In May 2014, the Industrial Injuries Advisory Council (IIAC) published a command paper in which recommendations were made to add Dupuytren’s contracture, due to hand-transmitted vibration, to the list of prescribed diseases. The recommendation was to prescribe Dupuytren’s when severe enough to involve fixed flexion deformity and following exposure of at least 10 years in aggregate to the tools and activities presently scheduled in relation to Prescribed Disease A12(a) (carpal tunnel syndrome).

DiseaseOccupation
Dupuytren’s contracture resulting in fixed flexion deformity of one or more digitsAny occupation involving the use of hand-held powered tools whose internal parts vibrate so as to transmit that vibration to the hand, but excluding those tools which are solely powered by hand, where the use of those tools amounts to a period or periods in aggregate of at least 10 years and where, within that period or those periods, the use of those tools amounts to at least 2 hours per day for 3 or more days per week and where the onset of the disease fell within the period or periods of use specified in this paragraph.

The IIAC proposed that cases affecting only the palm with no involvement of the fingers should be excluded from prescription.

In 2019, the Department for Work and Pensions (DWP) requested that the 2014 command paper be reviewed by the IIAC to ensure that it accurately reflected the IIAC’s intentions to only prescribe the more disabling conditions.

The IIAC subsequently reviewed the 2014 paper and agreed that the terminology needed to be more robust, so recently revised the recommendation of the wording of the prescription as set out below.

DiseaseOccupation
A. 15 Dupuytren’s contracture of the hand involving:

(i) fixed flexion deformity of one or more metacarpophalangeal joints greater than 45 degrees that developed during the period or periods set out in the second column in relation to this paragraph; or

(ii) fixed flexion deformity of one or more interphalangeal joints that developed during the period or periods set out in the second column in relation to this paragraph; or

(iii) fixed flexion deformity of one or more metacarpophalangeal joints greater than 45 degrees that developed after the period or periods in the second column in relation to this paragraph if there is evidence of the onset of metacarpophalangeal joint involvement or palmar changes (nodules or thickening) during that period or periods; or

(iv) fixed flexion deformity of one or more interphalangeal joints that developed after the period or periods set out in the second column in relation to this paragraph if there is evidence of the onset of metacarpophalangeal joint involvement or palmar changes (nodules or thickening) during that period or periods		Any occupation involving the use of hand-held powered tools whose internal parts vibrate so as to transmit that vibration to the hand (but excluding those tools which are solely powered by hand) where:

(a) the use of those tools amounts to a period or periods in aggregate of at least 10 years; and

(b) within that period or those periods, the use of those tools amounts to at least 2 hours per day for 3 or more days per week

The IIAC hopes that this clarification will help to reduce the number of claims from workers who have the less disabling features of Dupuytren’s contracture.

A link to the independent report, “Dupuytren’s contracture: clarification of intention and amendment of the prescription”, updated on 14 April 2023, can be found here.

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