Registration: The cornerstone of reach

Review of European Community and International Environmental Law

Volumn 17, Issue 1, 2008, Pages 107-125

  Hansen, Bjorn ^a   Blainey, Mark ^b  

^a EINDHOVEN UNIVERSITY OF TECHNOLOGY   (Netherlands)

^b HEALTH AND SAFETY EXECUTIVE   (United Kingdom)

Author keywords

[No Author keywords available]

Indexed keywords

CHEMICAL POLLUTANT; ENVIRONMENTAL PLANNING; ENVIRONMENTAL PROTECTION; EUROPEAN COMMISSION; WASTE MANAGEMENT;

EID: 42149167873     PISSN: 09628797     EISSN: 14679388     Source Type: Journal    
DOI: 10.1111/j.1467-9388.2008.00588.x     Document Type: Article

References (109)

1. In the European Parliament, the REACH second reading deal was passed by 529 votes in favour, 98 against and 24 abstentions. See 'Parliament adopts REACH - new EU chemicals legislation and new chemicals agency', press release (13 December 2006), available at .
2. Regulation (EC) No 1907/2006 of the European Parliament and of the Council of 18 December 2006 concerning the Registration, Evaluation, Authorization and Restriction of Chemicals (REACH), establishing a European Chemicals Agency, amending Directive 1999/45/EC and repealing Council Regulation (EEC) No 793/93 and Commission Regulation (EC) No 1488/94 as well as Council Directive 76/769/EEC and Commission Directives 91/155/EEC, 93/67/EEC, 93/105/EC and 2000/21/EC, [2006] OJ L396/1, available at .
3. European Parliament, 'First reading opinion on REACH' (P6_TAPROV (2005) 0434, 17 November 2005), available at .
4. Common position adopted by the Council on 27 June 2006 with a view to the adoption of a Regulation of the European Parliament and of the Council concerning the Registration, Evaluation, Authorization and Restriction of Chemicals (REACH), establishing a European Chemicals Agency, amending Directive 1999/45/EC of the European Parliament and of the Council and repealing Council Regulation (EEC) No 793/93 and Commission Regulation (EC) No 1488/94 as well as Council Directive 76/ 769/EEC and Commission Directives 91/155/EEC, 93/67/EEC, 93/105/EC and 2000/21/EC (7524/8/06 REV 8, 27 June 2006), available at .
5. Communication from the Commission to the European Parliament pursuant to the second subparagraph of Article 251(2) of the EC Treaty concerning the Common Position of the Council on the adoption of a Regulation of the European Parliament and of the Council concerning the Registration, Evaluation, Authorization and Restriction of Chemicals (REACH), establishing a European Chemicals Agency, amending Directive 1999/45/EC; and a Directive of the European Parliament and of the Council amending Council Directive 67/548/EEC in order to adapt it to Regulation (EC) No ... 2006 (REACH) COM (2006) 375 final, available at .
6. Council Directive 67/548/EEC of 27 June 1967 on the approximation of laws, regulations and administrative provisions relating to the classification, packaging and labelling of dangerous substances, [1967] OJ 196/1, as amended by Commission Directive 2004/73/EC, [2004] OJ L152/ 1, corrected in [2004] OJ L216/3.
7. In the European Parliament, the REACH second reading deal was passed by 529 votes in favour, 98 against and 24 abstentions. See 'Parliament adopts REACH - new EU chemicals legislation and new chemicals agency', press release (13 December 2006), available at .
8. Council Regulation (EEC) 793/93 of 23 March on the evaluation and control of existing chemical substances, [1993] OJ L84/1, as amended by Regulation (EC) No 1882/2003 of the European Parliament and of the Council, [2003] OJ L 284/1.
9. Council Directive 76/769/EEC of 27 July 1976 on the approximation of laws, regulations and administrative provisions relating to restrictions on the marketing and use of certain dangerous substances and preparations, [1976] OJ L262/201, as last amended by Directive 2005/90/ EC of the European Parliament and of the Council, [2006] OJ L33/28.
10. EINECS (European Inventory of Existing Chemical Substances, [1990] OJ C146, Annex) was drawn up by the European Commission in application of Article 13 of Directive 67/548/EEC, n. 6 above. It is a registry for each chemical substance commercially available in the EU between 1 January 1971 and 18 September 1981, based on industry submissions, and contains 100,204 substances. In terms of Article 1(4) of Directive 67/ 548/EEC, as amended, these are substances to which the new substance notification provisions of the Directive do not apply. See European Chemical Substances Information System (European Chemicals Bureau, undated), available at , which is a database of the substances included on EINECS.
11. The information required is dependent on the tonnage placed on the market or imported, but at the 1 tonne level it is equivalent to the 10 tonnes level (Annexes VII and VIII) of REACH (see n. 2 above).
12. In the European Parliament, the REACH second reading deal was passed by 529 votes in favour, 98 against and 24 abstentions. See 'Parliament adopts REACH - new EU chemicals legislation and new chemicals agency', press release (13 December 2006), available at .
13. The information required is equivalent to the 10 tonnes level (Annexes VII and VIII) of REACH, n. 2 above.
14. The information required was limited to all available data.
15. Article 8 of Regulation (EEC) 793/93 (n. 8 above) states that the Commission, in consultation with the Member States, will regularly draw up lists of priority substances that require immediate attention because of their potential effects to people or the environment. Since 1994, four such priority lists have been published. Substances on priority lists must undergo an in-depth risk assessment covering the risks posed by the priority chemical to people (covering workers, consumers and man exposed via the environment) and the environment (covering the terrestrial, aquatic and atmospheric ecosystems and accumulation through the food chain).
16. Commission Regulation (EC) No 1488/94 of 28 June 1994 laying down the principles for the assessment of risks to man and the environment of existing substances in accordance with Council Regulation (EEC) No 793/ 93, [1994] OJ L161/3, available at .
17. Where a risk assessment concludes that a substance is of concern and that further risk reduction measures - beyond those already in place - are required, then a risk reduction strategy must be developed. The elaboration of such a strategy is done utilizing the Technical Guidance Documents on Risk Reduction. See European Commission, Technical Guidance Documents on Risk Reduction (European Commission, January 1998), available from . This guidance is not legally binding but represents a common commitment by the Commission, Member States and participating non-governmental organizations (NGOs) on how risk reduction recommendations pursuant to Regulation 793/93 could be framed.
18. B.G. Hansen and M.A. Blainey, 'REACH: A Step Change in the Management of Chemicals', 15:3 RECIEL (2006), 270-280; B.G. Hansen and M.A. Blainey, 'REACH - An Update', 3:5 JEEPL (2006), 446.
19. Commission of the European Communities, White Paper on a Strategy for a Future Chemicals Policy COM (2001) 88 final, available at . Commission White Papers are documents containing proposals for Community action in a specific area and where it is favourably received by the Council, it can lead to action in the area concerned.
20. To assist the Commission in implementation of the White Paper proposals, a number of technical expert working groups were convened by the Commission from October 2001 to February 2002. The working groups were made up of stakeholder experts from authorities in the Member States, industrial associations and NGOs.
21. A 'top-down' approach means that a larger set of information is in principle needed, but waiving would reduce the required information if it is not necessary. The 'bottom-up' approach is one where a minimum data set is required and then on a case-by-case basis further information needs may be identified. The Commission Working Group on Testing, Registration and Evaluation concluded that ideally both approaches should result in the same information being generated, but the former (the 'top-down') was easier to enforce.
22. See B. G. Hansen and M. A. Blainey, n. 18 above.
23. See White Paper on a Strategy for a Future Chemicals Policy n. 19 above.
24. See Regulation 1907/2006, n. 2 above, Title II.
25. Ibid., Title III.
26. Ibid., Title IV.
27. Ibid., Title V.
28. Ibid., Title VI.
29. Ibid., Title VII.
30. Ibid., Title VIII.
31. Ibid., Title IX.
32. Ibid., Title XI.
33. In REACH speak, 'safe' means 'adequately controlled' (see ibid., Annex I, para. 6.4) or minimized (see ibid., Annex I, para. 6.5).
34. See nn. 5-9 above.
35. Only two substances out of 3,500-odd notified substances have been restricted: Ugilec 141 and Ugilec 121 were developed as safe alternatives for PCBs but after their commercial introduction, concentrations were found in fish and sediments in the same order as PCBs and were assessed to constitute a potentially high risk to man and environment. See M. Herrmann, Ugilec (undated), available at .
36. German Federal Ministry for the Environment, Nature Conservation and Nuclear Safety, Is This Truly a 'Better REACH?' Evaluation of the VCI/ CEFIC Proposals (Federal Ministry for the Environment, Nature Conservation and Nuclear Safety, 2005), available at .
37. Base-set means the tests required under Directive 67/548/EEC for a new substance that is manufactured or imported.
38. High Expected Regulatory Outcome (HERO) substances are those for which the application of regulation will result in a high probability of a regulatory outcome, i.e. identification of a carcinogen, mutagen or a substance toxic to reproduction and subsequent restriction.
39. See n. 21 above, for an explanation of the top-down approach.
40. REACH, n. 2 above, Annex XI(3) on substance-tailored, exposuredriven testing provides a possibility to waive testing in accordance with sections 8.6 and 8.7 of Annex VIII, Annex IX and Annex X based on exposure scenarios. Also for specific endpoints, column 2 provides that exposure considerations and/or results of the Chemical Safety Assessment may be used to justify waiving of testing for the endpoint.
41. These were the Environment Committee; Industry Committee; Internal Market and Consumer Protection Committee; Economic and Monetary Affairs Committee; Employment and Social Affairs Committee; Budgets Committee; Women's Rights Committee; Legal Affairs Committee; International Trade Committee; and Petition Committee.
42. European Parliament legislative resolution on the proposal for a regulation of the European Parliament and of the Council on the Registration, Evaluation, Authorization and Restriction of Chemicals (REACH), establishing a European Chemicals Agency and amending Directive 1999/45/EC and Regulation (EC) No.../... (on Persistent Organic Pollutants) (COM (2003) 0644 - C5-0530/2003 - 2003/0256 (COD)) (P6_TA-PROV (2005) 0434, 17 November 2005).
43. See Common Position, n. 4 above.
44. The Chemical Safety Report (CSR) documents the Chemical Safety Assessment (CSA) undertaken for substances manufactured or imported in quantities starting at 10 tonnes. The CSA is in effect a combined risk assessment/risk reduction strategy carried out by the registrant for all the identified uses of their substance.
45. Committee on the Environment, Public Health and Food Safety, Recommendation for Second Reading on the Council Common Position for Adopting a Regulation of the European Parliament and of the Council concerning the Registration, Evaluation, Authorization and Restriction of Chemicals (REACH), establishing a European Chemicals Agency, amending Directive 1999/45/EC of the European Parliament and of the Council and repealing Council Regulation (EEC) No 793/93 and Commission Regulation (EC) No 1488/94, as well as Council Directive 76/769/EEC and Commission Directives 91/155/EEC, 93/67/EEC, 93/105/EC and 2000/21/EC (7524/8/2006 - C6-0267/2006 - 2003/0256 (COD)) (A6-0352/2006, 13 October 2006), available at .
46. 'Trialogues' are normally discussions during conciliation between the co-decision actors, the Council and the Parliament, with the Commission in attendance to decide on issues surrounding the particular dossier being discussed. In the case of a second reading deal, any trialogues are termed informal as they do not have a specific standing in the rules of procedure.
47. See Regulation 1907/2006, n. 2 above, Articles 3(4), 3(33), 3(20), 3(37) and 3(38) respectively.
48. Ibid., Articles 9, 11, 14, 21, 22, and 23.
49. Ibid., Article 3(22).
50. Ibid., Article 9(7).
51. Ibid., Article 13.
52. Ibid., Article 23.
53. Ibid., Article 138.
54. CEFIC, 'Revised REACH proposals: The right direction on "scope" but no progress on "workability"' (MD/PRESS/1806, 8 October 2003), available at ; UNICE, An EU Industry recommendation to improve the efficiency and workability of REACH (UNICE, 2005), available at .
55. The Royal Commission on Environmental Pollution's Twenty-Fourth Report, Chemicals in Products, Safeguarding the Environment and Human Health, Cm 5827 (June 2003), available at ; L. Bergkamp and J.C. Hanekamp, 'The draft REACH regime: Costs and benefits of precautionary chemical regulation', 5 Env. Liability (2003), 167.
56. CEFIC, New Proposals to Improve Workability of REACH: The Contribution of the European Chemical Industry (CEFIC, 2005), available at .
57. Draft Opinion of the Committee on the Internal Market and Consumer Protection for the Committee on the Environment, Public Health and Food Safety on the proposal for a regulation of the European Parliament and of the Council concerning the Registration, Evaluation, Authorization and Restriction of Chemicals (REACH), establishing a European Chemicals Agency and amending Directive 1999/45/EC and Regulation (EC) (on Persistent Organic Pollutants), COM (2003) 0644 - C6-0531/2003 - 2003/ 0256 (COD).
58. Industrial use (workers with a high standard of competence, qualifications and skills, a high standard of supervision and control and a high standard for technical measures), commercial use (workers with various/different competences, qualifications and skills lower or varying standard of supervision and control and a lower standard for technical measures) or consumer use (no expertise/fewer skills for implementing measures, no technical measures (except for certain products), no individual protection (except for gloves or protective glasses in certain cases), sensitive group).
59. In the EU classification system, CMR substances are placed in one of three categories, with category one indicating the substances that are most likely to cause the relevant effect.
60. Criteria for high toxicity: High toxicity is indicated for substances that are very toxic, toxic, corrosive, sensitizing. CMR Category 3, aquatic toxicity less than 1 mg/l.
61. Criteria for high exposure: High exposure is indicated for repeated, long-term exposure of human beings, or repeated, longterm exposure of the environment. High exposure is not indicated for substances that break down easily in the environment, are bound into a matrix, are used in preparations in concentrations of less than 1% or are used in products in concentrations of less than 0.1%. These are covered, with regard to their use, by other regulated areas excluded from REACH.
62. See Regulation 1907/2006, n. 2 above, Annex VIII, Parts 8.6 and 8.7.
63. The Commission has estimated that 80,000 dossiers will be registered for 30,000 substances; see European Commission, Questions and Answers on REACH (European Commission, July 2007), available at .
64. See n. 36 above, for example. T. Musu, 'REACH: Industry's meltdown predictions groundless but fierce lobbying goes on', 27 HESA Newsletter (June 2005), 5, available at . E. Forsberg, 'Editorial' (KEMI, 14 March 2006), available at . World Wide Fund for Nature (WWF), WWF Factsheet: Hazard information, risk assessment and REACH (WWF, undated), available at .
65. F. Leone, 'Note on the Further Work Concerning the Impact Assessment of REACH', 2:3 JEEPL (2005), 195.
66. Presented, discussed and reviewed at the Luxembourg Presidency Workshop on REACH, 10-11 May 2005. See Luxembourg Presidency Workshop on REACH, Presidency Report (Government of Luxembourg, undated), available at .
67. The following physicochemical hazards were assessed by the initiators of the proposal as being essential for computer-based assessment of the substance as potentially exposing human beings or environmental spheres: state of the substance at 20°C and 101.3 kPa; vapour pressure; water solubility; partition coefficient n-octanol/water; flash point; flammability; explosive properties; granulometry (if applicable).
68. These are: Main use category (industrial use, professional use or consumer use); specification for industrial and professional use (use in closed system, use resulting in inclusion into or onto matrix, non-dispersive use or dispersive use); significant route(s) of exposure (human exposure (oral, dermal, environmental exposure through water, air, solid waste)); pattern of exposure accidental/infrequent, occasional, continuous/frequent.
69. Structural activity relationships and quantitative structural activity relationships, collectively referred to as (Q)SARs, are theoretical models that can be used to predict the physicochemical, biological and environmental fate properties of molecules. In the hazard and risk assessment process, (Q)SARs are generally used in combination with other sources of information on chemicals, either to prioritize chemicals for further assessment, or to replace testing. See Joint Research Centre (JRC), Computational Toxicology (JRC, undated), available at .
70. The tests that were added are found in Annex VII, para. 6.5.1 on acute toxicity (oral route), para. 7.1.2 on growth inhibition study aquatic plants (algae preferred), and para. 7.2.1.1 on ready biodegradability of Regulation 1907/2006, n. 2 above.
71. The Commission supported the full Malta/Slovenia proposal as it only prioritized 5 percent of substances, as did certain Member States.
72. European Council, Impact Assessment of Alternative Approaches to Registration of Low Volume Substances, Commission Services Working Document 301/05 (7 November 2005), available at .
73. See Opinion of the Committee, n. 57 above.
74. Opinion of the Committee on the Industry, Research and Energy for the Committee on the Environment, Public Health and Food Safety on the proposal for a regulation of the European Parliament and of the Council concerning the Registration, Evaluation, Authorization and Restriction of Chemicals (REACH), establishing a European Chemicals Agency and amending Directive 1999/45/EC and Regulation (EC) (on Persistent Organic Pollutants).
75. For an NGO briefing on the Malta/Slovenia proposal, see MT/SI Proposal for a 'Risk-based prioritization' of Low Volume Chemicals (27 June 2005), available at .
76. One Substance, One Registration: A Joint Proposal from Hungary and the UK (European Parliament, undated), available at .
77. Proposal for a Regulation of the European Parliament and of the Council concerning the Registration, Evaluation, Authorization and Restriction of Chemicals (REACH), establishing a European Chemicals Agency and amending Directive 1999/45/EC and Regulation (EC) (on Persistent Organic Pollutants) (SEC (2003) 1171) COM/2003/0644 final - COD 2003/0256 (2003). Article 10 related to the joint submission of data by members of consortia. Manufacturers and importers of the same substance may form a consortium for the purposes of registration and each member would pay onethird of the registration fee.
78. Core data in this case consists of the physicochemical, toxicological and ecotoxicological data in Annexes VII-X of REACH, n. 2 above, the classification and labelling of the substance and any proposals for testing.
79. DEFRA, One Substance One Registration: Final Report (DEFRA, December 2004). available at .
80. Commission Staff Working Paper of 29 October 2003 on Regulation of the European Parliament and of the Council concerning the Registration, Evaluation, Authorization and Restrictions of Chemicals (REACH), establishing a European Chemicals Agency and amending Directive 1999/45/ EC and Regulation (EC) (on Persistent Organic Pollutants): Extended Impact Assessment, COM (2003) 644, available at .
81. See Regulation 1907/2006, n. 2 above, Article 11.
82. See n. 44 above.
83. See Proposal for a Regulation of the European Parliament and of the Council concerning the Registration, Evaluation, Authorization and Restriction of Chemicals (REACH), n. 77 above, Annex I, para. 5.1.1, which states: 'These exposure scenarios may be as wideranging or specific as necessary...'.
84. See n. 47 above.
85. Amendment 413 of the first reading in Parliament sets out a new section in Annex IV containing explanations on how to determine the main use category for a substance (including categorization as industrial/ professional/consumer use and significant routes of exposure). See n. 42 above.
86. See Regulation 1907/2006, n. 2 above, Annex I, para. 0.5.
87. D.J. Kent and J.E. Heinze, The EU REACH Regulatory System: Pre-Registration Evaluation of OECD SIDS-Approved Chemicals - LAB and LAS as Case Studies (ECOSOL/CLER, undated), available at .
88. Commission Services, REACH in Brief (European Commission, November 2007), available at . V.J. Brown, 'REACHing for Chemical Safety', 111:14 Environmental Health Perspectives (2003) 767, available at .
89. Report on the operation of Council Directive 67/548/EEC of 27 June 1967 on the approximation of the laws, regulations and administrative provisions relating to the classification, packaging and labelling of dangerous substances, Council Directive 76/769/EEC of 27 July 1976 on the approximation of the laws, regulations and administrative provisions of the Member States relating to restrictions on the marketing and use of certain dangerous substances and preparations, Directive 1999/45/EC of the European Parliament and of the Council of 31 May 1999 concerning the approximation of the laws, regulations and administrative provisions of the Member States relating to the classification, packaging and labelling of dangerous preparations and Council Regulation (EEC) No 793/ 93 of 23 March 1993 on the evaluation and control of the risks of existing substances, available at . SEC (1998) 1986 final (1998).
90. See White Paper on a Strategy for a Future Chemicals Policy n. 19 above, para. 2.3.
91. CEFIC, Health, Safety and Environment: Responsible Care (CEFIC, undated), available at . See also 'Two Decades of Responsible Care: Credible response or comfort blanket?', 360 ENDS Report (January 2005), available at .
92. The Toxic Substances Control Act (TOSCA) of 1976, 15 USC s/s 2601 et seq. (1976).
93. J.J. McKetta (ed), 19 Encyclopaedia of Chemical Processing and Design (Marcel Dekker, 1993), at 224-226.
94. United States General Accounting Office, Toxic Substances Control Act: Legislative Changes Could Make the Act More Effective (GAOiRCED-94-103, September 1994), available at .
95. US Government Accountability Office, 'Chemical Regulation: Options Exist to Improve EPA's Ability to Assess Health Risks and Manage its Chemical Review Program (GAO-05-458, June 2005), available at .
96. Canadian Environmental Protection Act 1999, SC 1999 Ch. 33 and 34, available at .
97. 'Chemicals management may be getting tougher' Environmental Science and Technology (1 November 2006), available at .
98. ENGO Delegation to the Parliamentary Review of CEPA Burden of Proof, Reverse Onus CEPA 1999 (October 2005), available at .
99. Notification G/TBT/N/EEC/52 of 30 January 2004 on COM (2003) 644 Final Proposal for a Regulation of the European Parliament and of the Council concerning the Registration, Evaluation, Authorization and Restriction of Chemicals (REACH), establishing a European Chemicals Agency and amending Directive 1999/45/EC and Regulation (EC) (on Persistent Organic Pollutants); Proposal for a Directive of the European Parliament and of the Council amending Council Directive 67/548/EEC in order to adapt it to Regulation (EC) of the European Parliament and of the Council concerning the registration, evaluation, authorization and restriction of chemicals, available at .
100. Thirteen sets of comments were received from the USA, Japan, Canada, China, Brazil, Australia, Chile, Singapore, Taiwan, Thailand, Cuba, the American Chemistry Council (ACC) and the Asia-Pacific Economic Co-operation Chemical Dialogue (APEC).
101. Notification G/TBT/N/EEC/52/Add.2 of 17 August 2006 on COM (2003) 644 final, Proposal for a Regulation of the European Parliament and of the Council concerning the Registration, Evaluation, Authorization and Restriction of Chemicals (REACH), establishing a European Chemicals Agency and amending Directive 1999/45/EC and Regulation (EC) (on Persistent Organic Pollutants); Proposal for a Directive of the European Parliament and of the Council amending Council Directive 67/548/EEC in order to adapt it to Regulation (EC) of the European Parliament and of the Council concerning the registration, evaluation, authorization and restriction of chemicals, available at .
102. Notification G/TBT/N/EEC/52/Add.3.Rev 1 of 9 February 2007 on COM (2003) 644 final, Proposal for a Regulation of the European Parliament and of the Council concerning the Registration, Evaluation, Authorization and Restriction of Chemicals (REACH), establishing a European Chemicals Agency and amending Directive 1999/45/EC and Regulation (EC) (on Persistent Organic Pollutants); Proposal for a Directive of the European Parliament and of the Council amending Council Directive 67/548/EEC in order to adapt it to Regulation (EC) of the European Parliament and of the Council concerning the registration, evaluation, authorization and restriction of chemicals, available at .
103. M. Blainey, C. de Avila and P. van der Zandt, 'REACH: Substances in Articles - A Step in the Right Direction', 6 JEEPL (2007), 424.
104. Response from the European Communities to Comments Submitted by WTO Members under G/TBT/N/EEC/52 Regulation concerning the registration, evaluation and authorization of chemicals (known as REACH), COM (2003) 644 final (European Commission, undated), available at .
105. The main WTO issues that have been raised by the countries who commented (see n. 100 above) relate to Article 2.1 of the TBT Agreement that requires 'domestic regulations to accord treatment no less favourable than that accorded to like products of national origin'. In addition, Article 2.2 of the TBT Agreement requires all WTO members to 'ensure their technical regulations are not more trade restrictive than necessary to fulfil a legitimate objective, taking account of the risks non-fulfilment would create'. See Agreement on Technical Barriers to Trade (Marrakesh, 15 April 1994), Articles 2.1 and 2.2.
106. M. Bronkers and P. Charro, 'REACH Reviewed under WTO Law', 3 JEEPL (2005), 184.
107. AMCHAM EU, CEFIC, FECC, Discussion paper on the trade impact of REACH (AMCHAM EU, CEFIC, FECC, 30 November 2004), available at .
108. Field Fisher Waterhouse, 'Field Fisher Waterhouse's Competition and EU Regulatory team successful in UK High Court Challenge to REACH'' (undated), available at .
109. ETUC, The impact of REACH on occupational health with a focus on skin and respiratory diseases (ETUC, September 2005), available at .