Occupational diseases—illnesses related to work but not recognized by social security systems—have a significant impact on public health. Quantifying and describing these diseases makes it possible to estimate underreporting of occupational illnesses, target preventive measures, and update the list of occupational diseases with the aim of reducing the burden associated with occupational exposures. This is why, since 2003, Santé publique France has established, in collaboration with the Occupational Health Inspection, a unique surveillance system for OODs that draws on the expertise of occupational physicians and their teams. Today, the Agency is publishing new findings that examine MCPs between 2012 and 2018 and their trends over 12 consecutive years, as well as a specific analysis of organizational, relational, and ethical exposure factors associated with these conditions. The main MCPs reported remain musculoskeletal disorders (MSDs) and psychological distress, and these reports are on the rise. Furthermore, women are more affected by MCPs and by organizational, relational, and ethical exposure factors when they suffer from MCPs.

Surveillance of Occupational Diseases for the 2012–2018 Period in France: New Findings on Workers’ Health

The report and summary published today cover the results of occupational disease surveillance for the 2012–2018 period in France. In 2018, more than 40,000 employees were seen as part of the MCP program. Over the 2012–2018 period, 1,375 occupational physicians participated in the MCP program.

Overall, a sharp increase in the reporting rate of occupational diseases was observed between 2016 and 2018, rising by a factor of 1.4 among men and 1.5 among women. The main occupational diseases reported are musculoskeletal disorders (MSDs) and psychological distress.

The results show an increase in the prevalence of MSDs since 2015. The prevalence of psychological distress, meanwhile, rose gradually between 2007 and 2018.

Women were more affected than men by MSDs (2.8% to 4.4% depending on the year) as well as by psychological distress (3.5% to 6.2% depending on the year). Psychological distress is particularly common among women aged 35 to 44 and men aged 45 to 54.

MSDs vary depending on the type of work performed. MSDs are more common among manual workers than among managers. Biomechanical factors (repetitive movements, posture, work requiring physical force) account for 80% of the causes of these MSDs.

For psychological distress, the trend appears to be reversed, although these results should be interpreted with caution due to possible underreporting among manual workers.

For conditions that meet the criteria for an occupational disease, the vast majority are not reported as such, primarily due to the employee’s lack of knowledge of the procedure prior to consulting the occupational physician and an inadequate diagnostic evaluation. Thus, approximately 75% of MSDs meeting the criteria for an occupational disease were not reported as such. There is no occupational disease classification for mental distress.

This surveillance, in particular, enables better understanding of high-risk situations (sectors of activity, occupations, etc.) to help prioritize preventive measures. It highlights the importance of better informing workers, strengthening and targeting preventive actions by improving working conditions and reducing exposure, particularly among workers identified as being at the highest risk. The high rate of MCP reporting observed starting at age 45 confirms the particular attention that must be paid to aging workers and the need to adapt work to advancing age.

Management, workplace relationships, and job-related demands are among the determinants of musculoskeletal disorders (MSDs) and psychological distress

Chemical, biological, physical, or biomechanical exposures (movements or postures) and organizational, relational, and ethical factors (FORE) are determinants of musculoskeletal disorders (MSDs). These factors include, in particular, work organization, workplace relationships, and ethics, all of which have consequences for workers’ health. For the first time, Santé publique France has described the role of FORE in relation to MSDs and psychological distress among employees seen during occupational health medical visits and how these factors have evolved over time.

The main findings show that between 2009 and 2017, FORE factors were associated with psychological distress or MSDs more frequently among women than among men. “Management,” “work relationships and violence,” and “job-related demands” accounted for more than nine out of ten FOREs linked to MSDs or psychological distress.

“Job-related demands” were associated with one in two MSDs, “management” with one-third, and to a lesser extent “relationships and violence” (10%). Male managers, those in intermediate professions, or office workers, as well as female managers, were at greater risk of having a FORE associated with an MSD than manual workers. An overall downward trend in FOREs associated with MSDs among men was observed between 2009 and 2017.

The FOREs most frequently associated with psychological distress were those related to “management” (1 in 2), followed by “workplace relationships and violence,” which accounted for one-third of them. Finally, “job-related demands” accounted for one in ten FOREs linked to psychological distress. An upcoming publication on psychological distress reported in the MCP surveillance program will focus in particular on FOREs associated with the most common mental health disorders.