Corporate report

IIAC annual report: 2024 to 2025

Published 19 August 2025

© Industrial Injuries Advisory Council copyright 2024

This publication is licensed under the terms of the Open Government Licence v3.0 except where otherwise stated.

Where we have identified any third party copyright information you will need to obtain permission from the copyright holders concerned.

This publication is available at: Industrial Injuries Advisory Council

Any enquiries regarding this publication should be sent to us at: caxtonhouse.iiac@dwp.gov.uk

Foreword

IIAC has continued to hold regular Council and Research Working Group hybrid-format meetings this year. This year the Council completed its evaluation of the impact of COVID-19 on the transport and education sectors and published a Command paper in autumn 2024. IIAC concluded that the overall evidence for education workers did not reach IIAC’s requirement for prescription. Although evidence relating to SARS-CoV-2 infection in transport workers was sparse, the mortality data consistently showed increased risks, particularly for public-facing transport workers such as coach or bus, and taxi or cab drivers. IIAC therefore recommended prescription for transport workers who have been working in proximity to the general public and develop one or more of 5 serious pathological complications following COVID-19.

Two commissioned reviews produced important findings, some of which may be taken forward for further detailed evaluation. The first reviewed occupation and chronic obstructive pulmonary disease (COPD), lung cancer and other respiratory diseases and highlighted carcinogens such as silica and occupations such as cleaning, and agriculture in relation to COPD.  The second review was a scoping review of reviews on the issue of women’s occupation and ill-health, a topic which has not been specifically addressed before by IIAC. Although a substantial number of papers were reviewed, a number of limitations about the evidence were noted. Nevertheless, the review identified several occupations of concern and various ill-health issues within these. Mental health, reproductive issues and musculoskeletal disorders were particularly highlighted.

There is continued concern about neurodegenerative disease in sportspeople. The Council completed an in-depth review of the literature and has commissioned further reviews on cognitive impairment and Parkinson disease.

This reporting year heralds a change of chairmanship. As the outgoing Chair, I wish to thank the members of the Council and Secretariat for the huge amount of work they have carried out and their dedication to this during my period of appointment, a period that included particular challenges during the pandemic. I would also like to thank observers from the Health and Safety Executive (HSE) and Ministry of Defence (MoD) and many members of DWP, for their input into the Council’s deliberations and their assistance in resolving many of the issues the Council has addressed.  I welcome the incoming Chair, Professor Gillian Leng, and wish her every possible success in continuing the important work of the Council in support of workers injured or made ill through their occupation.

Dr Lesley Rushton OBE
IIAC Chair to 31 March 2025

I am both excited and daunted by the task of taking over as Chair of the Industrial Injuries Advisory Council.  Its work is challenging and important in equal measure, with the potential to change lives of those affected by occupational diseases and conditions. 

I am extremely grateful to Lesley for her expert leadership of the committee over the last 7 years.  During her tenure, she oversaw evaluations across a wide range of occupation-related health issues, including the impact of the COVID-19 pandemic on UK healthcare staff.  This represented one of the most challenging topics in IIAC’s recent history. 

I look forward to working with the excellent IIAC members and many others who support the work of the Council.   We will be holding a public meeting in October 2025, providing an important opportunity to engage with stakeholders on future plans and potential areas for detailed consideration.  It is rare to find a committee with the longevity of IIAC, and I am honoured to be its next Chair.

Professor Gillian Leng CBE
IIAC Chair from 1 April 2025

Introduction

The Industrial Injuries Advisory Council (IIAC) is a non-departmental public body (NDPB) established under the National Insurance (Industrial Injuries) Act 1946, which came into effect on 5 July 1948. The Council provides independent advice to the Secretary of State for Work and Pensions in Great Britain and the Department for Communities (DfC) in Northern Ireland on matters relating to Industrial Injuries Disablement Benefit and its administration.  The historical background to the Council’s work and its terms of reference are described in Appendix A and Appendix B respectively.

The Role of the Council

The statutory provisions governing the Council’s work and functions are set out in sections 171 to 173 of the Social Security Administration Act 1992 and corresponding Northern Ireland legislation. The Council has 3 main roles:

• to consider and advise on matters relating to Industrial Injuries Disablement Benefit (IIDB) or its administration referred to it by the Secretary of State for Work and Pensions in Great Britain or the DfC in Northern Ireland
• to advise on any other matter relating to IIDB or its administration
• to consider and provide advice on any draft regulations the Secretary of State proposes to make on IIDB or its administration

IIAC is a scientific advisory body and has no power nor authority to become involved in individual cases nor in the decision-making process for benefit claims. These matters should be taken up directly with the Department for Work and Pensions, details of which can be found on the gov.uk website.

Composition of the Council

IIAC usually consists of around 17 members, including the Chair. It is formed of independent members with relevant specialist skills, representatives of employees and representatives of employers. The independent members currently include medical and scientific experts and a lawyer. Membership of the Council during 2023 to 2024 is described in Appendix C.

Legislation leaves it to the Secretary of State to determine how many members to appoint but requires that IIAC includes an equal number of representatives of employees and employers (Social Security Administration Act 1992, Schedule 6).

Conditions for ‘Prescribing’ Diseases

Much of the Council’s time is spent considering which diseases, and the occupations that cause them, should be included in the list of prescribed diseases (PD) for which people can claim IIDB.

The conditions which must be satisfied before a disease may be prescribed in relation to any employed earners are set out in section 108(2) of the Contributions and Benefits Act 1992. This requires that the Secretary of State for Work and Pensions should be satisfied that the disease:

• ought to be treated, having regard to its causes and incidence and any other relevant considerations, as a risk of occupations and not as a risk common to all persons; and
• is such that, in the absence of special circumstances, the attribution of particular cases to the nature of the employment can be established or presumed with reasonable certainty

In other words, a disease can only be prescribed if the risk to workers in a certain occupation is substantially greater than the risk to the general population and the link between the disease and the occupation can be established in each individual case or presumed with reasonable certainty.

In some instances, recommendations for prescription of a disease can be made on the basis of clinical features which confirm occupational causation in the individual claimant. Increasingly, however, the Council has to consider diseases which do not have clinical features that enable the ready distinction between occupational and non-occupational causes (e.g., chronic obstructive pulmonary disease, which can be caused by tobacco smoking as well as having occupational causes). In these circumstances, in order to recommend prescription, IIAC seeks epidemiological evidence that the disease can be attributed to occupation on the balance of probabilities under certain defined exposure conditions (generally corresponding to evidence from several independent research reports that the risk of developing the disease is more than doubled in a given occupation or exposure situation), and thus is more likely than not to have been caused by the work. In 2015, the Council prepared a lay person’s guide to prescription, which was published on the gov.uk website.

Research

The Council relies on research carried out independently, which is published in specialist medical and scientific literature. IIAC does not have its own research budget to fund medical and scientific studies (other than limited funding from DWP for the occasional commissioning of reviews). When IIAC decides to investigate a particular topic its usual practice is to ask other bodies and interested parties to submit any relevant research in that field.  IIAC has a sub-committee, the Research Working Group (RWG), which meets separately from the full Council to consider the scientific evidence in detail. The Council’s secretariat includes a scientific adviser who researches and monitors the medical and scientific literature to keep IIAC abreast of developments in medical and scientific research and to gather evidence on specific topics which the Council decides to review.

In March 2015, the Council published some informal guidance on how it reviews and reports on published literature, particularly epidemiological studies, to provide evidence for potential prescription for IIDB.

Key achievements of 2024 to 2025

Command Papers ^{[footnote 1]}

Occupational impacts of COVID-19 in transport and education workers, published November 2024.

Position Papers ^{[footnote 2]}

No position papers were published 2023 to 2024.

Information Notes ^{[footnote 3]}

No information notes were published 2023 to 2024.

Regulations proposed by the Secretary of State

The law requires that draft regulations proposed by the Secretary of State which concern the Industrial Injuries Disablement Benefit Scheme are referred to the Council for its advice and consideration. There were no regulations put to the Council for consideration in 2024 to 2025.

Stakeholder Engagement

No public meeting was scheduled for 2024 as it is held biannually. The next meeting will be held in London in October 2025. It is intended it will be a hybrid meeting, allowing as many stakeholders to attend as possible.

There are several projects underway which will aim to raise the profile of the Council and to raise awareness of its work.

IIAC Meetings

Meetings of the full Council and its Research Working Group (RWG) have taken place using a hybrid approach where some members have attended in person with others joining the meetings online, facilitated by the secretariat.

The full Council met 4 times in 2024 to 2025. Its RWG also met 4 times during the year.

Meetings continue to be conducted in a hybrid manner.

Summary of work undertaken in 2024 to 2025

The Council continued to undertake its advisory function effectively and the work undertaken is summarised below.

COVID-19 and occupation – ongoing monitoring of the emerging data for other occupations.

Although most people infected with SARS-CoV-2 experienced relatively mild or short-term symptoms, a small proportion reported longer-term symptoms that led to persisting loss of function and disability.

The pandemic of Coronavirus Disease 2019 (COVID-19) caused by infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) began early in 2020 in the UK. Since then, the Industrial Injuries Advisory Council (IIAC) has been continually reviewing the accruing scientific evidence on the occupational risks of COVID-19. Two papers have been published: an interim Position Paper (COVID-19 and occupation: IIAC position paper 48) published in February 2021 based on information available in 2020; a Command Paper published in November 2022 which recommended prescription for Health and Social Care Workers of 5 serious pathological complications following COVID-19 that have been shown to cause persistent impairment and loss of function in some people (COVID-19 and Occupational Impacts - GOV.UK). Although associations between several other occupations and death and infection related to COVID-19 were also found, the evidence available at that time for any increased risk was much weaker, with inconsistent results over different time periods.

Since the publication of the 2022 Command paper, more evidence became available for transport workers and those working in the education sector. However, there were sparse or poor-quality data on other specific occupations and also on the group of occupations classified as key workers by the UK government; this position was largely unchanged from that of their previous 2 reports.

There was sparser evidence relating to SARS-CoV-2 infection in transport workers especially in the early stages of the pandemic and in subgroups of transport workers. However, the mortality data for the transport sector relating to COVID-19 consistently showed increased risks, particularly for public-facing transport workers such as coach or bus and taxi or cab (including private hire) drivers. IIAC considered that the mention of COVID-19 on death certificates gave a good indication of the occurrence of infection. From the mortality data, IIAC took the view that the risks of infection were likely to be more than doubled in transport workers who have been working in proximity to the general public. Based on the available scientific evidence, IIAC therefore recommended prescription of the same 5 serious pathological complications (as observed for health and social care workers) following COVID-19 which have been shown to cause persistent impairment and loss of function in some people.

Evidence update of the relationship between occupational exposures and selected malignant and non-malignant respiratory disease

Some of the current prescriptions for respiratory diseases have been re-evaluated more than once since their inception many decades ago. However, they do not always reflect occupations and modern work practices where exposure may occur more frequently than in the past, such as in the construction industry and/or new products are now in use such as the use of artificial or composite stone which often contains a high percentage of quartz. 

Currently COPD is only prescribed in relation to coal mining. However, there is a large literature in many different industries showing consistent associations from several occupational-related exposures with increased risk of death or incidence of COPD, for example: work in construction, tunnelling, manufacture of ceramic fibres, iron and steel foundry work, cotton manufacture, grain handling, welding, and agriculture.

For lung diseases, a particular challenge for prescription is how to take account of important confounding exposures, and in particular, smoking. This is illustrated in the current prescription for COPD and coal mining, which was based on data that included both smokers and non-smokers; smoking habits of claimants are thus ignored.

The Council appointed the Institute of Occupational Medicine (IOM) to carry out the review and work has progressed.

Following discussions with the Council, 6 priority exposure/disease combinations were agreed for further consideration:

• silica and COPD
• silica and lung cancer
• cleaners and nurses and COPD
• farming or pesticide spraying and COPD
• hexavalent chromium and lung cancer
• asbestos and lung cancer

This review is now complete so the Council will consider the outcomes and develop a strategy for translating these into recommendations or advice for the industrial injuries scheme.

Neurodegenerative brain disease in professional sportspeople

There has been considerable public debate regarding neurodegenerative diseases in sportspersons and requests to consider this have been made to IIAC on behalf of professional footballers and others.   IIAC last considered the issue in 2016 and noted “the evidence in relation to dementia and Parkinson’s disease is sparse and insufficient to support prescription. More evidence exists for an increased risk of amyotrophic lateral sclerosis (ALS) [but] given the various limitations in the evidence base, the Council is unable to recommend prescription.”

The Council received correspondence from a charity giving information about a former professional footballer for whom a Coroner had recorded a verdict of ‘death by an industrial disease’. A consultant neuropathologist found considerable evidence of trauma to the footballer’s brain likely to have been exacerbated by his profession. Evidence was submitted to support this claim and a request was made for IIAC to investigate the potential link to neurodegenerative disease (NDD) in professional football players.  Subsequently, the Professional Footballers Association (PFA) wrote to the Council to ask it to look into the possible link. Following a review of NDD in rugby players, this prompted the Council to expand the investigation to include other sports.

This is a particularly complex topic to investigate as it is not always possible to determine the exposure. Also, published literature often refers to neurodegenerative disease, whereas in reality there are different disease conditions with differing morphology. It was decided to focus initially on amyotrophic lateral sclerosis (ALS or Lou Gehrig’s disease) and motor neurone disease (MND) as these appear to have positive signals in the literature.

There is clear evidence that both genetic and lifestyle/environmental factors are important in the development of ALS.  The 2 that are most likely to be relevant to professional sportspersons are exercise and head trauma.

Professional sportspersons are likely to exercise more vigorously and in some sports are at high risk of head trauma and so might be at greater risk.

Following an extensive review of the literature, the Council identified 20 studies relating to ALS in professional sportspersons though most are small and many have overlapping study subjects. This evidence is currently being evaluated to establish if it is sufficiently robust to recommend prescription.

The Council identified that other neurodegenerative diseases may have links to professional sportspeople, so it embarked upon a competitive tender exercise to appoint an organisation to carry out coping reviews into potential links between cognitive impairment (dementia) and professional sportspeople and Parkinson’s disease and professional sportspeople.

The Thomas Ashton Institute (Manchester University) was successful with its bids and will run both reviews concurrently. It is expected these reviews will conclude and report in April or May 2026.

Other work carried out in 2024 to 2025

Women’s occupational health

IIAC has not evaluated the specific issue of women’s ill health due to workplace exposures, so it felt appropriate to address this issue.

IIAC commissioned the Institute of Occupational Medicine to carry a scoping review to inform the potential for a more detailed evaluation of specific health outcomes and occupations.

This research comprised an umbrella review of the epidemiology literature on work and non-malignant diseases relevant to women in workforce, in order to complete the following objectives:

• to search for reviews published in the peer-reviewed literature and (where absent for a topic) large-scale cohort or case-control studies to identify the industries and/or occupations and/or exposures associated with non-malignant occupational diseases that occur:

  (a) only in women, or

  (b) where women are at greater risk than men where both are similarly exposed

• to give an approximate estimate, where feasible, of the range of the magnitude of the risks and the numbers/proportions of working women likely to be affected
• to assess the size of the literature base for outcomes/exposures for more detailed evaluation of specific health outcomes and occupational circumstances

Despite the substantial number of papers reviewed, evidence around women’s occupational health was generally limited and the reviews generally did not report results by gender. The reviews often reported weak evidence and/or inconsistent findings and odd ratios (OR) and relative risks (RR) were invariably less than 2.0. Relatively few studies specifically addressed gender differences. Many of the reviews which were included in this umbrella review highlighted the difficulties in interpreting results pertaining to women’s occupational health due to confounding gender differences in health outcomes in the general population.

The report summarised key findings by occupation, some examples of which included:

• Animal Care Workers
  • impacts on mental health were discussed
• Care Workers
  • musculoskeletal issues were discussed
• Childcare workers
• Cleaners
  • exposure to cleaning chemicals and a possible link to asthma were discussed
• Fitness Workers/Athletes
  • impacts on mental health were discussed
• Hairdressers
  • musculoskeletal disorders were discussed
  • reproductive health impacts were discussed
• Healthcare workers – this occupational sector accounted for 40% of the papers screened. This section was subdivided by health outcomes, examples of which were:
  • mental health
  • suicide
  • PTSD or trauma
  • stress or depression
  • musculoskeletal disorders
  • reproductive effects
  • violence or assault
• Teachers
  • mental health and musculoskeletal disorders were discussed.
• Office workers

The Council will consider this report and evaluate its findings to establish if any warrant further investigation.

The full report will be published on the IIAC website in the summer of 2025.

Other topics on which IIAC provided advice

DWP officials consulted the Council for advice or guidance on a number of topics, some examples of which were:

• hypersensitivity pneumonitis as a synonym for extrinsic allergic alveolitis
• the Chair provided some advice on potential organophosphate poisoning in cabin crew following a ‘fume event’
• mesothelioma latency period
• mesothelioma ‘in situ’

Correspondence

IIAC regularly receives correspondence from a variety of sources. The points below demonstrate some of the correspondence IIAC received and the subsequent responses.

• The Council received correspondence from a stakeholder asking if the prescription for unilateral or bilateral diffuse pleural thickening (DPT, PD D9) could be reviewed with respect to asbestos exposure.  After due consideration and discussion at a number of meetings, the Council concluded that whilst DPT may be caused by asbestos exposure, it notes that there are also other causes (i.e. DPT is not exclusively an occupational disease) and may occur after severe respiratory disease such as pneumonia with empyema. In general, the levels of asbestos found underground may not be sufficient to cause DPT. The PD D9 prescription reflects the view that an individual’s asbestos exposure has to be more than minimal to attribute their pleural thickening to the exposure.

• A firefighter wrote to the Council asking about bladder cancer related their occupation. The Council’s response referred to its position paper 47: Firefighters and cancer which indicated that whilst there appeared to be an association between bladder cancer and firefighting, the risks identified did not meet the required levels to be considered for recommendation that this disease be added to the list of prescribed diseases which qualify for industrial injuries disablement benefit (IIDB).

• An MP referred a constituent’s concerns to the Council around the support available for teachers and support staff who have contracted COVID-19 in their workplace and are now suffering from debilitating long COVID. The response referred to IIAC’s command paper ‘Occupational Impact of COVID-19 in the Transport and Education Sectors’ which found no evidence of any marked increase in death rates in workers in the education sector associated with COVID-19. The risk of developing COVID-19 among education workers in schools varied depending on when and where the studies were carried out. IIAC accepted that in some studies, the risks faced by education workers with direct student contact were likely to have been diluted by the risks of those who did not have such direct contact, and there were likely to be circumstances where education workers developed infection as a consequence of contact with students. Taking the infection and mortality data as a whole, IIAC was unable to conclude there was sufficient evidence of a doubled risk in education workers and was therefore unable to recommend prescription for this occupational sector.

• The Council received a letter from an MP and former chair of an all-party Parliamentary group which expressed concerns relating to the debilitating effects of long COVID and requested whether IIAC has considered reviewing the allocation of Long Covid as an occupational disease for those working in Health and Social Care and other frontline sectors. IIAC responded by acknowledging the concerns but indicated that the Council identified major concerns with the available studies including lack of uniformity of the definitions and criteria used to identify long COVID in research studies and limitations with regards to methodology. IIAC notes that there remains poor understanding of the pathophysiology of long COVID which is further confounded by a lack of specific diagnostic testing and variable definitions of the condition. IIAC requires objective and clear evidence of both disease definition and diagnosis and of exposure circumstances. The issues highlighted above thus limit IIAC’s ability to make recommendations for prescription of long COVID.

• A member of the public emailed the Council expressing concern that although they had Dupuytren’s in both hands, they were unable to make a claim for PD A15 (Dupuytren’s contracture) as their occupation as a typist was not recognised. IIAC’s response referred to very little evidence to link typing to the development of Dupuytren’s contracture.

Future Work of the Council

In addition to maintaining its reactive brief, the Council will continue with its horizon scanning of the recently published scientific research literature which will help inform its work programme for 2025 to 2026. In September 2023, it was announced that funding had been secured to assist the Council in its work and to provide additional scientific support. Discussions are ongoing to develop a network of suppliers which the Council can call on to help progress its work.

Summary of sources and outcomes of IIAC investigations

IIAC continues to be committed to publishing statistics related to the sources and outcomes of investigations to improve transparency.

The information shown below illustrates the breakdown in sources of referrals made to the Council and the outputs of these investigations.

Table 1: Source of IIAC investigations 2024 to 2025

Source	Percentage
Public/Stakeholders	59%
Media	18%
MP or Parliamentary	17%
DWP or OGD	6%

Table 2: Outcomes of IIAC investigations 2024 to 2025

Outcome	Percentage
Letters or email	79%
Command paper	7%
Ongoing	7%
Outreach or presentation	7%

Stakeholder Engagement

Networking activities

During the year the Chair delivered a presentation to the TUC’s Health and Safety Committee meeting and discussions took place to deliver a longer talk in the future. The Chair also attended the UK and Ireland Occupational and Environmental Epidemiology Societies annual meeting to raise awareness of the work the Council undertakes.

Members attended the Society of Occupational Medicine and the Faculty of Occupational Medicines Conference, presenting an abstract on IIAC’s work.

External experts

IIAC consulted with Professor Kevin Talbot, (head of department and professor of motor neuron biology at the Nuffield department of clinical neurosciences, Oxford University)

Calls for additional research, highlighting occupational risks for prevention

IIAC’s remit does not extend to commissioning primary research studies. Thus, IIAC must rely on published research when considering whether a disease and exposure warrant prescription. IIAC strives to identify robust evidence from the peer-reviewed scientific literature, but where such information is lacking will seek other avenues to provide information, such as approaching researchers directly to ask for additional analyses of, or further information about, their data.

The Council will make calls for evidence to the wider scientific community via the Industrial Injuries Advisory Council website, the Society of Occupational Medicine’s newsletter and through a targeted approach to the occupational sectors involved when required.

Membership

Under the Social Security Administration Act 1992 (Schedule 6) the Secretary of State appoints a Chair and any other number of members as they may determine. Legislation requires that there shall be an equal number of persons to represent employers and employed earners.

Since April 2018 the IIAC chair receives an annual fee.  However, the Chair and members of IIAC are not salaried. For each meeting they attend, members receive a fee and reimbursement of travelling expenses and subsistence (where appropriate) in line with civil service arrangements.

IIAC members are required, at the start of each meeting, to declare any conflict of interest in relation to the business of the meeting. For transparency these are recorded in the minutes of meetings, and a register of members’ interests is updated biannually, and both are published on the website Industrial Injuries Advisory Council.

Appointments and reappointments

Professor Gillian Leng was appointed as the new Chair of IIAC from 1 April 2025. She follows Dr Lesley Rushton who agreed to stay for an additional month following the end of her tenure on 31 March 2025 to ensure a smooth handover of the role.

Dr Jennifer Hoyle, Lesley Francois and Daniel Shears have been reappointed to the Industrial Injuries Advisory Council for a final 5-year term from 1 September 2024.

Full details of IIAC membership throughout the year can be found at Appendix C.

Appendix A – Historical background to the Council’s work

The first Workmen’s Compensation Act passed in 1897 made no provision for industrial diseases. Subsequently, a Departmental Committee identified a need for additional statutory provision and a Schedule was added to the Workmen’s Compensation Act of 1906 listing industrial diseases for which compensation was available. Initially only 6 diseases were prescribed (anthrax, poisoning by lead, mercury, phosphorus, and arsenic, and ankylostomiasis) in respect of specific work processes. The 1906 Act also empowered the Home Secretary to add other diseases to the Schedule, though the criteria to be applied in doing so were not specified.

The Samuel Committee was appointed in 1907 to inquire into this and set out to identify diseases currently not covered by the Act which, firstly, caused incapacity for more than one week and, secondly, were so specific to the given employment that causation could be established in each individual case. Using these criteria, the Committee recommended that 18 diseases should be added to the Schedule. Further diseases were added to the schedule later, but there were no significant changes to the scheme until the setting up of the Welfare State after the Second World War. By 1948 compensation was available for 41 diseases.

IIAC was established under the National Insurance (Industrial Injuries) Act 1946. Under this Act, which came into effect on 5 July 1948, a new Industrial Injuries Scheme was established, financed by contributions from employers, employees and the Exchequer. The State, through the Scheme, assumed direct responsibility for paying no-fault compensation for work related injury and diseases. The Council’s terms of reference, set down in the Act, were to advise the Minister on proposals to make regulations under the Act and to advise and consider such questions relating to the Act that the Minister might, from time to time, refer.

The 1946 Act also contained provisions for the prescription of diseases (section 55 of the 1946 Act, now section 108(2) of the Contributions and Benefits Act 1992). The Minister could prescribe a disease if they were satisfied that it ought to be treated as a risk of occupation and not as a risk common to the general population, and that the attribution of individual cases to the nature of the occupation could be established or presumed with reasonable certainty. An employee disabled by a prescribed disease would have a right to claim benefit under the Act.

In 1947 the Government appointed the Dale Committee. Part of its brief was to advise on the principles governing the selection of diseases for insurance under the National Insurance (Industrial Injuries) Act, having regard to the extended system of insurance which was about to be set up by the National Insurance Act 1948 and any other relevant considerations. The advice of the Dale Committee included proposals that a small specialised standing committee should be appointed by the Minister to consider the prescription of diseases specifically referred to it, to review periodically the schedule of prescribed diseases and to recommend subjects on which more research was needed. The Minister concluded that this was a suitable task for a newly established IIAC. In 1982 the Government widened the Council’s terms of reference allowing it to advise the Secretary of State on any matter relating to the Industrial Injuries Disablement Benefit Scheme or its administration.

Appendix B – Terms of Reference

To note: An action from DWP’s internal review of the Industrial Injuries Advisory Council in 2023 was “to set up a Framework Agreement for IIAC to strengthen its governance, bringing it into line with DWP’s other NDPBs”. This will be published online when agreed.

Purpose and constitution

To advise the Secretary of State for Work and Pensions, the Medical Advice Team of the Department for Work and Pensions (DWP) and the Department for Communities in Northern Ireland on the Industrial Injuries Scheme.

The Social Security Administration Act 1992 sets out the Council’s remit. The Council exists to provide consideration and advice to the Secretary of State on matters relating to Industrial Injuries Disablement Benefit (IIDB) or its administration, and to consider any draft regulations the Secretary of State proposes to make in relation to that scheme. In particular this includes advising which diseases and occupations should give entitlement to Industrial Injuries Disablement Benefits.

Membership

The Council consists of a Chair appointed by the Secretary of State and such number of other members so appointed as the Secretary of State shall determine. Currently, independent members include specialists in occupational medicine, epidemiology, exposure measurement and the law. Legislation also requires an equal number of representatives from employers and employees.

Appointments shall be made by the Secretary of State or another Minister of the DWP as determined by the Secretary of State. Appointments shall be made in accordance with the Governance Code of Practice for public appointments published by the Cabinet Office which sets out the regulatory framework for public appointments processes within the Commissioner for Public Appointment’s remit.

Members serve an initial term specified within their terms of appointment, usually an initial 5 years and can be reappointed (dependent on satisfactory appraisal) for a second term allowing up to a maximum of 10 years in total.

Others, not members of the Council, will at its invitation attend meetings of the Council as advisers or observers.

Deputy-Chair and sub-groups

The Chair shall determine who should deputise for them in their absence, and in the case of any sub-group of the Council, who shall chair that sub-group.

The Council has a standing sub-group – the Research Working Group (RWG), which undertakes the detailed scientific investigations required by the Council’s work, particularly with reference to the prescription of diseases within the Industrial Injuries Disablement Benefit Scheme. The make-up of the RWG is decided by the Chair, in discussion with the RWG Chair.

The Chair will determine the need for other sub-groups as required by the Council’s work programme. In agreement with the Council, they will set their terms of reference, membership and Chair.

Authority

The Council has no executive or operational functions in relation to the Industrial Injuries Disablement Benefit Scheme, which is operated by the DWP and has no authority in relation to individual benefit decisions or appeals.

Conduct and frequency of meetings

The full Council meets 4 times a year, and in addition the RWG also meets 4 times a year. Further meetings will be arranged if required and as directed by the Chair. The Council will also hold regular open public meetings in different locations of the United Kingdom, offering opportunities for members of the public to question the Council on matters relating to its advice to Government.

Partnership of the Council

The Private Pensions and Arm’s Length Body Partnership Division within DWP will partner the Council. Partnership will consist of ensuring the Council has the means to carry out its advisory function efficiently and independently and that it operates in line with Government guidance for Non-Departmental Public Bodies and Scientific Advisory Committees.

Partnership of the Council will take place in line with the high-level Framework of Principles set out in the Departmental Framework published by the DWP for managing the relationships of the Department with its Arm’s Length Bodies.

The DWP will provide staff to act as the Secretariat for the Council (including experienced scientific support) and provide financial resources for the Council to carry out its business, administered by the Secretariat.

The Department will carry out tailored reviews of the Council as both a Non- Departmental Public Body and a Scientific Advisory Committee, as required by Cabinet Office and Government Office of Science guidance.

These terms of reference will be reviewed and updated when required.

Annual report

The Council will publish an annual report, usually by the end of July each year, setting out its work in the previous year and its forward work programme for the ensuing year.

Publications

Where the Council advises the Secretary of State to make legislative changes to the Industrial Injuries Disablement Benefit Scheme, the Council will prepare a Command Paper to be presented to Parliament by the Secretary of State for Work and Pensions by Command of Her Majesty. Where the Council has carried out a full review of a topic but is not advising the Secretary of State to make legislative changes, the Council will prepare a Position Paper for publication, setting out its conclusions and reasoning.  Where there is little evidence to allow the Council to carry out a full review, an Information Note will be published.

The Council shall, with the aid of the Department, provide updates to its presence on gov.uk, including its remit, cleared minutes of its meetings will be published, copies of its advice to Ministers shall be made available, details of membership, a register of members interests and other matters and items of information shall be published.

Method of enquiry

The Council’s task is to advise the Secretary of State on the Industrial Injuries Disablement Benefit Scheme. The majority of this work concerns updating the list of Prescribed Diseases and the occupations that cause them for which IIDB can be paid.

Identifying areas of investigation

The Council’s work programme has reactive and proactive elements.

Reactive elements

The Council interprets its reactive role liberally, to include responsiveness to stakeholder questions and the emerging research literature. Its work programme therefore considers requests from many parties, including (but not limited to): The Secretary of State, Members of Parliament, the DWP, medical specialists, trade unions, health and safety professionals and agencies, victim support groups, delegates of public meetings, and Council members themselves. It also takes account of new peer-reviewed research reports, items in the scientific and general press and the decisions of IIDB Upper Tier Tribunals.

This reactive element is an essential ongoing component of the work, valued by stakeholders, and which makes the Council accessible and open to reasonable enquiry, adaptable, and an intelligent user of information.

Proactive elements

The Council employs a range of tools to directly and continuously monitor changing scientific evidence and new topics that may impact on the Industrial Injuries Scheme. These include periodic review of existing Prescribed Diseases and their terms; a watch list of topics from earlier reports; periodic review of IIDB statistics; review of an annual compendium of research abstracts; benchmarking exercises which compare the IIDB list with lists of other schemes; and, when budgetary constraints allow, commissioned reviews of topics of relevance to the work plan.

The Council’s approach

Once an area of investigation has been identified the Council’s approach will typically be to:

• check original sources
• conduct a review of the relevant scientific peer-reviewed literature
• check the reports of major authorities (such as the International Agency for Research on Cancer)
• take evidence from subject experts
• make a public call for evidence and, where appropriate, direct calls for evidence to key informants (e.g., trade unions, health and safety professionals, Health and Safety Executive)
• collate the evidence, summarise it, and formulate a view in the context of the Scheme
• draft an appropriate report, agreed by the RWG and the full Council, setting out the Council’s advice to the Secretary of State for Work and Pensions and to other stakeholders

Openness and transparency - this requirement to be met in various ways:

• laying and publication of Command Papers in Parliament
• deposit and publication of Position Papers in the Houses of Parliament Libraries
• publication of Information Notes
• deposit and publication of an Annual Report
• publication of the minutes of Council and RWG meetings
• regular public meetings and other stakeholder engagement
• publication of the proceedings of public meetings
• accessibility to stakeholder enquiries
• information published on the IIAC pages on gov.uk

Where inquiries are more than trivial and of sufficient public interest there is always an intention to publish and to respond constructively to the original inquirer. Reports shall cite the considered background literature (to allow a transparent audit trail) and offer a glossary where required (to promote understanding).

Appendix C – Members of the Council in 2023 to 2024

Dr Lesley Rushton Chair OBE BA MSc PhD CStat Hon FFOM

Appointed 1 April 2018, reappointed for a final 2 years from 1 April 2023. The Chair stood down following a one month extension to her appointment allowing for a smooth transition to the new Chair’s appointment from 1 April 2025.

Independent scientist

Emeritus Reader in Occupational Epidemiology, Department of Epidemiology and Biostatistics, Imperial College London

Member, UK Committee on Carcinogenicity

Honorary Fellow, Faculty of Occupational Medicine

Professor John Cherrie BSc PhD CFFOH

Appointed 1 November 2018, reappointed for a final 5-year term from 1 November 2023

Independent member with expertise in exposure measurement

Professor of Human Health, Heriot Watt University and Principle Scientist, Institute of Occupational Medicine, Edinburgh

Member of the Health and Safety Executive’s Workplace Health Expert Committee Chartered Fellow, Faculty of the British Occupational Hygiene Society

Lesley Francois LLB(Hons) MA LLM

Appointed 1 September 2019, reappointed for a final 5-year term from 1 September 2024

Independent member with legal expertise

Magistrate and Justice of the Peace on the Family Panel, Ministry of Justice

Member of Law Society’s Personal Injury Panel

Member of Association of Personal Injury Lawyers accredited with Senior Litigator Status, Occupational Disease Specialist Status, Asbestos Disease Specialist Status

Dr Richard Heron MB ChB FRCP FFOM SFFMLM

Appointed 3 January 2023 for a 5-year term

Representative of employers

Independent Chief Medical Officer

Managing Director, Heron Health Consulting Ltd

Honorary Professorial Fellow, International Business and Health, Department of Medicine, University of Nottingham

Expert Advisor, NHSE/NHSI Health and wellbeing expert advisory group

Co-chair, International Occupational Medicine Society Collaborative

Dr Sally Hemming PhD BSc Sociology MICPD

Appointed 3 January 2023 for a 5-year term

Representative of employers

Health and Wellbeing Lead, EY, UKI

Associate wellbeing services, JP Hemming Ltd

Professor Max Henderson MSc PhD MRCP MRCPsych HonFFOM

Appointed 1 November 2018, reappointed for a final 5-year term from 1 November 2023

Independent member with expertise in psychiatry

Professor, Psychological Medicine and Occupational Psychiatry, University of Leeds

Honorary Fellow, Faculty of Occupational Medicine

Dr Jennifer Hoyle MRCP Edin FRCP

Appointed 1 September 2019 for a 5-year term, reappointed for a final 5 years from 1 September 2024

Independent member with expertise in general and respiratory medicine with an interest in occupational lung disease    

Consultant Physician, North Manchester General Hospital

Member, Royal College of Physicians, Edinburgh

Fellow, Royal College of Physicians

Dr Ian Lawson MB BS FFOM FRCP FRSPH

Appointed 1 November 2018, reappointed for a final 5-year term from 1 November 2021

Representative of employers, with expertise in hand arm vibration syndrome

Retired Occupational Health Physician, formerly Chief Medical Officer, Rolls-Royce plc

Fellow, Faculty of Occupational Medicine Fellow, Royal College of Physicians

Fellow, Royal Society for Public Health

Professor Damien McElvenny BSc MSc CStat CSci

Appointed 1 December 2021 for a 5-year term

Independent member with specialist skills in biostatistics and epidemiology

Principal Epidemiologist, Institute of Occupational Medicine and Senior Research Fellow, Centre for Occupational and Environmental Health, University of Manchester

Member of the Royal Statistical Society

Member of the International Commission on Occupational Health and Secretary of Epidemiology Scientific Committee (EPICOH)

Secretary UK and Ireland Occupational and Environmental Epidemiology Society

Associate Editor, Occupational and Environmental Medicine

Assistant Editor, Occupational Medicine

Steve Mitchell LLB

Appointed 3 January 2023 for a 5-year term

Representative of employed earners

Deputy Head of Legal Services, Union of Shop, Distributive and Allied Workers

Daniel Shears

Appointed 1 September 2019 for a 5-year term, reappointed for a final 5 years from 1 September 2024

Representative of employed earners

National Health, Safety and Environment Director, GMB Trade Union

Member, Health and Safety Executive Industry Advisory Committees including Construction Industry Advisory Committee and Paper and Board Industry Advisory Committee

Member, TUC Union Health and Safety Specialists Committee

Dr Chris Stenton BSc MB BCh BAO FRCP FFOM

Appointed 1 December 2018, reappointed for a final 5-year term from 1 December 2023

Independent member with expertise in respiratory medicine

Locum Consultant Physician, Royal Victoria Infirmary Fellow, Royal College of Physicians

Fellow, Faculty of Occupational Medicine

Dr Sharon Stevelink BSc PhD MSc

Appointed 3 January 2023 for a 5-year term

Independent member with expertise in epidemiology and psychological medicine

NIHR Advanced Fellow, Department of Psychological Medicine, King’s College, London

Senior Lecturer in Epidemiology, Department of Psychological Medicine and King’s Centre for Military Health Research, King’s College, London

Academic member of the Psychological Medicine PhD Sub-Committee, King’s College, London

Chair of the assessment sub-board for MSc in War and Psychiatry, King’s College, London

Associate editorial board member, BMC Psychiatry

Dr Gareth Walters MD FRCP FHEA

Appointed on 1 December 2021 for a 5-year term

Independent member with expertise in occupational respiratory medicine and interstitial lung diseases

Honorary Senior Clinical Research Fellow, Occupational Respiratory Medicine, Institute of Applied Health Research, Birmingham University

NHS consultant, Birmingham Chest Clinic

Member, British Thoracic Society (BTS) Clinical Statement Group on occupational asthma

Member, Group of Occupational Respiratory Disease Specialists (GORDS) UK

Appendix D: IIAC Secretariat, Officials and Observers

IIAC has a secretariat, supplied by the DWP, dedicated to the Council’s requirements. It consists of the Secretary, a Scientific Adviser and an administrative secretary.

Members of the Secretariat

Mr Stuart Whitney, Secretary

Mr Ian Chetland, Scientific Adviser

Ms Catherine Hegarty, Administrative Secretary

Contact Details

Industrial Injuries Advisory Council
Caxton House
Tothill Street
London
SW1H 9NA

Email: caxtonhouse.iiac@dwp.gov.uk  

Website: Industrial Injuries Advisory Council - GOV.UK

Officials and Observers attending meetings

Officials from the DWP attend Council meetings to give advice and guidance to IIAC on policy matters and the operation of the IIDB Scheme. Representatives from the HSE and the Ministry of Defense attend as observers.

From the DWP:

Dr Matthew Goldstone, Disability Employment and Support Directorate

Ms Parisa Rezai-Tabrizi, Disability Employment and Support Directorate

Mr Lewis Dixon, Disability Employment and Support Directorate

Ms Georgina Wood, Disability Employment and Support Directorate

Ms Catriona Hepburn, DWP Legal Services

Mr Lee Pendleton, Benefit Services Directorate

From the HSE:

Ms Lucy Darnton, Science, Engineering and Analysis Division

From the MoD:

Dr Clare Leris, Medical Adviser, Armed Forces Compensation Schemes

Appendix E: Expenditure

The Council does not have a budget of its own. However, DWP provides an administrative budget of £155,000 to allow the Council to function. This includes additional funding from departmental budgets which allows the Council to commission or scope reviews where additional resources are required to help it undertake its expanding work plan. During the year IIAC asked the Institute of Occupational Medicine to undertake a scoping review of women’s occupational health following a tender process.  This is now complete, and the expenditure included in the table below. Other details of spending include:

Fees for members attending IIAC and RWG meetings were reviewed and increased from February 2024 as follows:

Meeting and Type of member	Amount of fee
Full Council meetings – Member	£257
RWG meetings – Chair	£329
RWG meetings- Member	£257

Following the review of member fees, the IIAC Chair’s fee was increased to £22,000 p/a from 1 April 2024 for up to 60 hours per year.

Travel expenses are also payable to members in accordance with DWP rates and conditions. Expenses are only claimed by those attending in person.

An overview of expenditure for 2024 to 2025 was as follows:

Type of expenditure	Amount
Professional fees	£41,049.00
Expenses	£5,729.95
Printing	£1,456.91
Research Material	£19,180.00
Total	£67,415.86

1. A Command Paper is a Council report that includes a review of the relevant literature and contains recommendations which require changes to legislation (e.g., recommending a disease and/or an exposure be added to the list of prescribed diseases for the purposes of prescription). These papers are laid before Parliament. ↩

2. A Position Paper is a Council report which details a review of a topic that did not result in recommendations requiring legislative changes. These papers are deposited in House libraries. ↩

3. An Information Note is a short summary of an IIAC review which did not result in recommendations requiring legislative changes and where the evidence base is still emerging and may be liable to change, or where there was insufficient evidence to warrant a Position Paper. ↩