Enzymes

As a prelude to a discussion of compensation issues specifically concerned with occupational asthma (OA), it is useful to review how occupational diseases per se evolved from the pre-eminence of injury as a raison d’eˆtre for workers’ disability and compensation. The concept of protecting workers from the consequences of occupational disease-as contrasted to occupational injury-is a relatively recent development among industrial countries. In the late 19th century, middle European countries, starting with Switzerland, Germany, and Austria, began to compensate workers for work-related injuries (1). Similar legislation appeared in Britain in the first decade of the 20th century. This change is reflected in the transformation of the names given to agencies that are responsible for compensation. For example, in Quebec, the first name of the agency was Commission of Labor Injuries (‘‘Commission des accidents de travail’’), and it was only in 1980 that the name of the agency became Commission of Health and Security at Work (‘‘Commission de la sante´et se´curite´ du travail’’) (2). In the United States, workers’ compensation legislation was under the purview of individual states, thereby resulting in a heterogeneity of disease definitions, covered diseases, exposure criteria, and other inconsistencies that still exist. Apart from three separate federal systems administered under the Federal Coal Mine Health and Safety Act of 1969, the Longshoreman’s and Harbor Worker’s Compensation Act, and the Federal Employees Compensation Act, there are no uniform governmental standards in the United States to guide individual state compensation disability programs. The first compensation laws adopted by individual states restricted compensation to those diseases caused by accidental injuries. These were modeled after the original British Workers’ Compensation Statute of 1897. Massachusetts was the first state to extend legislation allowing for the compensation of ‘‘nontraumatic’’ occupational diseases. In 1920, New York State adopted the first schedule of compensable occupational diseases (3,4). California rapidly followed suit, and by the early 1930s, most states had passed workers’ compensation laws concerning occupational diseases, although few of these provided broad coverage for many of the occupational diseases then being reported.

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