Published on 20 Aug 2025

Safeguarding Worker Health: Evidence-based Recommendations for occupational disease compensation

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Anna Gribble Clinical Guidance Lead Contact me

MBIE needed to update Schedule 2 of the Accident Compensation Act 2001, which provides compensation for workers with specific occupational diseases. Allen + Clarke was commissioned to support MBIE to deliver the update. We analysed hundreds of exposure-disease relations and applied scientific criteria to identify 14 workplace conditions that warranted addition to Schedule 2. Our recommendations were supported by clear evidence and expert consensus through an Expert Panel, which we established and facilitated.

See the Panel's recommendations here
Our triaging process allowed us to efficiently narrow hundreds of potential conditions down to those supported by solid evidence. This saved time while maintaining the required scientific rigor. We identified areas with emerging evidence for monitoring and consideration in future Schedule 2 updates. This will support the client to keep Schedule 2 up-to-date as required.

A structured, evidence based approach to outdated worker protections

Schedule 2 of the Accident Compensation Act provides streamlined access to compensation for workers with specific occupational diseases. Schedule 2 had not been updated since 2008, meaning there was a gap between current science and covered work-related illnesses. 

MBIE needed clear, evidence-based recommendations to modernize Schedule 2. This required navigating complex epidemiological research, applying technical causality criteria, and making practical recommendations that would benefit workers. 

Our methodology included:

  • Systematic Triaging - A significant challenge was the volume of potential conditions to be assessed. We addressed this by developing a robust triaging process that prioritised potential exposure/disease pairings and established evidence from credible sources such as the International Labour Organisation and the International Agency for Research on Cancer. 

  • Evidence Reviews - for pairings that had been triaged as a priority, we scrutinized the research, assessing consistency across studies and evaluated key factors like strength of association and biological plausibility. This approach ensured that our recommendations were based on solid scientific evidence. 

  • Expert Panel Advice - we established an independent panel of occupational health specialists to assess the evidence. The Expert Panel applied their clinical judgement to the evidence, assessing it against established causality criteria including strength of association, consistency, specificity and temporality. 

  • Gender and Equity Analysis - we then applied an intersectional lens to identify potential gaps affecting underrepresented groups. 

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Clearer Pathway for Workers affected by occupational diseases

Our comprehensive report recommended 14 specific additions to Schedule 2. By bridging complex epidemiological evidence and practical policy recommendations, we helped MBIE create a clearer pathway to support workers affected by occupational diseases. 

Our report also delivered additional value to MBIE by:

  • Establishing a clear methodology for future Schedule 2 updates, which will create a more responsive system for recognising occupational diseases. 

  • Identifying 10 exposure / disease pairings with emerging evidence for monitoring. 

  • Highlighting areas where more research is needed to address gender-specific occupational health issues. 

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