CELEX: 51987DC0655
Language: en
Date: 1987-12-14 00:00:00
Title: COMMISSION MEMORANDUM, FIFTH ECSC MEDICAL RESEARCH PROGRAMME " PROTECTION OF WORKERS AGAINST RISKS ARISING FROM WORK IN THE COAL AND STEEL INDUSTRIES "

l^oC^Bo                              Official ]ournal of th^ European C^ornTnuniti^s                      1^.^.^
                                                              IT
                                               COMMISSION
                                             COMMISSION MEMORANDUM
                                  FIFTH ECSC MEDICAL RESEARCH PROGRAMME
              Protection of workers against risks arising froni work in the coal and steel industries'
                                                     ^COA^^^^^^
                                                     MEMORANDUM
        I INTRODUCTION                                                                                  B
        ^. NEED FOR THE PROPOSED PROGRAMME                                                              ^
        3 PROGRAMME                                                                                     ^
            3.L Occuoational cancels                                                                    ^
            3.^. Occupational hvooacusis                                                                ^
            3.3. OccuoationaMesoi^ato^v diseases                                                       10
            3.^. Occuoationaln^uscula^s^eletatcomolaints                                               10
            3.^. Diseases linked to e^oosu^e to certain chemicals                                      10
            3.D. Training and inforrnation of those involved in the industries                         tt
            3.^. Methods fo^ measuring ^vo^e^e^oosu^e                                                  It
        ^t. COORDINATION O F ^ O R ^                                                                   It
        ^. RESULTS OFTHE PROGRAMME                                                                     M
        6. FINANCIALASPECTS AND DURATION OFTHE PROGRAMME                                               t^
        B5 CONCLUSIONS                                                                                 t^
 ---pagebreak--- r^^                                   Official Journal of the European Communities                             l^ooe^BB
                       1. ^^rod^ctio^                            current work on chronic respiratory diseases is intended
                                                                 tofollowupthemany projects conductedunder earlier
Thefourth E^C^ medical researchprogrammeon the                   programmes methodically and carefully and to fill any
effects on the health of workers of physical and other           gaps in respiratory functiontesting.
occupational factors at the workplace, adopted pursuant
to Article^^ of theEC^C Treaty andpuhlishedinthe
C ^ c ^ ^ r ^ ^ ^ ^ r ^ ^ C A ^ ^                                A total of ^D research projects, most of them still in
of ^ ^o^remher t ^ t , has expired. The nine million             progress, ha^e received financial aid under the fourth
units of account made available were used up hy the end          programme. They were selected on the basis of how
of the programme.                                                likely they weretoproduceresultswithsomepractical
                                                                 application.
                                                                 ^ome^eryusefulprojects, althoughnot yet completed,
The fourth programme was a natural continuation of               ha^e already e^aminedthe following subjects^
earlier medical programmes dating hack to l^D,which
examined hasicprohlems such as the aetiopathogenesis
of pneumoconiosis, chronic bronchitis and emphysema              — the harmonization and standardization of lung tests,
andthe^arions aspects of respiratory physiopathology.
                                                                 — the evaluation of the health risk presented by the
                                                                     action of various metals ^chrome and nickel in
                                                                     particulars on iron and steel workers,
foefinite progress has heen made in the knowledge of the
respiratory diseases affecting iron^ore and coal miners
and steel workers,with particular attention heing paid to        — astudy of the cell populations of the deeplung and
pretention and early detection.                                      thebiologicalmechanismsin^ol^ed,usingthebron
                                                                     choalveolar lavage technique,
                                                                 — the influence of the temperature and humidity of the
The research being carried out under the fourth                      air breathed by workers exposed to climatic stress,
programme shows how the scope of the earlier
programmes has clearly been extended.                            — the early diagnosis and analysis of the development
                                                                     of the various types of respiratory disease, including
                                                                     astudy of bronchial hyperreactivity,
Respiratory diseases are notthe only diseases to strike          — the pretention of back pain in the mining industry,
workers in this sector and, in response to the wishes
expressed by those in^ol^ed in the industries and in ^iew
of the most recent biological discoveries, the                   — a study of the physical factors governing the
programme^se^perimentalandepidemiologicalresearch                    depositionof inhaledparticlesinthelungs,
has been extended to include all of the harmful agents in
the workers^ environment in these industries and indP
vidualfactorsrelatingtosensitivity. particular attention         — aspects of specific skin complaints in miners.
has thus been paid to cancers and the earlydetection of
cancer by research into the carcinogenic nature of atmoD
spheric pollutants in the E C ^ industries. The                  CBOne of the programmers major achievements was the
programme also now includes the development of an                updating of the E C ^ questionnaire on chronic bron
information and training system for all those responsible        chitis and pulmonary emphysema drawn up in t^DB. This
for the pretention and detection of occupational                 wasnecessary totake account of scientific progress, to
diseases, aimed at improving the methods used by occuD           make the questionnairemoremanageableandto ensure
pational physicians and safety engineers for the quali           comparableresults wereobtained.Thenew^ersionwill
tativ^e and quantitative evaluationofharmfulagents.              be useful in the fifth programme for obtaining truly
                                                                 comparable data fromthe^arious^iember states.
                                                                 Theresults of thefourthprogramme willbecollected,
^here iron and steel works and coking plants are                 assessed and combined, and will be made available to
concerned, epidemiological, biological and functional            interested parties atasymposiumdue to beheld during
research takes into account all operations which may              1 ^ . widespread circulation of the results will assist
ha^re harmful effects on health, paying particular               their implementation inthe industries concerned,one of
attentionto certain specific diseases.                           the aims of the fifth programme too.
 ---pagebreak--- No C 47/8                               Official Journal of the European Communities                                 19. 2. 88
           2. Need for the proposed programme                          apply likewise to the ECSC sector and which come
                                                                       under the broader framework of the Council Resol-
Despite the remarkable progress made during earlier                    utions on Community programmes on safety and
programmes and the wide scope of the fourth                            health at work,
programme, workers in the coal and steel industries are
still being exposed to major health hazards and even to
unforeseen risks arising from, for example, the intro-
duction of new processes and technologies and the use              — a Community action programme is being launched
of new chemicals.                                                      against cancer and contains a number of measures for
                                                                       the prevention of occupational cancer including
                                                                       defining and coordinating topics for practical
                                                                       research at the workplace.
Respiratory diseases are certainly still widespread in the
industries, but only certain specific aspects of pneumoco-
niosis, chronic bronchitis and emphysema require further
study. It is highly likely that when the research projects         Furthermore, an ILO recommendation and convention
initiated during the fourth programme are completed                on the organization of health services at work were
and evaluated, a huge quantity of information will                 adopted in 1985, reconsidering the question of how
become available and only in certain specific cases will           occupational medical services should be structured and
more detailed examination be needed. This is true in               funded. A detailed examination of the potential effects of
particular of the epidemiological projects, most of which          this proposal in the coal and steel industries would be
will be completed in 1987, which will provide new infor-           useful.
mation on the frequency and different types of respi-
ratory diseases in miners and iron and steel workers, and
in particular on the prevalence of the radiological and
respiratory    function     anomalies     associated    with       In view of the above and at the request of the industries
emphysema, and on the influence of smoking and                     concerned, it is proposed to introduce a fifth medical
various environmental factors.                                     research programme with the following objectives:
                                                                   (1) to respond to workers' needs by improving the
The results of the projects will then have to be put into               physical and psychological conditions in which they
practice in the prevention of disease in the industries.                work;
Likewise, the work carried out during the last two                 (2) to help protect the health of workers, including
programmes on standardizing respiratory function tests                  preventing all types of occupational disease;
should enable simple, reliable techniques to be
implemented at the workplace.
                                                                   (3) to help the ECSC industries to implement preventive
                                                                        measures and in particular to comply with
Only if the results can be incorporated into the short and              Community objectives, including EC Directives, in
medium-term preventive measures taken in the industries                 relation to health at the workplace;
concerned, will the respiratory element of the fourth
programme be successful.
                                                                   (4) to promote projects to use the results of earlier
                                                                        programmes to fulfil the objectives described above.
Furthermore, it is an accepted fact that other conditions
may be responsible for diseases in the two sectors in
question and that it is therefore necessary to take a
broader view of the diseases contracted by iron and steel                                 3. Programme
workers, coking plant workers and iron-ore and coal
miners. Examples include occupational cancers, which               An analysis of the proposals put forward by national
are very serious, and osteo-articular diseases which are           experts on the advisory committees and in the Working
very common.                                                       Party on Industrial Medical Services — Coal and Steel
                                                                   indicates that the fifth programme should concentrate
                                                                   mainly on priorities, but should not overlook certain
                                                                   lesser aspects about which the various bodies are
In this context it must be remembered that:
                                                                   concerned.
— there are certain Council Directives on the protection
     of workers against the risks of exposure to certain           In line with the resolution of the ECSC Consultative
     agents at the workplace, the provisions of which              Committee of 23 March 1984 (OJ N o C 114 of 28 April
 ---pagebreak--- 19. 2. 88                             Official Journal of the European Communities                              No C 47/9
1984, page 3), the projects involved in the research will             In view of the lack of reliable methods of measuring
be of specific practical value to the sectors concerned,              levels of past exposure, at epidemiological level
and will be initiated and directed by industrial medical              priority should be given to exploratory studies. A
officers or hospital and university doctors working in                prevalence of stomach cancer in miners and cancer
close contact with the industries concerned.                          of the lung and larynx in steel workers has been
                                                                      noted which merits specialized research.
                                                                      It must also be remembered that there has been
This will encourage the pooling of research at                        growing scientific speculation over a number of
Community level by giving priority to projects involving              years about the possible link between exposure to
cooperation between two or more Member States.                        silica dust and the occurrence of lung cancer; conse-
                                                                      quently it would seem necessary to provide for
                                                                      research in this field taking care to allow for the
                                                                      possibility that other carcinogenic substances may
In addition, care will be taken to ensure that projects are           also be present.
undertaken by a particular sector known to observe
Community standards relating to the environment,
health and industrial safety.                                         Looking at the problem generally, consideration
                                                                      should be given to promoting research in areas such
                                                                      as the early detection of cancer and the devel-
                                                                      opment of a system to educate and inform workers
                                                                      about recognized carcinogenic agents. Furthermore,
The particular subjects selected for the programme are as             it will be necessary to prepare morbidity and
follows.                                                               mortality statistics which are comparable at
                                                                       Community level.
3.1. Occupational cancers                                        3.2. Occupational hypoacusis
                                                                      The Council Directive on the protection of workers
      Within the overall framework of the resolution of                from the risks related to exposure to noise at work
      the Council and representatives of the Governments               was adopted in 1986 (OJ No L 137 of 24 May
      of the Member States of 7 July 1986 on a                         1986). It contains a series of measures to afford
      programme of action of the European Communities                  workers the highest level of protection, and
      against cancer (OJ No C 184 of 23 July 1986),                    guidelines for monitoring the hearing of those
      research will continue in order to define and assess             exposed.
      the risks presented by recognized or suspected
      carcinogenic agents found at workplaces in these
                                                                       Although several projects have already been carried
      industries, with a view to establishing a specific
                                                                       out during earlier programmes, noise still poses a
      policy of prevention.
                                                                       considerable health problem in the ECSC industries.
                                                                       At the present time hearing protection and preser-
                                                                       vation depend mainly on technical measures to
                                                                       reduce noise at source. However, the results of
      Research has already been carried out during earlier             these measures can be evaluated only by
      programmes in specific sectors — iron-ore mines and              audiometric screening and monitoring by means of
      coking plants — which were found to have an                      specific longitudinal studies.
      increased risk of lung cancer. Other projects are in
      progress to assess the risk of cancer as a result of
      exposure to high concentrations of nickel and                    For this reason there must be close cooperation
      chrome compounds in the fumes released during the                between the medical research carried out in this
      welding of stainless steel or in the production of               sector and other ECSC programmes dealing with
      special steels.                                                  ergonomics or technical noise control.
                                                                       Once the provisions of the Council Directive are
      In addition to these questions, which may require                implemented, the industries will have stricter
      further study, it will be necessary to encourage                 responsibilities than in the past. Research in this
      research aimed at identifying carcinogenic chemicals              field could therefore lead to the development of
       and assessing them at both epidemiological and                   suitable systems for protecting workers' safety and
      laboratory level, with appropriate mutagenicity and               health from the effects of noise on the hearing and
      carcinogenicity tests.                                            other areas.
 ---pagebreak--- N o C 47/10                            Official Journal of the European Communities                                  19. 2. 88
3.3. Occupational respiratory diseases                                 A project on the epidemiology of low back pain in
                                                                       coal mines is being carried out under the Fourth
                                                                       programme, but a greater effort is required at
     Although much attention has been devoted in earlier
                                                                       Community level to standardize techniques for
     programmes to respiratory diseases such as pneumo-
                                                                       assessing the prevalence of low back pain in various
     coniosis, chronic bronchitis and emphysema,
                                                                       working conditions.
     allowing remarkable progress to be made in the
     prevention of these diseases, it cannot be denied
     that specific, well-defined research is still needed in
                                                                       It now seems an appropriate time to carry out
     this field.
                                                                       experiments to draw up aptitude criteria for ac-
                                                                       tivities which are particularly stressfull for the
     In the pneumoconiosis sector there are still problems             vertebral column.
     to be solved, such as:
                                                                       The results of the research taken together with the
     — the limit values for mixed dusts;                               recommendations of the ad hoc committee on risks
                                                                       to the lower back at work will enable objective
     — variations in the frequency of pneumoconiosis                   criteria to be drawn up for direct application in the
         between coalfields with the same percentage of                ECSC industries.
         quartz, and therefore the interaction of quartz
         with other dusts;
                                                                       Furthermore, it must be remembered that other
                                                                       diseases in this field have been found in the ECSC
     — intermittent dust;                                              industries and require careful investigation. There
                                                                       are, for example, knee diseases such as chronic
     — aggravating co-factors;                                         meniscosis, chondritis, etc. and elbow diseases
                                                                       (epicondylitis).
     — new methods of diagnosis.
                                                                       An analysis of this area must also include meticulous
     In addition to 'classic' pneumoconiosis attention                 identification of the causes of these complaints and
     should also be given to the risk presented by metal-              the role played by factors such as vibration.
     lurgical graphite in steelworks, which seems to have
     attracted particular interest recently.
                                                                  3.5. Diseases linked to exposure to certain chemicals
     As far as chronic bronchitis and emphysema are
     concerned, research in progress under the Fourth
                                                                       In addition to certain chemicals which cause cancer
     programme may produce comprehensive results or
                                                                       (see 3.1), there are many other agents which are
     may leave some areas for further investigation, such
                                                                       acknowledged or suspected to have a harmful effect
     as the definition of dust limit values or the role of
                                                                       on workers. Moreover, detailed toxicity assessments
     coal dust or silicate suspensions during continuous
                                                                       are rare or non-existent for many chemicals.
     casting in iron and steel works. It may also be
     necessary to study the relationship between these
     diseases and problems affecting the upper airways,
                                                                       Particular attention should therefore be given to the
     as well as occupational asthma.
                                                                       risks of skin disease (including allergies) and renal,
                                                                       hepatic, cardiovascular and neurological diseases
     This research may also cover the adverse effects of               arising from exposure to substances such as:
     unfavourable climatic conditions, including a study
     of the use of protective breathing apparatus in
     relation to airway resistance and type of exposure.               — isocyanates (used in adhesives and resins),
     The final aspect is to provide for the application and            — solvents and detergents          (used   in   electro-
     assessment at the workplace of simple, reliable res-                   mechanical maintenance),
     piratory function tests and of the revised version of
     the ECSC questionnaire on respiratory symptoms.
                                                                       — cutting oils and used oils, whether natural or
                                                                            synthetic (used in particular in cold reduction
3.4. Occupational muscular-skeletal complaints
                                                                            mills and roll adjustment),
     Muscular-skeletal complaints in general and lumbar
     complaints in particular continue to be a major                   — additives derived from hydrocarbons (used in
     cause of absence from work in the ECSC industries.                     steel production),
 ---pagebreak--- 19. 2. 88                              Official Journal of the European Communities                             No C 47/11
     — organic phosphorous compounds            (present in       the industrial sector in consultation with worker-rep-
         hydraulic transmission fluids).                          resentatives. The Committee of Producers' and Workers'
                                                                  on Industrial Safety and Medicine, and more specifically
                                                                  its subcommittee, will subsequently inform            the
     This is not an exhaustive list in that any substance         Commission of the opinions of management and workers
     suspected of having a harmful effect on workers              on the various projects. Finally, a committee of
     could be the subject of research.                            government experts comprising appropriately qualified
                                                                  senior civil servants nominated by the Member States
                                                                  will submit its opinion on the projects, taking into
3.6. Training and information of those involved       in the      account the policies and experience of the Member
                                                                  States.
     industries
     If the safety and health protection of workers is to
     be improved, it is necessary to promote and develop          In accordance with the resolution of the ECSC Consul-
     the transfer of knowledge acquired in pure, physio-          tative Committee of 23 March 1984, the Commission
     logical and clinical research to the practical               will be assisted for the first time in the course of the
     measures designed to bring about this improvement.           medical research programmes by national groups mainly
                                                                  comprising senior occupational physicians from under-
                                                                  takings in the coal and steel industries. The groups will
     Programmes must therefore be devised for trans-              form a compulsory link with the Commission and its
     ferring such knowledge, including training and               advisory committees for selecting research projects and
     information schemes for specific groups such as              fixing priorities at national level. When the Commission
     young people or those in key positions in their              accepts a project it will conclude a contract with the
     undertakings.                                                party concerned which makes it compulsory to submit
                                                                  technical reports on the work carried out.
3.7. Methods for measuring workers' exposure
                                                                  The reports will be examined and discussed by the
     Controlling harmful agents at the workplace                  committee of scientific experts, which will also coor-
     requires precise knowledge of the pollution levels           dinate the research programme by setting up working
     caused by the agents concerned, in order to evaluate         parties for the various subjects; the working parties will
     precisely the dose/effect ratio.                             also have direct contact with the researchers at meetings
                                                                  to be held mainly in Luxembourg.
     A considerable amount of work has already been
     done in this field in both medical research and
     research on industrial hygiene, but there are still
     many untouched areas to be investigated.                                     5. Results of the programme
                                                                  Concise final reports on the projects and, where appro-
     Appropriate monitoring methods must be tested for            priate, combined reports on groups of projects will be
     measuring regular exposure, whether or not                   drawn up and distributed in the relevant sectors of the
     accidental, so that the samples taken are represen-          industries.
     tative of workers' individual exposure.
     As little is still known about some harmful                  The network of national groups and the committee of
     substances, it would also seem necessary to devote           scientific experts could be an effective way of keeping
     more research to establishing biological limits so           the various sectors in touch with progress and devel-
     that pollution levels at the workplace may be                opments as they arise in the programme.
     assessed.
                                                                  To ensure that information on the launching of the
                 4. Coordination of work
                                                                  programme and the research undertaken reaches a wide
As in earlier programmes, the Commission will be                  public, details will be published in Euro-Abstracts.
advised on the scientific aspects of research projects by a
committee of scientific experts comprising a maximum of
two experts from each of the Member States, which will
consult persons qualified in the various fields involved.         Copies of complete final reports will be provided by the
These experts will be nominated to the Commission by              Commission on request for any interested parties.
 ---pagebreak--- No C 47/12                             Official Journal of the European Communities                                19. 2. 88
The results of the projects may be included in conference         success of the programme and to provide an effective
presentations and/or published in scientific journals of          contribution to improving the health of workers in the
recognized status and with a large readership.                    ECSC industries, a research appropriation of 12 million
                                                                  ECU must be provided, spread over five years from 1988
When the programme expires, the results will be made              onwards.
available to those concerned in the coal and steel
industries at symposium.
                                                                                        7. Conclusions
   6. Financial aspects and duration of the programme             The Commission of the European Communities:
                                                                  — in view of the need to encourage medical research
All of the earlier medical research programmes ran for                dealing with the protection of workers against risks
five years, which proved sufficient for obtaining positive            at the workplace in ECSC undertakings and to
results.                                                              improve health, hygiene and well-being in these
                                                                      undertakings,
It is therefore proposed that the fifth programme should
have the same duration.                                           — account being taken too of the favourable opinions,
                                                                      approval and views expressed by the advisory
The funds to be allocated to the programme must                       committees of experts and the professional and
include not only the financial aid for the projects, but              government representatives,
also the related costs of implementing the programme              — having regard to Article 55 of the Treaty establishing
and disseminating the results, fees paid to experts                   the European Coal and Steel Community,
consulted, the costs of publication, translation, typing,
conferences, etc.                                                 proposes a total appropriation, depending on the budget
                                                                  funds available, of 12 million ECU for the implemen-
In assessing the funds required, account was taken of the         tation over a period of five years from 1988 of the fifth
cost of previous projects, average cost increases, the            medical research programme on the protection of
annual budget for social research in the coal and steel           workers against risks arising from work in the coal and
sector, the equipment required by institutions and the            steel industries.
staff needed for the satisfactory organization of the
programme.                                                        In the light of the above and given the importance of the
                                                                  programme of action of the European Communities
In view of the above and the fact that the financial aid          against cancer, the Commission also proposes that
granted by the Commission is usually no more than                 approximately one third of this budget be devoted to the
60 % of the total cost, it is considered that, to ensure the      part of the programme concerning occupational cancers.