The Coset program is a longitudinal study monitoring work-related health. It covers all occupational settings in France.

Coset focuses on a variety of health issues (musculoskeletal problems, cardiovascular and respiratory problems, cancer, mental health, etc.) and all types of working conditions.

Objectives

• Monitor the health status of current and former workers over time;

• Observe and describe the links between occupational characteristics, working conditions, and health issues (musculoskeletal disorders, cardiovascular and respiratory problems, cancers, mental health, etc.);

• Issue recommendations to prevent health risks.

To this end, Santé publique France collects and compiles information on health status and occupational activity from large samples of working-age individuals in France, who will be followed over many years.

Analysis of the collected data makes it possible to study the frequency of health problems among the working and formerly working population and thus helps identify occupations and working conditions associated with health risks.

Methodology

The program is based on data collected from two cohorts managed by Santé publique France:

• Coset-MSA, which covers current and former workers in the agricultural sector (farmers and employees)

• Coset-Indépendants, which covers current and former self-employed workers (non-agricultural): artisans, merchants, and professionals

Within these two cohorts, information related to work and health is collected: questionnaire data is gathered directly from volunteers, and supplementary data is extracted from various medical and administrative data sources.

For employees covered by the General Social Security Scheme, the program draws on information already collected as part of the Constances cohort (Inserm - Cnam), which includes 200,000 volunteer participants.

Analysis of the data collected from these three sources will enable Santé publique France to regularly publish epidemiological reports on working conditions, health, and the links between the two, across these three major occupational groups: the agricultural sector, self-employed workers, and employees covered by the General Social Security Scheme.

Participant follow-up and data collection are planned to last at least 20 years in order to explore the long-term relationships between health and work, including after changes in employment or retirement.

Study Design

For the Coset-MSA and Coset-Indépendants cohorts, recruitment took place in 2017–2018 by inviting a large sample of individuals enrolled in 2016 with the MSA and the Social Security Scheme for Self-Employed Workers to join the program by completing a questionnaire on their health, employment status, working conditions, and career history.

As a result, 27,000 people volunteered to join the Coset-MSA cohort, and 20,000 joined the Coset-Indépendants cohort.

Given the COVID-19 pandemic and its potential impact on both the health and professional situation of agricultural workers and self-employed individuals, specific follow-up questionnaires were offered to volunteers in 2020 and 2022 to assess their health and professional situation in this context.

The first published results focus on the consequences of the COVID-19 pandemic; an epidemiological assessment based on data collected in the 2017–2018 questionnaires will follow. The next follow-up questionnaire will be offered to participants by 2026.

Learn more: https://www.coset.fr

What is the purpose of these findings?

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 workplace prevention by identifying occupations, activities, or work environments that are beneficial or harmful to health.