COMMUNICATION FROM THE COMMISSION CONCERNING THE EUROPEAN SCHEDULE OF OCCUPATIONAL DISEASES
Date: 1996-09-20
Institutions: European Commission
Subjects: data collection, indemnification, information analysis, occupational disease, public health

COMMISSION OF THE EUROPEAN COMMUNITIES 

Brussels,  20.09.1996 
COM(96) 454 final 

COMMUNICATION  FROM THE COMMISSION 

CONCERNING 
THE EUROPEAN  SCHEDULE OF 

OCCUPATIONAL  DISEASES 

INTRODUCTION 

On  22  May  1990,  the  Commission  of  the  European  Communities  adopted  a 
recommendation  concerning  the  adoption  of  a  European  schedule  of  occupational 
diseases,  which  updated  a  recommendation  of  23 July  1962  on  the  same  subject.  The 
Member  States  were  requested,  inter  alia,  to  inform  the  Commission  of  the  measures 
taken or envisaged  in response to the recommendation. 

On the basis of this information,  the Commission  is to examine the extent to which the 
recommendation  has  been  implemented  in  the  Member  States,  in  order  to  determine 
whether there is a need for  binding legislation. 

SCOPE 

As regards pathological  conditions affecting  workers, a distinction  can be made between 
diseases attributable to the occupation, ailments which are aggravated by the work or are 
more prevalent because of the working conditions (work-related diseases), and conditions 
which are in no way  linked to the work. 

Occupational  diseases comprise all pathological  conditions induced  by prolonged  work, 
e.g.  through  excessive  effort  or exposure to harmful  agents inherent  in work materials, 
work equipment or the working environment. They are essentially  defined  by etiological 
characteristics,  i.e.  the  slow-acting  cause  (as  opposed  to  accidents,  where  the  cause  is 
instantaneous), and not by nosological  characteristics, which  are, for the most part, non 
specific. 

There  are  diseases  which,  by  and  large,  affect  only  workers,  and  there  are  conditions 
which  have  a  low  incidence  among  the  general  public.  Such  diseases  can  be  clearly 
linked  to  an  occupation  or  to  specific  occupational  exposure.  However,  there  are  also 
diseases whose incidence  is  high within  a given  population,  such  as chronic  bronchitis 
in areas with  heavy  atmospheric pollution,  in respect of which  it is difficult  to establish 
whether the cause and effect  are linked to the occupational  activity. 

It is possible to identify  a specific  cause of  certain  diseases,  whereas  others  are due to  a 

number of harmful  factors.  Moreover,  there are ailments which  are caused  by  etiological 

factors  inherent  in  the  circumstances  in which  work  is  carried  out,  such  as  bad  posture, 

repetitive  physical  effort  or  mental  stress,  and  which  could  therefore  justifiably  be 

recognised  as  occupational  diseases. 

It  is  clear  that  the  effects  and  consequences  of  occupational  diseases  in  the  European 

Communities  are  very  important,  not  only  in  economic  terms  but  also  in  terms  of  the 

associated  human  suffering. 

From the economic point of view, several  countries have carried  out analyses of the costs 

occasioned  by  occupational  diseases,  revealing  that the  sums involved  are very  high  and 

that they  impinge  on the persons concerned,  on  businesses  and  social  protection  systems 

and,  consequently,  on  society  as  a whole. 

COMMUNITY  MEASURES 

The  Commission  has  adopted  three  recommendations  to  the Member  States  concerning 

occupational  diseases,  the  first  of  which  appeared  in  1962. 

1. 

On  23  July  1962,  the  Commission  adopted  a  recommendation  to  the  Member 
States concerning the adoption  of  a European  schedule  of  occupational  diseases.1 

With  regard  to  occupational  diseases,  as  stated  in  the  explanatory  memorandum 

to the  recommendation,  the  Member  States  were to  adopt  in  their  legislation  the 

"list"  system  whereby  a limited  list  of  diseases  recognised  as being  occupational 

in  origin  is  drawn  up. 

The  lists  of  diseases  laid  down  in  the  legislation  of  the  Member  States  differed 

for  various  reasons:  nomenclature,  conditions  for  applying  assistance,  etc. 

It  was  considered  in  the  recommendation  that  this  diversity  may  give  rise  to 

significant  differences  in  the  guarantees  afforded  to  workers  not  only  in  respect 

of  the  prevention  of  occupational  diseases  but  also  as  regards  the  granting  of 

compensation. 

J.O.C.E  ref.  2188/62  of  31.08.1962 

2 

The recommendation concluded that it would thus seem advisable for the Member 

States to  adopt  a uniform  European  schedule  of  diseases  or causative agents. 

Detailed  analysis  of  the  national  lists  has  shown  that  it  is  possible  to  bring 
together within  a single  schedule,  on the basis of classification  according to their 
nature,  diseases  or agents  appearing  in  one  or more national  lists. 

Accordingly,  the Commission  recommended,  inter alia,  that the Member States: 

a) 

introduce  into  their  laws,  regulations  and  administrative  provisions  on 

occupational  diseases 

the  European 

schedule 

[annexed 

to 

the 

recommendation] as a list of occupational  diseases for which compensation 

is  payable  under  their  legislation,  supplementing  for  that  purpose  their 

national  schedule  or  their  tables  of  occupational  diseases  for  which 

compensation  is payable; 

b) 

in  addition,  introduce  into  their  laws,  regulations  and  administrative 

provisions  a right to  compensation  under  the  legislation  on  occupational 

diseases, where adequate proof is provided by the worker concerned that, 

by reason of his work, he has contracted an illness which  does not appear 

in the national  schedule. 

2. 

On  27  July  1966,  the  Commission  adopted  a  recommendation  (66/464/EEC) 

addressed to the Member  States,  concerning medical  checks  on workers  exposed 
to  particular risks.2 

The  fourth  part  of  the  explanatory  memorandum  points  to  the  advisability  of 

taking the European schedule of occupational  diseases as the basis for a European 

schedule  of  specific  risks  entailing  the  obligation  to  conduct  periodic  medical 

surveillance  of workers; it was also felt  that medical  checks  should  be  extended 

to  potential  risks  referred  to  in  the  annexed  schedule,  mainly  with  a  view  to 

collecting  useful  information. 

J.O.C.E  ref.  2753/66  of  17.08.1966 

3 

3. 

In 1990, the Commission decided to update the European schedule of occupational 

diseases,  for the following  reasons: 

In  the  intervening  period  since  the  adoption  of  the  1962  and  1966 

recommendations,  each  Member  State's  schedule  of  the  different 

occupational  diseases  carrying  entitlement  to  compensation  had  been 

subject to change. 

This was due to a number of factors,  such as technical  developments,  the 

appearance of new substances, different  activities and more varied stresses 

at the workplace. 

The  number  of  diseases  deemed  to  be  occupational  in  nature,  i.e.  for 

which  there  is  every  reason  to  believe  that  they  are  closely  linked  to 
certain  activities,  but  which  have  yet  to  be  recognised  by  the  Member 

States  as carrying  entitlement  to  compensation,  is  in  a continual  state  of 

flux. 

The Commission's considered opinion was that a recommendation be used 

as the legal  instrument  for the update. 

Having  regard  to the fact  that the  schedule  concerns  diseases  liable  for  compensation  -

being  a  matter  for  the  Member  States  -  the  Commission  chose  as  the  appropriate 

instrument a recommendation  (90/326/EEC)  of 22 May  1990 concerning  the adoption  of 
a  European  schedule  of  occupational  diseases3.  It  recommends  that the  Member  States 
introduce,  as  soon  as  possible,  into  their  national  laws,  regulations  or  administrative 

provisions  concerning  scientifically  recognised  occupational  diseases 

liable 

for 

compensation  and subject to preventive  measures,  the European  schedule  in  Annex  I. 

The recommendation  also includes,  in Annex  II,  an additional  list  of  diseases  suspected 

of being occupational  in origin which would be subject to notification  and which may be 

considered  at a later stage for  inclusion  in  Annex  I to the European  schedule. 

J.O.C.E  n* L  160  of  26.06.1990,  p.  39 

4 

In this connection, it is recommended  that the Member  States take steps to introduce into 

their  national  laws,  regulations  or  administrative  provisions  the  right  of  workers  to 

compensation  in  respect  of  occupational  diseases  if  the  worker  is  suffering  from  an 

ailment  which  is  not  listed  in  Annex  I  but  which  can  be  proved  to  be  occupational  in 

origin  and  nature,  particularly  if  the  ailment  is  listed  in  Annex  II. 

The  Member  States  are  therefore  urged  to  ensure  as  far  as  possible  that  all  cases  of 

occupational  disease  are  reported,  to  develop  and  improve  the  various  preventive 

measures  for  occupational  diseases,  to  circulate  notices  on  the  occupational  diseases  in 

their  national  list,  to  provide  adequate  training  for  the  personnel  responsible  for 

implementing  the national  provisions resulting  from  the recommendation,  to  introduce a 

system  for  the collection  of information  or data  concerning the epidemiology  of  diseases 

of  an  occupational  nature,  and  to  promote  research  in  the  field  of  ailments  linked  to  an 

occupational  activity. 

The  recommendation  does  not  apply  to  diseases  which  are  not  recognised  as  being 

occupational  in  origin.  It  is  for  the  Member  States  themselves  to  determine  the  criteria 

for  recognising  each  occupational  disease  in  accordance  with  their  current  national  laws 

or  practices. 

It is necessary to point out that, even though a recommendation  does not in principle have 

any  binding  effect, 
in  Case  C-322/88  Salvatore  Grimaldi  v  Fonds  des  Maladies 
Professionnelles  de  Belgique4,  the  Court  of  Justice  of  the  European  Communities  has 
ruled  : 

"In  the  light  of  the  fifth  paragraph  of  Article  189  of  the  EEC  Treaty,  the  Commission 

recommendation  of  23  July  1962  concerning  the  adoption  of  a  European  schedule  of 

occupational  diseases  and  Commission  recommendation  66/462  of  20  July  1966  on  the 

conditions  for  granting  compensation  to  persons  suffering  from  occupational  diseases 

cannot  in themselves  confer  rights  on  individuals  upon  which  the  latter  may  rely  before 

national  courts. However,  national  courts  are bound  to take those  recommendations  into 

consideration  in  order  to  decide disputes  submitted  to them,  in  particular  where  they  are 

capable  of  casting  light  on  the  interpretation  of  other  provisions  of  national  or 

Community  law." 

Ruled  on  13.12.1989,  Rec.  1989,  p.  4407 

5 

FOLLOW-UP TO THE  1990 RECOMMENDATION 

Since  the  adoption  of  its  recommendation  of  22  March  1990,  the  Commission  has 
monitored  the  extent  to  which  it  has  been  implemented  in  the  Member  States;  in  the 
course of various meetings with Member State representatives to discuss and evaluate the 
various  aspects  of  the  recommendation,  it  has  been  established  that  the  occupational 
diseases listed in Annex I are already, for the most part, covered by the Member States' 
provisions granting  entitlement  to  compensation  through  the cause  of the disease,  even 
though the underlying  circumstances may be found  to differ  greatly. 

Moreover,  there  are diseases in respect  of which  the epidemiological  data collected  on 
an ongoing basis indicate significant  links with exposure to certain agents and substances 
present in  specific  working environments. 

Bearing in mind that additional research will be needed to demonstrate these causal links, 
it may be possible to consider, in a few years' time, the inclusion in  Annex I of certain 
diseases  suspected  of  being  occupational  in  origin  which  are  currently  contained  in 
Annex II  to  the  recommendation,  following  in-depth  analysis  of  available  data  in 
cooperation  with the Member States. 

Moreover, with a view to making it easier for the Member States to establish the criteria 
for recognising each of the occupational  diseases described in Annex I, the Commission 
published,  in  1994, "Explanatory  notes for the diagnosis of occupational  diseases". 

These notes are derived  from  the  "Medical  information  notices  on  diseases included  in 
the European schedule of occupational diseases" published by the European Commission 
in  1963 following  the adoption  of the  1962 initial  recommendation. 

The explanatory  notes for the diagnosis of occupational  diseases provide information  on 
the causal links between diseases and exposure at the workplace; they describe the toxic 
effects  of  certain  agents  and  include  an  analysis  of  exposure  criteria  which  may 
determine,  inter alia, the acute or chronic nature of the ailment. 

These  documents  constitute  a  source  of  information  for  interested  parties  (physicians, 

industrial  hygienists,  social  partners,  national  administrations,  etc.),  since  it  is clear  that 

methods of identifying,  recognising and providing compensation for occupational  diseases 

in  the  different  Member  States  are  still  far  from  uniform. 

The Commission  started to look into ways of resolving this problem  in  1991, with a view 

to  establishing  a  suitable  methodology  for  the  comparable  collection  of  statistical  data. 

A report  on  the  subject  was  drawn  up  by  a  group  of  experts  in  1994,  in  the  wake  of  a 

survey  of  existing  systems  in  the  Member  States  relating  to  occupational  diseases 

included  in  Annexes  I  and  II  to  the  recommendation.  This  report  also  contained  a 

proposal  for  the  compilation  of  harmonised  Community  statistics  geared  to the  adoption 

of measures to prevent  occupational  diseases, taking account  of the views of the Member 

States,  with  the  latter  having  been  actively  involved  in  drawing  up  the  proposal. 

Following this work,  in January  1995, the Commission  launched  a pilot project  aimed  at 

achieving  comparability  of  data  on  occupational  diseases  recognised  in  the  Member 

States. 

The first phase of this pilot project  entails the collection  of data on all  instances in  which 

the  31  most  representative  items  in  Annex  I  to  the  European  schedule  of  occupational 

diseases  were  recognised  during  1995. 

Having regard to the different  systems of recognition  in the Member  States, provision  has 

also been  made  for  a  project  to  evaluate  the  results,  in  order  to  verify  whether  the  said 

results  are truly  comparable  from  the epidemiological  and  statistical  points  of view;  this 

project  will  be  started  in  the  second  half  of  1996. 

Furthermore,  the Commission  had,  in  previous years, given thought  to the availability  of 

sufficient  epidemiological  data  which  could  be  used  in  certain  cases  to  identify  the 

cause/effect  relationship in respect of harmful  agents responsible for causing  occupational 

diseases. 

The Commission was also aware of the difficulties  encountered in obtaining reliable data 
and of the restricted  availability  of such data. 

Subsequently,  in  September  1995,  the  Commission  entered  into  a  contract  with  a 
university institute to develop a project aimed at analysing the bases for future  "codes of 
practice"  and  recommendations  to  harmonise  the  collection  of  data  on  occupational 
diseases, and also to put forward  recommendations concerning the type and quantity  of 
data to be collected  for  epidemiological  research into occupational  diseases. 

The results of this project  will  be known  at the end of  1997 and are expected to prove 
extremely useful  for establishing a more reliable methodology geared to determining the 
links between  cause and  effect  in  respect  of  certain  agents  and diseases,  which  are not 
yet properly  understood. 

CURRENT SITUATION IN THE MEMBER STATES 

in 

the  Member  States  concerning 

The  situation 
the 
recommendation,  as  described  in  Annex  III  to  the  recommendation,  has  not  changed 
substantially  in general terms. 

implementation  of 

the 

It has to be borne in mind, though, that in  1990 some Member  States (e.g. Belgium and 
Italy) were in the process of amending their provisions in this field, and that on 1  January 
1995  the  European  Community  was  enlarged  to  take  in  three  new  Member  States 
(Austria, Finland  and  Sweden); the  latter  countries  are still  in the transitional  phase of 
bringing their legislation  into line with the Community texts. 

A further point to consider is that there has probably not yet been enough time, since the 
adoption  of the  1990 recommendation,  either for  far-reaching  legislative  changes to be 
implemented in the Member States in an area which affects national systems of protection 
and  social  security,  or for  highly  innovative  data deriving from  technical  and  scientific 
progress to be obtained. 

Moreover, the possible inclusion in Annex I of certain diseases listed in Annex II, which 

are suspected of being occupational  in origin, will  have to be discussed in detail with the 

Member States, having regard to new data which could establish a definitive link between 

cause and  effect. 

CONCLUSIONS 

In the light  of the foregoing,  the Commission  considers that: 

- 

the Member States have made a great effort to comply with the provisions set out 

in Annex  I to the  recommendation; 

the  incorporation  in  Annex  I  of  certain  diseases  currently  included  in  Annex II 

calls for  subsequent  in-depth  analysis,  which  could be carried out in  conjunction 

with  revision  of  the  Annexes  to  the  recommendation  in  the  light  of  new 

knowledge  deriving from  technical  and scientific  progress,  having regard also to 

the changing  situation  in the Member States; 

- 

the  "Explanatory  notes  for  the  diagnosis  of  occupational  diseases"  may  prove 

useful  in  helping the Member  States to  apply the recommendation  uniformly; 

in statistical  terms, the results of the pilot project on the 31  occupational  diseases 

from  Annex  I  could  pave  the  way  for  establishing  a  methodology  to  obtain 

comparable,  more  reliable  data 

in  this  field  throughout  the  European 

Communities; 

- 

it  is  necessary  for  the  Member  States  to  set  about  creating  a  system  for  the 

collection  of  epidemiological  information  on diseases  of  an occupational  nature; 

the results  of  the project  launched  by  the Commission  may  assist  them  in this; 

- 

the  mixed  system  of  compensation  could  be  introduced  on  a wider  scale  in  the 

Member States, allowing, in certain cases, for compensation in respect of diseases 

which  are  occupational  in  origin  but  are  not  included  in  the  national  schedule, 

where the worker concerned provides evidence that the ailment is occupational  in 

origin;  this  could  be  a  very  positive  development,  making  it  possible  in  the 

medium  or  long  term  to  move  away  from  the  current  approach  involving  a 

specific  list  of  occupational  diseases for  which  compensation  is  available. 

Consequently,  it may be concluded that: 

- 

the  Commission  does  not  consider  it  necessary,  at  the  present  time,  to  propose 

binding legislation  to replace the  1990 recommendation,  since  such  a step would 

appear to  be  premature.  It  may  nevertheless  give  consideration  to  the  matter  in 

conjunction  with  any  future  update  of  the  European  schedule  of  occupational 

diseases  before  the  year  2000,  in  the  light  of  data  deriving  from  scientific  and 

technical  progress,  and  having  regard  also  to  the  results  of  the  various  above-

mentioned  activities  and  projects  aimed  at  improving,  among  other  things,  the 

collection  and  comparability  of  data  concerning  occupational  diseases  and their 

epidemiological  analysis. 

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ISSN 0254-1475 

COM(96) 454 final 

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