Dangerous Changes to the Diagnosis of Prescribed Disease C3

In the UK as long ago as 1897 legislation was proposed that would provide a remedy for those injured at work. When debating the issue no less a person than Winston Churchill stated, "I do not say that workmen have not been treated well in the past by the kindness and consideration of their employers, but this measure removes the question of the shifting sands of charity and places it on the firm bedrock of law..."

The devised scheme was intended to have injured workers compensated for each industrial accident without having to prove employer negligence, and to make the economic burden for the compensation system part of the cost of production.
In this way all that had to be proven was that the injury was caused during the course of employment.

Initially the scheme was limited to the most dangerous employment in work such as mining, engineering and factory work and in efforts to promote safety the Employer's Liability Act of 1880 and the Workmen's Compensation Act of 1897 were written into the legislation.

In the UK the legislation was amended in 1906 when occupational diseases were also included in the scheme for specific types of employment. The Workmen's Compensation Act of 1906 included diseases caused by "elemental and inorganic phosphorus", largely because of the disaster to workers' health in the matchmaking industry where phosphorus was used in the striking heads of the matches.
In 1942 triphenyl and tricresyl phosphates were included in the Chemically-induced disease section under C3 because they were known to cause peripheral neuropathy even though they were considered not to have anticholinesterase properties. Many countries around the world based their schemes on the British experience where the Workmen's Compensation Scheme preceded the current Industrial Injuries Disablement Scheme, which was established in the legislation in 1948.

In 1958 both inorganic phosphorus and organophosphates were included, as was phosphine and anticholinesterase compounds of phosphorus. Trialkyl phosphates were left as a separate prescription.

In 1981 pseudo anti-cholinesterase acting compounds of phosphorus compounds were included in the prescription.

By 1992 the legislation included
Black, red and white elemental phosphorus (for which the full dangers were not known even then - although phosphorus used in matchmaking had been suspected of causing Phossy Jaw by unknown means);
Phosphine (phosphoretted hydrogen, phosphorus trihydride, hydrogen phosphde) with the additional information volunteered that "Phosphine is usually liberated accidentally when acid and metal or alkali react to produce hydrogen. The action of hydrogen on phosphorus liberates phosphine" (This explains the warnings not to mix or store OPs in metal containers);
Inorganic compounds of phosphorus other than phosphine. (toxicity being related to that part of the compound which is not phosphorus e.g., chlorine, bromine, fluorine);
and Organo-phosphorus pesticides, one or more of a large group, which were admitted to cause irreversible inhibition of acetyl cholinesterase and at high doses to impair the action of other enzymes. Organic phosphorus compounds were admitted to be ingested, inhaled or absorbed rapidly through the skin.
Repeated absorption of small doses is cumulative to a point where a slight additional uptake is sufficient to cause an attack of poisoning.
That is the very definition of repeated low-dose exposure.

It was also admitted that some people who had suffered from such acute episodes might never fully recover from the effects of the poison.

As with the information in the UK Government's Medical Series paper MS 17 all the dangers of the above were long-known and recognised by the authorities but cases of poisoning in agriculture were growing in number in the UK and when cases were won in the law courts around the world in 1997 and even Select Committees had confirmed that the dangers were known before people had been exposed by government approved OPs officials saw the danger and took steps to hide the truth.

This process began with the Committee on Toxicity investigation into OPs which reported in 1999 and found ever more inventive ways to allow dismissal of all scientific reports that confirmed the long-term effects of repeated low-dose exposures to OPs.
From then on the usual reaction of officials and scientists when asked about those effects was to suggest that the symptoms people suffered with and which had previously been recognised were "all in the mind", "psychiatrically induced" or even "Somatisatiion Syndrome". Some were even told that they had invented their symptoms to comply with those they had read about but the truth was that most had no idea that they had been poisoned until they or their doctors had realised that their symptoms were the recognised effects of the poisons.

When doctors could see for themselves that those symptoms were recognised officials had to ensure that the information was suppressed.

They began by re-writing the Medical Series 17 paper on OP poisoning, removing many of the serious toxic effects that were admitted in the draft paper released to a select few before the COT report and further weakened a document that had been firm in its warnings in the 1980s.

Then they set to work ensuring that the Industrial Injury Legislation was also weakened with the information found therein removed.
It is important for those injured by Organophosphorus chemicals to realise that these changes greatly reduce the chances both of recognition of the cause of their illness and the success of any claim.

The process of changing the criteria for PD C3 appears to have begun in 2002 when a report by the Industrial Injury Advisory Council recommended changes on the grounds that few claims had been made. The intention behind the changes appears to be to make any claims impossible to succeed and to ensure that the information about the known dangers of these toxins is no longer presented in the legislation.
Perhaps it is of benefit to note that some of those who made the decision to alter the legislation were themselves responsible for helping to approve the use of the very dangerous chemicals about which they now deny the long-known dangers.
In April 2003 one of them declared of the description of PD C3 "there is no mention of repeated low dose exposures causing long-term ill-health." However it is well recognised in internationally accepted literature that “repeated low-dose exposures” can cause increasing sub-acute harm, much of which will inevitably be impossible to quantify, and which will eventually result in acute poisoning from which some individuals may never recover. In fact it is known that further exposures before recovery of the enzymes is complete can be extremely dangerous. This is why the manufacturers routinely blood test their staff and remove them from any possible contact with organophosphates until they have fully recovered. To deny such facts is both dangerous and wholly irresponsible.

Before continuing it should be noted that the official view, challenged by experts in the British Courts, is that no organophosphorus chemical is approved for use if it has the potential to cause peripheral neuropathy. Numerous claims have involved sufferers with diagnosed and confirmed peripheral neuropathy but their claims have also been rejected in the past, with that decision presumably based on the false claim that commercial OPs cannot cause such damage to the nervous system.

In the February 2002 "Report by the Industrial Injuries Advisory Council in accordance with Section 171 of the Social Security Administration Act 1992 reviewing the prescription of conditions due to chemical agents" it was written
"48. History of prescription
Poisoning by phosphorus has been a prescribed disease since the start of the scheme in 1948. At that time it was prescribed as poisoning by phosphorus, but from July 1958 the prescription was amended to “poisoning by phosphorus or phosphine or poisoning due to the anti-cholinesterase action of organic phosphorus compounds”. In October 1983 the wording was changed to read: “poisoning by phosphorus or an inorganic compound of phosphorus or the anti-cholinesterase or pseudo anti-cholinesterase action of organic phosphorus compounds”.
49. Number of cases
During 1998-99 four cases reached the stage where the claimant’s disablement was assessed."

It should be noted that the Department for Work and Pensions is notorious for "errors" in such information when official requests are made and that the figure for case numbers mentioned above in no way tallies with other official figures "rounded to the nearest 10" provided in 2013 in answer to a Parliamentary written question. Of importance in those "rounded" figures is that for each year that case numbers were given before the suggested changes all ten in each year were successful whereas after the changes not one of the ten claims reported as made in each year was accepted.
This does strengthen the view that the changes were designed to prevent successful claims and to enable the knowledge of the adverse effects of the poison to be removed from the legislation.

Interestingly in a footnote to the official figures given in 2013 the Minister stated boldly that
"Phosphorus Exposure is listed as a prescribed disease and not as a cause of accident"
and that "The year ending 1998 is the earliest available data, prior to that figures were not broken down to individual disease level."

Once again these statements are grossly misleading as cases of PD C3 had been listed in correspondence released in 1997 with figures not only given for each year from 1990 to 1996, but also the level of payments for each claim. Poisonings by organophosphates have been denied despite scientifically supported diagnosis but accepted as "Industrial Accidents" - presumably to hide the numbers poisoned - but even that was not permitted in the regulations, which stated that
"A claimant may contract a disease because of an industrial accident in prescribed circumstances. The claimant may be entitled to benefit for the PD and the industrial accident. But benefit can only be awarded under one heading. 1 SS CB Act 92, s 108(1)(a)(b)
66056 Benefit must be based on the PD if at the time of the accident

1. a disease is prescribed for a claimant and
2. the injury resulting from the accident is the contraction of the disease. It does not matter that the claim was made on the basis of an industrial accident. 1 s 108(6)
A man employed in an occupation involving the use of carbon tetrachloride is poisoned by fumes when a container is accidentally broken and suffers liver toxicity as a result. Liver toxicity is a disease prescribed for him (PD C26). Although he has had an industrial accident, benefit is dealt with under the PD provisions because he has suffered no other injury."

The disease diagnosis should therefore take precedent over the accident.
However. Decision Makers do not enforce that rule and even poisonings confirmed by scientific diagnosis have been denied only to be regarded as Industrial Accidents with the benefit paid then reduced further on the false grounds of "pre-existing conditions" that were not in reality present before the poisoning.

A later IIAC Report for 2002/3 entitled PROGRAMME OF WORK 2002/3 reported
A. Review of the schedule of prescribed diseases
1. Conditions caused by exposure to chemical agents (C-diseases)
The Council’s main report was published on 14 February 2002. However, during the year IIAC carried out further work in relation to:
Diseases due to phosphorus (PD C3)
IIAC recommended in its report that, in the light of current evidence, the prescribed disease should no longer include the anti-cholinergic effects of organophosphates. At the Minister’s request, IIAC looked again at this issue during the summer, but reached the same conclusion. The Minister accepted the recommendation, but decided not to change the terms of prescription of PD C3 at the moment, in order to wait for the results of research being carried out by Department for the Environment, Food and Rural Affairs (DEFRA) which are due in 2005.

The above paragraph indicates that Ministers were reluctant to weaken the legislation and to remove the anticholinesterase information, especially given that it is this very action of OPs that had for many years been used as the only means to determine poisoning by OPs, but the advisers seemed determined to hide the reality of the known affects of the poisons, which in commercial formulations included solvents that also had known neurotoxic effects.

In 2007 once again Ministers were reluctant to weaken the PD C3 prescription but the scientific advisers repeatedly hid the truth.
Quote below from another Industrial Injury Advisory Committee report and we should not forget that all commercial OPs are in combination with solvents and that OP exposure is known to affect sperm quality and fertility.
It is not simply OP poisoning, though that is enough -
50. In the Command Paper ‘Conditions due to Chemical Agents’ IIAC stated that it would review separately the neuropsychological effects of occupational exposure to organic solvents (see paragraph 52). Also, it drew attention to the potential for lead to impair fertility, but found that other industrial chemicals have also been linked with reproductive disorders. Therefore IIAC has decided to cover the reproductive effects of occupational activities and exposures in a separate enquiry once the review of the schedule of prescribed diseases is complete.

Peripheral neuropathy due to exposure to organophosphates
51. In the 2002 ‘C’ diseases report IIAC recommended that the terms of prescription for PD C3 be amended such that the previous description (poisoning by phosphorus) be replaced by PD C3a (phossy jaw) and PD C3b (peripheral neuropathy with or without accompanying toxicity to the central nervous system). The Council recommended that for PD C3b peripheral neuropathy due to exposure to organophosphates should follow an acute episode. Evidence at that time from published research and consultation with experts showed that chronic low dose exposure to organophosphates was not associated with peripheral neuropathy. The Minister accepted the scientific strength of these recommendations but withheld implementation until research by other government departments was completed. The Council is making regular checks on the progress of this research.

Neuropsychological effects of organic solvent exposure
52. IIAC commissioned a review of the neuropsychological effects of occupational exposure to organic solvents, which was placed on the IIAC website for a consultation period of three months. The Council evaluated the evidence and set out its recommendations in a position paper published in December 2003. It found that the neuropsychological effects of organic solvents were not specific to a well-defined clinical disease and did not recommend prescription.

In March 2012 The UK "The Social Security (Industrial Injuries) (Prescribed Diseases) Amendment Regulations" changed the prescription for the C3 Industrial injury after advice from the Industrial Injury Advisory Council.
On 1st March 2012 the following advice was given:
(4) For the entry relating to prescribed disease C3 (poisoning by phosphorus or inorganic and organic phosphorus compounds) substitute—
“C3. (a) Phossy Jaw. Work involving the use or handling of, or exposure to, white phosphorus.
C3. (b) Peripheral polyneuropathy or peripheral polyneuropathy with pyramidal involvement of the central nervous system, caused by organic compounds of phosphorus which inhibit the enzyme neuropathy target esterase. Work involving the use or handling of, or exposure to, organic compounds of phosphorus.”

This now stands as the criteria for the industrial disease - unless it is further weakened in the future. Please compare with the 1992 version of PD C3 and note that, as with the Medical Series advice provided by the Health and Safety Executive MS17, there has been a gradual decline in the standards and accuracy of the information provided over time and that can only be a consequence of attempts to hide the truth.

In addition the UK may well have acted in breach of the United Nations Charter for Universal Human Rights and the European Charter Of Patients’ Rights as agreed in Rome in November 2002, which provides that
"As European citizens, we do not accept that rights can be affirmed in theory, but then denied in practice, because of financial limits. Financial constraints, however justified, cannot legitimise denying or compromising patients’ rights. We do not accept that these rights can be established by law, but then left not respected, asserted in electoral programmes, but then forgotten after the arrival of a new government.
The Nice Charter of Fundamental Rights will soon be part of the new European constitution. It is the basis of the declaration of the fourteen concrete patients’ rights currently at risk: the right to preventive measures, access, information, consent, free choice, privacy and confidentiality, respect of patients’ time, observance of quality standards, safety, innovation, avoidance of unnecessary suffering and pain and personalised treatment, and the right to complain and to receive compensation.
These rights are also linked to several international declarations and recommendations, issued by both the WHO and the Council of Europe. They regard organisational standards and technical parameters, as well as professional patterns and behaviour.

This is a blatant attempt to renege on the historic obligations, dating from the 19th Century to those who work for the good of the Nation and who have contributed to the National Insurance Contributions Scheme, which promised to provide financial support to those injured and made disabled in the course of their work.
That betrayal is compounded by the policies of the Coalition Government in the UK which introduced swingeing cuts to the benefit system and ensured that everyone in receipt of state benefits was treated exactly the same whether of not they had ever worked or paid their contributions. There are even proposals to end the National Insurance Contributions Scheme and include the costs in Income Tax deductions which would finally put an end to the historic obligations to the employed that have been accepted by all political parties for well over a century.

The World Health Authority recognises poisoning by organophosphorus chemicals by accident, deliberate actions and by occupational exposures under the definitions listed in the ICD-10 WHO Classification of diseases.

By refusing to recognise these illnesses and the effects of these deadly DNA toxins the UK Government is causing a massive increase in long-term illness and is acting in breach of numerous obligations and internationally agreed rights including those signed up to under the International obligations to uphold human rights, but under the Coalition even worse things have been done and those very people, harmed as they have been by regulatory failures, have now been forced to pay the price for the economic failure of the richest in society.

Senior politicians have deliberately incited the hatred of a minority, the disadvantaged and disabled, in order to gain support for that policy.

Dated 16/4/2013

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