Work-related illnesses

Work-related illnesses and disorders are caused by occupational exposure to chemical, physical (noise, repetitive motions, etc.), psychosocial, and organizational hazards. These include mesothelioma and other cancers, asthma and chronic obstructive bronchitis, mental health issues, musculoskeletal disorders, Parkinson’s disease, and amyotrophic lateral sclerosis.
Surveillance programs for occupational diseases (MCP) and work-related accidents and occupational diseases (AT-MP) recognized by the major health insurance schemes make it possible to monitor conditions directly linked to work, primarily musculoskeletal disorders (MSDs) and mental health issues, as well as other conditions such as skin diseases or hearing disorders that are not currently subject to specific surveillance.

Diverse and multifactorial conditions

Since the early 1990s, there has been a steady increase in the number of occupational diseases compensated under both the general Social Security system and the agricultural system. Musculoskeletal disorders are by far the leading cause of compensated occupational diseases. Their occurrence is linked to physical and/or psychological and/or organizational factors. Asbestos remains the primary risk factor for mesothelioma, and the list of carcinogens recognized by the International Agency for Research on Cancer is steadily growing as new knowledge emerges. Exposure to certain chemicals can cause respiratory conditions such as asthma. Exposure to psychosocial factors can lead to psychological distress or even burnout.

Multimodal monitoring

Santé publique France has established various studies and systems with the aim of informing and guiding the coordinated action of public authorities and social protection schemes:

• Epidemiological surveillance systems for the working population: general cohorts (Coset, Cosmop) or specialized cohorts (chlordecone, EpiNano, cohorts in workplaces and institutions such as the prison system, Espri), a system for monitoring occupational diseases via a network of occupational physicians and multidisciplinary teams;

• Monitoring the frequency and intensity of occupational exposures, both for carcinogenic, mutagenic, or reprotoxic (CMR) agents and for other agents, whether physical or organizational;

• Surveillance of specific conditions: mesothelioma and other cancers, musculoskeletal disorders, chronic respiratory diseases, mental health disorders, and neurodegenerative diseases;

• Occupational Health Alert Groups (GAST), which constitute a regionalized system designed to collect and process reports of unusual health events in the workplace: suspected clusters of disease cases, unexplained collective syndromes, and atypical exposures.

The MCP program, the surveillance of occupational accidents and illnesses, as well as cohorts, the PMSI, the Health Barometer, and specific projects help to expand this surveillance. Similarly, investigations into clusters of chronic conditions occurring in the general population, and investigations into unusual health events in the workplace—whose reports fall under a specific occupational health alert system, the GAST (Occupational Health Alert Groups).

A contribution to the development of prevention measures

The epidemiological data obtained are essential for helping the various prevention stakeholders (National Health Insurance Fund, Agricultural Social Mutual Fund, INRS, OPPBTP, Regional Committees 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 national plans (Occupational Health Plan—PST3, etc.) implemented at the regional level (Regional Occupational Health Plan—PRST).