Éditeur(s) : HAL CCSD Wiley
Résumé : International audience
Background: Health care workers (HCWs) are occupationally exposed to various hazards, some associated with adverse pregnancy outcomes in previous reviews. This systematic review aims at synthesizing the recent literature on occupational exposures among HCWs related to fetal death, congenital anomalies, and fertility disorders. Methods: We searched the Medline database from 2000 to 2015 for articles about all potential occupational exposures of women and men working in this sector. Results: We retained 32 studies, most of them (n = 30) among women HCWs. Studies based on job title reported excess risks of some congenital anomalies (especially nervous and musculoskeletal systems) among HCWs compared to non-HCWs but no evidence about fetal death. Excess risks associated with specific exposures includes reports of some congenital anomalies forwomenexposed to anesthetic gases. Exposure to some sterilizing agents and, with less evidence, to antineoplastic drugs and to ionizing radiation, is associated with increased risks of miscarriage but not stillbirth. Strenuous work schedules appear to be associated with fertility disorders, but the evidence is limited. Only a few studies have been published since 2000 about non-ionizing radiation, or about fertility disorders related to chemical or physical agents, or about male HCWs. Conclusions: Despite the establishment of recommendations to limit exposures of HCWs, some excess risks of adverse pregnancy outcomes are still reported and need to be explained.
ISSN: 0271-3586

hal-01560148
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01560148
DOI : 10.1002/ajim.22711
PUBMED : 28514021

Éditeur(s) : HAL CCSD
Résumé : International audience
Effective and sustainable prevention of work-related musculoskeletal disorders (WR-MSDs) remains a challenge for preventers and policy makers. Coordination of stakeholders involved in the prevention of WR-MSDs is a key factor that requires greater reflection on common knowledge and shared representation of workers’ activities among stakeholders. Information on workers’ strategies and operational leeway should be the core of common representations, since it places workers at the center of the “work situation system” considered by the intervention models. Participatory ergonomics permitting debates among stakeholders about workers’ activity and strategies to cope with the work constraints in practice could help them to share representations of the “work situation system” and cooperate. Sharing representation therefore represents a useful tool for prevention, and preventers should provide sufficient space and time for dialogue and discussion of workers’ activities among stakeholders during the conception, implementation and management of integrated prevention programs
Safety and Health at Work

hal-01279095
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01279095
DOI : 10.1016/j.shaw.2016.02.001
PUBMED : 27340607

Éditeur(s) : HAL CCSD BMJ Publishing Group
Résumé : International audience
OBJECTIVES: To compare the quality of life (QoL) in three groups of workers suffering or not from shoulder pain (SP) lasting more than one month during the preceding 12 months. METHOD: Between 2002-2005, 3710 workers were randomly included in a French surveillance system of work-related musculoskeletal disorders. In 2007, 2332 responded to a follow-up questionnaire, 2049 were still active. Workers completed the Nordic Questionnaire to assess SP and the SF-36 for QoL. Three groups were defined according to health status at follow-up: Group 1: workers without SP (men: 87.9%; women: 79.2%) Group 2: workers with SP without neck, elbow and hand/wrist pain lasting more than one month during the preceding 12 months (men: 4.2%; women: 6.0%) Group 3: workers with SP and neck, elbow or hand/wrist pain lasting more than one month during the preceding 12 months (men 7.9%; women 14.8%) The mean scores of SF-36 were compared with Kruskall-Wallis test and post-hoc comparisons were performed. Analyses were stratified by gender. RESULTS: Workers in group 2 had lower scores of physical health compared to workers in group 1, whatever the gender. Workers in group 3 had lower scores of physical and mental health compared to workers in group 1. Two dimensions of mental health in men and the four dimensions of physical health and one dimension of mental health in women had lower scores in group 3 compared to group 2. CONCLUSIONS: Workers with SP and upper-limb pain have poorer QoL compared to workers without SP and workers with SP without upper-limb pain.
ISSN: 1351-0711

hal-01063898
https://hal.archives-ouvertes.fr/hal-01063898
DOI : 10.1136/oemed-2014-102362.258

Éditeur(s) : HAL CCSD
Résumé : International audience
OBJECTIVES: To detect new hazards ("signals"), occupational health monitoring systems mostly rest on the description of exposures in the jobs held and on reports by medical doctors; these are subject to declarative bias. Our study aims to assess whether job-exposure matrices (JEMs) could be useful tools for signal detection by improving exposure reporting. METHODS: Using the French national occupational disease surveillance and prevention network (RNV3P) data from 2001 to 2011, we explored the associations between disease and exposure prevalence for 3 well-known pathology/exposure couples and for one debatable couple. We compared the associations measured when using physicians' reports or applying the JEMs, respectively, for these selected diseases and across non-selected RNV3P population or for cases with musculoskeletal disorders, used as two reference groups; the ratio of exposure prevalences according to the two sources of information were computed for each disease category. RESULTS: Our population contained 58,188 subjects referred with pathologies related to work. Mean age at diagnosis was 45.8 years (95% CI 45.7; 45.9), and 57.2% were men. For experts, exposure ratios increase with knowledge on exposure causality. As expected, JEMs retrieved more exposed cases than experts (exposure ratios between 12 and 194), except for the couple silica/silicosis, but not for the MSD control group (ratio between 0.2 and 0.8). CONCLUSIONS: JEMs enhanced the number of exposures possibly linked with some conditions, compared to experts' assessment, relative to the whole database or to a reference group; they are less likely to suffer from declarative bias than reports by occupational health professionals.
International Archives of Occupational and Environmental Health

hal-01560279
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01560279
DOI : 10.1007/s00420-017-1215-1
PUBMED : 28299449

Éditeur(s) : HAL CCSD
Résumé : International audience
The aim was to identify patterns of work organization characteristics using data from epidemiological surveillance program of musculoskeletal disorders (MSD) implemented in the Pays de la Loire region between 2002 and 2005. A total of 3710 workers were included and completed a administered questionnaire including 16 organizational variables. Ascendant hierarchical clustering (AHC) of organizational variables and AHC of workers had identified five patterns of work organization characteristics: technical constraints and weak decision latitude; internal/external demand and mean decision latitude; weak pace constraints and mean decision latitude; internal/external demand and high decision latitude; weak pace constraints and high decision latitude. Relationships with MSD diagnosed by occupational physicians were then studied.
The specific health programs (SHP) are one of the four mechanisms of prevention planned by the Health and Safety at work Law in the province of Quebec. If the Law appoints only a responsible doctor, it is in reality Health at work teams (HWT) that develop these SHP. In this communication, based on the model of the working situation and the diagram of inter professional practices of collaboration, we study the practices of inter professional collaboration (CIP) in the HWT. The observed practices vary between independent practices, in parallel, of consultation, of dialogue and in shared services. Formalization of the teams, coordination of communication, leadership, respect and professional identities influence particularly the practices of CIP.
L’objectif était d’identifier des patterns de caractéristiques d'organisation du travail à partir des données du programme de surveillance épidémiologique des troubles musculo-squelettiques (TMS) mis en œuvre dans les Pays de la Loire entre 2002 et 2005. Au total, 3 710 salariés ont été inclus et ont répondu à un questionnaire comportant notamment 16 variables organisationnelles. Une classification ascendante hiérarchique (CAH) des variables organisationnelles puis une CAH des salariés ont permis d’identifier cinq patterns de caractéristiques d’organisation du travail : contraintes techniques et faible latitude décisionnelle ; demande interne/externe et latitude décisionnelle moyenne ; faibles contraintes de rythme et latitude décisionnelle moyenne ; demande externe/interne et forte latitude décisionnelle ; faibles contraintes de rythme et forte latitude décisionnelle. Les associations avec les TMS diagnostiqués par des médecins du travail ont ensuite été étudiées.
Actes du 50ème congrès de la Société d'Ergonomie de Langue Française
Paris, France

halshs-01307785
https://halshs.archives-ouvertes.fr/halshs-01307785