Fate of Outstanding COIDA Occupational Disease Claims Following Closure of the Western Cape Provincial Medical Advisory Panel in 2008 : An audit

Background and objectives: The Western Cape Provincial Medical Advisory Panel (PMAP) was established in 2004 in terms of Section 70(1) of COIDA. A primary function was to improve the efficiency of medical assessment of occupational disease claims. The PMAP was closed by the Compensation Commissioner in 2008. This audit aimed to determine the fate of claims outstanding at the time of closure. Methods: A total of 68 claims outstanding in April 2008 were followed up by telephone; email and/or internet to determine what proportion had progressed or; if accepted; had resulted in a permanent disablement compensation payment. Results: Of the 68 claims; 31 (44) were confirmed as having progressed. Of these; payment of permanent disablement awards could be confirmed in only 15 claims (22). The remaining 56 either showed no progress or no longer had a record in the COIDA system. Those stages of the claims process that had previously been aided by PMAP functioning had deteriorated in efficiency. Conclusions: Overall; the low proportion of outstanding claims finalised and awarded is consistent with inefficiency in claims handling of occupational disease; a finding echoed by recent complaints about general Compensation Fund performance from both healthcare providers and parliamentary investigation

Compensatability and contact dermatitis in the canning industry.

If reports from the Workmen's Compensation Commissioner are compared with international figures, dermatitis in South African industry appears to be underestimated. Compensation for occupational dermatitis in South Africa relies on the presence of a positive patch test. A prevalence study at a canning factory in the western Cape showed high rates of dermatoses. No association could be shown between dermatitis, intertrigo or chronic paronychia and patch-test positivity. It is argued that patch-test positivity is purely coincidental to the dermatoses and that patch testing has little role to play where the majority of occupational dermatoses are irritant in nature. Reform of the system of compensation for occupational skin disorders is urgently needed and should be integrated in workplace-based preventive and curative programmes.

Dermatoses--an occupational hazard in the canning industry.

Despite the recognition that occupational dermatitis is extremely common, few data exist on the prevalence of skin disorders in South African industry. A cross-sectional prevalence study among 686 female workers in a canning factory in the western Cape showed high rates of dermatoses--in particular, chronic paronychia, intertrigo and dermatitis of the hands. A statistically significant association was found between exposure to 'wet work' in the industry and the prevalence of chronic paronychia and intertrigo. Age was also found to be associated with these dermatoses, irrespective of duration of service. The prevalence of dermatitis of the hands was increased among high-exposure workers, but not significantly. Dermatoses are an important occupational hazard in the canning industry, and there is a need for improved preventive measures.

Dermatoses in the canning industry--the roles of glove use and non-occupational exposures.

Primary prevention is the mainstay of management of occupational dermatoses. Despite the high rates of dermatoses found in a study of 686 female workers in a canning factory in March 1990, use of protective gloves was extremely low, even though there was evidence that they prevented acute paronychia and intertrigo. Reasons associated with low glove use were unavailability, discomfort and workers' failure to perceive a protective role for gloves. Difficulties with replacement of damaged gloves were an important cause of unavailability. Domestic and other non-occupational exposure at the workplace appeared to be unimportant in the development of dermatoses. Important preventive interventions are possible in the industry to reduce the rates of dermatoses among the workforce.