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In order to provide a comprehensive view of the issues relating to the application of ratified Conventions on social security, the Committee considers it appropriate to examine Conventions Nos 121 (employment injury benefits), 128 (invalidity, old-age, and survivors’ benefits), 130 (medical care and sickness benefits), and 168 (employment promotion and protection against unemployment) together.
The Committee notes the observations of the Central Organization of Finnish Trade Unions (SAK), the Finnish Confederation of Professionals (STTK), and the Confederation of Unions for Professional and Managerial Staff in Finland (AKAVA), communicated with the Government’s reports on the above-mentioned Conventions.
Article 7(1) of Convention No. 121. Definition of industrial accident. The Committee takes note of the Government’s indication that the Occupational Accidents, Injuries and Diseases Act adopted in 2015 (Act No. 459/2015) has not changed the principle of causality between a disease and a work-related injury necessary for entitlement to employment injury benefits. The Government further indicates that the compensation praxis in cases of employment injuries has been unified to avoid any inconsistency in the application of the national legislation that existed before the adoption of Act No. 459/2015.
Article 8of Convention No. 121. Occupational diseases. (i)Procedure for the recognition of the occupational origin of diseases. The Committee takes note of the Government’s indication that the recognition of the occupational origin of diseases which are not on the national list of occupational diseases may require an additional examination by the Finnish Institute of Occupational Health. The Government further indicates that insurance companies bear all necessary medical expenses in this respect. The average duration of an additional examination is about 6-8 months. According to the statistical data for 2020, the occupational origin of diseases was recognized in 934 out of 2520 cases. The Committee takes due note of this information.
(ii) Diseases caused by occupational exposure to moisture and asbestos. The Committee notes the observations of the SAK, the AKAVA and the STTK pointing out the lack of income protection for workers suffering from symptoms caused by moisture damage in the workplace since many of these workers fail to qualify for social security benefits. The SAK, the AKAVA and the STTK indicate in this respect that the national legislation should be more precise regarding the obligations of insurance companies to provide compensation due to diseases caused by moisture damage. The SAK, the AKAVA and the STTK also indicate that insufficient measures have been taken to ensure screening, monitoring and appropriate treatment of workers exposed to asbestos at the workplace. The Committee requests the Government to provide information on the measures taken to ensure the provision of employment injury benefits due to diseases caused by occupational exposure to moisture damage. With respect to the measures to be taken for the prevention and protection of workers against health hazards due to occupational exposure to asbestos, the Committee refers to its detailed comments under the Asbestos Convention, 1986 (No. 162).
Article 15(3) of Convention No. 128, in conjunction with Articles 17 and 18.Early retirement for workers in arduous and unhealthy occupations. The Committee notes that according to section 11 of the Employees Pensions Act (Act No. 395/2006), the retirement age for persons born between 1962 and 1964 has increased to 65 years old. The retirement age for persons born in 1965 and thereafter will be linked to life expectancy. The Committee further notes that according to sections 15 and 16 of Act No. 395/2006, a partial early retirement pension can be provided to persons born in 1964 at the age of 62 and to persons born in 1965 and thereafter at the age adjusted to life expectancy. In addition, as per section 53a of Act No. 395/2006, persons are entitled to a career pension at the age of 63 if they have been in hazardous work for at least 38 years and if their working capacity has been impaired because of an illness or disability.
The Committee recalls that according to Article 15(3) of the Convention, if the pensionable age is 65 years or higher, the age shall be lowered, under prescribed conditions, in respect of persons who have been engaged in occupations that are deemed by national legislation, for the purpose of old-age benefit, to be arduous or unhealthy. The Committee further recalls that the purpose of this provision is intended to ensure additional protection, through a more favourable system, to persons employed on arduous or unhealthy work, by allowing them to draw an anticipated old-age pension, of which the rate and qualifying period must conform to Articles 17 (old-age pension’s rate) and 18 (minimum qualifying period) of the Convention. In this respect, the Committee observes that the qualifying period of 38 years for the entitlement to the career pension under section 53a of Act No. 395/2006 exceeds a 30-year period of contributions or employment, which is the standard qualifying period for the entitlement to an old-age pension at the minimum level required by the Convention (Article 18). The Committee further observes that a partial early retirement pension is subject to a certain reduction which may result in the amount lower than old-age pension’s rate of 45 per cent of the reference wage required, according to Articles 17 and 26 of the Convention. The Committee therefore requests the Government to indicate other possibilities for workers in arduous and unhealthy occupations to draw a pension which meets the requirements of Articles 17 and 18 of the Convention at an age lower than 65.
Article 35(1) of Convention No. 128. General responsibility of a State for the due provision of invalidity, old-age, and survivors’ benefits. The Committee notes the observations of the SAK, the AKAVA and the STTK raising concerns about the sustainability of the pension system financed through employers’ and employees’ contributions. In particular, the SAK, the AKAVA and the STTK indicate the increased use of various contractual arrangements instead of labour contracts while the individuals concerned may be de facto in subordinate and dependent relationships with their employers. The SAK, the AKAVA and the STTK further point out that employers do not have to pay social security contributions for persons not employed under labour contracts which may affect not only the financial sustainability of the pension system but also result in lower pension levels.
In this respect, the Committee notes the Government’s indication regarding the proposal of a working group of the Ministry of Social Affairs and Health to amend the Self-Employed Persons’ Pensions Act with a view to improve pension security of the self-employed. The Committee welcomes this development and requests the Government to keep it informed on the outcome of this process.The Committee also requests the Government to continue to provide information on the measures taken or envisaged to ensure the sustainability of the pension system, in application of Article 35(1) of the Convention,
Article 13(c) of Convention No. 130, in conjunction with Article 17. Cost-sharing for pharmaceutical supplies. Further to its previous request on the reimbursement of costs for pharmaceutical supplies, the Committee notes the Government’s indication that the changes in the reimbursement rules made in 2016 aimed to ensure access to pharmaceuticals for persons who heavily depend on them and persons with low income. In this respect, for example, the basic reimbursement of costs for pharmaceuticals increased from 35 to 40 per cent. In addition, there was a decrease in the annual ceiling and only after reaching this ceiling of €579.7 is a fixed co-payment of £2.5 per each medicine required. The Committee also notes the Government’s indication that the Ministry of Social Affairs and Health has launched a comprehensive reform of pharmacotherapy, which will also involve reviewing the medicine reimbursement rules.
The Committee notes from the 2021 publication of the World Health Organization “Can people afford to pay for health care? New evidence on financial protection in Finland” that medicines account for the largest share of “catastrophic spending”, particularly in the poorer quintiles, and that people with chronic conditions are more sensitive to co-payments. Furthermore, not all people in vulnerable situations have effective access in practice to social assistance benefits provided to cover out-of-pocket payments for outpatient prescribed medicines. The Committee recalls that according to Article 17 of the Convention, cost-sharing for medical care benefits, including the necessary pharmaceutical supplies, shall be so designed as to avoid hardship and not to prejudice the effectiveness of medical and social protection. The Committee therefore requests the Government to provide information on the measures taken or envisaged to ensure effective access topharmaceutical supplies for persons protected, particularly those with low income and those who suffer from diseases recognized as entailing prolonged care, without financial hardship. In this respect, the Committee encourages the Government to take advantage of the pharmacotherapy reform to ensure that the medicine reimbursement rules are so designed as to avoid hardship and not to prejudice the effectiveness of medical and social protection, in line with Article 17 of the Convention.
Article 30(1)of Convention No. 130. General responsibility of a State for the due provision of medical care benefits. The Committee notes the Government’s indication that according to the Health Care Act, medical treatment in non-urgent cases shall be provided within a reasonable time not exceeding three months for primary medical care and six months for specialized medical care, including oral health care, since the assessment of patients’ needs. The Government further indicates that in 2021, there were no cases in which waiting times went beyond a maximum of three months and approximately 60 per cent of patients received primary medical care within one week since the assessment of patients’ needs. Only 6.8 per cent of patients were waiting for treatment longer than the statutory six-month maximum period for specialized medical care at the end of December 2021.
Furthermore, the Committee notes with interest that the Ministry of Social Affairs and Health submitted a draft law amending the Health Care Act to the Parliament on 12 May 2022 which ensures the provision of medical care within seven days from the assessment of patients’ needs for outpatient medical care and within three months for oral health care. The Government also indicates the allocation of more than €200 million to regional development projects seeking to improve access to medical care. The Committee requests the Government to continue providing information on the measures taken to ensure the due provision of medical care benefits to persons protected, in line with Article 30(1) of the Convention.
Articles 7 and 8 of Convention No. 168. Promotion of productive employment. With respect to the measures taken or envisaged topromote full, productive and freely chosen employment, including among disadvantaged persons, the Committee refers to its detailed comments under the Employment Policy Convention, 1964 (No. 122).
Article 21of Convention No. 168. Suitable employment. The Committee notes the Government’s indication that a jobseeker’s employment plan is elaborated after a jobseeker’s initial interview with the Employment and Economic Development Office (TE office). The jobseeker’s employment plan takes into account the jobseeker’s competence and professional skills, work ability, duration of unemployment as well as labour market situation. The Government also indicates that a jobseeker shall usually apply for four jobs each month in line with his/her employment plan to continue receiving unemployment benefits. The Committee also takes note of the Government’s indication that a jobseeker is bound to accept a job offer if the job search has lasted for more than six months since the initial interview.

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In order to provide a comprehensive view of the issues relating to the application of ratified Conventions on social security, the Committee considers it appropriate to examine Conventions Nos 121 (employment injury benefits), 130 (medical care and sickness benefits), and 168 (employment promotion and protection against unemployment) together.
The Committee notes the observations of the Central Organisation of Finnish Trade Unions (SAK), the Finnish Confederation of Professionals (STTK), and the Confederation of Unions for Professional and Managerial Staff in Finland (AKAVA), communicated with the Government’s reports on the above-mentioned Conventions.
Article 7(1) of Convention No. 121. Definition of industrial accident. Reform of national legislation on employment injuries. Referring to its previous comments on the reform of accident insurance and occupational diseases, the Committee takes note of the Occupational Accidents, Injuries and Diseases Act (459/2015), which entered into force on 1 January 2016. The Committee notes the indications provided by the Government in its report that the new Act does not significantly change the content of the system of employment injury insurance, nor the types and amounts of benefits. The Committee also notes the observations of the SAK, STTK and AKAVA that insurance companies no longer pay compensation in respect of incapacity for work due to complications arising from the medical treatment of an employment injury due to the new interpretation of the principle of causality which is being applied to such cases. The Committee requests the Government to provide information in this respect.
Article 8. Occupational diseases. The Committee notes the information provided by the Government in reply to its previous request to provide information regarding the new list of occupational diseases and, notably, the adoption of the Occupational Accidents, Injuries and Diseases Act (459/2015) and the Occupational Diseases Decree (769/2015). The Committee also notes the Government’s explanations that, in accordance with Article 8(c) of the Convention, Finland follows a mixed approach for the identification and definition of occupational diseases, which includes both a list of occupational diseases and a general definition of occupational disease set out in the legislation. With respect to the procedure for the recognition of the occupational origin of diseases that are not included in the list, the Government indicates that such a procedure requires “a higher level of proof in individual cases of the causal link between exposure and illness, because the illness is not generally recognised as being a typical occupational disease”. The Committee requests the Government to indicate the average duration of such a procedure, the allocation of the burden of proof, the number of requests submitted and the number of cases of occupational diseases recognized under this mechanism, particularly with regard to the substances covered by Article 8 and Schedule I of Convention No. 121.
Article 13(c) of Convention No. 130, in conjunction with Article 17. Cost-sharing – pharmaceutical supplies. The Committee notes the Government’s indication that the expenditure allocated to the reimbursement of insured persons for the costs of pharmaceutical supplies has grown in recent years, and that means for curbing this growth had to be sought. In this regard, the Committee notes the Government’s indication of the introduction in 2016 of an initial co-payment of €50 per calendar year for pharmaceutical reimbursements for all persons aged 18 or over and an increase of the co-payment for each reimbursed pharmaceutical from €1.50 to €4.50. The Committee also notes that the maximum total co-payment per year for reimbursed pharmaceuticals (annual cap) decreased from €700.92 to €610.37. The Committee further notes that, according to SAK, STTK and AKAVA, the increase in co-payments for medicines forces many low-income persons to “compromise on the purchase of medicines and abandon treatment because they are not able to afford it”. The Committee requests the Government to indicate the measures taken to ensure that the participation of protected persons in the costs of pharmaceutical supplies does not entail financial hardship nor prejudice the effectiveness of medical and social protection.
Article 30(1). General responsibility of a Member for the due provision of the benefits. The Committee notes the indication provided by the SAK, STTK and AKAVA on the introduction of a National Health Care Guarantee which includes the establishment of a maximum time limit for the provision of medical treatment, within the framework of the Act on Specialized Health Care of 2005. The Committee also notes the indication of SAK, STTK and AKAVA that, although the introduction of the National Health Care Guarantee has reduced the period before persons in need of healthcare receive treatment, there are still cases in which the prescribed deadlines are not met. The Committee requests the Government to provide information on progress made in the implementation of the National Health Care Guarantee with a view to ensuring the due provision of medical care benefits to protected persons, in line with Article 30(1) of the Convention.
Articles 7 and 8 of Convention No. 168. Promotion of productive employment. The Committee takes due note of the information provided by the Government on Finland’s employment policy, in reply to its previous comments. The Committee also notes the indications provided by SAK, STTK and AKAVA that measures to promote employment, particularly with respect to providing employment opportunities and vocational education and training programmes, are still needed. In this regard, the Committee refers to its detailed comments under the Employment Policy Convention, 1964 (No. 122).
Article 21. Suitable employment. The Committee notes the Government’s indications that the active labour market policies in place in Finland put an increased emphasis on the responsibility of unemployed persons to seek work actively and to accept jobs offers, as a prerequisite for receiving unemployment benefits. The Government indicates more specifically that jobseekers are obliged to accept employment from outside their travel-to-work area if the daily commute by public transport, car or bicycle does not exceed an average of three hours. The Government further indicates that jobseekers no longer have a valid reason for refusing to accept a full-time job where the total wages together with any adjusted unemployment benefit, with deductions of commuting costs and other costs incurred through accepting the job, are less than the unemployment benefit that they would be entitled to otherwise. In this regard, SAK, STTK and AKAVA point out that the tightening of the eligibility requirements for entitlement to unemployment benefits, the extension of the sanction system and the obligation for unemployed persons to participate in all services offered to them, even if such services were not agreed upon in the employment plan, raise issues of compatibility with the Convention. The Committee requests the Government to explain how the criteria specified in Article 21(2) of the Convention, namely the age of unemployed persons, their length of service in their former occupation, their acquired experience, the length of their period of unemployment, the labour market situation, and their personal and family situation, are taken into account by the administrative authorities in assessing the suitability of the employment or service offered.

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Reform of national legislation on employment injuries. With reference to the issues raised previously by the Central Organization of Finnish Trade Unions (SAK) and by the Confederation of Unions for Academic Professionals in Finland (AKAVA), the Government indicates that a reform process of the legislation on accident insurance and occupational diseases is currently being prepared by the Ministry of Social Affairs and Health together with key central labour market organizations and other stakeholders. The goal of the reform is to update the national legislation to correspond to the altered conditions of working life and new objectives. The reform will also address issues brought up by central labour market organizations concerning, for example, the level of benefits and the improvement of the protection of workers suffering from symptoms caused by moisture damage in the workplace. For their part the SAK, the AKAVA and the Finnish Confederation of Salaried Employees (STTK) stress that, while there have been attempts to solve the problem as part of the reform process, progress has so far been slow. Victims of moisture damage are often left without social security coverage following expiry of their sick leave compensation, since their symptoms are not regarded as sufficient for an occupational disease diagnosis. These problems could be solved rapidly by ensuring prompt examination of persons concerned and uniformity between insurance companies’ compensation practices. The Committee takes note of this information and hopes that the Government together with the social partners will reform the national legislation on employment injuries in the best interest of protected persons and in accordance with the provisions of the Convention.
Article 8 of the Convention. Occupational diseases. With reference to previous comments, the Government indicates that, since the current list of occupational diseases contained in Decree 1347/1988 (ammattitautiasetus) is not a closed list, a disease not mentioned in the list can nonetheless be compensated as an occupational disease on the basis of a general provision of the Act on occupational diseases (1343/1988) (ammattitautilaki) if a likely causal relationship can be proven to exist between the disease and the work considering the worker’s degree of exposure. The Government also indicates that, given that the legislation on accident insurance and occupational diseases is currently being reviewed, the list of occupational diseases will be updated in view of European Commission Recommendation 2003/670/EC of 19 September 2003 concerning the European schedule of occupational diseases. Taking note of this information, the Committee asks the Government to indicate progress achieved in the reform process with respect to the list of occupational diseases, indicating how the new list, if adopted, gives effect to Article 8 of the Convention. Please also provide information regarding the implementation of the procedure for the recognition of the occupational origin of diseases which are not included in the national list.

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Article 8 of the Convention. With reference to its previous direct request, the Committee notes that hard-metal pneumoconiosis is listed as a typical occupational disease caused by cobalt and its compounds in section 3(6) of Decree No. 1387 on occupational diseases of 29 December 1988, as amended. With respect to occupational diseases in item No. 27 of the list in Schedule I of the Convention, the Government states that dry distillation products of wood and coal and distillation residues of crude oil, as well as diseases caused by them, such as cancer of the skin were included in Decree No. 639 and Decision No. 640 of 1967 previously in force, and that new legislation is being drafted to incorporate these diseases again in Finnish legislation. The Committee requests the Government to submit new legislation once it is adopted.
Observations by the Central Organization of Union of Finnish Trade Unions (SAK). The Committee recalls that the Government’s report of 2007 contained the statement of SAK that the Employment Accidents Insurance Act did not respond anymore to the changed requirements of working life and that compensation for occupational accidents was problematic, in particular for upper limb injuries. SAK also referred to the incoherence in the determination of the annual income to establish the level of compensation which puts employees in unequal positions. Daily sickness benefits in case of a temporary incapacity, compensated at a rate of 100 per cent, were reduced by 15 per cent when converted into an accident pension, and were not taken into account for the calculation of the old-age pension. In the direct request of 2008 the Committee invited the Government to reply to SAK’s observations. The Government replied in 2009 that tripartite negotiations have been conducted on the grounds for compensation for certain strain injuries of the upper limbs and that the drafting of necessary amendments was under way; in other respects a reply to the observations will be provided in the context of the next periodic report.
Observations by the Confederation of Unions for Academic Professionals in Finland (AKAVA). In its comments included in the Government report of 2009, AKAVA expressed its concern about the situation of employees who contracted the skin diseases mentioned in item 26 of Schedule I of the Convention due to exposure to biological agents from water damage in buildings. These employees might find themselves without an income after the expiration of the maximum period of sickness benefits because the Social Insurance Institution does not consider them incapable to work or entitled to benefits. Compensation through statutory accident insurance might be a problem with respect to establishing the burden of proof of the cause of the disease. AKAVA indicated that compensation practices of insurance companies responsible for the implementation of the statutory accident insurance are incoherent and poorly managed. Employees might be without any source of income when they are unable to return to work and the employer refuses to employ them at other premises. The Committee recalls that AKAVA already highlighted the question of the establishment of the burden of proof in the report of 1999 with respect to broncho-pulmonary diseases caused by impurities in indoor air, to which no reply from the Government was received.
The Committee considers that the observations of SAK and AKAVA raise substantial problems regarding the application of the Convention in law and practice, which require much more focused attention from the Government. The Committee requests that in future the Government will reply to the observations of the workers’ organizations in a thorough and detailed manner, so that the ILO supervisory bodies may fully benefit from the practical knowledge and wisdom of the social partners. The Committee expects that the Government’s next report due in 2012 will contain full explanations on all the questions concerning the application of the Convention in Finland raised by the national trade union organizations since 1999.

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The Committee notes the Government’s report for the period from
1 June 1999 to 31 May 2007, which also contains its reply to the direct request of 1999 and an observation made by the Central Organization of Finnish Trade Unions (SAK). The Committee notes the statistical information concerning adjustment of benefits requested under Article 21 of the Convention and provided by the Government in its report on Convention No. 128.

With regard to the application of the Articles of the Convention, the Government states that it has “nothing new to report”. The Committee would like to point out that, even if no legislative changes have occurred in the reporting period, under the report form on the Convention, the Government is requested to supply once every five years updated statistical information on the scope of personal coverage of the Convention, the amounts of the benefits paid for different contingencies and their replacement level in relation to the reference wage of a standard beneficiary. In order to confirm that the quantitative requirements of the Convention are being complied with, the Government is requested to furnish such detailed statistical data for examination by the Committee at its next session in November–December 2009.

Article 8 of the Convention. For many years, the Committee has been pointing out 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 1 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 take measures to ensure that 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, and to consider the possibility of including these diseases into the list contained in Decree No. 1347.

In reply, the Government states that lung diseases caused by hard metal dust are included in Decree No. 1347. The Committee asks the Government to confirm this statement by supplying a consolidated copy of the Decree including all the amendments made and indicating the relevant provision. As regards primary epithiliomatous cancer of the skin caused by tar, pitch, bitumen, mineral oil, anthracene, or the compounds, products or residues of these substances, the Committee regrets to note that no specific measure has been taken during the reporting period to recognize the occupational origin of such disease. The report states however that the Ministry of Social Affairs and Health has established a working group to reform the current Act on Occupational Diseases (1343/1988), which will consider the Committee’s recommendations in this respect. The Committee hopes that the Government in the near future will take measures to expressly recognize occupational origin of the disease mentioned in item No. 27 of the list given in Schedule I to the Convention, so as to dispense the afflicted workers of the burden of proof.

Finally, the Committee hopes that the Government will reply to the observation made by the Central Organization of Finnish Trade Unions (SAK) in its next report.

[The Government is asked to reply in detail to the present comments in 2009.]

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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.

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Article 8 of the Convention. In reply to the Committee's previous comments, the Government confirms that the list of the physical, chemical or biological agents present in work and the typical pathological manifestations likely to be caused by the agent in question, contained in section 3 of Decree No. 1347 of 1988, is not exhaustive; even if a factor or disease is not mentioned in the list, a disease can be compensated for as an occupational disease if it is probably and primarily caused by subjection to a physical, chemical or biological factor at work. According to the Government, this procedure will be applied to the following diseases, which are not mentioned in Decree No. 1347 despite the fact that they figure in the list of occupational diseases (amended in 1980) in Schedule 1 to the Convention: (a) broncho-pulmonary diseases caused by hard-metal dust (item No. 2); and (b) primary epitheliomatous cancer of the skin caused by tar, pitch, bitumen, mineral oil, anthracene, or the compounds, products or residues of these substances (item No. 27). The Committee notes this information with interest. It would like 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.

The Committee has also taken note of the observations presented by the Central Organization of Finnish Trade Unions (SAK).

Article 21 of the Convention. The Committee takes note of some statistical data covering the implementation of this Article of the Convention which calls for the adjustment of long-term benefits due in case of employment injury. In order to fully assess the situation the Committee would like the Government to supply in its next report all the statistical data requested under Article 21 (questions B, C and D) by the report form adopted by the Governing Body.

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Article 8 of the Convention

1. With reference to its previous comments, the Committee takes note of Act No. 1343 and Decree No. 1347 respecting occupational diseases which were adopted on 29 December 1988. In this connection, it notes that section 1 of Act No. 1343 defines "occupational disease" as "a disease which has probably been caused mainly by physical, chemical or biological agents in work which has been performed on the basis of a wage-earning or salaried relationship or in activity as an agricultural entrepreneur". In section 2 of the Act, a causal relationship between a disease within the meaning of section 1 and a physical, chemical or biological agent present in work shall be deemed to exist where an agent specified in the Decree has been present in the work to such an extent that it may be the principal cause of the disease. Section 3 of Decree No. 1347 gives a list of physical, chemical and biological agents and, for each agent, lists a number of typical pathological manifestations likely to be caused by the agent in question. The Committee understands that the list of pathological manifestations is not restrictive and that consequently, for the workers exposed to the agents mentioned in section 3 of Decree No. 1347 the occupational origin of the disease is presumed, whatever the pathological manifestation. The Committee asks the Government to confirm whether this is indeed the case. Please indicate also whether diseases other than those caused by the agents mentioned in section 3 of Decree No. 1347 of 1988 can be considered as occupational diseases within the meaning of section 1, subsection 1, of Ordinance No. 1343 of 1988.

2. Decree No. 1347 of 1988 does not mention the following diseases despite the fact that they appear in the list of occupational diseases (amended in 1980) in Schedule 1 to the Convention: (a) broncho-pulmonary diseases caused by hard-metal dust (item No. 2 in the list in the Convention); (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). The Committee would be grateful if the Government would indicate how 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.

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The Committee takes note of the information supplied by the Government in its report as well as of the coming into force of the new Occupational Diseases Act No. 1343 of 1988. It also notes certain observations made by the Finnish Employers' Confederation (STK), the Employers' Confederation of Service Industries (LTK), the Commission for Local Authority Employers (KT), the Central Organisation of Finnish Trade Unions (SAK) and the Confederation of Salaried Employees (TVK), which have been communicated by the Government in its report.

In view of the time necessary for translating the new Occupational Diseases Act, the Committee is not in a position to consider this case at the present session. It decided to defer its examination to its session in March 1991.

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