Table 1. Review of systems and compensation for occupational asthma (OA) and work-aggravated asthma in various countries.
Country | Administration | Responsible institution | Is OA compensated? | Is work-aggravated asthma compensated? | Examination of cases | Total workforce million# | List of agents for OA | Open system for OA causing agents? | Is a positive SIC a pre-condition? | Is specific IgE or positive SPT a pre-condition? | Is NSBHR a pre-condition? | OA cases per year n | Degree of disability to be compensated | Worker’s possibility to avoid further exposure | Permanent disability allocated? |
Belgium | National agency | Public insurance agency with equal number of representatives from trade unions and employers Insurance premium paid by employers |
Yes | No | Board of specialists | 4.87 | Yes | Yes | No | No (if positive SIC) |
No (if positive SIC) |
Mean of 77 claims accepted annually by the Workers’ Compensation Board between 1992 and 2002¶ | Yes (based on airway obstruction, NSBHR and medications) plus additional award based on reduced chances on the job market | Yes | Yes |
Canada | 18.99+ | ||||||||||||||
Quebec | Agency | Employers public insurance Administrative board with equal number of representatives from trade unions and employers Insurance premium paid by employers |
Yes | Variable | Specialists | 4.29§ | No | Yes | Yes, if feasible | No | No | 40–70 | 0–100% | Yes | Yes |
Ontario | Agency: Ontario Workplace Safety and Insurance Board | Employers | Yes | Yes | Medical information from physicians that may include specialists Claim decision reached by a claims adjudicator with additional physician input if considered needed |
7.32§ | No | Yes | No | No | Not an absolute pre-condition but helpful | ∼20 per year by 2002 | Yes | Yes | |
Finland | National agency | Employers/insurers | Yes | Specialists | 2.64 | 304 (in 2002) | Yes | ||||||||
France | Regional agencies | Employers | Yes | Variable | Social security practitioners | 28.35 | Yes | Yes | No | No | No (but pulmonary function tests compulsory) | 222 (in 2009) | 0–100% | Yes | Yes |
Germany | Branch-oriented statutory accident insurance institutions | Employers/insurers | Yes | Yes | Specialists | 41.01 | No | Yes | No | No | No | 700ƒ (in 2009) | 0–100% (depending on the degree of reduced chances on the job market; 2–3 yrs) | Yes | Yes |
Italy | National | Employers | Yes | No | Board of specialists | 24.29 | Yes | Yes | No | No | No | 167 (in 2003) | 0–100% | Yes | Yes |
Norway | National agency and private insurance (compulsory) | Government employers and private insurers | Yes | Specialist | 2.52 | No | Yes | No | No | No | 174 (in 2000) | 15–100% | Yes | Yes | |
Denmark | National agency | Employers and government | Yes | No | Specialists | 2.88 | Multiple means | Yes | No | No | No | 50–70 | Depending on the degree of reduced chances on the job market | Yes | Yes |
Spain | Government agency | Employers and government agency | Yes | No | Board of specialists | 22.96 | Yes | No | No | No | Not an absolute pre-condition |
258–294 (in 2000–2003) | No | Yes | Yes |
The Netherlands | No specific system | Employers and employees | No official acceptance | No official acceptance | Insurance physicians and, in civil cases, chest and occupational physicians | 8.62 | None | ? | No | ||||||
UK | Government agency | General taxation | Yes | No | Career specialists for assessing occupational diseases | 30.79 | Multiple | With individual proof and due to sensitisation | No | No | No | 170 in 2009 | At least 14% required | No requirement |
Yes |
USA | Varies by state | Varies by state | Varies by state | Varies by state | Varies by state | 153 | No | Yes | No | No | Varies by state | No national data | Varies by state | Varies by state | Varies by state |
SIC: specific inhalation challenge testing; Ig: immunoglobulin; SPT: skin-prick test; NSBHR: nonspecific bronchial responsiveness. #: data from [118]; ¶: data from the Fonds des Maladies Professionnelles–Fonds voor de Beroepsziekten; +: data from [119]; §: data from [120]; ƒ: also includes objective cases with work-aggravated asthma or occupational chronic obstructive pulmonary disease. Modified and extended with data from [121].