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Workshop B
Friday 19, November, 2004
17:45 - 19:30, No.2 Conference Room

Workshop B
Asbestos and Construction
Chairs: Naoki Toyama and Anders Englund

Check of Medical Receipt for Detection of Pneumoconiosis and Asbestos-Related Diseases at the Tokyo Construction Health Insurance Society
Kyoichi Yamada
Tokyo Construction Health Insurance Society, Japan

ABSTRACT

There are four types of medical insurance in Japan; "Employee's health insurance" for employees of business organizations (68 million 670 thousand subscribers); "Mutual aid associations" for public employees (10 million 10 thousand subscribers); "Municipalities-operating national health insurance" for self-employed workers (43 million 370 thousand are insured); "National health insurance society" operated by fellow industries (4 million 250 thousand are insured).
Tokyo Construction National Health Insurance Society (TOKEN-KOKUHO) was established by seven construction labor unions, which organize employees of construction industries, in July 1970. Subscribers attain to 15,646 and 34,740 are insured as of 31 May.
TOKEN-KOKUHO has checked receipts of medical remuneration since 1994 in order to find out our colleagues who have been suffered from pneumoconiosis and help them using compensation for absence from work by way of industrial accident compensation insurance, because anybody who had been engaged in construction work could use asbestos-containing materials and be exposed by the dust, resulting in falling victim to pneumoconiosis. We also addressed ourselves to this action as enlightenment about asbestos injuries.
The TOKEN-KOKUHO have checked the receipts of medical remuneration since January 1994. Once a month, our staff extract the receipts of medical remuneration of our colleagues who have at least one of eight types of diseases (1.Lung cancer, including the suspected, 2.Silicosis, 3.Pneumoconiosis, 4.Lung fibrosis, 5.Mesothelioma, 6.Lung phthisis, 7.Asbestosis, 8.Pleural plaques) from 31,000 receipts, and send them to designated medical institution delegated by the TOKEN-KOKUHO to be judged by physicians.
The physicians rank the extracted receipts Special A, A, B, C in order of causation between diseases and jobs. Workers who are suffered from diseases which are considered to have the clearest relation to their jobs are ranked Special A. The TOKEN-KOKUHO notifies the Special A -ranked workers and their labor unions that they are allocated so. It is necessary to investigate their job history and whether they have subscribed the industrial accident compensation insurance. Since 1990, public health nurses belonging to the designated medical institutions and staff of labor unions which the Special A - ranked workers join have visited them to explain pneumoconiosis using booklets, and inquire their job history and whether they subscribe the industrial accident compensation insurance. They have also recommended that the Special A - ranked workers take medical advice from Hirano Himawari Clinic, the designated medical institution.
We have thus visited over 50 Special A - ranked patients since 2000, and carried off 9 recognition as occupational diseases (compensation benefits for absence from work and/or bereaved family compensation).
We have accomplished certain results. However, not a few colleagues could not apply for the insurance program because they did not register the industrial accident compensation insurance. We need to strongly recommend our colleagues to register the industrial accident compensation insurance in cooperation with labor unions which comprise the TOKEN-KOKUHO.