Workers' Daily | Can cervical spondylosis be included in the list of occupational diseases?

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On the occasion of the 22nd Publicity Week of the Law on the Prevention and Treatment of Occupational Diseases, professionals called for timely and flexible adjustment of the Classification and Catalogue of Occupational Diseases, and appropriate simplification of the procedures for identifying work-related injuries of employees with occupational diseases, so as to better protect the occupational health rights and interests of workers.

From April 25 to May 1, it is the 22nd Publicity Week of the Occupational Disease Prevention and Control Law in the mainland. At present, focusing on improving the occupational health literacy of workers and protecting the rights and interests of occupational health, various forms of publicity activities have been carried out in various places.

"Are cervical spondylosis and low back pain considered occupational diseases?", "Why is it difficult to identify work-related injuries when they have been diagnosed as occupational diseases?", "Will the spectrum of occupational diseases change with the introduction of new technologies and processes?" When it comes to occupational diseases, some workers raise questions, and some workers are troubled.

In this regard, some professionals told reporters that with the economic transformation and upgrading, new types of work and working methods continue to emerge, and the occupational environment and occupational hazards that workers are exposed to are more complex and diverse, and the "Classification and Catalogue of Occupational Diseases" should be adjusted in a timely and flexible manner, and the procedures for identifying work-related injuries of employees with occupational diseases should be appropriately simplified to better protect the occupational health of workers.

Can cervical spondylosis be included in the list of occupational diseases?

The reporter interviewed and found that many office workers, including drivers, called for cervical spondylosis, frozen shoulder, "mouse hand" and other diseases to be included in the list of occupational diseases. Master Jiang, who was "injured at work", is one of them.

Master Jiang has been driving a taxi in Shenzhen for nearly 20 years, and due to sitting for a long time, he suffered from cervical spondylosis and lumbar disc herniation, "Those who have been in the industry for more than 15 years have more or less these problems, which are difficult to avoid." ”

"I sit in the car for 12 hours a day, and sometimes when I get out of the car, my legs are numb and my waist is very tired. Master Jiang said that when cervical spondylosis is sick, the shoulders are numb and the headache is terrible, and when the lumbar disc is herniated, it is painful at least and difficult to get up at worst.

In response to the call of many workers to include cervical spondylosis and lumbar spondylosis in the list of occupational diseases, Ren Guoyou, deputy dean and professor of the School of Safety Engineering of the China Institute of Labor Relations, said bluntly: "The inclusion of musculoskeletal diseases in the list of occupational diseases is a positive measure, but at present, there is a lack of operational technical means to identify diseases caused by work, which needs to be promoted scientifically and cautiously. ”

Guan Tieliu, a senior partner of Guangdong Huashang (Longgang) Law Firm, told reporters that to include musculoskeletal diseases in the list of occupational diseases, diagnosis will be a big problem. "The diagnosis of an occupational disease requires the establishment of a causal relationship between the disease and work, and the proof that there are no other hazards in daily life. In addition, even if an occupational disease can be diagnosed, the subsequent assessment of the disability level is not easy to carry out. ”

"More importantly, once an occupational disease is diagnosed, reemployment will inevitably be affected. Guan Tieliu said frankly that the Law on the Prevention and Treatment of Occupational Diseases stipulates that employers should transfer occupational disease patients who are not suitable to continue to work in their original jobs and make proper arrangements. "Most occupational diseases cause irreversible damage, while musculoskeletal diseases are reversible. In addition, if the diagnosis of cervical spondylosis and lumbar spondylosis is listed as occupational diseases, the employees diagnosed with occupational diseases will be transferred from their posts, and it will be difficult to work in their original positions in the future. ”

Whether the procedures for determining work-related injuries can be appropriately simplified

"Unexpectedly, my work-related injury determination was stuck on the confirmation of the labor relationship. "Since the early 90s of the 20th century, Mr. Hua has been mining in a gold mine in Zhangjiakou City, Hebei Province. In 2014, Mr. Hua sought a diagnosis of an occupational disease due to lung discomfort. However, after being diagnosed with an occupational disease, he was not recognized as a work-related injury because he could not prove the employment relationship. So far, he has not been able to enjoy work-related injury benefits.

The reporter learned that in 2005, the gold mine where Mr. Hua worked was a collective enterprise, and now it has gone bankrupt and been restructured into a mining company. He continued to mine at the same site and resigned at the end of that year.

In September 2016, the Occupational Disease Diagnosis Agency issued a diagnosis certificate confirming that Mr. Hua had occupational pneumoconiosis, but the employer was a collective gold mine, not a restructured mining company. In May 2019, he applied for labor arbitration, seeking confirmation of the existence of an employment relationship with the mining company in 2005, which was not accepted. After he sued the court, the court ruled that there was an employment relationship between the two parties after the establishment of the mining company and before Mr. Hua's resignation.

However, when Mr. Hua declared his work-related injury, the local social security department decided not to accept the case on the grounds that the gold mine had gone bankrupt and had been deregistered, as the diagnosis of an occupational disease proved that the employer was a collective enterprise before bankruptcy. In desperation, Mr. Hua had no choice but to apply for an occupational disease diagnosis from the local occupational disease diagnosis agency again, requesting him to change the employer to a mining company. The agency made it clear that it could not be re-diagnosed, and the change of employer must be confirmed by the mining company's seal.

In 2023, Mr. Hua used a mining company as the employer to declare a work-related injury, but it was not accepted by the human resources and social security department. For this, he filed a lawsuit again......

"After nearly 10 years and 10 lawsuits, due to labor relations, employer confirmation and other issues, the determination of work-related injuries could not be completed, and occupational disease protection and work-related injury benefits could not be enjoyed. Guan Tieliu believes that the root cause of the problem lies in the fact that when an employee suffering from an occupational disease is identified as a work-related injury, he must confirm the existence of an employment relationship with the employer.

Guan Tieliu revealed that Mr. Hua's experience is not unique, and after some employees are diagnosed with occupational diseases, they are often stuck in proving the labor relationship when they are subsequently identified as work-related injuries. Unlike work-related injuries caused by mechanical external forces, occupational diseases mostly have an incubation period and require continuous or even lifelong treatment.

"Occupational etiology, caused by occupational activity. Occupational history, exposure history, and clinical manifestations sufficient to confirm the diagnosis of occupational disease. Therefore, a specific employment relationship does not constitute a decisive factor in determining whether a work-related injury is determined. In this way, it is proved that there is an employment relationship, which makes it difficult for the employee to determine the work-related injury. "Guan Tieliu appealed whether the procedure could be appropriately simplified. At the same time, it is recommended that workers should know whether their jobs are exposed to occupational disease hazards as soon as possible, and consciously preserve work-related evidence in case of complex employment relationships or changes in the main body of the employer.

Establish a dynamic update mechanism for the catalogue of occupational diseases

The reporter found that since 1957, when the mainland first issued the "Regulations on the Trial Implementation of the "Scope of Occupational Diseases and Measures for the Treatment of Occupational Disease Patients", the catalogue of occupational diseases has been adjusted three times, and the types of diseases have also increased from 14 to 132 in 10 categories. The most recent adjustment was in 2013.

At present, new technologies, new materials, and new processes are constantly being updated, new occupations, new types of work, and new forms of business are constantly emerging, and some new occupational hazards are beginning to appear.

"With the wide application of new materials, workers may be exposed to more new chemical substances, some of which may cause potential harm to the human body. For example, Ren Guoyou said that the hazards of physical factors such as electromagnetic radiation and non-ionizing radiation are gradually emerging, and emerging industries such as biomedicine and gene editing may expose workers to new biological hazards, such as viruses and bacteria.

Ren Guoyou believes that the catalogue of occupational diseases should not only maintain a certain degree of stability, but also establish a dynamic update mechanism to make the catalogue more flexible and applicable, and it is recommended to focus on the newly generated occupational hazards, assess their impact on the health of employees, and timely include related diseases in the catalogue.

In this regard, Guan Tieliu also agrees. In response to the new occupational disease hazards, he suggested that the catalogue of occupational diseases should be supplemented with open clauses, "for example, the open clauses on occupational chemical poisoning in the current catalogue – other chemical poisoning that is not mentioned in the above entries and has a direct causal link with exposure to occupational hazards." ”

Ren Guoyou believes that it is necessary to strengthen the scientific and professional nature, discover and evaluate new occupational disease hazards in a timely manner, and further improve the dynamic adjustment mechanism of the catalogue so as to better adapt to the changing occupational environment. At the same time, establish a monitoring and early warning system for occupational diseases to provide timely and accurate information support.