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Article 5 of the Convention. Medical examinations during the period of employment and thereafter to evaluate their exposure and supervise their state of health. With reference to its previous comments under this Article, the Committee notes that the Government has indicated in its report that as the law now stands, under Chapter 4, section 5 of the Work Environment Act (SFS1977:1160), the Work Environment Authority is not empowered to prescribe continuing medical checks for employees after exposure to carcinogenic substances or after their employment has ended. The Government also states that there are at present no plans for changing the Work Environment Act in this respect. With reference to the information provided in the Government’s report this year on the application of the Asbestos Convention, 1986 (No. 162), the Committee notes that, in the commentary to section 30 of the Work Environment Authority’s regulations on Medical Screening in Working Life (AFS 2005:6), it is recommended that workers have a periodical medical check-up even after the exposure has ceased, provided the exposure exceeds ten years. The Committee requests the Government to indicate how this recommendation is applied in practice and what measures have been taken to ensure that workers who have been exposed to occupational hazards are provided with such medical examinations as are necessary in order to fully apply Article 5 of the Convention.
1. The Committee notes the information contained in the Government’s report and the attached legislation.
2. Articles 1 and 6 of the Convention. Carcinogenic substances and agents and national legislation – synthetic inorganic fibres. The Committee notes with interest the extensive legislative revisions undertaken by the Government resulting in the adoption in 2005 of the Provisions of occupational exposure limit values and measures against air contaminants (AFS 2005:17), which prescribes occupational exposure limits value reductions for asbestos, toluene diisocyanate, cadmium compounds, chromium (VI) compounds, wood dust and certain synthetic inorganic fibres. It also notes the Government’s statement that through the adoption of revised Provisions on Synthetic Inorganic Fibres (AFS 2004:1), the occupational exposure limit values have been reduced for certain fibres judged to be carcinogenic in relation to those of certain other synthetic inorganic fibres, and that the former types of fibres can only be handled upon authorization of the competent authority, and require periodic exposure measurements and medical examinations to be carried out. The Committee understands that the revision concerning the handling of cytostatics and other pharmaceuticals with long-term toxic effect has been terminated and resulted in the adoption of Provisions on cytostatic and other drugs with enduring toxic effects (AFS 2005:5) and that the Provisions on thermosetting plastics (AFS 2005:28) has been issued. It further notes the adoption of the Provision on the protection of workers from risks related to exposure to biological agents at work (AFS 2005:1). In addition, the Committee notes the recent adoption of the Provisions on asbestos (AFS 2006:1) and, in this respect, refers to its comment in 2005 under the Asbestos Convention, 1986 (No. 162). In this context, the Committee also notes the information that the project “Exposure to synthetic inorganic fibres”, which preceded the adoption of the revised regulations, demonstrated that many undertaking were unaware that they were handling fibres or to be ignorant of which fibres they were handling. The Committee asks the Government to continue to provide information on legislative measures taken to give effect to the provisions of the Convention.
3. Articles 1 and 2, paragraph 1. Conditional permits. With reference to its previous comments in which the Committee requested the Government to provide information on the impact of the issuing of conditional permits, i.e. whether a practice of submitting the handling of carcinogens to prior authorization in fact would lead to their replacement as well as to the introduction of safer work processes. The Committee notes that the Government found it difficult to document the effect of the procedure for which conditional permits could be granted but that their general impression was one of widespread hesitance from employers side at the prospect of the inconvenience which the requirements of a permit entailed. The Committee requests the Government to provide it with any additional information in this respect, should any such information become available in the future.
4. Article 5. Medical examinations. The Committee understands that the Provisions on medical examinations in working life were adopted on 17 February 2005 (AFS 2005:6) provide that employers are obliged to provide medical examinations free of costs to the workers, in accordance with the Convention. It also notes that the revised Provisions on synthetic inorganic fibres referred to above require medical examinations for workers exposed to refractory ceramic fibres, special fibres and synthetic inorganic crystalline fibres. It notes in this respect the Government’s statement that medical examinations are to be carried out every third year and that spirometry is to be performed on each examination, but that lung X-rays need only be taken on every second occasion. However, with respect to the medical costs, the Committee notes that the Government indicates that these are to be covered by the employers for the duration of the employment relationship and that it is recommended that the employer continue to arrange medical examinations if this is medically justified after the termination of the employment relationship but that, if an employer fails to do so, the worker is to be referred to the County Council medical care. Against this background, the Committee feels obliged to reiterate that the need to examine workers after they have ceased their employment is due to the fact that the occupational origin of cancer is often difficult to demonstrate and that the latency period for cancer is notoriously long extending sometimes to 30 years or more. The Committee requests the Government to provide additional information in its next report on the manner in which it is ensured that the medical examinations free of costs to the workers are carried out after the period of employment is terminated, in accordance with Article 5 of the Convention.
The Committee notes that the Government’s report has not been received. It hopes that a report will be supplied for examination by the Committee at its next session and that it will contain full information on the matters raised in its previous direct request, which read as follows:
The Committee notes the information provided by the Government in relation to Article 3 of the Convention. Further to its previous comments, it draws the Government’s attention to the following points.
1. The Committee notes the adoption of the overarching Provisions on Chemical Hazards of the Work Environment (AFS 2000:4) of 23 March 2000, and the Provisions on Occupational Exposure Limit Values and Measures Against Air Contaminants (AFS 2000:3) of 23 March 2000, issued by the Swedish National Board of Occupational Safety and Health (AFS), which consolidated and updated the existing national provisions aiming to prevent cancer at work.
2. Articles 1 and 2, paragraph 1, of the Convention. The Committee notes that certain carcinogens, namely the agents hydrazine, monomethyl hydrazine and dimethyl hydrazine were added to group B of Annex 3 to the Provisions on Occupational Exposure Limit Values and Measures Against Air Contaminants (AFS 2000:3) indicating the substances that pursuant to section 23 may only be handled upon authorization of the competent authority. The Government considers that the grant of conditional permits would represent, on the one hand, an effective instrument to control the handling of substances having carcinogenic properties and, on the other hand, it would motivate the employer to deliberate on alternative non- or less-harmful substances or working methods. Taking note of the Government’s considerations, the Committee invites the Government to provide information on the impact of this approach in practice, i.e. to know whether the submission of the handling of carcinogens to prior authorization in fact would lead to their replacement as well as to the introduction of safer work processes.
3. The Committee further notes the revision concerning the handling of cytostatics and other pharmaceuticals with long-term toxic effects through the adoption of the Provisions on Cytostatic and Other Drugs with Enduring Toxic Effects (AFS 1999:11) aiming to reduce the exposure of workers significantly when handling them. The Committee also notes the adoption of the Ordinance on Asbestos (AFS 1996:13) revising and completing the Provisions AFS 1992:2 on the same subject. The Committee wishes to refer to its comments provided under the Asbestos Convention, 1986 (No. 162). The Committee finally notes the revision of the Provisions on Thermosetting Plastics (AFS 1996:4). The Government adds that the Work Environment Authority has allocated considerable resources to the supervision of workplaces where workers are exposed to isocyanates, which represent one of the most important thermoplastics. The Government further explains that, since certain isocyanates are deemed to entail a potential risk of cancer, the supervision was focused to the isocyanate hypersensitivity of the respiratory tract. With regard to the categorization of certain mineral fibres as carcinogens set forth in the European Union Directive 97/69/EC, amending Directive 67/548/EEC, the Swedish Work Environment Authority is charting the use and the exposure to mineral fibres in special projects. In this context, the Government indicates that a revision of the Provisions on Synthetic Inorganic Fibres (AFS 1990:9) is planned. The Committee taking due note of this information, requests the Government to supply additional information on the projects launched concerning workers’ exposure to mineral fibres. Finally, the Government is asked to transmit a copy of the Provisions on Synthetic Inorganic Fibres (AFS 1990:9) once they have been revised.
4. Article 5. The Committee notes the Government’s indication according to which the revision of the Provisions on Statutory Medical Checks has not been finished yet. Owing to the Swedish approach to eliminate the carcinogenic factors in the work environment in order to prevent cancer of occupational origin at its source, the Work Environment Authority has given an operational priority to this work and therefore the Provisions on Statutory Medical Checks are still being revised. In this respect, the Government adds that chemical and physical factors in the Swedish work environment are estimated to contribute only less than one-thousandth of all cancer cases in the country while a few decades ago the estimate was 2 per cent. Nevertheless, the revision work on statutory medical checks is in progress and the Work Environment Authority intends to study closely the possibilities of medical examinations, which will facilitate the early discovery of cancer in work environments with heightened cancer risks, so that rules on medical examinations can be introduced when it proves medically justifiable. With regard to medical examinations of workers after the termination of employment, the Government merely indicates that the setting of rules on this issue does not lie within the competence of the Work Environment Authority. The Committee, while noting with interest the different activities of the Work Environment Authority to eradicate carcinogenic factors in the work environment as well as the current revision of the Provisions on Statutory Medical Checks, wishes to underline the importance of medical examinations during and after the period of employment, which are necessary to evaluate the exposure of workers and their state of health. With regard to the Government’s indicated priority to eliminate the carcinogenic factors in the work environment, the Committee points out that periodic health examinations of workers frequently reveal the existence of health hazards in the workplace. The need to examine workers after they have ceased their employment is due to the fact that the occupational origin of cancer is often difficult to demonstrate, as from the clinical and pathological point of view, there is no difference between occupational cancer and other non-occupational forms. Moreover, its development is generally very slow, with the latent period stretching over anything from ten to 30 years or more. The Committee accordingly urges the Government to take the necessary measures to guarantee that workers are provided, during and after their employment, with medical examinations or biological or other tests or investigations necessary to evaluate their state of health in relation to the occupational hazards. The Government is also requested to transmit a copy of the Provisions on Statutory Medical Checks once they are have been revised.
5. Part IV of the report form. With regard to the Government’s indication concerning the planned supervision of workplaces in relation to workers’ exposure to isocyanates, the Committee asks the Government to provide information on the outcome of the above described supervision of workplaces and on its impact on future legislative measures, e.g. the revision of the Provisions on Synthetic Inorganic Fibres (AFS 1990:9).
The Committee notes the Government’s report. It notes with interest the information provided by the Government in relation to Article 3 of the Convention. Further to its previous comments, it draws the Government’s attention to the following points.
1. The Committee notes with interest the adoption of the overarching Provisions on Chemical Hazards of the Work Environment (AFS 2000:4) of 23 March 2000, and the Provisions on Occupational Exposure Limit Values and Measures Against Air Contaminants (AFS 2000:3) of 23 March 2000, issued by the Swedish National Board of Occupational Safety and Health (AFS), which consolidated and updated the existing national provisions aiming to prevent cancer at work.
2. Articles 1 and 2, paragraph 1, of the Convention. The Committee notes with interest that certain carcinogens, namely the agents hydrazine, monomethyl hydrazine and dimethyl hydrazine were added to group B of Annex 3 to the Provisions on Occupational Exposure Limit Values and Measures Against Air Contaminants (AFS 2000:3) indicating the substances that pursuant to section 23 may only be handled upon authorization of the competent authority. The Government considers that the grant of conditional permits would represent, on the one hand, an effective instrument to control the handling of substances having carcinogenic properties and, on the other hand, it would motivate the employer to deliberate on alternative non- or less-harmful substances or working methods. Taking note of the Government’s considerations, the Committee invites the Government to provide information on the impact of this approach in practice, i.e. to know whether the submission of the handling of carcinogens to prior authorization in fact would lead to their replacement as well as to the introduction of safer work processes.
The Committee notes the information provided by the Government. It notes that certain ordinances, such as the Ordinance on Occupational Limit Values (1993) and the Asbestos Ordinance (1992), are currently being revised and that the Ordinance on Dangerous Substances has been revised and adopted in 1994. Furthermore, the Committee notes with interest that pursuant to the Chlorinated Solvents (Various) Ordinance the professional use of methylene chloride and trichloroethylene is prohibited after 1 January 1996.
Article 3 of the Convention. The Committee notes the Government's indication according to which the work regarding the computerization of the official register of the National Board of Occupational Safety and Health ("Board") into which all data concerning permits for the handling of carcinogenic substances issued by authority of the Occupational Exposure Limit Values Ordinance, as well as the permits issued by the Board under the Asbestos Ordinance, is still in progress. It also notes the Government's explanation that priority has been given to the registration of data concerning new permits. The Government is requested to continue to provide information on the measures taken to protect workers against the risks of exposure to carcinogenic substances.
Article 5. With reference to its previous comments in which the Committee requested the Government to indicate the measures taken to ensure that all workers exposed to all types of carcinogenic substances undergo medical examinations or biological or other tests or investigations during the period of employment and thereafter, since only workers exposed to asbestos were provided with medical examinations during their employment and workers previously exposed to asbestos were engaged in voluntary medical examinations. In its response the Government had indicated that the Board cannot make it obligatory for an employer to provide post-employment medical examinations. In its latest report, the Government indicates that according to its understanding of Article 5 of the Convention, medical examinations have the purpose to facilitate an assessment of exposure to carcinogenic substances and also to monitor the health status of persons exposed. Therefore, the Government refers to the general approach of Swedish policy in this area aiming to reduce workers' exposure to carcinogenic substances to the extent that no worker will risk in future to develop cancer from their working environment. Exposure to carcinogenic substances is monitored through a system of national registration in which all newly discovered cases of cancer are reported to the Swedish Cancer Register which are used as a basis for risk monitoring. The Government also points out that workers who have been exposed to asbestos and who are now retired or for any reason no longer exposed, are covered by the public medical system in terms of medical examination in the case that any symptoms of cancer may occur. Nevertheless, the Government indicated that the National Board of Occupational Safety and Health is drafting an ordinance on medical checks to indicate when such checks are appropriate and meaningful. The Committee would recall that the inclusion of obligatory post-employment medical examinations, as necessary, to evaluate the exposure to carcinogenic substances and to supervise the state of health of the worker in relation to the occupational hazards was intended to respond to the not uncommon situation wherein the cancer is not detected until after a worker has terminated the employment involving exposure. Further, the Committee would point out that, in order to ensure medical observation of all workers who have been exposed to all kinds of carcinogenic substances and also to ensure the discovery of cancer at the earliest stages, it cannot be left to the worker's decision whether he or she will undergo medical examinations under the public medical system. The Committee therefore expresses once again the hope that the Government will take the necessary measures to ensure that all workers exposed to carcinogenic substances are provided with medical examinations or biological or other tests or investigations during the period of employment and thereafter as are necessary to evaluate their exposure and supervise their state of health in relation to the occupational hazards. The Government is requested to indicate, in its next report, the progress made in this regard and to supply a copy of the ordinance on medical checks when it is adopted.
The Committee notes the information supplied in the Government's report in reply to its previous direct request.
Article 3 of the Convention. The Committee notes with interest the information provided by the Government concerning the computerisation of the official register of the National Board of Occupational Safety and Health (the "Board") into which all data concerning permits for the handling of carcinogenic substances issued by authority of the Occupational Exposure Limit Values Ordinance, as well as the permits issued by the Board under the Asbestos Ordinance, are entered. It further notes that measures are being taken to develop this database so that all previous manual records can also be entered into the computerised register. The Government has also indicated in its report that the Board has begun drafting special Ordinances on work with carcinogenic substances which will take into account the provisions of this Article of the Convention. The Government is requested to continue to provide information on the measures taken to protect workers against the risks of exposure to carcinogenic substances and to communicate copies of these special ordinances once they are adopted.
Article 5. In its previous comments, the Committee had noted that only workers exposed to asbestos were provided with medical examinations during their employment and that workers previously exposed to asbestos were engaged in voluntary medical examinations. The Committee had requested the Government to indicate the measures taken to ensure that all workers exposed to all types of carcinogenic substances undergo medical examinations or biological or other tests or investigations during the period of employment and thereafter. The Government has indicated, in its latest report, that the provisions of this Article would be taken into account in the draft special Ordinances on work with carcinogenic substances. The Government has also indicated, however, that the Board cannot make it obligatory for an employer to provide post-employment medical examinations. The Committee would recall that the inclusion of post-employment medical examinations, as necessary, to evaluate the exposure to carcinogenic substances and to supervise the state of health of the worker in relation to the occupational hazards was intended to respond to the not uncommon situation wherein the cancer is not detected until after a worker has terminated the employment involving exposure. The Committee, therefore, hopes that the Government will take the necessary measures to ensure that (whether by the employer or by the State) all workers exposed to carcinogenic substances are provided with medical examinations or biological or other tests or investigations during the period of employment and thereafter as are necessary to evaluate their exposure and supervise their state of health in relation to the occupational hazards. The Government is requested to indicate in its next report the progress made in this regard.
The Committee notes the information supplied in the Government's report, in reply to its previous direct request.
Article 3 of the Convention. The Committee notes that the information obtained in connection with the permits required for the handling of group A and B substances, under the Hygienic Limit Values Ordinance, AFS 1984:5, continues to be recorded manually at the National Board of Occupational Safety and Health, but that preparations are in progress for the introduction of a computerised system. The Committee hopes that the operation of the computerised system will enable the Government to assemble, in a comprehensive system of records, the different procedures for recording data concerning exposure to carcinogic substances.
Article 5. The Committee notes that the National Board of Occupational Safety and Health, acting in association with the National Board of Health and Welfare, is currently engaged in a voluntary medical examination of persons previously exposed to asbestos. The Committee would once again draw the Government's attention to the need to take measures in conformity with this Article of the Convention to ensure that all workers exposed to all types of carcinogic substances contained in the Hygienic Limit Values Ordinance, AFS 1984:5 undergo medical examinations or biological or other tests or investigations during the period of employment and thereafter in so far as these are necessary to supervise their state of health as concerns occupational hazards. It hopes the Government will make every effort to take the above mentioned measures in the near future and that it will be able to indicate the progress made in this respect in its next report.