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With reference to its previous comments, the Committee notes the information supplied by the Government in its report, as well as the statements made in this connection by the Confederation of Finnish Industry and Employers (TT), the Employers' Confederation of Service Industries in Finland, the Central Organization of Finnish Trade Unions (SAK) and the Confederation of Unions for Academic Professionals (AKAVA).

Article 8 of the Convention. In its previous comments, the Committee noted that the list of occupational diseases contained in Decree No. 1347 of 1988 does not mention the following diseases which appear in the list (amended in 1980) included in Schedule I to the Convention: (a) broncho-pulmonary diseases caused by hard-metal dust (item No. 2); (b) primary epithiliomatous cancer of the skin caused by tar, pitch, bitumen, mineral oil, anthracene, or the compounds, products or residues of these substances (item No. 27). Consequently, it has asked the Government to indicate how in practice the workers afflicted with the above diseases can benefit from the presumption of their occupational origin when they are engaged in work involving exposure to the risks concerned, and on whom rests the burden of proof.

In reply, the Government indicates that for a disease to be diagnosed as occupational, a two-step causality relationship must be established. First of all, the causality must be generally acknowledged, i.e. there must be evidence based on scientific research that exposure to the agent in question may cause the disease concerned. This requirement is considered to have been met if such a connection is mentioned in the list of Decree No. 1347. Secondly, it must be shown that the disease examined in each individual case is likely to have been caused primarily by such exposure. Sufficient on-the-job exposure of an employee with a diagnosed disease is an adequate basis for compensation in the case of diseases referred to in the said list. Otherwise, a normal medical explanation of the sufficiency of the exposure as the primary cause of the disease is required, taking into account the employee's individual circumstances and lifestyle. The Government does not indicate on whom rests the burden of proof in this two-step procedure of establishing the causality relationship proving the occupational origin of the disease, particularly as regards the diseases not mentioned in the list of Decree No. 1347.

The Committee understands from this information that while the proof of the occupational origin of the diseases mentioned in the list of Decree No. 1347 in the second stage of this procedure is greatly facilitated by the general presumption of the existence of the causality relationship between exposure to the agent concerned and the related disease in the first stage, this would not be the case for diseases which do not figure on this list and for which proof should be established on a case-by-case basis after an appropriate scientific and medical inquiry. With respect to the first stage inquiries, the Confederation of Unions for Academic Professionals (AKAVA) highlights the problem of the establishment of causality specifically as regards broncho-pulmonary diseases caused by impurities in indoor air, while with respect to the second stage medical explanation, the Central Organization of Finnish Trade Unions (SAK) expresses its concern over conflict situations between the attending physician and the insurance company's expert physician arising from differences of opinion concerning the work-related nature of an occupational disease. In the light of these comments, the Committee wishes to draw the Government's attention to the fact that the inclusion of the occupational diseases mentioned in items Nos. 2 and 27 into the list given in Schedule I to the Convention, resulted from the irrefutable body of international evidence establishing the causality link between the exposure to the agent and the disease in question under prescribed conditions and, consequently, an automatic presumption of their occupational origin dispensing the afflicted workers of the burden of proof. It therefore asks the Government to indicate the measures taken or contemplated to ensure that the workers exposed to the risk concerned and afflicted with the abovementioned diseases could fully benefit from the presumption of their occupational origin established by the Convention. In this respect the Committee further notes from the comments made by the Confederation of Finnish Industry and Employers (TT) and the Employers' Confederation of Service Industries in Finland that preparatory work is being carried out to revise the list of occupational diseases on the basis of current knowledge. The Committee hopes that in this process consideration will be given to the possibility of completing the list of occupational diseases of Decree No. 1347 of 1988 by the diseases mentioned in items Nos. 2 and 27 of the list given in Schedule I to the Convention. The Government is asked to indicate any progress made in this respect in its next report.

Article 21. With reference to its previous comments, the Committee notes the statistics for the period 1993-99 concerning changes of the working age index and the retirement age index used for adjusting employment injuries and survivors' pensions payable under the Accident Insurance Act to rising pay and price levels. The Committee points out that, in the absence of the concomitant data for the same period on the evolution of the cost of living and the general level of earnings, it is impossible for the Committee to assess the situation fully. It therefore once again expresses the hope that the Government will be able to supply in its next report all the statistical information requested under this Article in the report form adopted by the Governing Body.