No C 307/28 Official Journal of the European Communities 19. 11. 84 
13. As regards further negotiations between Yugoslavia and the Community, and in the 
context of the decisions to be taken by the Cooperation Council, the Committee would 
urge: 
— that preference be given to a Community approach rather than a bilateral approach for 
transport questions concerning Yugoslavia and the Member States of the Community, 
— social provisions which will extensively guarantee the social security rights of Yugoslav 
citizens working in the Community (special measures for Yugoslav workers wishing to 
return to their native land could be discussed), 
— joint EC-Yugoslav measures on the environment, 
— closer technical and financial cooperation in all other areas of common interest, 
— special provisions to involve economic and social interest groups in the implementation of 
the Cooperation Agreement, 
— that account be taken of the special economic and social characteristics of the frontier 
regions (above all, monetary and administrative measures which could have adverse effects 
on economic relations, particularly trade, between these regions should be avoided). 
Done at Brussels, 27 September 1984. 
The Chairman 
of the Economic and Social Committee 
Francois CEYRAC 
Opinion on occupational medicine 
(84/C 307/11) 
A. LEGAL BASIS FOR THE OPINION 
On 26/27 October 1983 the Economic and Social Committee, acting under the fourth 
paragraph of Article 20 of its Rules of Procedure, decided to draw up an opinion on 
occupational medicine. 
Procedure 
The Section for Social Questions, which was responsible for preparing the Committee's work 
on the subject, adopted its opinion on 13 September 1984, in the light of the report by 
Mr Mourgues. 
B. OPINION OF THE ECONOMIC AND SOCIAL COMMITTEE 
At its 219th plenary session (meeting of 27 September 1984) the Economic and Social 
Committee adopted the following opinion by 75 votes to eight, with two abstentions. 
1. Introduction 
1.1. This own-initiative opinion on occupational 
medicine reflects the Committee's permanent concern to 
work for better health protection and safety for workers 
at the workplace. This concern was also recently voiced by the Committee 
in its opinion on the Second Action Programme of the 
European Communities on Safety and Health at 
Work(1). 
(>) OJ No C 176, 4. 7. 1983. 
19. 11. 84 Official Journal of the European Communities No C 307/29 
1.2. Industrial accidents and work-related diseases 
are a scourge both in terms of their frequency and their 
seriousness. Some risks have undoubtedly been limited or 
eliminated as a result of technical progress and 
newly-acquired knowledge, but the introduction of new 
products and processes occasionally gives rise to new 
hazards and new ailments. 
Whatever the technical progress made, it is still essential 
in the interests oi both workers and the population as a 
whole to continually work for improvements in working 
conditions and methods of production. Preventive action 
to obviate risks and health hazards in undertakings also 
plays a part in improving the protection of the 
environment as a whole. 
1.3. The whole of society has to bear the burden of 
industrial accidents and work-related diseases. The 
workers concerned suffer physically, psychologically and 
financially; undertakings have to bear the cost of halts in 
production, repair work and the absence and replacement 
of sick and injured workers whilst also having to pay 
compensation; and society as a whole has to contribute 
to compensation schemes. Industrial accidents and 
work-related diseases represent a waste of human and 
material resources that needs to be combated. 
1.4. The Committee has on many occasions in the 
past supported Community initiatives to improve 
knowledge about health risks, provide workers with 
better protection against certain harmful agents, and 
develop preventive action and measures. The Committee 
likewise recognizes that occupational medicine has for 
many years been a major preoccupation of international 
organizations such as the Council of Europe (Committee 
of Ministers Resolution (72) 5 of 18 February 1972 on the 
harmonization of measures to protect the health of 
workers in places of employment), the International 
Labour Organization (ILO) and the European 
Community itself (EEC Commission recommendation of 
20 July 1962 on occupational medicine within 
the enterprise {Official Journal of the European 
Communities of 31 August 1962, p. 2181/62)). 
1.5. The Committee also considers that in 
undertakings where it has been introduced, occupational 
medicine has made a major contribution towards 
improving health protection and safety. This essential 
function of occupational medicine is recognized to a 
greater or lesser extent in the legislation of most countries 
of the European Community. 2. Need for Community action in the field of 
occupational medicine 
Given the importance of the role played by occupational 
medicine in improving health protection and safety at 
work, it is essential to ensure that all workers in all private 
and public-sector industries (including agriculture) are 
covered by occupational health services regardless of the 
size of the undertaking in which they work. Coverage for 
all workers is in the general interest. Hence the eagerness 
of the Committee to see the adoption of a Community 
Directive on occupational medicine. Such an instrument 
would secure occupational health coverage of workers on 
a general scale and would at the same time be consistent 
with action already taken by the Community in the field. 
A Community Directive would have to lay down various 
principles governing the role and organization of 
occupational medicine and would have to take due 
account of the tasks that could fall to the public 
authorities. 
3. Definition of occupational medicine 
The Committee subscribes to the following definition of 
occupational medicine: 
'Occupational medicine deals with the effects of work on 
health and with the effects of disease on capacity for 
work. Its function is to prevent the impairment of 
workers' health that could be caused by working 
conditions (this includes accident prevention) and to 
guarantee individual workers' jobs in keeping with their 
physiological and psychological aptitudes.' (Definition 
drawn up by the Advisory Committee on Medical 
Training attached to the Commission of the European 
Communities.) 
4. Role of occupational medicine 
4.1. The Committee considers that the primary aim 
of occupational health services is to contribute to the 
prevention of work-related diseases and accidents at 
work, as well as the prevention of all occupational 
risks. 
The curative role of occupational health services must be 
confined to emergency treatment at the workplace in the 
event of accidents or sudden illness. 
The preventive role of occupational health services 
implies action to improve working conditions and work 
organization so that these are geared as far as possible to 
No C 307/30 Official Journal of the European Communities 19. 11. 84 
the needs of the worker and so that the worker's health 
and safety are not jeopardized. Occupational health 
services must keep a close watch on all aspects of working 
and production conditions to ensure that they do not 
cause workers any physical or psychological harm. 
If preventive action is to be effective, occupational health 
services will not only have to work to improve existing 
working conditions but will also have to be consulted 
when new technologies are introduced or when new 
equipment or new types of work organization are 
envisaged. Any action must be taken before the changes 
are introduced and at a time when it is still possible to take 
account of the experience and knowledge of the 
occupational health services. The preventive role of 
occupational medicine requires a regular presence at the 
workplace. 
4.2. For this purpose occupational medicine must be 
able to call on the human and technical resources needed 
to: 
— detect occupational risks and track down health 
hazards, 
— collect data and carry out epidemiological surveys, 
— tackle working conditions as soon as premonitory 
signs or the first symptoms of disease manifest 
themselves, or as soon as signs of danger appear, 
— exchange information and experience with other 
occupational health services and other bodies 
operating in the field of risk and accident 
prevention. 
Occupational health services must be able to carry out 
medical examinations if such examinations can 
supplement the preventive action of occupational 
medicine with a view to detecting risks and health 
hazards. Such examinations cannot, however, be the sole 
function of occupational medicine, which must also aim 
to adapt work and the workplace to the worker. Medical 
examinations must also make it possible for workers to be 
assigned tasks appropriate to their physiological and 
psychological make-up. The autonomy of occupational 
health services must be guaranteed in this connection. 
Confidentiality must not be used as a justification for 
impeding the communication of information about the 
occurrence of work-related diseases and industrial 
accidents for the purposes of epidemiological studies. The 
anonymity of the individuals concerned, however, must 
be preserved. 
4.3. Doctors who practise preventive occupational 
medicine on a part-time basis must not be barred from also practising curative medicine away from the 
workplace. 
5. Organization of occupational medicine 
5.1. The Committee urges that all workers in all 
sectors and all undertakings, whatever their size, 
be covered by occupational health services. The 
organization of occupational health services must 
nevertheless be geared to the size of the undertakings, as 
provided for in some Member States' legislation. All 
undertakings must have their own service, be affiliated to 
a group service covering several undertakings, or have a 
service of any other equivalent form or structure that will 
guarantee the effective coverage of all workers. 
The Committee considers that the preventive role of 
occupational health services necessitates a regular 
presence at the workplace. The attendance time must 
reflect the scale and frequency of the risks and must be 
long enough to allow the service to gain a real knowledge 
of working conditions and take proper action. The 
periods of attendance laid down in the legislation of 
various Member States must be sufficient to allow 
occupational health services to function effectively. 
Similarly, the financial, technical and human resources 
available are still all too often inadequate so that the 
services are unable to achieve the objectives laid down by 
law. 
5.2. Since preventive action must encompass all 
aspects of working conditions, occupational health 
services must be multi-disciplinary and employ specialists 
from different fields (physicians, ergonomists, safety 
specialists, chemists, toxicologists, etc.). Such persons 
must have received appropriate training. 
5.3. If they are to be effective, occupational health 
services must liaise closely with the other bodies operating 
in the field of health and safety at work (e.g. safety 
departments, factory inspectorates) whose task is also to 
prevent industrial accidents and work-related diseases. 
5.4. Occupational health services must also operate in 
liaison with those most directly affected by production 
methods and working conditions, viz. the workers these 
19. 11. 84 Official Journal of the European Communities No C 307/31 
services are designed to help protect, and the employers. 
Employers are directly responsible for working 
conditions and production methods and are able to 
contribute to the development of preventive action. 
Workers are in daily contact with working conditions, so 
their personal knowledge and experience can be drawn on 
to increase the effectiveness of preventive action. 
Workers and their representatives must be consulted on, 
and informed about, the organization and running of 
occupational health services. This must be done through 
the usual representative channels existing for workers in 
undertakings. 
Works hygiene and safety committees have an important 
role to play here in so far as the tasks incumbent on them 
with regard to working conditions make them the most 
appropriate bodies for ensuring that the occupational 
health services' preventive action improves the protection 
afforded to workers. 
Occupational health service staff must be appointed 
under conditions that safeguard their autonomy. Their 
appointment cannot therefore be left solely in the 
hands of the employer. The conditions governing 
appointments, remuneration and dismissal must be such 
that the staffs independence and autonomy of action 
is guaranteed in accordance with the ethical codes 
applicable to the medical and scientific professions. 
5.5. The cost of occupational health services must 
be borne directly or indirectly by the undertakings 
themselves. 
Preventive action has already achieved very satisfactory 
results in a number of undertakings. 
6. Role of the authorities 
6.1. It is the employers who are primarily responsible 
for working conditions, and hence for the organization of 
occupational health services to obviate risks, industrial 
accidents and work-related diseases. However, it is the 
authorities which have the task of enforcing statutory and 
administrative provisions on occupational medicine. 
Done at Brussels, 27 September 1984. 6.2. The authorities also have the task of ensuring 
coordination between occupational health services and 
public health services and must help to gather and 
circulate information and findings arising out of 
epidemiological studies. 
The authorities have a role to play in monitoring the 
health of workers who, after having been exposed to 
health hazards at the workplace, change employers or 
retire. Such health monitoring is necessary not only in the 
interests of the workers themselves but also for the 
purposes of acquiring knowledge of the long-term effects 
of exposure to certain harmful agents so that preventive 
action can be more effective and more to the point. 
The authorities must also ensure the organization of 
specialist training in occupational medicine, such 
training being geared to multidisciplinary action 
in undertakings to improve working conditions. 
Occupational medicine must be recognized as a specific 
discipline and specialized training must be given on top of 
basic medical training. Such training must keep abreast 
of changes in production technologies and work 
organization and this requires regular updating of 
knowledge. 
The authorities must also help to promote research in 
the fields of occupational medicine and working 
conditions. 
7. Conclusions 
The Committee would like to see the adoption of a 
Community Directive on occupational medicine based on 
the principles set out in this present opinion. 
It would also emphasize the need for Community-level 
harmonization of statistics on industrial accidents and 
work-related diseases in order to facilitate the exchange 
of information and data. 
The Committee would also like to see the Community 
work towards a convergence of training programmes and 
specialist diplomas in occupational medicine. 
The Chairman 
)/ the Economic and Social Committee 
Francis CEYRAC 
No C 307/32 Official Journal of the European Communities 19. 11. 84 
APPENDIX 
to the opinion of the Economic and Social Comittee 
Rejected amendments 
The following amendments, tabled in accordance with the Rules of Procedure, were rejected by the 
Committee during plenary session discussions: 
Title Page: 
Change title from 'occupational medicine' to 'occupational health services'. 
The term 'occupational medicine' should similarly be replaced throughout the paper, with two 
exceptions: 
Page 7 (4.3): 
Retain 'occupational medicine'. 
Page 12: 
The term 'occupational medicine' should be deleted only in 7.1. Elsewhere on page 12, the term 
'occupational medicine' should be retained. 
Reasons 
Broadly, the opinion is concerned with 'occupational health services' rather than 'occupational 
medicine'. 
Result of the Vote: 
Votes for: 6. Votes against: majority. Abstentions: 8. 
Page 4: 
In the third line of point 2, replace 'all workers . . . industries' by 'workers employed in hazardous work 
processes'. 
Reason 
Given the restricted resources available, it is unreasonable for purely administrative activities, etc. to tie up 
part of the occupational health service's resources at the expense of hazardous activities. 
Result of the Vote: 
Votes for: 4. Votes against: majority. Abstentions: 7. 
Page 4, point 2, sixth line: 
Delete 'Hence the eagerness of the Section . . . public authorities'. 
Reason 
There is no need for a Directive. Further the ILO will probably adopt a convention on occupational safety 
services in 1985. 
Result of the Vote: 
Votes for: 6. Votes against: majority. Abstentions: 9. 
19. 11. 84 Official Journal of the European Communities No C 307/33 
Page 7, point 4.2, fourth line: 
Delete 'which must also aim to adapt work and the workplace to the worker'. 
Reason 
The occupational health service cannot be the authority to determine the organization of the 
workplace. 
Result of the Vote: 
Votes for: 5. Votes against: majority. Abstentions: 7. 
Page 7, last two lines of first paragraph (second paragraph of 4.2): 
Delete last sentence ('The autonomy . . . connection'). 
Reason 
Occupational health services are an integral part of the firm, and cannot be autonomous. 
Result of the Vote: 
Votes for: 5. Votes against: majority. Abstentions: 7. 
Page 8 (5.1): 
Delete from 'The Section' to 'occupational health services'. 
Reason 
Resources should be channelled to where they are most needed. 
Result of the Vote: 
Votes for: 4. Votes against: majority. Abstentions: 7. 
Opinion on the proposal for a Twentieth Council Directive on the harmonization of the laws of 
the Member States relating to turnover taxes - common system of value added tax: 
derogations in connection with the special aids granted to certain farmers to compensate for the 
dismantlement of monetary compensatory amounts applying to certain agricultural 
products 
(84/C 307/12) 
A. LEGAL BASIS FOR THE OPINION 
On 25 July 1984 the Council decided to consult the Economic and Social Committee, under 
Article 100 of the Treaty establishing the European Economic Community, on the 
abovementioned proposal. 
Procedure 
The Economic and Social Committee appointed Mr De Bievre as rapporteur-general with the 
task of preparing its work on the subject.