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DISEASE QUANTIFICATION

DISEASE QUANTIFICATION. 31-07-2013. CONTEXT. Background: theoretical liability and real liability. AIM: Move real liability closer to theoretical liability To determine number of people who have compensable disease

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DISEASE QUANTIFICATION

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  1. DISEASE QUANTIFICATION 31-07-2013

  2. CONTEXT • Background: theoretical liability and real liability. • AIM: Move real liability closer to theoretical liability • To determine number of people who have compensable disease • How much of the real liability is actually there will require improving service efficacy ( to get ex-miners to come into from which the this real liability could be calculated, over and above the benefit of getting a service.) • Improving Service Efficacy - requires funding from the state and other services/sources

  3. Context • No absolutely accurate data • Estimates adequate • Mathematical formula to estimate extent of disease

  4. APPROACHES 1. A RISK/INFORMATION BASED MODEL, with a potential to access one that already exists. • Alternatively we could derive a model which could be refined using existing data with current miners and PATHAUT for EXMINERS.   • SOMEBODY IS WORKING ON A MODEL AND THIS INFORMATION COULD BE available in the next few months. • Can be used for both current and ex-miners

  5. RISK/INFO BASED MODEL DETAILS • could be used to calculate levies as an entry base while services are being set up to provide information on an ongoing basis. Permission from chamber- to get hold of this model. • In this model we need to make sense of what we have. • Exposure : single year of exposure can work out /project how much disease expected and time • Data: exposure related data? Silicosis incidence, silicosis prevalence, TB based on claim rates- TTD and permanent lung function loss. • Pneumoconiosis: e.g. silicosis =dust response relationship, ds progression, at what point to pay compensation then use these to get to a number, know risk shifts! • After doing this (dust response relationship) for 1year exposure for current miners….. this could be used for 40years eventually for ex-miners as well.

  6. OTHER APPROACHES 2. Collecting data from other countries where appropriate (coal worker’s surveillance system does have ex miners) on different diseases, and disease patterns • Refining a population of former miners based on TEBA database 4. Surveys of former miners (Trapido like study)- Epidemiological surveys- while services being set up: random sample of former miners to see the extent of ds.   5. Service based study- METHODOLOGY – collect information from the service (capture re capture model) ds sense- set up a service collect names and ds filling in a questionnaire, random sample of the population served by the service s and see how many people have ds but never utilized the service and how many used service and were captured by random sample. Then estimated ds extent in the pop that you are serving. Necessary for the next 20years.

  7. Other approaches 6. Very important part of the exercise- collecting information on Disease extent in current miners (to calibrate model and can also be used to estimate in ex-miners need) 7. More work to be done on disease progression (liability need to understand disease progress) All these can be done in parallel. Timeframes and role players to be discussed on Friday. • VERY NB: Meta analysis to be undertaken on Pneumoconioses, TB studies conducted in SA to date.

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