J. Brière

Surveillance of fatal occupational injuries in France: 2002–2004

BACKGROUND Insufficient use is made of available information about workplace and commuting accidents covered by social insurance workers compensation funds in France. We sought to determine whether these data could be used to calculate national indicators for surveillance of fatal occupational injuries for 2002-2004. METHODS We calculated the number of deaths, mortality rate, and years of potential life lost from workplace and commuting accidents (by sex, age, economic activity, and cause of accident) for employees by collecting data from eight social insurance funds in France. The number of deaths, the mortality rates, and the attributable fraction of accidental deaths due to work were estimated for both employees and self-employed workers. RESULTS The mean annual number of employee deaths from workplace and commuting accidents reached 1,330 in 2002-2004. The mortality rate from workplace accidents (6.0 per 100,000) increased with age among men and was especially high in three sectors: agriculture-forestry-fishing, transportation, and construction.Overall, for employees and the self-employed combined, the mean annual number of deaths from workplace and commuting accidents was estimated at 1,557 (95% CI: 1,478-1,640). The attributable fraction of accidental deaths due to work for those aged 15-59 years was estimated at almost 20% among men. CONCLUSIONS Despite data limitations, it was possible to calculate previously unknown national indicators of fatal workplace and commuting accidents and to compare them with other work-related health problems. These results are consistent with those observed in comparable industrialized countries.

Occupational health indicators from the French epidemiological surveillance programme for work-related musculoskeletal disorders

Objectives Since 2002, the French Institute for Public Health Surveillance (InVS) has developed an epidemiological surveillance program for work-related musculoskeletal disorders (MSDs) in order to set up health indicators according to gender, age, occupational categories and economic sectors. Methods As indicators of health impact, the incidence of carpal tunnel syndrome (CTS), the prevalence of the main upper limb MSDs, the fractions of incident CTS cases and the number of surgical CTS cases attributable to work were estimated. As indicators of exposure, scores of exposure to biomechanical, psychosocial and organisational risk factors were constructed using a random sample of 3710 workers from the Pays-de-la-Loire region. Results Incidence rates of CTS and prevalence rates of clinically-diagnosed MSDs were estimated (data published). Other health impact indicators show that fractions of incident CTS cases attributable to work ranged from 16% to 33% in females clerks, from 8% to 16% in females blue-collar workers, and from 30% to 56% in male blue-collar workers. The estimated number of surgical CTS cases attributable to work among female workers aged 20–59 ranged from 22% to 51% of all surgical cases of this age group in France. Occupational exposure indicators show for instance that 20% (95% CI 18 to 22) of females and 17% (15 to 19) of males were exposed to a highly repetitive job (>4 h/day), to at least one extreme posture and to a forceful exertion (>2 h/day). Conclusions These indicators will be regularly produced to make the results of this surveillance program more helpful for prioritising preventive strategies.