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Bladder Cancer in Aluminum Smelter Workers
2000/03/16-02
THE WORKERS' COMPENSATION BOARD OF BRITISH COLUMBIA
RESOLUTION OF THE PANEL OF ADMINISTRATORS
Re: Bladder Cancer in Aluminum Smelter Workers
WHEREAS:
Pursuant to Section 82 of the Workers Compensation Act, RSBC 1996, Chapter 492 and amendments thereto, the Panel of Administrators ("Panel") must approve and superintend the policies and direction of the Workers' Compensation Board ("Board"), including policies respecting compensation, assessment, rehabilitation and occupational safety and health, and must review and approve the operating policies of the Board;
AND WHEREAS:
Section 6 of the Workers Compensation Act provides for the compensation of workers with occupational diseases;
AND WHEREAS:
The Board's policy on adjudicating bladder cancer claims from aluminum smelter workers is provided in Section 30.10 of the Rehabilitation Services and Claims Manual;
AND WHEREAS:
Section 30.10 of the Rehabilitation Services and Claims Manual considers only exposure to benzene-soluble materials;
AND WHEREAS:
The scientific literature indicates that benzo-a-pyrene is a better predictor of bladder cancer risk among aluminum smelter workers than benzene-soluble materials;
AND WHEREAS:
Aluminum smelter workers may be exposed to beta-naphthylamine and consequently may be entitled to the presumption that their cancer is work-related under Section 6(3) of the Workers Compensation Act;
AND WHEREAS:
The Policy Bureau has consulted with the stakeholders most directly affected (Alcan and the Canadian Autoworkers Union, Local 2301) on the matter;
THE PANEL OF ADMINISTRATORS RESOLVES THAT:
- Section 30.10 of the Rehabilitation Services and Claims Manual is amended to adjudicate bladder cancer claims from aluminum smelter workers on the basis of benzo-a-pyrene exposure. The policy is also amended to acknowledge that workers in this industry may be exposed to beta-naphthylamine, which is recognized in Schedule B as a bladder carcinogen.
- The amendments to Section 30.10, as attached, are approved.
- The amended Section 30.10 is effective on April 28, 2000. This policy will apply to all claims adjudicated on or after March 13, 1989 (the date the original bladder cancer policy was approved).
DATED at Richmond, British Columbia, April 28, 2000.
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APPENDIX 1
REHABILITATION SERVICES & CLAIMS MANUAL
PROPOSED AMENDMENTS
[Deletions Struck Through, Additions in Bold]
Chapter 4 — Compensation of Occupational Disease
#30.10 Bladder Cancer
Schedule B lists "Primary cancer of the epithelial lining of the urinary bladder, ureter or renal pelvis" as an occupational disease. The process or industry described opposite to it is "Where there is prolonged exposure to beta-naphthylamine, benzidine, or 4-nitrodiphenyl". In adjudicating a claim for bladder cancer it is incumbent on the Board officer to assess whether the worker has had prolonged exposure to any of the substances listed in Item 4(h) of Schedule B.
In addition to the chemicals listed in Schedule B, the Board recognizes the that aluminum smelter workers exposed to coal tar pitch volatiles have an increased incidence of bladder cancer for aluminum smelter workers exposed to coal tar pitch volatiles.
The Board's policy for the adjudication of claims for bladder cancer resulting from exposure to coal tar pitch volatiles is as follows:
Claims for bladder cancer from aluminum smelter workers which do not meet the descriptions contained in Schedule B are adjudicated on the basis of cumulative (or total) exposure to benzo-a-pyrene, a constituent of coal tar pitch volatiles. In the adjudication of such a claim the following principles and procedures apply:
1. If the disease develops within 10 years of a worker's first exposure to benzo-a-pyrene coal tar pitch volatiles, it will not normally be considered to have resulted from that exposure.
2. In determining the severity of a worker's exposure, regard will, where the information is available, be given to the following ranking of exposure: classification of jobs at the aluminum smelter in Kitimat according to the degree of exposure criteria previously recommended by a committee comprising management and union representatives for the purposes of a survey conducted by the B.C. Cancer Control Agency. This classification contains the following job categories:
|
Category Ranking of Exposure |
Exposure to B.S.M. (mg/m3) |
|
|
|
|
Zero |
0 |
|
Low |
0.1 |
|
Medium |
0.6 |
|
High |
1.5 |
B.S.M. refers to benzene soluble materials.
3. To determine a worker's the total occupational exposure of a worker in the course of the worker's employment over the years, the years which the worker has spent in each job will be multiplied by the concentration of B.S.M. determined for that job by the rankingsclassification referred to above. For example, five years in a high risk job will produce a total exposure to B.S.M. of 7.5 mg/m3 years (5 multiplied by 1.5). The worker's total or cumulative exposure to benzene-soluble materials is the sum of the exposures calculated for each job.
Any exposure which occurred in the 10 years immediately preceding the date the bladder cancer was first diagnosed shall be excluded from this calculation.
4. To convert benzene-soluble materials exposure to benzo-a-pyrene exposure, the worker's total exposure to benzene-soluble materials (expressed in milligrams per cubic metre years or mg/m3 years) is multiplied by 11.0. The result (total or cumulative benzo-a-pyrene exposure) is expressed in micrograms per cubic metre years or μg/m3 years.
4. Where the application of the above formula gives a total
exposure to B.S.M. of 5.6 mg/m3 years or more, it will be
considered that there is at least a 50% probability of the condition
being caused by the exposure and that the claim is an acceptable one.
5. The worker's relative risk of having developed bladder cancer as a result of his/her employment in the aluminum smelter is then determined by comparing the worker's cumulative exposure to benzo-a-pyrene (calculated in accordance with the above principles) with the relative risk figures contained in the following table:
|
Cumulative Exposure to |
Relative Risk |
|
|
|
|
0 |
1.00 |
|
5 |
1.16 |
|
10 |
1.32 |
|
15 |
1.48 |
|
20 |
1.64 |
|
25 |
1.80 |
|
30 |
1.96 |
|
31.25 |
2.00 |
|
35 |
2.12 |
|
40 |
2.28 |
|
45 |
2.44 |
|
50 |
2.60 |
|
60 |
2.92 |
|
70 |
3.24 |
|
80 |
3.56 |
|
90 |
3.88 |
Note: These numbers take into account scientific uncertainty and are based on the upper 95% confidence limit of the exposure-response relationship.
Where the worker's corresponding relative risk is equal to 2.00 or greater, it will be considered that the bladder cancer resulted from such employment and the claim will be accepted.
56.Where the application
of the above formula gives a total exposure of less than 5.6 mg/m3
years or the information required to apply the formula is not available,
having applied the above principles, the worker's relative risk is
less than 2.00, or where the information necessary to calculate the
worker's relative risk is not available, a detailed investigation
will be carried out by the Board Officer Adjudicator
into the worker's job history to determine whether the level
amount of exposure assessed for that
worker allowed by the classification referred
to above is reasonable. Relevant considerations may include special
work assignments, hours of overtime, individual work practices, and
any other characteristics of the workplace or work environment which
may have had an impact on the duration and intensity of the exposure.
If, following this investigation, it is concluded that the total
exposure was less than 5.6 mg/m3 years worker's
relative risk is less than 2.00, it will be considered that there
is a less than 50% probability of the condition being caused by the
exposure and that the claim is not an acceptable one the bladder
cancer is not due to the worker's employment in the aluminum smelter
and the claim will be disallowed.
67. Where the employer and the worker, through the worker's union, reach an agreement as to the total exposure of the worker to benzene-soluble materials in mg/m3 years or to benzo-a-pyrene in μg/m3 years, the Board is not bound to accept this amount and may follow the investigation and determination procedures outlined in paragraphs 2, 3 and 5 above. The amount agreed by the employer and the union may, however, be accepted in lieu of the investigation and determination procedures set out in paragraphs 2, 3 and 5 above if the agreed amount appears reasonable in the known circumstances of the case.
8. Smoking is a strong non-occupational risk factor for bladder cancer. Smoking and exposure to benzo-a-pyrene act synergistically in increasing the risk of developing bladder cancer. If the worker's relative risk calculated in accordance with the above principles is 2.00 or greater, the worker's smoking history will not change the conclusion that the bladder cancer was due to the employment.