Impact of REACH on Occupational Health in Europe: Skin and Respiratory Diseases Study

1. REACH:Impact on Occupational Health Simon Pickvance University of Sheffield

2. Previous estimates • RPA • TOTAL: 28-54 Billion euros • Skin: 11.6-102.9 million euros • Respiratory: 4-53 million euros (30 years, discounted, present value)

3. Recognised Occupational diseases in Europe in 2001 Source: EODS Eurostat, 2004

4. How many are chemical-related ? (*): including chemical dust Source: extrapolated from EODS Eurostat, 2004

5. Objective of the ETUC (ongoing) study • Assessment of the impact of REACH on occupational health with a focus on skin and respiratory diseases Why a focus on those 2 occupational diseases ? • Benefits from REACH are underestimated in the RPA study because underdeclaration was not considered • 88 % of occupational skin diseases are related to chemicals exposure • 36 % of occupational respiratory diseases are related to chemicals exposure • Short time lag between exposure and effects (reflecting the present work conditions)

6. Method of work • Assess number of cases of disease • Estimate the proportion of cases preventable via REACH • Model the impact of REACH • Calculate costs per case • Analyse benefits

7. How many cases of occupational disease ?The problem with social protection statistics • Systems exclude some sections of the workforce; e.g. self-employed and state employees • Have restrictive definitions of disease • Varying levels of incapacity to qualify (1-33%) • Different routes of access

8. * In the EU-15 LFS = Labour Force Survey, Eurostat 1999 ad hoc module What other sources of information are available ?

9. Calculating attributable fractions • Use population prevalence/incidence of the condition • Find out how this varies across occupations • What proportion of cases are expected in each occupational group given its size ? • What proportion could therefore be attributable to work ?

10. Incidence of three major diseasesEurostat 15/2004, ELFS

11. Health Benefits from REACH: Assumption: • Information on health effects from chemicals will lead to reduction of exposure and prevention of illness • Some of the chemicals-related occupational diseases are linked to unknown effects from these chemicals

12. What proportion of exposures could be reduced through REACH ?

13. Major suspected aetiologies in cases reported by the ONAP in 1997 Kopferschmitt-Kubler et al 2002

14. Corroboration of estimates • Correction factors: few cases in population studies are compensated • Missed cases (occupation-specific studies) • PARs show good consistency and use different methods of assessing exposure • Other surveys give comparable estimates

15. % Wheeze at work ECRHS Blanc et al 2003

16. % Job change attributed to Breathing difficulties Blanc et al 2003

17. Step 2: Estimation of the economic costs per case per year (RPA) • These costs include: • costs of medical treatment • the value of lost output • human costs (for cancer = value of a statistical life )

18. Step 3: Economic value of the future diseases avoided as a result of REACH (= results step 1Xresults step 2) (RPA) Skin diseases 0.189 % Respiratory diseases 0.098 % Neuro. diseases 0.126 % Eye disorders 0.001 % € 50 billion over 30 years* Cancer deaths 99,586 % (*): 2000 prices, discounted over 30 years at 3%

19. Estimated benefits for « real » number of cases: Assumption: real nb of cases = half nb of self-reported cases

20. Conclusions: • REACH direct costs: € 2.3 billion • REACH benefits for occupational skin and respiratory diseases only : € 1.4 billion REACH is clearly an opportunity to reduce the nb of chemicals-related occupational diseases and the associated costs for both industry and the society