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COMMISSION OFTHEEUROPEAN COMMUNITIES
COM<81)30final
Brussels,28th\tanuary1981
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MEMORANDUM
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FourthECSCmedicalresearchprogramme
Effectsonthehealthonworkersofphysicaland
otheroccupational factorsattheworkplace
COM(81)30final

MEMORANDUM
Fourth ECSG medical research programme
Effects onthehealth -ofworkers ofphysical andother
occupational factors attheworkplace
I. Introduction
II.Newguidelines andbroadening ofscope
III .Consulations with advisory committees
IV. Coordination ofwork
V. Justification andresearch topics
VI.Implementation oftheprogramme
VII •Financing andduration oftheprogramme
VIII .Conclusions
I. INTRODUCTION
Λ
Inaccordance with theprovisions ofArticle 55,§2oftheECSG Treaty
onthepromotion ofresearch ,further action isproposed inthefield
ofoccupational medicine .
Theprinciples behind thework proposed bytheCommission ofthe
European Communities ;andthemethods used toimplement itaresetout
inthepublication "TheHigh Authority 'sPolicy forthePromotion of
Studies andResearch onIndustrial Health ,Medicine andSafety "(+) .
(+)Office forOfficial Publications oftheEuropean Communities
Luxembourg ,1966

-2-
This programme isconcerned mainly with respiratory diseases .Ithas
been drawn upinsuch awaythat itreplies tothewishes ofthe
profession *concerned .TheCommission oftheEuropean Communities ia
aware that there exist other subjects inthefield ofoccupational
health that could have been included .Thus subjects such as
cardiovascular disease anditseffect onmanpower inthese industries ,
-skin disease ,anddiseases ofthevertebral-column arethemes which
arecertainly worthy ofcloser consideration ,andwhich could figure
inaprogramme ofaction based onpreparatory research included inthis
programme .
Thenewresearch programme isafollow-up work carried outduring the
past decade andalthough use ismade ofthescientific andpractical
information obtained ,anessential feature isthebroadening ofits
scope tocover ,inECSC undertakings ,physical andother occupational
factors attheworkplace andproblems associated with technological
developments inproduction ,processing andtheuseofproducts .
a)Basic research into chronic respiratory diseases andtheir aetio –
pathogenesis hasgradually been reduced over theyears toleave
more room forapplied research .Inthepast ,theemphasis hasbeen
ontheaetiop'athogenesis oftypes ofpneumoconiosis ,thecytocidal
properties ofsilica andtheeffects ofvarious qualities ofdust ;
recently research workers have turned their attention tothe
microbiology ofbronchial andpulmonary cells inanattempt to
discover treatments andcures andtoinvestigate efficient preventive
measures inassociation with early detection techniques .
From nowonbasic research must concentrate onthedevelopment of
preventive measures anddetection techniques .This will involve
biological andtherapeutic research into thebiological interactions

-3-
inthemucous membrao.es oftherespiratory tract ,and thereactions
andbiological defexs.ce mechanisms oftheindividual .
b)Respiratory function tests toestablish individual respiratory
capacity have been developed anddiversified considerably over the
past fewyears andthis hasmade itpossible torefine techniques
already tested anddevelop newmethods fortheearly detection of
minor orincipient changes inrespiratory function .
For thenext fewyears aspecial effort must bemade tostandardize
simple andreliable techniques forusebyoccupational physicians .
Occupational physicians must begiven tools which they canuseona
large scale with maximum reliability inorder todotheintensive
prevention work required intheiron ,andsteel industry and incoking
plants andcoal mines .
c)For assessment oftheextent ofthevarious diseases encountered in
theECSC industries andidentification oftheir causes ,epidemiology
hasproved tobetheessential scientific approach whereby medical
knowledge canbeadvanced ;ithelps -topin-point thecauses of
diseases andidentify thefactors responsible forthestrain and
discomfort associated with specific tasks . ';
Epidemiological research ,based oncarefully defined criteria ,must
gohand inhand with both basic biological research andthestudy
ofthe effects onthe individual inhis environment .The last two
programmes have included important investigations ofthis kind into
thefrequency andaetiology ofchronic bronchitis .Inthenext years ,
epidemiology will beextended toallnuisance factors intheECSC

-4-
industries andtheir individual effects ,andwhich could lead to
newperspectives ;theepidemiology ofdiseaia andaortal LeyInthe
ECSC industries will hedeveloped andcomparisons will bemade with
thestatistical data available onpopulations exposed ornotexposed
toother specific risks .
 
i
d)Inthis programme research isnolonger restricted tothespecific
problems oftherespiratory tract butcovers thechemical pollutants
andclimatic factors ofeach ,sector ofECSC industrial activity .
Inline with itssocial research policy ,theCommission hasmade a
point ofincluding asfaraspossible theresearch topics suggested
byproducers ,.workers andgovernment representatives ;occupational
physicians have also been involved inthepreparation ofthe
programme .Theintention istherefore tostudy new topics directly
connected with working conditions butfuture research projects will
nevertheless besubmitted toadvisory committees forassessment to
ensure that theprogramme issufficiently homogeneous toguarantee
maximum efficiency (+) .
Inorder toavoid toomuch ,diversification ofeffort and tomake the
best useoftheinformation obtained ,theprogramme isbased mainly
onthemost recent results ofmedical research .Thenewtopics reflect
technological developments andtheworking conditions associated
with ,these andmean that research ,intheyears tocome will bebroader
inscope .
' o
(+)Research projects which arerecognized asimportant foroccupational
medicine butarenot consistent with th6broad scope ofthis programme
maybeconsidered bytheCECeither forsubsidies under this programme ,
iffunds areavailable ,orthey maybejudged priority projects and
awarded special grants ,depending ontheopinion oftheadvisory
committees . .

-5-
11•NEW GUIDELINES AND BROADENING OFTHE SCOPE OFTHE PROGRAMME
-Inthelight ofthemost recent biological information ,thescope
ofexperimental andepidemiological •research needs tobeextended
toallharmful agents intheworking environment andindividual
sensitivity factors .These items must beinvestigated inmuch greater
detail through epidemiological surveys taking into account not only
identified andquantified agents butalso thecomplex physical ,
chemical and -ciimati'c factors which cancombine toproduce effects
which differ according toindividual receptivity andreaction .
.\
Special attention must begiven tocancers andparticularly totheir
early detection through research into thecarcinogenicity of
atmospheric pollutants intheECSC industries taking allrelated
pollutants andclimatic factors into accojunt .
Extending thisprogramme alsomeans developing asystem ofinformation
andtraining forallthose whoareresponsible forpreventive
medicine andthedetection ofoccupational diseases incoal mines ,
Λ
iron mines ,coking plants andiron andsteel works ,Theaim isto
improve themethods used byoccupational physicians andsafety
engineers forqualitative andquantitative assessment "ofharmful
agents inthese industrial branches .Investigation techniques
developed inlaboratories must beused formedical surveillance and
early detection ofanychange inhealth ,sothat thereliability of
thetests andmethods already used inpractice canbeassessed and
checked .Finally ,oneoftheobjectives ofthis programme isto
establish the orientations for future research .
-Where iron andsteel works andcoking plants areconcerned ,
epidemiological ,biological andfunctional research must take into
account alloperations which ,mayhave harmful effects onhealth and
payparticular attention tothespecific diseases found inblast
furnaces ,rolling mills andcoking plants asaresult oftheclimatic

1
-6-
conditions andtoxic substances peculiar tothese workplaces .This
means gearing research more specifically tothediseases which the
occupational physician islikely find intheiron andsteel works
andcoking plants .Chronic bronchitis ,because itissocommon ,will
still beacentral theme but works must also bedone onthe
identification oftoxic andcarcinogenic substances .
-The study ofchronic respiratory diseases incoal andiron miners
isofprime importance intheECSC industries .During this programme
themany projects conducted during thepast decade will befollowed
upmethodically andcarefully .Many problems remain tobesolved and
westill know very little about thecauses oftheoften premature
respiratory insufficiency from which miners buffer .
I
While respiratory function testing represents animportant step ,the
gaps inourknowledge oflung disease caused byvarious types ofdusts
must also bemade good through acoordinated study ofagents and
immunological effects ;another important question istheradiological
investigation ofpneumoconiosis .Finally ,aneffort should bemade
tofind outwhyyoung miners arelosing interest intheir work and
determine theunderlying causes ofthis psychological phenomenon and
itsconnection with working conditions .
o
o o
V

-7-
111 .CONSULTATIONS WITH ADVISORY COMMITTEES
TheECSC Consultative Committee will beconsulted about this programme
asstipulated inArticle 55,paragraph 2oftheECSC Treaty .
Lik6 theother research programmes launched since 1957 bytheEuropean
Coal andSteel Community ,this draft programme drawn upforthe
Commission oftheEuropean Communities bytheHealth andSafety
Directorate will besubmitted initially totheadvisory committees
working onsocial research foranopinion .
1 '  ' «
TheProducers andWorkers Committee onOccupational Safety and
Medicine and theCommittee ofGovernment Experts onOccupational
Medicine andRehabilitation andHuman Factors andErgonomics will be
consulted andthefinal programme will bebased ontheopinions of
these two committees ..
Thetopics andpriorities oftheprogramme therefore reflect the
concerns oftheoccupational milieux involved andtheneeds of
workers interms ofhealth ,preventive medicine andmedical
surveillance . ..
'I
Theobject isascientific andpractical approach tothediseases
associated with thespecific environment oftheECSC industries asa
result ofthe harmful substances inhaled and the effects ofclimatic
*
conditions andtheworking environment ;thescope must berestricted
inthis way toproduce acoherent programme andaconcerted effort
toensure maximum success .
Many topics associated with occupational medicine areofcourse
worthy oftheconsideration theprofessional organizations would
like them tohave andthere arestill alarge number ofproblems
outstanding .

-8-
Thescope ofthis programme isdetermined bytheresources and
admini«tr»tlve work which theCECcanprovide forthepromotion of
research inthis field atthemoment but this does not mean that
research which proves inthenext five years tobeurgent and
appropriate intheopinion oftheprofessional organizations andthe
CECwill notbeconsidered ,under anadministrative procedure designed
for thepurpose bytheCEC .
Theresearch must fulfil theneeds of -theworkers andimprove their
physical andpsychological working conditions .Itmust help to
improve preventive medicine ,early detection andtreatment of
occupational disease incoal mines ,coking plants andiron andsteel
works .
\
o
o o
< .
IV.COORDINATION OFWORK ,■
Work will becoordinated ,asonprevious occasions ,bythe
scientific committee setupfortheduration ofthe'programme bythe
departments oftheCommission oftheEuropean Communities responsible
forlaunching theprogramme andsupervising itover thenext five
years .
Inpractical terms ,theresearch iscoordinated bytheworking parties
setupatthebeginning oftheprogramme onthebasis ofthetopics
tobestudied .These meet twotothree times ayear . ' ,
Themembers ofthescientific committee forthis programme are
appointed bythedepartments oftheCommission oftheEuropean
Communities inconsultation with theProducers and Workers and the
Government Experts .Itsmembers must people experienced and
qualified inthevarious sectors concerned intheprogramme .-

-9-
V.JUSTIFICATION
H
-The first research programme ,onsilicosis andpneumoconiosis in
coalminers ,resulted ,inabetter knowledge ofthepathogenesis ,
radiological aspects ,complications aridfunctional repercussions of
these diseases .Functional spirography tests were standardized
throughout theMember States oftheCommunity .
-Thesecond programme focused onchronic bronchitis andemphysema ,
with mayaccompany peumoconios.is ordevelop independently andthe
socio-economic significance ofwhich iswell known .Basic research
was done into these problems .Astandardized questionnaire was
developed inthevarious Member States with aview tocarrying out
epidemiological surveys ofthese disorders .
-Thethird programme ,nowcoming toanend ,focused both on
pneumoconiosis andonchronic bronchitis andemphysema .Asregards
thelatter diseases ,theprogramme paid particular attention tothe
biological processes responsible fortriggering them .Promising
results were obtained concerning thevalue ofcertain newtechniques
which permit early detection andimproved treatment ofthese diseases .
Thecoal industry also launched aprogramme torehabilitate bronchitis
suffered intheinitial stages ofthedisease .Atthesame time work
onharmonizing andstandardizing respiratory function tests at
Community level wascontinued .
Progress wasmade onthestudy andepidemiological monitoring of
pneumoconiosis .Studies were also carried outonthepreventive
effects ofP2Q4 and aluminium salts .
o
o o

-10-
Atthevarious meetings ofthethree Working Parties -WPon
Physiopathology andRehabilitation ,WPonBasic Research andWPon
Epidemiology -which included representatives oftheoccupational
physicians in .thecoal andsteel industries inthevarious Community
countries ,itemerged that chronic respiratory diseases were still a
major cause ofmorbidity ,both among miners andamong workers incoking
plants andintheiron andsteel industry .Priority importance must
still beattached tostudies aimed atestablishing thelinks between
these diseases andcharacteristic workplace nuisances ,inparticular
exposure todust ,fume andgases ,along with theinfluence ofother
factors ,such astemperature ,humidity andaircurrents .vThese studies
should provide thenecessary data forsocial andpolitical programmes
toimprove the'environment andhealth ofthelabour force The
participants also acknowledge that other factors might beresponsible '
fordiseases inthetwosectors inquestion .Thus ,while research into
respiratory diseases should becontinued ,thefield ofstudy should be
extended toinclude other diseases ofworkers insteelworks ,coking
plants ,coal mines andiron mines .
o
o o
Research work ofthis ,kind calls for amultidisciplmary approach ,
involving biology ,epidemiology andrespiratory function analysis .
This threefold approach isindispensable forthedevelopment of
effective preventive measures andmethods oftreatment .
a)Studi esrelating tothehealtharidworking condition sofworkers in
coalmines andironmines A_incokingplantsand intheironand
steelsector
1.Inthe case ofthese studies one should bear inmind the extent
towhich biological research inrecent years hasimproved
knowledge ofdefence mechanisms andoftheways inwhich
individuals react toaerogenic aggressions .

-11-
Animal experiments and thestudy ofoccupationally-mduced
bielsgieal <Sls<?rdar »inwerkars h*v# prcvl4&d detailed inferaatien
onthefollowing aspects ;without aknowledge ofwhich adequate
preventive andtherapeutic measures cannot beimplemented :
-thenature and themodes ofaction oftheagents involved ;
-thegrowing importance ofindividual sensitivity factors inthe
production ofthese reactions . ~ ■
2.Moreover ,epidemiology should -make itpossible tostudy ,inthese
workers ,thelinks between exposure todust ,fume ,gases and .
climatic factors onthe one hand and health onthe other hand .
This should enable thepotential harmfulness of .recently-developed
mining techniques tobedetermined ,inparticular with respect
tochronic bronchitis .,emphysema andcancer .'
3.Asregards research into respiratory function ,thefollowing
points should bestressed :
-newCommunity studies arenecessary toevaluate techniques of
early diagnosis ,ofchronic bronchitis which canbeapplied at
theworkplace , - .
-at-thesame time theCommunity should encourage better
information andtraining fordoctors andparamedical ,staff
responsible forcarrying outthese tests ,
-finally ,there isaneed tostudy new andmore sophisticated
tests ,which cannot beapplied attheworkplace ,with aview
toassessing disability andtheresults oftreatment ;these
laboratory tests will also permit theassessment ofsimpler
tests usable attheworkplace .

-12-
b)Studies relating specifically toworkers intheIron and steel
sectorandincokingplants
1.Theepidemiological approach would seem tobeparticularly
•.important forthese workers forthree reasons :
-this approach enables therelevance ofchronic respiratory
diseases tooverall chronic disease inworkers xinthese sectors
tobedetermined ;
-this approach will also provide abetter understanding ofthe
health hazards associated with specific types ofwork inthese
industries ,inparticular thehazard ofbronchopulmonary cancer ;
themain areas involved arewelding operations ,work involving
exposure toiron dust atblast furnaces ,tographite dust
during pig-iron desulphurization ortooilaerosols during
cold-rolling ,andoperations carried outathigh temperatures ,
etc.; V,
-finally ,epidemiological studies areparticularly useful in
studying potentially toxic substances ,such aschrome ornickel
inparticular .
2.Biological andrespiratory function studies should also becarried
out inthis field ;these different techniques areindispensable
fordetermining anatomical andfunctional disorders induced by
thevarious factors referred toabove .
c)Research rela tingspecifical lytocoal andiron miners
1.Little isyetknown about thecauses oftherespiratory
insufficiency -sometimes premature -which isassociated with
characteristic jobs inthese sectors .These disabling disorders
seem tobelinked both topneumoconiosis andtoconventional
chronic bronchitis ,tobronchiolitis ,ortoother factors -in
particular vascular -yettobespecified .Studies inthis field

-13-
should draw simultaneously onepidemiological ,biological and
functional investigative techniques with aview toobtaining a
clearer picture ofthenature ofthese disorders ,determining
' /
howthey canbeprevented andtreated ,andspecifying theextent
towhich they should ,betaken into consideration forpurposes of
compensation . •
2.Incountries inwhich young people areagain entering themining
sector onefrequently hears thecomplaint that these young miners
abandon their trade atanearly age ;asthis situation maypartly
bedue totheenvironmental andatmospheric conditions ,oneremedy
might befound inimproved evaluation oftheir working conditions ,
inconjunction with astudy ofrespiratory function .
3.Therecent development ofpneumoconiosis intheECMembers States
again raises ,certain pathogenic problems which were thought tor
have beep ,solved ,notably asregards thecontribution ofdust ,
silica andvarious co-factors ,particularly ofanimmunological
nature ,totheproduction ofthese disorders .Inparticular ,
studies ,inthis field should help toexplain thecauses oflate
pneumoconiosis ,which seems :tobebecoming' particularly frequent
incertain areas oftheCommunity .These studies draw on
epidemiological andbiological techniques .Thereclassification
ofaffected workers isalso being considered . -
4.Finally ,therecent revision oftheILOinternational .
classification ofradiographs ofthepneumoconiosis hasleft a
number ofproblems unsolved .Inparticular ,there isaneed to
define model films whose purpose istodetermine thelimits
between various ,categories ofsimple pneumoconiosis .This is.a
basic problem ,thesolution ofwhich will facilitate comparison
oftheepidemiology ofpneumoconiosis andthus contribute toits
prevention inthedifferent Community Member States .
. X . • • O :
O o

-14-
Annex
fourth ECSC medical research prograaaaa
Effects onthehealth ofworkers ofphysical andother
occupational factors attheworkplace
a)Studi esrela tingtothehealth andworking conditions ofworkers incoal .
mines andironmines,incoking plant sand intheironandsteel sector
1.Research into thebiological processes ,including individual factors ,
responsible fortheappearance anddevelopment ofemphysema and
chronic bronchitis inthese workers .Application ofthis research
totheprevention and treatment ofthese diseases .
2.Standardization andimplementation ofworkplace tests conducted for
'theearly diagnosis ofchronic bronchitis andemphysema .
\
3.Evaluation oftechniques andoftheresults ofvarious preventive
andtherapeutic measures applied topersons suffering from respiratory
diseases intheir early stages .
4.Evaluation oftheresults offunction tests atrest andduring
exercise with aview todetermining working capacity ,inparticular
theresidual working capacity ofworkers with respiratory disorders ,
inthelight ofthephysiological requirements ofcertain workplaces .
5.Preparatory research into cardiovascular disease anditseffect on
manpower ,skin diseases anddiseases ofthevertebral column .
b)Studies relating specifical lytoworkers inthe ironandsteelsector
and incokingplant s
1-.Epidemiological studies ofthemain causes ofdisease anddeath in
theiron andsteel industry andincoking plants andofhowthey
correlate with working conditions (gases ,fume ,temperature ,humidity ,
aircurrents ,etc.).

2.Study andprevention ofthespecific health ,risks ,including the
risk ofbronchopulmonary cancer ,associated with certain
characteristic operations intheiron andsteel industry and in
coking plants ,such as (
A
-welding work ;
-work involving exposure toiron dust "atblast furnaces ;
-work involving exposure tographite dust during pig-iron
desulphurizatiofi ;
-work involving exposure tooilaerosols during cold-rolling ;
-work involving exposure tohigh ,temperatures ,etc .
3.Identification ofthehazards associated with potentially harmful
substances such asnickel ,chromium andother substances used in
alloys ,with aview todetermining whether existing threshold values
forexposure involve ahealth risk .
)Researchrelating specifically tocoal andiron miners
1.Study ofthecauses ofrespiratory insufficiency which isresponsible
fordisability (sometimes premature )incharacteristic jobs in
those sectors .Prevention and treatment .
2.Epidemiological studies ofthemain causes ofdisease anddeath in
coalminers andiron miners ,andtheir relationship with working
conditions (gases ,fume ,temperature ,humidity ,aircurrents etc.). .
3.Study ofthecontribution ofsilica ,other dusts ,andexogenous
andendogenous co-factors totheabnormally rapid appearance and
development ofsimple pneumoconiosis andmassive progressive
pneumoconiosis .Prevention ofsuch ,development .Reclassification of
affected workers .
4.Validation ,atCommunity level ,oftheILOinternational classifica­
tion ofradiographs ofthepneumoconiosis (revised in1980 )including
astudy ofthevalue ofmodel films illustrating thelimits between
thecategories .

-16-
VI..IMPLEMENTATION OFTHE PROGRAMME
TheCommittee ofScientific Experts advises theCommission ,ona
permanent basis ,onthescientific aspects ofthevarious research
projects forwhich financial aid isrequested .
Toimplement theprogramme ,theCECwill ,asonprevious occasions ,
call upon research institutes inthemember countries tohelp ,after
theCommission oftheEuropean Communities haspronounced onthis
Memorandum .
I .
Asthetopics ofthis programme cover more ground than those of
previous years ,alarger sicentific committee instituted atthe
beginning ofthenewprogramme will beasked tohelp theCommission
form opinions onscientific aspects oftheresearch projects .After
studying theprojects ,theProducers' andWorkers' Committee and
Committee ofGovernment Experts will beasked togive their opinions .
These opinions determine whether ornotfinancial aid istobe
awarded according tothespecific criteria oftheECSC industries .
During thework ,working parties chaired byCommission representatives
andassisted bythescientific committee will meet regularly and
distribute theinterim results toscientific andprofessional bodies ,
thus encouraging acontinuous exchange ofinformation between the
research institutes :and the circles concerned .
When theresearch programme hasbeen completed ,thescientific' committee
will help toarrange seminars andpublish theresults ;thevarious
research institutes which have received financial aidduring the
programme arerequired tomake their research findings available to
theCommission oftheEuropean Communities andthescientific committee
sothat these maybedistributed with aview topractical application .

17-
VII .-FINANCING AND DURATION OFTHE PROGRAMME
Itisestimated that implementation ofthefourth ECSC medical research
programme ontheEffects onthehealth ofworkers ofphysical and
other occupational factors attheworkplace will cost 9million ECU
over five years .This isbased onthefollowing :
1°)Theprogramme proposed isboth anextension ofthepreceding
programme (forwhich 5million ECUS were awarded forfour years )
andanexploration ofnew topics asshown in ,this Memorandum .
2°)Thescope ofresearch into preventive medicine andtheimprovement
ofworking conditions will goondeveloping inallthefields
covered bytheprogramme .
3°)Research costs have increased considerably inrecent years .This
means that theresearch projects submitted totheCommission of .
theEuropean Communities must becarefully selected .
Aconcerted effort must bemade ifpractical objectives are tobe
achieved through coordinated andefficient development .
/
With this financial aidtheresearch programme will cover ,inaddition
/
todirect aid totheinstitutes ,alladministrative costs arising
from :
.-scientific coordination andcooperation
–experts andresearch workers visits
-publication anddistribution ofreports
-bibliographical documentation ,etc. ...

-18-
Furthermore ,theinstitutes benefitting from financial aidcontribute
tothecost ofthere&eareh bymaking their ownresearch workers ,
scientific equipment andfinancial resources available tothe
Commission oftheEuropean Communities .
Inview ofallthese factors ,thebudget forthis research project
amounts toatotal of9million ECUforfive years .Asinthepast ,
Community aidrepresents only aportion ofthefunds necessary for
thevarious research projects .
o
o o
■ /
CONCLUSION
TheCommission oftheEuropean Communities : ,
V
–mview oftheneed toencourage medical research ,dealing with the
Effects onthehealth ofworkers ofphysical andother occupational
factors attheworkplace inECSC undertakings andtopromote research ,
projects toimprove health andwell-being inthese undertakings ;
–account being taken toofthefavourable opinion andapproval of
theProducers 1andWorkers' Committee andtheprofessional and
government representatives ;
x
–having regard toArticle 55oftheTreaty instituting theEuropean
Coal andSteel Community ;
–proposes anappropriation of9million ECUover five years forthe
implementation ofthefourth ECSC medical research programme onthe
Effects onthehealth ofworkers ofphysical andother occupational
factors attheworkplace inECSC undertakings .
\ ,
o
o o