Dupuytren's Contracture (DC) is a condition that affects the sufferer by causing a thickening of the tissue located in the palm of the hand. In severe cases it can cause the fingers to bend inwards towards the palm of the hand causing difficulties in straightening the fingers. The condition bears the name of Baron Guillaume Dupuytren, who first described it in 1831. It is sometimes also referred to as "Miner's Claw".

This condition has various established non-occupational causes including diabetes, epilepsy, heavy alcohol consumption and cirrhosis of the liver. In the past a number of studies have been carried out and there have been conflicting medical opinion on whether this condition could also have occupational causes.

Recognition as an industrial disease

The Industrial Injuries Advisory Council (IIAC) is an independent statutory body set up in 1946 to advise the Government on whether a list of prescribed diseases for which benefit may be paid should be enlarged or amended. In 2006 IIAC carried out a review of work-related upper limb disorders and found that the data available was insufficient to meet the normal threshold for prescription for DC. In January 2011 IIAC were again asked to review the position in relation to coal mining by a Member of Parliament. In particular IIAC were tasked with reviewing the link between the development of DC and work involving hand-transmitted exposure to vibration. IIAC's report was published in May 2014 and this recommended that DC be added to the list of prescribed diseases for which Industrial Disablement Benefit is payable following work for 10 or more years which involves use of hand-held power tools.

It should also be noted that other work-related upper limb disorders that can be caused by using vibratory tools, Vibration White Finger and Carpal Tunnel Syndrome, have already been added to the list of prescribed diseases. 

IIAC's report states that DC has established non-occupational causes and does not have clinical features that differ in cases alleged to arise in an occupational context. It goes on to say that the argument for prescription therefore rests on reliable evidence of a doubling or more of risk in exposed workers. A full review of the relevant medical studies was carried out and the report notes that some of these lacked a clear account of the tools giving rise to exposure and their magnitude of exposure. However, what is commented on as being "striking" in the report is the consistency with which increased risk was reported (whilst using hand-held vibratory tools) above IIAC's threshold of two.

IIAC recommends that the condition is added to the list of prescribed diseases for which benefit is payable on the following basis:

  • Any occupation involving the use of hand-held powered tools where the use of      those tools amounts to a period or periods in aggregate of at least 10 years and were within those period(s).
  • The use of those tools amounts to at least two hours per day for three or more days per week.
  • Onset of symptoms should be after first exposure to the tools.

It is IIAC's view that the presence of any non-occupational risk factors for DC should not be construed as ground for rebuttal of presumption assuming the qualifying conditions referred to above are met.

Ramifications of the decision

It has been reported that union leaders are celebrating IIAC's decision and it is suggested that some unions provided IIAC with supportive evidence. Claimant solicitor firms have wasted no time and a number have posted articles about this decision and encouraged potential claimants to contact them to obtain legal advice and assistance in relation to any application for benefit for this condition. Once IIAC's decision has been ratified and IIDB is available to claim for this condition we will need to review the number of claims for benefit that are received and see whether there is any trend for common law compensation claims to be brought in relation to DC. 

In their report IIAC suggest that DC could arise, from manual aspects of using heavy industrial equipment and not solely from the use of vibratory tools. Employers therefore need to focus on both reducing exposure to vibratory tools and take appropriate risk control measures in relation to manual handling.

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