Usefulness of the results of a surveillance program for uncompensated work-related diseases in France

Background

French employees receive compensations for diseases officially recognized as professionnal disease. Reimbursment data are thus used to produce statistics. Such data do not integrate uncompensated work-related diseases (UUWRD) defined as likely to be of occupational origin but not recognized as well. In 2003, the National Public Health Agency implemented a surveillance program on UWRD. This program is a complement to the compensation system for occupational diseases.

This communication presents results UWRD program can provide.

Methods

Twice a year, a network of volunteer occupational physicians (OP) reports ill health and associated work exposures of employees. Employee sociodemographics are notified. In 2018, half of French regions are integrated in the program.

Prevalence rates are calculated for UWRD. Chi-squared tests are used to compare prevalence rates between groups. Multivariate logistic regressions are conducted to evaluate:1- risks to report UWRD between groups, 2- prevalence rates trends. Underreporting rates of UWRD are approximated using an indicator capturing differences between figures produced by UWRD program and the compensation system.

Results

Over the 2009-2014 period, women working in mass food retail were observed at higher risk to present musuculoskeletical disorders than women of other sectors (ORa = 2.0). Same results were noted for men (ORa = 1.3). In mass food retail, decreases in musculoskeletal disorder prevalence rates were reported. Estimated average annual change rates were of 7.0 % for women and 11.0% for men. In 2011, UWRD data highlighted that between half and three-quarter of work-related musculoskeletal disorders were unreported by the compensation system.

Conclusions

UWRD data are used to identify vulnerable groups, analyse temporal trends and evaluate underreporting of professionnal disease.

Key messages

URWD program is a complement to the compensation system and let to better monitor health status of communities. Such informations are of interest to guide prevention policies.

Work-related diseases in temporary workers in France between 2009 and 2014

Background

The percentage of temporary workers in the workforce has increased in many European countries. The working environments of temporary workers are often characterized by job insecurity and exposure to hazardous working conditions. Studies have investigated the health status of this population but few of them have specifically investigated work-related diseases. The aim of this study is to compare the risk of uncompensated work-related diseases (UWRD) in temporary workers with permanent contract workers in France between 2009 and 2014.

Methods

UWRD and suspected associated exposure factors were notified by occupational physicians involved in French UWRD surveillance programme. Sociodemographic and professional characteristics were recorded for all salaried workers consulted by occupational physicians. We analysed musculoskeletal (MSD) disorders (elbow, hand/wrist, shoulder, back) and mental health disorders (MHD) according the type of consultation (periodic check-up, hiring...) using logistic regression. The distributions of notified exposure factors for MSD and MHD were compared between temporary and permanent workers.

Results

Of the 433 148 salaried workers consulted as part of the surveillance programme, 5.3% and 80.2% had temporary and permanent contracts, respectively. Temporary workers were as likely to have work-related shoulder, elbow and hand/wrist MSD as permanent workers. The former had a lower risk of MHD irrespective of the type of consultation ([OR] = 0.4, 95 % CI 0.3-0.5) and a lower risk of back MSD during on-demand/return-to-work consultations ([OR] = 0.2, 95% CI 0.1-0.5) and during periodic check-ups ([OR] = 0.3, 95% CI 0.2-0.7).

Conclusions

Temporary workers were not at a higher risk of UWRD (MSD and MHD) than permanent workers. This suggests that the generally poor health status found in temporary workers in previous studies may be linked more to their general health status and perceived job insecurity than to poorer working conditions.

Key messages

In our study, the risk of work related musculoskeletal disorders and mental health disorders in temporary workers was no greater than that in permanent workers. Poor general health known in temporary workers, may be linked more to their general health status, job insecurity and decreasing career trajectory than to poorer working conditions.