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The Committee notes the observations of the Turkish Confederation of Employers’ Associations (TISK) communicated with the Government’s reports.
Article 2 of Convention No. 42. Restrictive nature of the list of occupational diseases. In its previous comments, the Committee requested the Government to provide information on the procedure for recognition of the occupational origin of diseases not included in the national list of occupational diseases. The Committee notes the Government’s indication in its report that in this instance the Social Security High Health Board determines whether a particular disease is occupational by conducting necessary examinations in accordance with the Regulation on duty, authority and working methods and principles of the Social Insurance High Health Board of 2013 and related legislation. The Committee notes that the TISK points out that Turkey does not adopt a restrictive approach on the indemnification of occupational diseases since even a disease not included in the national list of occupational diseases can be recognized as occupational according to the established procedure. The Committee recalls that Article 2 of the Convention establishes a legal presumption of the vocational origin of the diseases listed in the Schedule appended to it, whenever the workers concerned are employed in the corresponding trades, industries and processes, which relieves the worker of the burden of proving the occupational origin of a disease and the costs of complex and lengthy judicial proceedings. The Committee therefore requests the Government to provide complementary information on the manner in which the burden of proof is regulated in the above-mentioned procedure, its average duration, and the number of requests submitted and of cases of occupational diseases recognized by the Social Security High Health Board, particularly with regard to the substances covered by the Schedule appended to the Convention and not by the national list.
Application of Convention No. 42 in practice. In its previous comments, the Committee requested the Government to provide information on improvement and facilitation of the detection and recognition of occupational diseases. The Committee takes note of the measures indicated by the Government which include, among others, training activities on occupational diseases provided to physicians, issuing of guidelines on diagnosis and notification of occupational diseases, adoption of the National Pneumoconiosis Prevention Action Plan (2017–21), and other activities and projects. The TISK further indicates the ongoing work and in particular the joint efforts of the Ministry of Health and the Ministry of Labour and Social Security on developing a system for identifying occupational diseases. The Committee requests the Government to demonstrate with reference to statistical data the impact of the taken measures on the number of detected and compensated occupational diseases.
Part X (Survivors’ benefit). Article 64, in conjunction with Article 69 of Convention No. 102. Suspension of benefit. The Committee notes from the 37th (2018) report on the application of the European Code of Social Security (Code) that pursuant to an amendment made by the Regulation of Social Insurance Procedures on 5 December 2017, in case the late breadwinner has a debt of insurance contributions, his/her survivors will receive pension only as of the beginning of the month following the date when the debt will be paid. The Committee observes that this rule may effectively deprive the dependants of the deceased of their right to survivors’ benefit if the breadwinner’s family does not dispose of the necessary savings to repay his/her debt to the social insurance institution. In addition, it may penalize them unduly when the debt is due to the non-payment of employer’s contributions or where the employer has failed to remit the deceased worker’s contributions. In this regard, the Committee recalls that the Convention, in its Article 69, limits the cases in which the benefit can be suspended to acts imputable to the persons protected or to their personal circumstances. The Committee therefore requests the Government to indicate whether the payment of a survivors’ benefit is suspended if the default in the payment of contributions is imputable to the employer.
Part XI (Standards to be complied with by periodical payments). Articles 65 and 66. The Committee requests the Government to provide information on the replacement rate of benefits in accordance with Titles I–V of the report form for the Convention.

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The Committee notes the information provided by the Government and the detailed explanations of developments in national law and practice relating to the application of the Convention supplied by the Turkish Confederation of Employer Associations (TİSK) and the Confederation of Turkish Trade Unions (TÜRK-İŞ).
Restrictive nature of the list of occupational diseases. In reply to the Committee’s comments concerning the restrictive nature of the list of occupational diseases, the Government refers to the adoption of Act No. 5510 of 31 May 2006 concerning social insurance and universal health insurance. This Act has brought profound changes to the social security system and established the new legal framework applicable to occupational diseases. The Government also refers to the adoption of the regulations concerning procedures for determining the degree of incapacity for work and the degree of earning capacity (Official Journal No. 27579 of 12 May 2011) which establish, inter alia, the new list of occupational diseases and the procedure to be followed regarding the recognition of the occupational origin of certain diseases not included in the list of occupational diseases or manifesting after the legally recognized latency period. According to the Government’s report, the list of occupational diseases does not have a restrictive nature inasmuch as the Social Security Health Board can now recognize the occupational nature of a disease not mentioned in the schedule. The Committee notes this information with interest and requests the Government to send full details of the operation of this additional procedure for the recognition of the occupational nature of a disease not mentioned on the list, particularly the steps that are necessary for submitting such a request.
Part V of the report form. Application of the Convention in practice. In its previous comments the Committee asked the Government to provide detailed information in reply to the observations made by TÜRK-İŞ in 2006 indicating the low number of occupational diseases recorded owing to the inadequacy of the system for the recognition of occupational diseases, insufficient numbers of medical personnel, failure to undertake the necessary clinical examinations and inadequate training and awareness-raising for medical personnel in this field. In a further communication of 2 May 2011, TÜRK-İŞ adds that the number of workers who are victims of occupational diseases has not been determined correctly. First, the lack of medical personnel and the absence of material resources make it impossible to establish with any validity the occupational nature of a disease. Second, no statistics are available with regard to occupational diseases of non-declared workers, who are estimated to account for 45 per cent of the workforce, a total which is equivalent to the number of declared workers. This being the case, TÜRK-İŞ emphasizes that the statistics sent by the Government cannot be taken as a true reflection of the real situation. According to these statistics, the number of cases of occupational disease recognized between 2005 and 2009 is 3,269 (of which 42 concerned women workers) compared with 2,308 between 2001 and 2004 (of which 18 concerned women workers). The Government also indicates that a protocol of cooperation was signed on 26 January 2010 between the Ministry of Labour and Social Security and the Ministry of Health in order to collaborate on occupational safety and health. The aims of this collaboration are as follows: to establish an action plan and a national policy with regard to prevention of occupational diseases and the early diagnosis thereof in order to ensure access to and updating of statistics concerning occupational diseases and accidents and to prepare a guide on the recognition of occupational diseases. Moreover, the Government states that, in order to promote the rights of the victims of silicosis usually caused by processes for sanding jeans, national law now prohibits the use of materials containing sand and silica crystals in the finishing process for all kinds of material. Workers suffering from silicosis are now entitled to receive a pension and to benefit from universal health services (section 67 of Act No. 6111 of 13 February 2011 concerning the restructuring of certain debts and Council of Ministers Resolution No. 15758 of 2009).
The Committee requests the Government to indicate the manner in which the recent measures referred to above, especially the adoption of the protocol of cooperation between the Ministry of Labour and Social Security and the Ministry of Health, have made it possible to improve and facilitate the detection and recognition of occupational diseases. The Government is also requested to indicate whether the protocol stipulates the provision of additional human and material resources to improve the functioning of the national apparatus for the detection and recognition of occupational diseases, especially among women workers. The Government is further requested to provide information on the use in practice of the appeal procedures launched by persons who wish the occupational nature of their diseases to be recognized, including, if applicable, copies of decisions issued by the competent authorities on this matter.
Moreover, the Committee invites the Government to reply to the observations made by the TÜRK-İŞ, according to which the adoption of Act No. 5510 of 31 May 2006 concerning social insurance and universal health insurance has significantly reduced the rights of victims of occupational accidents or diseases who suffer from permanent incapacity for work of 25 per cent or more by abolishing the minimum replacement income previously established by the law in force.

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The Committee notes the information and statistics provided by the Government, and the observations made by the Confederation of Turkish Employers’ Associations (TISK) and the Confederation of Public Servants’ Trade Unions (MEMUR-SEN) on the application of the Convention.

Developments in national law and practice. The Committee notes that several amendments have been made to the national legislation during the period covered by the last report. Accordingly, TISK reports the adoption of Act No. 5510 on social insurance and general health insurance of 31 May 2006, which has been in force since 1 January 2007, and which appears to establish the new legal framework applicable to occupational diseases. Furthermore, according to the Government’s report, Act No. 5489 of 19 April 2006 has had the effect of modifying the composition of the Higher Medical Social Insurance Council, which intervenes in determining the occupational origin of pathologies. Finally, MEMUR-SEN indicates that certain diseases have been recognized as being of occupational origin by the Higher Medical Social Insurance Council, although this recognition has not been extended to employees of the public service, who are governed by other legislative texts (Act No. 5434 on pension funds).

The Government adds that the development of the system relating to the pathological manifestations of occupational diseases has been given priority in national objectives relating to occupational safety and health for the period
2006–08 and indicates that a study is being undertaken on this subject.

The Committee would be grateful if the Government would indicate in its next report the manner in which the above amendments to the national legislation affect the application of the Convention. Please provide information on the outcome and action taken as a result of the above study, together with copies, where possible translated, of the new texts governing occupational diseases and, where appropriate, an updated list of such diseases. The Government is also requested to reply to the comments made by MEMUR-SEN calling for the establishment of a tripartite commission covering the issue of the extension to employees in the public service of the newly recognized occupational diseases.

Application of the Convention in practice. In its previous comments, the Committee requested the Government to provide detailed information with regard to the concerns expressed by the Confederation of Turkish Trade Unions concerning the inadequacy of the system for the recognition of occupational diseases, and, in particular, the low number of occupational diseases, recorded (1,055 cases in 1997). According to this organization, this figure demonstrates that the system for the determination of occupational diseases is not adequate: insufficient numbers of medical personnel, the failure to undertake the necessary examinations and the lack of awareness and insufficient training of medical personnel in this field.

The Committee notes that, with the exception of the information concerning the programme for the development of the system relating to the pathological manifestations of occupational diseases, the Government’s report does not contain any other information relating to the concerns expressed by the abovementioned organization with regard to the operation of the system for the recognition of occupational diseases. It notes in this respect that the figures provided by the Government in its report show that the number of occupational diseases recognized each year in the country is clearly declining in relation to previous figures. Indeed, the number of occupational diseases recognized annually fell constantly between 2001 and 2005, from 883 to 384, respectively. The data provided also show a very marked imbalance between men and women since, for 2004, there were 380 cases of recognized occupational diseases affecting men workers, compared with four for women. In view of the above, the Committee would be grateful if the Government would provide detailed information on the operation of the national system for the recognition of occupational diseases indicating, among other information, the trades, industries or processes giving rise to occupational diseases or poisoning, and specifying the importance of these trades, industries or processes, the number of workers employed therein and the number of cases of diseases or poisonings that have been reported.

Restrictive nature of the schedule of occupational diseases. In its previous comments, the Committee requested the Government to amend the national legislation so as to clearly indicate that the schedule of pathological manifestations is of an indicative nature. It observes that, despite the amendments made to the legislation during the period covered by the report, this specification has not yet been made, although the Government reiterates, on the one hand, that any disease that is not referred to in the schedule of occupational diseases, may nevertheless be recognized as an occupational disease by the Higher Medical Social Insurance Council and, on the other hand, that the schedule of pathological manifestations is not restrictive, but of an indicative nature. The Committee notes this information and hopes that on the occasion of a future revision of the relevant national legislation, and in order to prevent any ambiguity, the Government will take the necessary measures to explicitly indicate that the schedule of occupational diseases is of an indicative nature.

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The Committee notes the information and statistics provided by the Government and the observations made by the Confederation of Turkish Employers' Associations and the Confederation of Turkish Trade Unions on the application of the Convention.

1. In reply to the Committee's comments, the Government confirms that any disease which is not mentioned in the schedule annexed to the Regulations of 3 July 1985 may nevertheless be recognized as an occupational disease by the Higher Medical Social Insurance Council and that the schedule of pathological manifestations is of an indicative, not of a restrictive nature. On this subject, the Confederation of Turkish Employers' Associations also indicates that the compensation of occupational diseases is not subject to a restrictive approach and that Turkey has opted for a dual system composed of a schedule of occupational diseases and the possibility of considering diseases which are not included in the schedule as occupational diseases, in accordance with section 65 of the above Regulations. However, the Confederation of Turkish Trade Unions draws attention to the low number of occupational diseases reported (1,055 cases in 1997). According to the Confederation, this figure demonstrates that the system for the determination of occupational diseases is not adequate, particularly due to the insufficient numbers of medical personnel, the failure to undertake the necessary examinations and the lack of awareness and insufficient training of medical personnel in this field.

The Committee notes this information. It considers that it would be desirable, in order to prevent any ambiguity, that on the occasion of a future revision of the relevant legislation the Government should take all the necessary measures to add a provision to the legislation clearly indicating that the schedule of pathological manifestations is of an indicative nature (section 129 of Act No. 506 respecting social insurance, to which the Government refers on this matter, concerns the composition of the Higher Medical Social Insurance Council). Furthermore, the Committee would be grateful if the Government would provide detailed information in its next report with regard to the concerns expressed by the Confederation of Turkish Trade Unions concerning the inadequacy of the system for the recognition of occupational diseases.

2. With reference to its previous comments, the Committee notes with interest the Government's statement to the effect that the Regulations of 3 July 1985 establish, for each type of disease, a minimum duration of exposure to the hazard determined in the light of current scientific knowledge, and not a duration determined in a general manner for all the listed occupational diseases.

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The Committee notes the Government's statement in its report to the effect that, in accordance with the Regulation of 3 July 1985, for a disease to be considered an occupational disease, the insured person must have worked in a particular job for a period of at least three years, although the Supreme Medical Board may accept such a disease as being an occupational disease before the expiry of this prescribed period. The Committee recalls in this respect that the emergence of an occupational disease is not only linked to the period of exposure to the risk in question, but also to the nature of the risk, the type of disease and the level of exposure. It therefore considers that a minimum period of exposure may be considered admissible under the terms of the Convention provided that it is determined as a function of each type of disease in the light of current scientific knowledge, and not in a general manner, and provided that the levels of exposure to which the worker has been subjected are lower than the exposure limits that are generally accepted or determined by national legislation. Indeed, the determination of a minimum period of exposure in general for all diseases without taking into account the level of exposure is liable to deprive workers of their right to compensation when they are engaged in processes involving a high level of risk or in enterprises in which the preventive or protective measures are inadequate. The Committee therefore hopes that the Government will be able to re-examine the question and replace the requirement to have worked in a particular job for a period of three years by the specification of minimum periods of exposure to the risk which are determined for each type of disease, in accordance with current technical knowledge and taking due account of the above comments. For example, the Committee considers that the determination of a minimum exposure period is not justified in the case of anthrax infection, which can be contracted through a single contact with infected or contaminated animal carcasses, parts of carcasses or merchandise.

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With reference to its previous comments, the Committee takes note of the report of the Government, as well as the comments submitted by the Turkish Confederation of Employer Associations. The Government explains in its report that any disease which does not appear in the Regulation of July 1985 may be accepted as an occupational disease by the Social Insurance Supreme Medical Board. The Committee notes this information. The Committee trusts that the Government will take the necessary measures to clarify in the legislation that the list of symptoms is intended to be indicative rather than restrictive in nature.

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With reference to its previous comments, the Committee notes with interest that the list of pathological manifestations under the heading "Diseases and symptoms", contained in the list of occupational diseases appended to the Regulations of 3 July 1985 under each of the occupational diseases, is of an indicative nature.

It again asks the Government to indicate how this is specified in the above list, by referring, for example, to the corresponding provision.

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