thematic dossier
Work-related illnesses
Dues à des expositions professionnelles, les principales maladies en lien avec le travail sont surveillées par Santé publique France dans l’objectif d’élaborer, avec les partenaires, les...
World Day for Safety and Health at Work 2021
To mark World Day for Safety and Health at Work on April 28, 2021, Santé publique France highlights, through a number of studies, the initiatives it has undertaken in the areas of workplace health surveillance and promotion.
The COVID-19 pandemic has had numerous impacts on the world of work and has led governments, employers, workers, and the general public to face unprecedented challenges related to the SARS-CoV-2 virus. The theme of the 2021 World Day for Safety and Health at Work is “Anticipate, Prepare, and Respond to Crises—Invest Now in Resilient Occupational Safety and Health Systems.”
Improving workers’ overall health: a challenge for occupational health and public health
2021 is an important year for occupational health, with:
the draft Occupational Health Prevention Act, which aims to strengthen risk prevention and efforts to prevent workers from falling out of the workforce, as well as dialogue with industry sectors,
the renewal of the Occupational Health Plan (PST4 2021–2025).
The relationship between health and work is strong: work can have positive or negative health impacts depending on working conditions. Workers are exposed to risk factors and/or protective factors/resources depending on their working conditions and, more generally, their living conditions. Exposure to these risk factors (combined and accumulated over time) results in health impairments among workers that affect their professional lives. The scale of certain work-related phenomena (in terms of severity and scope) constitutes a public health issue. Furthermore, there are interactions between workers’ health and the environment: workers’ health is influenced by the environment, and the health of ecosystems is impacted by work, which calls for a comprehensive “One Health” approach.
With the COVID-19 health crisis, workers are facing significant changes in their working conditions and work organization, with potential economic difficulties and impacts on their mental and physical health.
In this context, Santé publique France is committed to drawing lessons regarding the need to break down barriers between public health and occupational health, to incorporate an integrated view of the environment—combining the general environment with the occupational environment—into its work, and to anticipate other emerging issues highlighted by the current health crisis. We conduct worker health surveillance, workplace alert systems, and health prevention and promotion activities across various settings—including the workplace—through the development of advocacy initiatives on occupational and environmental health using a “One Health” approach that integrates human and ecosystem health.
Santé publique France’s Responsibilities in Occupational Health
Santé publique France conducts surveillance activities on occupational risks, work organization, and their effects on health by generating data to support public authorities, occupational health and safety professionals, stakeholders, and social partners through its systems, studies, and cohorts. Our cross-cutting approaches—based on exposures, diseases, and populations—help improve the physical and psychosocial work environment through the prevention of occupational risks. To advance this work, we rely on a network of partners from the world of work, including occupational health services, and we share our findings with the ministries responsible for occupational health and with occupational risk prevention agencies (INRS, ANACT, Cnamts, CCMSA, OPPBTP). We also provide regular feedback to social partners, particularly through the Advisory Council on Working Conditions (Coct) for the general social security system and ad hoc bodies for the agricultural system.
Developing workplace health promotion
Santé publique France leads the development of workplace health promotion to improve workers’ health and well-being, foster healthier lifestyles and work practices, and advance toward sustainable development with equity and social justice. To this end, several partners will be mobilized in accordance with the specific missions of occupational health and public health stakeholders. This initiative will be carried out within the framework of the PST4 2021-2025.
Conducting investigations in workplaces, particularly in the context of unexplained incidents
To respond as effectively as possible, an organizational structure is being established in each region involving regional health agencies, regional directorates for the economy, employment, labor, and solidarity, and the occupational and environmental pathology departments of university hospitals. A plan is under consideration to integrate this expertise into a structured occupational health and environmental framework.
Adapting to Environmental and Societal Challenges
(health crises, climate change, social inequalities, and regional vulnerabilities…), Santé publique France is adapting its activities to environmental and societal challenges and to changes in the world of work. For example:
Adapting our surveillance systems to study the impact of the COVID-19 pandemic on workers’ health (Coset MSA and self-employed cohorts, MCP).
The implementation of an advocacy strategy for occupational and environmental health within a “One Health” approach, to promote, based on evidence, behavioral or systemic changes that support health in various settings, including the workplace.
Collaboration with our international partners within the framework of the International Association of National Public Health Agencies (IANPHI), for which Santé publique France serves as the secretariat, to ensure that climate change becomes a priority in public health policies. Objective: to develop a position on global warming and promote it within the framework of COP 26.
Aligning our work with the national strategy
Santé publique France ensures that its work is developed in alignment with various national plans and strategies (Occupational Health Plans and MSA Health Strategy, National Health Strategy, National Health and Environment Plan, Ten-Year Strategy to Combat Cancer, National Nutrition and Health Program, National Sport, Health, and Well-being Strategy, National Tobacco Control Program, National Plan to Combat Addictions, Mental Health and Psychiatry Roadmap, etc.).
Participating in European projects
In addition, Santé publique France also participates in European projects to harmonize practices in occupational biomonitoring (HBM4EU and PARC projects).
Some examples of our work
Santé publique France is committed to producing reliable indicators covering both occupational exposures and the main work-related health conditions. The epidemiological data obtained through the MCP system are essential for helping various prevention stakeholders (Regional Association for the Improvement of Working Conditions, Regional Health Insurance Fund, Regional Committee for the Prevention of Occupational Risks, etc.) to identify and develop priority prevention measures for specific diseases, occupations, or sectors of activity, within the framework of regional plans such as the Regional Occupational Health Plan (PRST) or the Regional Public Health Plan (PRSP).
Learn more: Occupational Diseases Resource Center
The Coset program is a longitudinal study monitoring work-related health. It covers all occupational settings in France. Coset examines a wide range of health issues (musculoskeletal problems, cardiovascular and respiratory problems, cancer, mental health, etc.) and all types of working conditions. The findings will help improve our understanding of the links between working conditions and health among the working population in France and will inform recommendations for prevention in the workplace.
Learn more: COSET program
Between 2015 and 2016, 1,100 new cases of pleural mesothelioma were diagnosed annually in France, 27% of which were in women. Despite the ban on asbestos use in 1997 and due to the 30- to 40-year latency period between initial exposure and the onset of mesothelioma, the incidence of pleural mesothelioma continues to rise in France, and this increase is even more pronounced among women (a doubling of new cases over 20 years) than among men. It is essential to strengthen prevention efforts targeting current asbestos exposure—among workers, young people in training, healthcare professionals, and the general public—and to increase outreach efforts regarding the options for utilizing existing medical-social recognition programs.
This survey, conducted in 2019 among some 40 individuals from occupational health services, laboratories, and experts in toxicology and biomonitoring of occupational exposures, shows that chemical risks in the workplace are still often underestimated, particularly in small businesses. Biomonitoring of occupational exposures remains a marginal practice among occupational physicians regarding workers’ chemical exposures in France.
The European Commission launched the HBM4EU (Human Biomonitoring for Europe) research program for the 2017–2021 period to develop biomonitoring in Europe and harmonize existing practices in order to make this tool operational on a continental scale. As the lead agency for the national biomonitoring program, Santé publique France is heavily involved in HBM4EU.
This study describes changes between 2007 and 2015 in the populations of employees and self-employed workers in France, as well as differences in their exposure to flour and cereal dust and formaldehyde, based on a cross-analysis of population census data with three job-exposure matrices from the Matgéné program. This study highlights differences in exposure based on worker status and shows that the self-employed population, which has been growing in France over the past decade, is proportionally more exposed than the employed population. These findings can help guide prevention efforts by targeting sectors and occupational exposures that remain a concern, particularly for the self-employed population not monitored by occupational health services.
Work-related illnesses and disorders, such as mental distress and burnout, have a significant impact on public health in France. While they represent a major burden, exposure to occupational risk factors and the associated disorders and illnesses can be prevented through appropriate preventive measures.
With the first lockdown implemented in March 2020 to combat the spread of the COVID-19 pandemic, the work routines of most French people underwent significant changes, including work interruptions, a massive shift to remote work, and increases or decreases in work pace. It has been shown that these working conditions during lockdown were associated with an increased risk of low back pain among new teleworkers and among workers who continued to work outside the home at a more intense pace than usual. The implementation of preventive measures is necessary to reduce this risk of low back pain among workers.
Combating Sedentary Lifestyles Among Remote Workers
Since the start of the health crisis, the risks associated with a lack of physical activity and a sedentary lifestyle have increased, particularly during lockdowns, due to the sharp decline in opportunities for physical activity during leisure time, at work, or while commuting.
Smoke-Free Month in the Workplace
Since 2016, the Smoke-Free Month initiative has offered partner organizations the opportunity to share smoking prevention messages with their beneficiaries or employees through partnerships and specific tools. In 2018, an assessment was conducted focusing on corporate involvement in the initiative. In 2019 and 2020, this involvement continued: in 2019, 1,277 companies placed orders on the “Partners” section of the Smoke-Free Month website, and 701 did so in 2020, despite the challenging health context.
For more information: moisanstabac@santepubliquefrance.fr
