Solutions for the Medical Treatment of Work-Related Injuries andOccupational Diseases of Migrant Workers in the Pearl RiverDelta, China
Author: Jing Xiang
As everyone knows, workers in China are suffering fromoccupational diseases and work-related injuries. The Chinese Law on Prevention and Control of Occupational Diseasesand the Regulations on the Insurance of Work-Related Injuriesare important sets of rules in this field and regulateemployers' obligations when their employees are affected. Butfor many years economic development has had the highestpolitical priority, and China failed to protect the interests ofthe workers. Subsequently, the number of occupational diseasesand work-related accidents has been constantly on the rise. Thehead of the Department of the Insurance of Work-Related Injuriesof the Ministry of Human Resources and Social Security,Chen Gang, said at a recent conference that last year in thewhole of China out of 72,000 applications for the recognition ofa work-related injury 99 per cent were approved. That shows thatwe had at least 70,000 work-related accidents. But we estimatethat there is an equally high number of occupational diseasesand work-related accidents, affecting mostly migrant workers,that, for various reasons, were not reported to the Ministry. Infact, the exact number of cases per year in the whole country isunknown. Recently, I attended a conference on occupationaldiseases and work-related injuries, and the vice-president ofthe State Administration of Work Safetystated exactly that. Despite the lack of concrete numbers, fromthe everyday experience of working for an NGO that aims toprotect the interests of and gives legal support to workers withoccupational diseases or work-related injuries, we feel that theoccurrences of both are severe. The Pearl River Delta Workers' Service Centeralone helps several hundred people with occupational diseasesand work-related injuries every year. We think that thegovernment should take on the difficult task of limiting theoccurrence of occupational diseases and work-related injuries.When we look at certain cases, we and other labor NGOs in thePearl River Delta dealing with legal support for peoplesuffering from occupational diseases and work-related injuriesfeel that in the whole country as well as in the Pearl RiverDelta there are problems on the structural as well as the legallevel. I will briefly describe these problems, hoping to catchthe attention of government and society, and hoping that China'slegal system of work protection will improve further.
1. Difficulties in diagnosing occupational diseases orwork-related injuries lead to problems in medical treatment andrecovery of affected workers.
The diagnosis of occupational diseases and work-related injuriespresents two problems: The first one is the short time frame forthe determination of an occupational disease. The Department of Labor and Social Securityof Guangdong Province stated in its Notice on Steps to Solve Problems of the Prevention System ofWork-Related Injuries in the Province:"After an occupational disease has occurred in a work-unit(company) belonging to the administrative area of the GuangdongProvince (i.e. the employer that legally obtains the certificateor statement on the diagnosis of an occupational disease),employees leaving the company where the disease has occurredhave to get a diagnosis and recognition of the disease withintwo years. The application for the diagnosis and recognition ofthe occupational disease has to be sent in within one year. Onlythen the Departments of Labor and Social Securitycan accept the application and make a decision."
This two year time frame for a definite diagnosis conflicts withthe outbreak pattern of occupational diseases, because in mostcases the incubation period is very long. In some cases symptomsof the disease appear years or even decades after the employeeleaves the company where he or she caught the disease. In aprecious stones factory in Huizhou, for example, a worker namedLiu started to feel ill in November 2001, but only in November2004 the Institute for the Prevention and Control of OccupationalDiseasesin Sichuan Province diagnosed him with silicosis. Whileproviding legal assistance in a case of cadmium intoxication ina battery factory in December 2003, Professor Lu Ying of the SunYatsen-University in Guangzhou discovered that the cadmiumconcentration in the bodies of several workers was not stable,and for a long time it was impossible to make a definitediagnosis. Some workers had already died because of the cadmiumintoxication, and it was still neither possible to determine anexact cadmium concentration nor to diagnose an occupationaldisease.
Employees with occupational diseases seeking a definitediagnosis who surpass the two years and do not get recognized donot enjoy the benefits of the Regulations on the Insurance of Work-Related Injuries.If the employer refuses to pay for any medical expenses orcompensation, this will surely have serious effects on theworker's medical treatment, recovery and everyday life. In thecase of the above mentioned workers who were cadmium intoxicatedin a battery factory, until now no agreement could be made onthe coverage of the workers' medical costs and everydayexpenses. The way the Department of Labor and Social Securityin Guangdong Province is using the formulation "employeesleaving the company where the disease has occurred have to get adiagnosis and recognition of the disease within two years" doesclearly not correspond with the outbreak patterns ofoccupational diseases and is not in favor of the protection ofemployees' work safety.
We propose to eliminate the formulation "employees leaving thecompany where the disease has occurred have to get a diagnosisand recognition of the disease within two years". If employeesare diagnosed with an occupational disease they should get therecognition and enjoy treatment and compensation within oneyear.
Thesecond issue is the violation of clause 40 of the Law on Prevention and Control of Occupational Diseasesby the Ministry of Labor and Social Security:"According to the law employees can get a diagnosis for anoccupational disease at legally accepted medical institutionsfor the diagnosis of such diseases at the location of theemployer or the place of residence of the employee". TheMinistry refuses to accept diagnostic decisions of institutionsother than the Department for the Diagnosis of Occupational Diseasesat the location of the company. But the law states thatemployees can get a diagnosis both at the location of thecompany and at the "residence of the employee". For stateagencies, the "residence of the employee" usually refers to thelocation of his or her household registration.
The statement on the two locations for a diagnosis in the lawmakes sense, rationally and scientifically, because the medicaldiagnosis depends on the quality and capabilities of the medicalinstitution and its personnel. Different departments often comeup with completely different diagnostic conclusions. The workerJiang, for instance, who had worked in a precious stone factoryin Haifeng County, Guangdong Province, was diagnosed with a"first grade dust lung disease" in October 2005 in the Institute for the Prevention and Control of OccupationalDiseases inSichuan Province, but in April 2006, after an examination in asimilar institution in Guangdong Province, the result was "nodust lung". If the employee has the possibility to choose theinstitution for the diagnosis and to go to several institutionsfor an examination, he or she has a better chance to get anaccurate diagnosis. Moreover, in all parts of society so-called"regional protectionism" is widespread, sometimes not withoutreason. If employee and employer both have the right to choosethe site of the diagnosis, it is more likely that the validityof the diagnosis is recognized, effectively resolving doubts ofboth employee and employer. But some Departments for the Affirmation of Work-Related Injuriesonly accept findings on occupational diseases made by diagnosticinstitutions at the location of the company and refuse those byinstitutions elsewhere.
Let us look at the case of the above mentioned worker Liu whoworked in a precious stone factory. Several examinations inGuangdong Province resulted in the diagnosis that he did notsuffer from an occupational disease. Liu had already left thecompany and returned home for recovery. In his hometown he wentto an examination at the local Institute for the Prevention and Control of OccupationalDiseases,and there he was indeed diagnosed with silicosis. After drivingback to Huizhou in Guangdong he applied for the recognition ofthe occupational disease, but the Huizhou Department for the Affirmation of Work-Related Injuriesrefused to accept it because the diagnostic certificate was notissued in Huizhou or Guangdong Province. This refusal to approvethe diagnosis of an occupational disease in departments for thediagnosis of occupational diseases outside the location of thecompany is common practice in all parts of the Pearl RiverDelta.
Our proposal:Strengthen the government's concepts of "rule according to thelaw" and "administration according to the law". The Ministry of Labor and Social Securityshould strictly comply with each clauseof the Law on Prevention and Control of Occupational Diseases.The Departments of Labor and Social Securityon the provincial level should strictly control theadministrative actions of the departments on lower levels andapprove the decisions on occupational diseases of departmentsoutside the location of the company. Their decisions should havethe same legal effect as those of the departments at thelocation of the company. Moreover, looking at the revision ofregulations, the diagnostic decisions of the departments for thediagnosis of occupational diseases outside the location of thecompany should be considered. If there are conflicts with thedecisions of departments at the location of the company, thereshould be a concrete method to resolve that conflict.
2. Employers refuse to pay or are in arrears with paymentsfor the medical expenses so that employees cannot get theappropriate medical treatment.
According to a report by the Southern Daily,currently 13.51 million migrant workers are insured againstwork-related injuries in Guangdong Province, but the totalnumber of migrant workers is more than 27 million. Numerousemployers do not pay the insurance, and in case of awork-related accident of an occupational disease the employeroften just sees his own material interests and does not pay forthe medical expenses in time. Therefore, hospitals stop themedical treatment because their patients cannot pay for thecosts themselves, causing great pain for the migrant workers andtheir families. Furthermore, some enterprise owners stop payingfor the medical expenses, threaten the workers and force them toaccept their selfish and illegal demands. Some migrant workersand their families give in to the conditions set by theenterprise owners and give up legal rights and benefits becausethey want the employer to contribute to the medical expenses andthe worker to get medical treatment as quickly as possible
In 2006, our organization was visited by a worker called Huang.His body was burned 90 percent. He was just 30 years old andworked for an oil and chemistry plant in Guangzhou. His ruthlessboss had made "private" settlement offers to his family, so thecase did not go through the process for the recognition ofwork-related injuries. The boss just gave Huang some financialcompensation. We explained the legal situation to his family,and told them that a work-related accident has to be settled inaccordance with Chinese law so that rights and benefits can beguaranteed. Following our recommendation, Huang and his familyquickly applied for the recognition of a work-related injury,but the factory owner immediately stopped the medical paymentsand threatened Huang's family that if they did not withdraw theapplication for the recognition of a work-related injury hewould not pay for the medical expenses anymore. Seeing theirrelative suffering in the hospital and his medical conditionbeginning to worsen, and considering the potentially endlesslegal procedures, the injured Huang himself and his familyturned their back on our organization, withdrew the informationfor the appeal and signed a clearly unfair agreement with theenterprise owner, accepting a compensation of 150,000 Yuan. Thatsum included the follow-up medical expenses. We estimated thatthe 150,000 Yuan would not be enough to cover the whole medicalexpenses.
We regularly come across these kind of cases, where medicalexpenses are used to threaten the employees who suffer fromoccupational diseases and work-related injuries. This phenomenonseriously effects the medical treatment and final recovery ofworkers and brings great physical and mental injury to theworker as well as his or her family. These companies should bepunished.
Our proposals: 1) Create a system of advance payments out of the Insurance Fund for Work-Related Injuriesfor those employees with occupational diseases or work-relatedinjuries who have not yet been classified as such. If anenterprise owner refuses to deliver or pay first aid and medicalexpenses in advance, the Department of Labor and Social Securityshould immediately launch an investigation into the accident,confirm whether it is fulfilling the conditions of awork-related injury and use the fund to pay for medical expensesafter receiving the application for financial support by theaffected employee or one of his family members. 2) If employeesalready got the recognition of an occupational disease or awork-related injury, the Insurance Fund for Work-Related Injuriesshould, after receiving the application for financial support,make payments soon. 3) If the case of the worker is recognizedas an occupational disease or work-related injury, thegovernment should immediately penalize the employer byadministrative means or use civil or criminal law as well asdemand the reimbursement of medical expenses includinginterest.
3. During medical treatment the workers are in a precarioussituation, because they do not have the power to choose themedical treatment plan, the medical institution, etc.
Many employers do not pay the Insurance for Work-Related Injuriesfor their employees, and in case of an occupational disease orwork-related accident they follow their own interests. Theirfirst consideration is the reduction of medical expenses, notthe quality of the medical treatment. The quality of medicaltreatment determines the subsequent ability to work anddisability compensation, but, after all, the number of workersdemanding compensation after the appraisal of their workcapability and disability grade is low. (Most do not know how touse the law to deal with this problem.) Many companies are awareof the fact that migrant workers lack knowledge about the lawand the possibilities to defend themselves on legal grounds,thus they are not very eager to evaluate the work capability atany point. They frequently use all kinds of pressures to forceinjured workers to accept low compensations and close the case.
As a result, we often see this game: The hospital wants to makebusiness and please the employer; the employer wants to reducemedical expenses and sends its workers to one particularhospital for treatment. So the hospital serves the employer'sinterests first, not the patient's. As a favor to the companies,many hospitals refuse to give any information on the medicaltreatment to the patients but just give it to the employer.Thus, the worker does not have the necessary information for anapplication of the appraisal of a work-related injury and thedisability grade.
Workers with occupational diseases and work-related injuriesoften cannot choose the hospital and the medical treatment plan,and employers often choose a hospital with close ties. Theirmain consideration is usually reducing costs, with the effectthat the results of the medical treatment are not good and donot lead to the best possible recovery of the affected worker'swork capability. This often creates a conflict between thepatient and the hospital which can take the form of a "hospitaldisturbance". In the year 2007 alone our organization saw morethan ten cases of workers who were not satisfied with thequality of the medical treatment by a hospital chosen by theemployer and asked whether we knew of cases where workers couldchange the hospital and medical treatment. But it was not justthose ten cases. Among the several thousand cases ofoccupational diseases and work-related injuries we supported itwas very common that workers were not satisfied with the choiceof the hospital and medical treatment by the employer and hopedfor the possibility to choose the medical treatment. But theyfeared the employer would not pay for the medical expenses andwere forced to stop pursuing their own interests.
For example, the thumb of the right hand of a worker named Zhouwho worked for a door factory was cut off, producing a six gradedisability. The employer presumed that by sewing on areplacement thumb the disability grade would be lower. In orderto avoid any costs for implanting an artificial limb later, thecompany asked the hospital to transplant a toe from the injuredworker as a replacement for the thumb. Zhou did not agree atfirst because the doctors told him that the transplanted toemight not be functional. But the employer told him that if hedid not accept the toe they would treat his injury as"self-inflicted". The company not only refused to continuepaying for medical treatment, it also asked Zhou to reimbursethe medical expenses already paid. As a result, Zhou was forcedto accept the transplant, and he lost not only compensation forimplanting and replacing an artificial limb but also one of histoes. The transplanted toe did fill the gap left by the thumb,but there it had, in fact, no real function.
Our proposal: The Regulations on the Insurance of Work-Related Injuriesand the Guangdong Regulations on the Insurance of Work-Related Injuriesshould be revised and should specify that after an accident theaffected worker has the authority to select any medicalinstitution in the region with the necessary medical treatmentequipment to carry out the treatment, in accordance with theinsurance's Diagnosis Catalog for Work-Related Injuries,the Medication Catalog for Work-Related Injuriesand the Standard Cost Frame for the Treatment of Work-Related Injuriesin Hospital.The workers should have the right to get sufficient informationon the medical treatment plan and the full right to make theirown decision.
4. Not enough attention is paid to the worker's full recoveryand regaining of work capability after suffering from anoccupational disease or work-related injury.
We believe that for the medical recovery of a worker whosuffered from an occupational disease or work-related injury theregaining all body functions should have the highest priority.This is a reflection of the value the government, the societyand the employer want to attach to the worker as a human being.Medical recovery and regaining work capability is very importantfor workers and their chances to support themselves throughlabor. Unfortunately, every year our organization has to supportseveral hundred workers who suffered from an occupationaldisease or work-related injury. Among them some received medicalimplements, but hardly anyone enjoyed other treatments formedical and occupational recovery.
Case 1: A worker in a print shop had crushed his hand in a diecutter. During the treatment in hospital a three millimeterpiece of skin from his trunk was transplanted onto the back ofhis hand. One or two months later the wound had healed up, butafter the transplanting the skin on the back of the hand wasbetween one and two centimeters higher, seriously affecting theusage of the hand. The injured worker applied for furthertreatment at the Board for the Evaluation of Work Capability.The board replied that the wound had already healed completely,and, therefore, the Insurance Fund for Work-Related Injurieswould not pay for further medical expenses.
Case 2: A worker had suffered facial burns. After the wounds hadhealed up he applied for further treatment to fully recover.After presenting his application to the Board for the Evaluation of Work Capabilityhe got this reply from the board: The treatment of facialinjuries is classified as "cosmetic surgery" and "cosmeticsurgery has no impact on the actual function". Since "it is notnecessary for medical recovery" the approval of the applicationwas denied.
Boards for the Evaluation of Work Capabilityin all parts of the country, deciding on the "treatment period"for victims of work-related accidents, and Labor Dispute Arbitration Committees,deciding on the "period of suspension with pay", could use adifferent perspective when considering whether local governmentbranches should pay the recovery wage to workers suffering froman occupational disease or work-related injury. Provision 23 ofthe Guangdong Regulations on the Insurance of Work-Related Injuriesstates: "After the evaluation of the disability grade of theworker who suffered a work-related injury the payment of theformer wage stops, and the worker receives disability paymentsin accordance with the regulations on the issue in thissection." In other words, the period of suspension with pay forworkers with work-related injuries should stop after thedecision on the disability grade by the Board for the Evaluation of Work Capability.Nevertheless, the Work Capability Appraisal Committeeof Guangzhou as well as all districts are only making decisionson the period of medical treatment; and the Labor Dispute Arbitration Committeesidentify the "period of medical treatment" as "period ofsuspension with pay", clearly negating the right to recover ofworkers who suffered from work-related injuries.
In the past, our organization has supported many workers inlabor disputes. We insisted not only that the injured workersshould have the right to get medical treatment but also theright to fully regain health and work capability. Therefore,during arbitration we insisted that the day of the "assessmentof the disability grade" should be the last day of the "periodof suspension with pay", but we could not win these arbitrationcases.
Since the Boards for the Evaluation of Work Capabilityand the Labor Dispute Arbitration Committeesrefuse the injured workers' recovery payments, many injuredworkers, though not yet fully recovered, are being forced by theemployer to start working again. Some wounds might have healed,but they have not fully regained their work capability, andsince they still feel pain they refuse to go back to work. As aresult, the employer sees that as unjustified absence from workand illegally fires the injured worker, causing new hardship.For example, a female worker in a metal factory in Panyi county,Guangdong Province, suffered injuries to her head and back.After the medical treatment had ended the wounds had completelyhealed, but her work capability were limited. When she refusedto return to work the employer decided to fire her. The hearingon this dispute is still not finished.
Our proposal: OnNovember 8, 2006, the Department of Labor and Social Securityof Guangdong Province issued Provisional Measures for the Handling of Cases of Work-RelatedInjuries.Afterwards it formulated two documents, the Guangdong Norms for the Intervention in Cases of Work-RelatedInjuries andthe Guangdong Standards for the Diagnosis and Treatment of Cases ofWork-Related Injuries.We hope that Departments of Labor and Social Securityon all levels make serious efforts to implement these documents,allowing all workers who suffered from occupational diseases orwork-related injuries to recover. We hope the National People's Congress(NPC) and the Chinese People's Political Consultative Committee(CPPCC) will investigate the situation every year. Labor unions,the Chinese Women's Associationand all NGOs should defend the right to recover fromoccupational diseases and work-related injuries and activelyguide and support those workers affected when they apply formedical treatment and recovery plans.
5. Employers go bankrupt or stop their business, making it hardfor workers who suffered from occupational diseases orwork-related injuries to get their wages and creating problemsfor follow-up applications for medical treatment and duringre-appearances of diseases.
Case 1: Tang, who worked in a Taiwanese metal parts factory inQiaotou, Dongguan, had an accident. After almost two years oflegal battle the worker won the case in court, but when askingthe court to force the employer to follow the ruling, Tang foundout that the owner had closed down the company and established anew business. Thus the court was unable to enforce its ruling.Afterwards the worker staged a so-called "jump off abuilding-show", bringing police, firefighters and media to thescene, and thereby forcing the newly found company to finallypay full compensation.
Case 2: A worker named Liu from a precious stone factory inHuizhou was diagnosed with an occupational disease in November2004. At the end of the same year the factory closed down, but,in fact, relocated in Haifeng county. By law the two companiesare not the same legal entity, and since the original employerdid not exist anymore, the Department of Labor and Social Securityin Huizhou refused Liu's application for the approval of awork-related injury. The Department of Labor and Social Securityin Haifeng refused to determine that the precious stone factoryin Haifeng had to take the responsibility for the work-relatedinjury because Liu had no work relations with that factory.
Case 3: A worker from a factory in Panyu had an accident andbroke his calf bone. Later, after legal procedures, the workergot compensation and returned to his hometown. One year later hediscovered he suffered from bone inflammation. He returned toGuangzhou, hoping the company would pay for the medicaltreatment. However, the employer he had worked for had gonebankrupt, and he was unable to ask him to cover his medicalexpenses.
These cases show the problem. Legislation, like the Regulations on the Insurance of Work-Related Injuriesor the Guangdong Regulations on the Insurance of Work-Related Injuries,include no clauses that resolve these problems. Companies followthe rules of the market and have the option to go bankrupt,close down or change legal ownership. Some enterprise owners useholes in the legislation, viciously go bankrupt, close down thefactory or sell the business. In recent times this has becomecommon practice when it comes to taking responsibility forworkers' benefits. As a result, the government needs to focus onthis issue of companies using fraudulent bankruptcy,closing-down and disappearance to avoid payments for theprevention and insurance of work-related injuries.
Our proposal: Use the complete legislation to solve thisproblem. The Insurance Fund for Work-Related Injurieshas to take the possibility of bankruptcy, closure ordisappearance of a company into account. Payments for workerswith work-related injuries after bankruptcies, factory closuresand disappearances need to be included so that the state can payall expenses for workers with work-related injuries from thatfund. In order to prevent enterprise owners escaping theirduties after a work-related injury, people in charge andrepresentatives of legal persons should not be able to openanother business for a couple of years. Thereby the wave ofbankruptcies, closures and disappearances could be contained.
6. Illegal company's handling of occupational diseases andwork-related injuries and the lack of effective protection.
Illegal companies are often very small scale. They usually onlyhave a few dozen workers, many even less than ten. When a moreserious work-related accident happens, managers often usemethods to avoid taking responsibility.
Case 1: In an unlicensed print shop in Haizhu district,Guangzhou, a worker called Zhou crushed his right hand in aprinting machine. After two investigations by the Labor Dispute Arbitration Committeeand the court, the court decided that the owner of the printshop had to pay Zhou a one-time compensation of more than130,000 Yuan. When the court ruling took effect the owner of theprint shop went into hiding and secretly took machines andequipment with him. Until now, Zhou has not received anycompensation.
Case 2: In 2005, a car oil tank exploded in an automobile repairand welding shop in Meizhou. A thirteen year old apprenticesuffered severe injuries: 75 percent of his body was burned.After the accident, the manager of the work shop gave him 40,000Yuan for medical expenses and declared that he was unable to paymore. Without money for medical treatment, the injured boy camedown with a serious infection over his whole body, causing anunbearable stench affecting the whole hospital department. Thecase attracted public attention, and after some donations byChristians he luckily survived. When our organization heardabout it, we immediately provided legal support and discoveredthat the owner of the work-shop had quickly hidden his property,leaving just an old building which had not changed ownershipyet. After our intervention, the building was assessed by theresponsible department and valued with just about 40,000 Yuan,not much compared to the 800,000 Yuan needed for the medicaltreatment of the injured boy. He had already completely lost hiswork capability but had no chance to get any compensation. Thewhole family suffered tremendously.
The described cases show how the government failed to supervisethe illegal companies in two aspects: 1) The Administration for Industry and Commercefailed to do its job, so these companies could start theirbusiness without official registration. 2) The Department of Labor and Social Securityfailed to do its job because it did not start investigations intime, and did not do anything about these companies notregistering their workers and not getting the Insurance for Work-Related Injuriesfor them. Therefore, it is only reasonable and fair if thegovernment uses its Insurance Funds for Work-Related Injuriesto cover the expenses of the workers who suffered work-relatedinjuries.
7. The work safety of female workers and minors needs to beimproved.
China's Regulations on Female Workers' Labor Protectionand the Law on the Protection of Minorsdescribe in detail measures to protect female workers and minors(under 18 years old) in manufacturing industries. Nevertheless,in the Pearl River Delta a vast number of companies still ignorethe protective provisions of the two laws. For example, it isvery common to employ minors in toxic work environments (likepaint shops, galvanization and dust-laden polishing). And incompanies with a high number of female workers special sanitaryrooms for them (e.g. for pregnant women and nursing) are rare.Apart from the daily eight hour shift, many companies ask theirfemale workers to do several hours of overtime. Even if femaleworkers do not feel well during their menstruation period,employers often refuse to let them leave during overtime hours.Some employers unreasonably restrict how often and how long aworker can go to the toilet, so female workers are unable todeal with their menstruation regularly, with serious effects ontheir health.
Our proposal: The Womens' Associationshould further protect the interests of women and minors,frequently check the development of the work environment andhealth protection for women workers and minors and startlawsuits against companies violating the Regulations on Female Workers' Labor Protectionand the Law on the Protection of Minors.
8. Government and society should make efforts to increase publicawareness about the prevention of work-related injuries andoccupational diseases and increase the punishment for companiesthat do not comply with the laws.
According to the latest report of the Chinese Academy of Social Science,54 percent of migrant workers currently work under unsafeworking conditions. Dealing with migrant workers on a dailybasis, we strongly feel that migrant workers lack informationabout work safety, and most of them know hardly anything aboutit. They work in poisonous and harmful environments without anyprotection but are unaware of all the dangers. In order toreduce production costs, employers do not install necessary andreliable protective facilities. The original intention of the Law on Prevention and Control of Occupational Diseasesand the Work Safety Lawis promoting workers' understanding of work safety and forcingemployers to ensure a safe work environment and protect thehealth of their employees. To reach that goal we propose:
1) Government and society should make efforts to increase publicawareness about the prevention of work-related injuries andoccupational diseases, including raising financial funds. Wepropose that the government takes steps to mobilize socialforces, especially learning from the governments of developedcountries and how they secure services from NGOs, vigorouslypromoting the awareness about the prevention of work-relatedinjuries and occupational diseases, evoking the workersthemselves to pay more attention to work safety and effectivelyreducing the rate of occupational diseases and work-relatedinjuries.
2) Increase the costs for companies that break the Law on Prevention and Control of Occupational Diseases,the Work Safety Lawand the Regulations on the Insurance of Work-Related Injuriesin order to force them to give more importance to work safety.Companies neglecting work safety protection, leading to theoccurrence of occupational diseases and work-related injuries,should not only pay the worker a financial compensation underthe Regulations on the Insurance of Work-Related Injuries,but also assume responsibility for other forms of civilcompensation. If the incidents leading to a worker'soccupational disease of work-related injury involve majormisbehavior or faults, the legal responsibility of therepresentative or manager should be investigated, too. That isbecause our judicial system does not allow to file civil lawsuits against those responsible for the neglect of work safetyleading to occupational diseases or work-related injuries. Wehope the 48th clause of the Work Safety Lawand the 52nd clause of Law on Prevention and Control of Occupational Diseaseswill be used in legal practice. The first one reads: "Employeeswho are injured in work safety accidents, according to the law,do not just fall under the Insurance for Work-Related Injuries,they also have the right to obtain compensation under civil lawand are able to demand compensation from their employer." Thesecond one says: "Patients with occupational diseases, accordingto the law, do not just fall under the Insurance for Work-Related Injuries,they also have the right to obtain compensation under civil lawand are able to demand compensation from their employer." Wehope these two clauses will nullify the opposed 12th clause ofthe People's Supreme Court Interpretation Regarding Certain LegalProblems Hearing Cases on the Compensation for Injuries:"When an employee of a company which, according to the law, hasto participate in the Insurance Plan for Work-Related Injuries,due to a work-related accident suffers bodily harm, thisemployee or family members can file a law suit at the People's Court,asking the employer to assume responsibility for civilcompensation, according to provisions in the Regulations for the Insurance of Work-Related Injuries".
3) Concerning the contributions of companies to the Insurance for Work-Related Injuries,besides paying a rate according to the risk degree in aparticular industry, the contribution to the insurance should bedetermined following the occurrence rate of occupationaldiseases and work-related injuries in a particular companywithin one year, thereby effectively raising the costs ofneglecting work safety.