Emphysema (Compensation of Coalminers) (Hansard, 20 February 1985)

§ Mr. Geoffrey Lofthouse (Pontefract and Castleford)

I beg to move, That leave be given to bring in a Bill to provide compensation for mineworkers under the Industrial Injuries Acts for emphysema. This must be the latest hour on record that a ten-minute Bill has been presented to the House. However, the unfortunate miners of whom I am speaking — some cannot walk more than a few yards and some cannot dress themselves—would not mind waiting even another three hours, having waited for more than a century, for us to put right the injustice with which the Bill deals.

This is the fourth occasion on which I have brought this subject to the attention of the House. I presented Bills in October 1982, in March 1983 and again in November 1983. I make no apology for my persistence because the evidence, based on learned study, supports the view that emphysema is prevalent among coalminers.

In presenting my previous Bills, I put before the House a detailed list of research. I shall not cite that detail again. I assure hon. Members that it was scholarly and decisive, and I simply draw attention to it in support of my Bill. However, I wish especially to draw attention to the paper "Cockroft et al" published in The Lancet on 11 September 1982. This report brings together all the findings of the research since 1966.

In further support of my Bill, I submit to the House the strong, short and easily understood argument contained in The Lancet editorial on 19 March 1983, based on 20 learned papers. Since presenting my last Bill on 23 November 1983, I have studied another learned paper entitled "Emphysema and Dust Exposure in a Group of Coal Workers" by Ruckley v. Anne et al published in the respected journal American View of Respirable Disease. The paper outlines how a distinguished team of medical experts examined the lungs of 450 coal miners from 24 British mines. In its summary, the paper concluded: We conclude that the association observed between respirable coal dust and emphysema in coal miners indicates a causal relationship. However, because it can be demonstrated only for men whose lungs show some dust-related fibrosis, it is suggested that the extent and nature of such fibrosis may be a crucial factor in determining the presence of centracinar emphysema. In presenting my previous Bills, I relied upon the evidence of learned papers. I now submit evidence of my own research within the catchment area of the Pontefract area health authority which is officially measured as having 169,800 people, although it is generally considered to be much larger in practice.

This research has shown me that, in the mortality rate over the period 1979–83 inclusive, there were 634 recorded deaths from chronic bronchitis and emphysema, which is an average of 177 a year. Expressed as a standardised mortality ratio, when the figure for England and Wales in 1981 is taken as an arbitrary 100, this comes to 169, which is a highly significant statistical difference from the national average. The standardised mortality ratio over the same period for lung cancer was 109.4, which is not significantly different from the national average.

It would be reasonable to assume that the lung cancer deaths are a reflection of the magnitude of smoking-related 1079 deaths in the district, and as these are not higher than the national average, the excess mortality from chronic bronchitis and emphysema might reasonably be attributed to other factors. The most likely of these are air pollution and occupational factors of which, of course, mining is by far the most important.

Of the hospital admissions in the Pontefract area health authority, over 7,000 bed days were utilised by patients with respiratory disease in 1983. This is most certainly a conservative estimate. In 1984, approximately 300 patients had to be admitted to the chest unit at the Pontefract general infirmary for chronic bronchitis and emphysema, out of a total of 1,000 inpatients in all disease categories over the same period. Of these, male patients outnumbered female patients by three to one. Of these men, approximately 80 per cent. were, or had been, miners, strongly suggesting an occupational factor in the aetiology of the disease. It is fair to say, however, that almost 100 per cent. of them were also smokers. I think that here we are seeing an additive effect of two potent causes of chest diseases.

Over the same period, the outpatient figures show that general practitioners referred 150 new cases of chronic bronchitis and emphysema to one consultant, and a further 800 patients with this condition were followed up in his clinic. The same male to female ratio applies to these patients as to the hospital admissions, as does the occupational history. Many of these men had simple and, usually, low-category, pneumoconiosis.

There were only 12 new referrals of patients with complicated pneumoconiosis where a high percentage of pension was being awarded. Some 88 follow-up patients fell into this category. It is obvious that chronic bronchitis and emphysema, with or without simple pneumoconiosis, is a much larger problem than the more severe forms of pneumoconiosis.

Section 76(2) of the Social Security Act 1975 provides that, before any disease can be prescribed for which 1080 industrial injury benefit is payable, the Secretary of State must first be satisfied on two points. First, he must be satisfied that the disease should be treated, having regard to its causes and incidence and any other relevant considerations, as a risk of occupation and not as a risk common to all persons. Secondly, he must be satisfied that the disease is such that, in the absence of special circumstances, the attribution of particular cases to the nature of the employment can be established or presumed with reasonable certainty.

As I told the House before when I presented my Bills, I understand from the medical profession that the individual can never be truly assessed during the course of his life. He can be assessed only by a post mortem examination after death, and that is too late. The evidence is such that these men should have to wait no longer.

In those circumstances, I hope that the Government will at least reward my consistency and examine this situation seriously. I am well aware that the Industrial Injuries Advisory Council is looking at evidence on this disease. It is 10 years since it last looked at the subject, and I am pleased that it is doing so again. I hope that, if the council decides to prescribe, the Minister will accept the recommendations. I hope that the House will support my Bill.