Mental suffering, the first reason for complaint to the occupational physician

2023-04-19 08:51:46

Occupational diseases (MCP), diseases related to work but not recognized by social security schemes, have a heavy impact on public health. According to Public Health France, the main PCDs reported remain psychological suffering and musculoskeletal disorders (MSDs) and these reports are increasing. Moreover, women are more affected by MCPs and by organizational, relational and ethical exposure factors.

The report and summary published by Public Health France concern the results of the monitoring of occupational diseases (MCP) for the period 2012-2018 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 took part in the MCP system.

Overall, a sharp increase in the reporting rate of PCDs is observed between 2016 and 2018, multiplied by 1.4 in men and 1.5 in women. The main MCPs reported are musculoskeletal disorders (MSDs) and mental suffering.

The results show an increase in the prevalence of MSDs since 2015. The prevalence of mental suffering increased 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 problems of mental suffering (3.5 to 6.2% depending on the year). Mental suffering is particularly observed in women aged 35 to 44 and in men aged 45 to 54.

MCPs are distinguished according to the activity carried out. MSDs are more common among workers than among managers. Biomechanical factors (repetitive movements, posture, work with force) represent 80% of the agents at the origin of these MSDs.

For mental suffering, the trend seems to be reversed, even if these results should be interpreted with caution due to possible under-reporting among blue-collar workers.

For illnesses that come under a table of occupational illness, the vast majority are not declared as such, mainly due to the employee’s ignorance of the procedure before consultation with the occupational physician and a insufficient diagnostic assessment. Thus, approximately 75% of MSDs corresponding to an OD table were not reported as an occupational disease. There is no MP table for psychological suffering.

This surveillance allows in particular, through better knowledge of risky situations (sectors of activity, professions, etc.), to help prioritize preventive actions. It shows the importance of providing more information to workers, of strengthening and targeting prevention actions by improving working conditions and reducing exposure, particularly among workers identified as most at risk. The high rate of PCM reporting observed from the age of 45 confirms the special interest that must be given to aging workers and the need to adapt work with advancing age.

Les facteurs organisationnels, relationnels et éthiques (Fore) sont des déterminants des MCP. Ces derniers recouvrent notamment l’organisation du travail, les relations au travail, l’éthique avec des conséquences sur la santé des travailleurs. 
Entre 2009 et 2017, les Fore étaient associés à la souffrance psychique ou aux TMS plus fréquemment chez les femmes que chez les hommes. Le « management », la « relation au travail et violence » et les « exigences inhérentes à l’activité » représentaient plus de neuf Fore sur dix en lien avec des TMS ou de la souffrance psychique.
Les Fore les plus fréquemment associés à la souffrance psychique étaient ceux en lien avec le « management » (1 sur 2), suivis par les « relations au travail et violences » correspondant à un tiers d’entre eux. Enfin, les « exigences inhérentes à l’activité » représentaient quant à elles un FORE sur dix liés à une souffrance psychique. Une prochaine publication sur la souffrance psychique signalée dans le programme de surveillance des MCP s’intéressera notamment aux Fore associés aux troubles psychiques les plus courants.

Surveillance program for occupational diseases in France. Results of the MCP Fortnights over the period 2012 – 2018, Homère J. et al, Studies and survey, Public Health, France, 2023.

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