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38. Pneumoconiosis and health care
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In Japan, many workers required medical treatment due to pneumoconiosis that was caused by inhaling dust over long periods of time. Therefore, the Pneumoconiosis Law was enacted in 1960 for the purpose of taking necessary measures for adequate health care, prevention, etc.
Thereafter, the Ordinance of Prevention of Hazards Due to Dust (1979) was enacted based on the Industrial Safety and Health Law, and this ordinance has been applied to prevention. (The Pneumoconiosis Law, and the Enforcement Ordinance of Pneumoconiosis Law)
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1. Classifications for supervision of pneumoconiosis (Law, Article 4)
With reference to the results of health examinations for pneumoconiosis,
the health conditions of workers are classified as follows:
| Classification for supervision of pneumoconiosis |
Results of health examination for pneumoconiosis |
| Supervision classification 1 |
Pneumoconiosis is not found.
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| Supervision classification 2 |
The image on the X-ray photo is of the category 1, and does not show remarkable
pulmonary dysfunction due to pneumoconiosis. |
| Supervision classification 3 |
| a. |
The image on the X-ray photo is of the category 2, and does not show remarkable
pulmonary dysfunction due to pneumoconiosis. |
| b. |
The image on the X-ray photo is of the category 3 or 4 (limited to cases
where the size of a large opacity is 1/3 or less of one lung field), and
does not show remarkable pulmonary dysfunction due to pneumoconiosis. |
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| Supervision classification 4 |
| a. |
The image on the X-ray photo is of the category 4 (limited to cases where
the size of a large opacity is more than 1/3 of one lung field). |
| b. |
The image on the X-ray photo is one of the category 1 to 4 (limited to
cases where the size of a large opacity is 1/3 or less of one lung field),
and shows remarkable pulmonary dysfunction due to pneumoconiosis. |
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Note: |
| Category 1 |
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There are a few granular or irregular opacities due to pneumoconiosis in
both lung fields, and no large opacity is observed. |
| Category 2 |
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There are many granular or irregular opacities due to pneumoconiosis in
both lung fields, and no large opacity is observed. |
| Category 3 |
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There are a good many granular or irregular opacities due to pneumoconiosis
in both lung fields, and no large opacity is observed. |
| Category 4 |
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A large opacity is observed. |
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2. Health examinations for pneumoconiosis
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| a. |
Health examinations at the time of engagement (Law, Article 7)
Workers who are newly engaged on a regular basis in dusty work |
| b. |
Periodic health examinations (Law, Article 8)
Employers must carry out health examinations of workers, etc. regularly
engaged in dusty work at the following frequency: |
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| (a) |
Workers who are regularly engaged in dusty work should be examined at least
once every three years. |
| (b) |
Workers who are regularly engaged in dusty work and who belong to pneumoconiosis
supervision classification 2 or 3 should be examined at least once every
year. |
| (c) |
Workers who have been regularly engaged in dusty work, who are presently
engaged in work other than dusty work, and who belong to pneumoconiosis
supervision classification 2 should be examined at least once every three
years. |
| (d) |
Workers who have been regularly engaged in dusty work, who are presently
engaged in work other than dusty work, and who belong to pneumoconiosis
supervision classification 3 should be examined at least once every year. |
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| c. |
Non-periodic health examinations (Law, Article 9; Ordinance Article 11)
In addition to periodic health examinations, employers must carry out health examinations at any time in the following cases:
| (a) |
Workers regularly engaged in dusty work who have been found to have pneumoconiosis
or who have been diagnosed with a suspected case of pneumoconiosis as a
result of periodic health examinations or specific health examinations
( for workers exposed to specific occupational hazards ) carried out according
to the Industrial Safety and Health Law (excluding cases that have been
categorized as supervision classification 2 to 4). |
| (b) |
A doctor has submitted the diagnosis that a worker who has been absent
from his/her workplace longer than one year due to medical treatment for
complications, is not required to remain absent any longer. |
| (c) |
A doctor has submitted the diagnosis that a worker who has been absent from his/her workplace longer than one year due to medical treatment for complications, no longer requires medical treatment.
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| d. |
Health examinations at retirement (Law Article 9-2, and Ordinance Article
12)
When a worker regularly engaged in dusty work retires, the employer must
carry out a health examination.
| (a) |
Workers who have been regularly engaged in dusty work longer than one year |
| (b) |
Workers who have been regularly engaged in dusty work longer than six months
and who belong to pneumoconiosis supervision classification 2 or 3 |
| (c) |
Workers who have been regularly engaged in dusty work longer than six months,
who are presently engaged in work other than dusty work, and who belong
to pneumoconiosis supervision classification 2 or 3 |
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| e. |
Relation of health examinations carried out according to the Industrial
Safety and Health Law (Law, Article 10)
In cases where health examinations for pneumoconiosis have been carried
out, periodic or specific health examinations according to the Industrial
Safety and Health Law may be omitted to the extent covered by the health
examinations for pneumoconiosis.
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3. Procedures, etc. for decisions on pneumoconiosis supervision classification
(Law, Articles 13 to 20; Ordinance, Articles 20 to 25)
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| The procedures regarding health examinations for pneumoconiosis resulting
in the decisions on classification for supervision of pneumoconiosis are
as follows: |
| a. |
Persons who have been diagnosed, as a result of health examinations for
pneumoconiosis, as being free from pneumoconiosis, belong to supervision
classification 1. |
| b. |
For workers who have been diagnosed, as a result of health examinations
for pneumoconiosis as having pneumoconiosis:
| (a) |
Employers submit the certifying documents, etc. of the results of X-ray
photos and health examinations for pneumoconiosis to the Director General
of the Prefectural Labour Bureau concerned. |
| (b) |
The Director General of the Prefectural Labour Bureau decides the supervision
classification based on the diagnosis and examination by the regional official
pneumoconiosis examination physician. |
| (c) |
The Director General of the Prefectural Labour Bureau notifies the employer
concerned of the decision on the supervision classification. |
| (d) |
The employer concerned notifies the worker concerned of the decision on
the supervision classification. |
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| c. |
Workers who are regularly engaged in dusty work or workers who have been
regularly engaged in dusty work may, at any time, file an application for
the decision on pneumoconiosis supervision classification with the Director
General of the Prefectural Labour Bureau concerned. |
| d. |
Employers may, at any time, file an application for the decision on pneumoconiosis
supervision classification with the Director General of the Prefectural
Labour Bureau concerned, for workers who are regularly engaged in dusty
work or for workers who have been regularly engaged in dusty work. |
| e. |
In the case where there is an objection to the decision of the Director
General of the Prefectural Labour Bureau
| (a) |
Persons who have an objection to the results of a decision on supervision
classification by the General Director of the Prefectural Labour Bureau
may ask the Minister of Health, Labour and Welfare to examine the results
based on the Law for the Examination of Objections against Administrative
Acts. |
| (b) |
The Minister of Health, Labour and Welfare decides the supervision classification
based on the diagnosis and examination by the senior pneumoconiosis examination
physician. |
| (c) |
Notification of the results of the decision is as described in (3)-b-(c) and (d). |
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| f. |
In cases where there is an objection to the decision of the Minister of Health, Labour and Welfare
In cases where there is an objection to the decision of the Minister of Health, Labour and Welfare, a suit for revocation of disposition may be filed with the court.
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| 4. Health care measures after a decision on pneumoconiosis supervision
classification (Law, Articles 20-2 to 21; Ordinance, Articles 26 to 28) |
| For persons who belong to supervision classification 2 or higher, the following
measures are taken: |
| a. |
Decrease of exposure to dust
The employer concerned takes measures, such as changing the place of employment
or shortening the time of engagement for dusty work, for workers belonging
to supervision classification 2 or 3a. |
| b. |
Change of workplace, etc.
| (a) |
The Director General of the Prefectural Labour Bureau may recommend to
the employer that workers belonging to supervision classification 3a be
regularly engaged in work other than dusty work. |
| (b) |
The employer concerned who has received the recommendation of the Director
General of the Prefectural Labour Bureau or who has a worker belonging
to supervision classification 3b should make efforts to ensure that the
worker is regularly engaged in work other than dusty work. |
| (c) |
When an employer changes the workplace, he/she should report this to the
Director General of the Prefectural Labour Bureau. |
| (d) |
The Director General of the Prefectural Labour Bureau may issue instructions
that workers belonging to supervision classification 3b be regularly engaged
in work other than dusty work. |
| (e) |
Employers should provide education and training for workers newly engaged
in work other than their previous dusty work. |
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| c. |
Medical treatment
Persons found to belong to supervision classification 4, and persons found
to be suffering from complications must be medically treated. |
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| 5. Payment of allowances for change of work (Law, Article 22; Ordinance,
Article 37) |
| When a worker has been disengaged from dusty work, the employer must pay
the worker, within seven days, the average wage corresponding to the following
number of days, as the allowance for change of work: |
| a. |
Workers falling under categories (4)-b-(a), or workers belonging to supervision
classification 3b: 30 days |
| b. |
Workers falling under categories (4)-b-(d): 60 days
In principle, the taxes and public charges on the allowance for change of work, and the transfer, mortgage and seizure of the right of receiving the allowance for change of work are prohibited. |
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| 6. Assistance, etc. from the national government (Law Articles 32 to 35;
Ordinance, Articles 34 to 37) |
| The national government provides the following, concerning the prevention
of pneumoconiosis, etc.: |
| a. |
Technical assistance
The national government extends technical assistance to employers concerning
measurement of dust concentration, prevention and inhibition of dust emission
sources, health examinations for pneumoconiosis, and other health care
measures, etc. |
| b. |
Assignment of countermeasure instructors
The national government assigns those who are learned and experienced in
sanitary engineering as dust countermeasure instructors (on a part-time
basis) to Prefectural Labour Bureaus, allowing them to provide technical
assistance concerning prevention. |
| c. |
Employment exchange, etc.
When the employer concerned cannot change the workers belonging to supervision
classification 3 to work other than dusty work in the workplace, the national
government makes efforts to ensure that adequate measures are taken for
employment exchange and vocational training. |
| d. |
Improvement of facilities, etc.
The national government makes efforts, for example, to improve facilities
for providing employment opportunities, and facilities for recovering working
capacities, in order to stabilize the life of workers suffering from pneumoconiosis. |
| e. |
Authority of the national government (Law, Articles 41 to 43)
The national government gives specific authorities to the Labour Standards
Inspectors, etc. concerning adequate enforcement of laws. |
| f. |
Reports by workers (Law, Article 43-2)
In cases where there is a violation of these laws in a workplace, workers may report this to a Labour Standards Inspector, etc.
It is prohibited for employers to treat the reporting workers disadvantageously.
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(The next article in this series covers the Labour Standards Law, and safety and health.)
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