6/5/2020 E-Library - Information At Your Fingertips: Printer Friendly For an occupational disease and the resulting disability or death to be compensable, all of the following conditions must be satisfied: 1. The seafarer’s work must involve the risks described herein; 2. The disease was contracted as a result of the seafarer’s exposure to the described risks; 3. The disease was contracted within a period of exposure and under such other factors necessary to contract it; and 4. There was no notorious negligence on the part of the seafarer.”[26] Here, it was shown that Gazzingan suffered recurring and intense chest and back pains associated with acute type-B aortic dissection during the term of his employment contract that led to his immediate medical repatriation to the Philippines. Upon arrival on August 5, 2006 and after medical evaluation at the Manila Doctor’s Hospital, Gazzingan was diagnosed by Dr. Cammayo to have dissecting aneurysm. Records also bear that he sought consultation and treatment at St. Paul Hospital in Tuguegarao City from September 13 to 14, 2006, whereby he was also found to be suffering from aortic aneurysm by Dr. George Ramos.[27] He then finally succumbed to death on January 30, 2008 because of ruptured dissecting aortic aneurysm. Aortic dissection, also called dissecting aneurysm,[28] is a potentially life-threatening condition in which there is bleeding into and along the wall of the aorta, the major artery leaving the heart.[29] The condition starts with a tear in the wall of the major artery carrying blood out of the heart and as the tear extends along the wall of the aorta, blood enters the aortic wall and “dissects” or separates the layers of the aorta from one another which leads to aortic rupture or decreased blood flow to the organs. [30] This can then result in heart attacks, strokes, paralysis, and renal failure among other medical conditions.[31] The ailment’s risk factors, which include but are not limited to aging, connective tissue and rare genetic disorders, atherosclerosis, inflammation, trauma, high blood pressure, heart surgery/procedures, and pregnancy, [32] do not seem to be direct causes of the disease, such that having one makes the chances of getting the condition higher but does not always lead to aortic dissection. [33] Thus, the exact cause of aortic dissection is still unknown and remains under investigation.[34] Nonetheless, the progression of this ailment is oftentimes caused by the increased stress in the aortic wall attributed to strenuous physical activities.[35] Patients are strongly advised to refrain from strenuous physical exertion and are often required to undertake lifestyle modification, such as change of occupation to sedentary jobs, in order to reduce the risk of enlargement of an already weakened aorta that might eventually lead to rupture, a fatal condition.[36] Gazzingan averred that his duties as a messman entailed work of an assistant chef steward which aggravated his health condition. Concomitantly, the Labor Arbiter opined that although the cause of the illness is unknown, there is probability that Gazzingan’s elibrary.judiciary.gov.ph/thebookshelf/showdocsfriendly/1/60638 7/14