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Applying a ‘presumably plausible’ principle in a new one-time financial compensation system for occupational diseases in the Netherlands
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Applying a ‘presumably plausible’ principle in a new one-time financial compensation system for occupational diseases in the Netherlands
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Journal Article
Applying a ‘presumably plausible’ principle in a new one-time financial compensation system for occupational diseases in the Netherlands
2024
Overview
ObjectivesIn the Netherlands, a new regulation has been adopted for recognition and compensation of serious substance-related occupational diseases. A national advisory committee has a key task of providing advice on the protocols for operationalisation of individual causality assessment in this new context.MethodsProtocol development involves gathering the best available population-level evidence on causality and using this evidence to determine individual causality. Here, the presumably plausible principle was adopted, which stipulates that uncertainties in individual causality should be weighed in favour of a fast and transparent one-time compensation for (ex-)workers.ResultsIn monocausal diseases, a limited workplace exposure assessment is considered sufficient to determine whether individual causality is presumably plausible in the Dutch context. For multicausal occupational diseases, individual causality assessment is more complicated. Modelling of existing data on the exposure–response relation helps establish the probability of causation, that is, the risk of the disease attributable to a work-related exposure. This operationalisation, applied in some protocols, makes use of the probability of causation, while being prudent in establishing exposure limits. An example from asbestos and lung cancer is provided in this short report.ConclusionsWe propose a pragmatic approach to individual causality assessment of substance-related occupational diseases, considering statistical and diagnostic uncertainties. This approach substantiates protocols towards a one-time financial compensation without long-winding recognition procedures.
Publisher
BMJ Publishing Group Ltd,BMJ Publishing Group LTD
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