Emphysema (Hansard, 11 March 1963)

§ 7. Mr. Pentland
asked the Minister of Pensions and National Insurance if he will include emphysema in the Schedule of the Industrial Diseases (Benefits) Acts for a person who has worked in industry where there is a danger from dust for a period of 10 years.

8. Mr. G. Elfred Davis
asked the Minister of Pensions and National Insurance if he will include emphysema in the Schedule of the Industrial Diseases (Benefit) Acts for a person who has worked in industry where there is danger from dust for a period of 10 years.

§ 9. Mr. Harper
asked the Minister of Pensions and National Insurance if he will include emphysema in the Schedule of the Industrial Diseases (Benefit) Acts for a person who has worked in industry where there is danger from dust for 10 years.

§ 10. Mr. Swingler
asked the Minister of Pensions and National Insurance if he will include emphysema in the Schedule of the Industrial Diseases (Benefit) Acts for a person who has worked in industry, where there is danger for dust for 10 years.

13. Mrs. Slater
asked the Minister of Pensions and National Insurance if he will include emphysema in the Schedule of the Industrial Diseases (Benefit) Acts for a person who has worked in industry, where there is danger from dust for a period of 10 years.

§ The Minister of Pensions and National Insurance (Mr. Niall Macpherson)
No, Sir. The term "emphysema" is used to indicate a variety of morbid states of the lungs. Certain special kinds of emphysema are sometimes found in conjunction with pneumoconiosis. I understand that in these particular circumstances and statutory authorities include any disablement due to these forms of emphysema in assessing the disablement due to the prescribed disease. Generalised emphysema, the common form of the disease, is widespread amongst all sections of the community, and I am advised that there is no evidence to date that work in dusty conditions plays a part in its development.

§ Mr. Pentland
Is the Minister aware that over the years the wider aspects of this disease of emphysema has caused great concern to the T.U.C., and to the National Union of Mineworkers in particular? Will he tell the House whether he has had any recent consultations with the T.U.C. on the matter? If he has not, will he raise it once again with the T.U.C.?

§ Mr. Macpherson
I am aware of the concern that has been felt about this subject. I am not aware that the T.U.C. has asked to see me about it of late, but if it does so I shall, of course, be willing to discuss the matter with the T.U.C.

§ Mr. Harper
Will the Minister tell the House how it is that these districts with the high dust-borne industries have a higher incidence of emphysema than there is in the rest of the country? In view of that, will he look further into the question and bring this disease into the schedule of industrial diseases?

§ Mr. Macpherson
This disease has been kept under review all the time by the Pneumoconiosis Research Unit of the Medical Research Council, but the fact is that up to date those concerned have been able to find no causal relationship between dust in these particular occupations and the disease.

§ Mr. Swingler
Is the right hon. Gentleman aware that his answer will cause grave dissatisfaction in coal mining and pottery areas and areas in which similar trades are carried on? Is he further aware that these people know from personal experience that emphysema is an occupational hazard and that it is closely associated with other hazards? Will he not, therefore, go back to his experts and have a further examination of this question in relation to its incidence in mining and other areas?

§ Mr. Macpherson
I understand the anxiety about this problem, but the fact is that emphysema is a generalised complaint. When a large number of people work together they are apt to ascribe to some particular factor in their employment the incidence of a generalised complaint. In fact, medical science has not been able to connect the two in a causal way at all.

Mrs. Slater
Is the right hon. Gentleman not aware that when emphysema exists among people who, for instance, have worked as cutters at the coal face, it is caused by the job which those people have done? There are in such areas large numbers of people who have emphysema. As we were told last week, the diagnosis of pneumoconiosis is not perfect. Wild not the right hon. Gentleman call his Advisory Council together again and get some practical evidence from those coalfield and pottery areas and see whether, as we ask in these Questions, the fact that when a man has worked in a dust industry for 10 years or more and has developed emphysema it should be scheduled and it would not counteract the suggestion that such a person as myself could get the disease without having worked in such an industry? Surely, if a man works at the coal face for so long and gets this disease it should be scheduled as an industrial disease?

§ Mr. Macpherson
We have to distinguish between the length of time during which a person may have worked in a particular occupation and the causal connection between, say, dust and a particular disease. There is a known causal connection between dust and pneumoconiosis. There is not a known causal connection between dust and emphysema, although some forms of emphysema can come as a result of the pneumoconiosis.

Dr. Stress
Does not the Minister accept that the essential cause of loss of elasticity of the lung, emphysema, is due to constant heavy coughing? Is it not true that men exposed to irritating dusts are compelled to cough and cannot help themselves, and that they do so all their working lives? Could he not take this fact into account?

§ Mr. Macpherson
I am certain that the Pneumoconiosis Research Unit will have taken this into account, but the Unit has still been unable to find a causal relationship.

§ Miss Herbison
The Minister has said that where pneumoconiosis is diagnosed, if the man is also suffering from emphysema, that is taken into account in deciding what rate of disability he should have. Does the Minister not think that the fact that the Pneumoconiosis Research Unit has come to that decision seems to suggest what we on this side of the House feel that working in dust conditions makes it much more likely that a person wild contract emphysema than otherwise? Is he not also aware that even though the Pneumoconiosis Research Unit and the Medical Research Unit cannot find any reason why we should associate emphysema with dust, there are many specialists outside these two bodies, particularly those who deal with patients from mining and pottery areas, who are just as convinced that the dust has an effect and does produce emphysema? Will not the right hon. Gentleman give serious consideration to having this matter again referred to the Pneumoconiosis Research Unit, the Medical Research Council and his own Advisory Council to find out if some justice cannot be given to these people who feel that they are suffering from a very grave injustice?

§ Mr. Macpherson
The Pneumoconiosis Research Unit is keeping this matter under examination the entire time, and it has still been unable to find any evidence that we could refer to the Advisory Council. This is the fact, and I think I should make it clear to the House that while some emphysema can develop from pneumoconiosis it can also exist entirely apart from pneumoconiosis. It is this latter form of generalised emphysema that is common to the public at large and is also shared among mineworkers, and it is not possible to ascribe it to the effects of the occupation.

§ Mr. Mitchison
Does this not involve the question which was asked the other day of the right hon. Gentleman's Parliamentary Secretary, namely, whether the definition of pneumoconiosis ought not to be enlarged? The Parliamentary Secretary replied that he would look into the matter. Has he looked into it, and is it going to be referred to the Council as was suggested?

§ Mr. Macpherson
No, Sir. Of course, he did look into it, following what he said to the House, but when I say "No", there really is nothing further to refer or to examine at present. It is under continuous examination, and there is no evidence that would cause us to ask for the present definition of pneumoconiosis to be revised. It was fully considered by the Industrial Injuries Advisory Council at the time and there is no fresh evidence to consider at present.