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REACH: Impact on Occupational Health Simon Pickvance University of Sheffield.

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Presentation on theme: "REACH: Impact on Occupational Health Simon Pickvance University of Sheffield."— Presentation transcript:

1 REACH: Impact on Occupational Health Simon Pickvance University of Sheffield

2 Previous estimates RPA –TOTAL: Billion euros –Skin: million euros –Respiratory: 4-53 million euros (30 years, discounted, present value)

3 Recognised Occupational diseases in Europe in 2001 Source: EODS Eurostat, 2004

4 How many are chemical- related ? Occupational diseases % linked to chemicals exposure % amongst all recognised diseases % chemicals related amongst all recd. diseases Cancers4 – 90* %5 % * % Neurological diseases 2 %8 %0.2 % Respiratory diseases 36 – 89* %14 %5.0 – 12.5* % Skin diseases88 %14 %12.3 % Total~ 18% to 30* % (*): including chemical dust Source: extrapolated from EODS Eurostat, 2004

5 Objective of the ETUC (ongoing) study  Assessment of the impact of REACH on occupational health with a focus on skin and respiratory diseases Why a focus on those 2 occupational diseases ?  Benefits from REACH are underestimated in the RPA study because underdeclaration was not considered  88 % of occupational skin diseases are related to chemicals exposure  36 % of occupational respiratory diseases are related to chemicals exposure  Short time lag between exposure and effects (reflecting the present work conditions)

6 Method of work Assess number of cases of disease Estimate the proportion of cases preventable via REACH Model the impact of REACH Calculate costs per case Analyse benefits

7 How many cases of occupational disease ? The problem with social protection statistics Systems exclude some sections of the workforce; e.g. self-employed and state employees Have restrictive definitions of disease Varying levels of incapacity to qualify (1- 33%) Different routes of access

8 RPA study (estimation of recognised cases/year)* ELFS (self-reported cases/ year)* Respiratory diseases (x 35) Skin diseases (x 11) * In the EU-15 LFS = Labour Force Survey, Eurostat 1999 ad hoc module What other sources of information are available ?

9 Calculating attributable fractions Use population prevalence/incidence of the condition Find out how this varies across occupations What proportion of cases are expected in each occupational group given its size ? What proportion could therefore be attributable to work ?

10 Incidence of three major diseases Eurostat 15/2004, ELFS Social protection Self- reporting Attributable Fraction Occupational asthma 3700 RPA (1780 asthma 823 COPD EODS) 29,00025,000 COPD17,000 Occupational dermatitis 12,000 (7378 EODS) 20,000200,000

11 Health Benefits from REACH: Assumption: Information on health effects from chemicals will lead to reduction of exposure and prevention of illness Some of the chemicals-related occupational diseases are linked to unknown effects from these chemicals

12 What proportion of exposures could be reduced through REACH ? Social protection Registries, etc Occupational asthma40% - 60% COPD (ECRHS) 10% - 20% Occupational dermatitis50%

13 Major suspected aetiologies in cases reported by the ONAP in 1997 Kopferschmitt-Kubler et al 2002

14 Corroboration of estimates Correction factors: few cases in population studies are compensated Missed cases (occupation-specific studies) PARs show good consistency and use different methods of assessing exposure Other surveys give comparable estimates

15 % Wheeze at work ECRHS Blanc et al 2003

16 % Job change attributed to Breathing difficulties Blanc et al 2003

17 Step 2: Estimation of the economic costs per case per year (RPA) Cost per Case per Year (€) Cancers€ 2.14 million Neurological diseases€ Eye disorders€ 600 Respiratory diseases€ Skin diseases€ 640 These costs include: costs of medical treatment the value of lost output human costs (for cancer = value of a statistical life )

18 (*): 2000 prices, discounted over 30 years at 3% Skin diseases % Respiratory diseases % Neuro. diseases % Eye disorders % Cancer deaths 99,586 % € 50 billion over 30 years* Step 3: Economic value of the future diseases avoided as a result of REACH (= results step 1 X results step 2) (RPA)

19 Estimated benefits for « real » number of cases: RPA benefits estimation (€ million) Correction factor Our provisional estimate (€ million) Skin diseases 100 (0.189 % of 50 billion) 9900 Respiratory diseases 50 (0.098 % of 50 billion) Total 1375 Assumption: real nb of cases = half nb of self-reported cases

20 Conclusions:  REACH direct costs: € 2.3 billion  REACH benefits for occupational skin and respiratory diseases only : € 1.4 billion REACH is clearly an opportunity to reduce the nb of chemicals-related occupational diseases and the associated costs for both industry and the society

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