral diffuse pleural thickening or fibrosis over 5mm thick and extending over more than a quarter of the chest wall be present? 3. add a quantifiable cumulative asbestos exposure requirement to the policy? 4. add a list of processes or industries to the proposed cumulative exposure requirement? If so, which of the two examined models should Worksafe BC follow? Recommendations and response 1. The discussion paper recommends that Worksafe BC maintain the asbestosis requirement based on current and supportable research. We are not convinced that this requirement is supportable. As stated above, we are concerned that the discussion paper took a narrow approach in reviewing the available scientific literature in this regard. As noted in the discussion paper, the 2005 Industrial Injuries Advisory Council (IIAC) Report from the UK found that "lung cancer could occur independently from asbestosis, where substantial occupational exposure to asbestos had occurred." While we are concerned with the possibility that removing this requirement may result in fewer cases with an automatic presumption of work causation, we feel that a more thorough examination of the issue is required before a conclusion can be reached. 2. The recommendation is to modify the 5mm diffuse bilateral pleural thickening/fibrosis over more than a quarter of the chest wall requirement because no research supports the current policy. The paper recommends that Worksafe BC adopt a requirement of 2mm thickness because it was used in the Cullen Study.

3 A component of NUPGE (CLC) Page 3 The BCGEU supports the move to modify the current requirement of bilateral diffuse pleural thickening of more than 5mm and extending over more than a quarter of the chest wall. However, we do not believe that the recommended change to a 2mm thickness requirement is any less arbitrary than the 5mm thickness requirement. Dr. Finklestein writes that, "measuring the extent of pleural thickening is difficult due to the inherent limitations in the accuracy of the imaging techniques." Any specification of thickness will therefore be problematic and impossible to determine accurately. As the 2005 Industrial Injuries Advisory Council (IIAC) Report from the UK states, this requirement is "unreliable as an indicator of substantial asbestos exposure." The UK has removed this requirement completely. The recommendation to change the requirement to 2mm thickness is much better than the current policy, but is still arbitrary and difficult to measure. Because of the problems raised regarding this issue, a more thorough examination of is required. 3. The recommendation is to adopt a cumulative exposure requirement to the policy. The BCGEU cannot support any recommendation that requires proof of cumulative exposure to asbestos in the workplace. Worksafe BC does not keep a database of asbestos exposure in workplaces in BC. If this recommendation is adopted, it will put the onus on the worker to prove that he or she was exposed to asbestos in the workplace. As the paper reports, Dr. Vedal noted "the difficulty of obtaining adequate quantitative exposure histories for many claimants without asbestosis." Workers should not be responsible for monitoring current asbestos danger or proving historical exposure. According to the discussion paper, Dr. Finklestein "recommends that decisions concerning attribution be based upon an "asbestos exposure index" or "duration of exposure" in an industry or occupation where asbestos associated lung cancer risk is known to be elevated." However, because no such index or database exists, this recommendation will prove impossible to follow. 4. The discussion paper recommends establishing a list of processes or industries with elevated risks of asbestos exposure. Two models are used for comparison: The Saskatchewan model uses a specific list of industries with elevated risks of asbestos exposure; the UK model uses a broad list of activities with elevated risks of asbestos exposure. The paper recommends adopting the Saskatchewan approach. Neither the Saskatchewan nor the UK model fit the situation in BC. The Saskatchewan list includes the following specific industries: Asbestos mining Insulation and filter production Construction

4 A component of NUPGE (CLC) Page 4 Plumbing and electrical work Pulp mill work Shipyard work Longshoring The UK model uses a list of a broad range of activities rather than specific industries, including: Manufacture of asbestos textiles Spraying of asbestos Asbestos insulation work Applying or removing materials containing asbestos in the course of shipbuilding The Saskatchewan model does not include some at-risk sectors that are present in BC. As the discussion paper states, this model "would more closely reflect the higher-risk trades where asbestos exposure is seen to be elevated in BC." The model used in the UK has the benefit of taking a broad approach, listing activities that may result in asbestos exposure rather than specific sectors. Again, however, the model does not accurately reflect the situation in BC. The paper states that "this approach may not capture the higher-risk trades where asbestos exposure is seen to be elevated in BC (i.e., mining and pulpmill work)." Because of these noted deficiencies, the BCGEU feels that Worksafe BC should create a list specific to BC, building on the work already done by the two aforementioned jurisdictions. This will ensure that no workers or sectors in BC are excluded based on a model developed elsewhere. The BCGEU strongly believes that workers should play a key role in the development of any such list of at-risk activities or industries. Further recommendations As the discussion paper notes, there has been very little record keeping in any area of asbestos exposure and disease in BC. The BCGEU has three recommendations in this regard: 1. We believe that the Occupational Disease Services Department of Worksafe BC should keep a full record of asbestos-related claims, both accepted and denied, so that accurate statistics are available. 2. The BCGEU also recommends that Worksafe BC builds a database of all exposures to asbestos in the workplace, regardless of duration or severity. Any exposure to asbestos can be highly dangerous, and proper records should be kept. 3. To further improve our knowledge of how asbestos has affected workers in BC, we believe that the BC Cancer Agency should keep a database of all lung cancer cases dealing with asbestos-exposed workers in BC.

5 A component of NUPGE (CLC) Page 5 Summary The current policy is arbitrary and not supported by research. All legitimate claims for health problems developed from exposure to asbestos in the workplace should be fairly compensated. We applaud the move to review and revise the current policy, but further action is required. We recommend that Worksafe BC undertake the following: Worksafe BC should take a precautionary approach rather than a strictly epidemiological approach to compensation. Worksafe BC and the BC Cancer Agency should improve their record keeping and build databases of asbestos-related claims, exposures and health problems. Worksafe BC should engage in further consultation with workers and health professionals as part of a more thorough review process so that Worksafe BC policy regarding workplace exposure to asbestos ensures that workers in BC that have been exposed to asbestos in the workplace are given fair compensation. Thank you for this opportunity to discuss these proposed policy amendments. Yours truly, Darryl Walker President DW/leg cope378