Co-exposures to physical and psychosocial work factors increase the occurrence of workplace injuries among French care workers.

Objective: The aim of this study was to analyze the effect of co-exposures to physical and psychosocial factors (PSF) regarding the incidence of workplace injuries (WI) among care workers. Additional objective was to identify the work factors associated with the co-exposure combinations leading to the highest rates of WI. Methods: The study sample consisted of 4,418 care workers participating to the French Working Conditions Survey both in 2013 and 2016. WI were assessed during the 4-year follow-up by matching the databases of the National Health Insurance Funds' compensation system. We assessed exposure for physical factors and PSF using factorial analyses and hierarchical clustering. We implemented a Poisson regression model with the WI incidence as the outcome and the clusters as independent variables of interest. Logistic regression model allowed identifying the work factors that predicted co-exposure combinations with a WI rate > 40%. Results: WI were highly related to both physical and psychosocial exposures. With low exposure to one or the other, there was no increased risk of WI. Physical factors and PSF potentiated each other and their co-exposure significantly increased the risk of WI, with model predicted rates per 1,000 persons-year for those most exposed to physical risk of 14.6 [4.5-24.8] with low PSF and 38.0 [29.8-46.3] with high PSF. Work factors that predicted co-exposure combinations with a rate > 40 WI% were: working as nursing assistant or hospital services officer, lack of predictability and flexibility of schedules, overtime, controlled schedules, work-family imbalance and insufficient preventive measures. Conclusions: Our findings highlight the need to take into account psychosocial factors in addition of only considering physical factors when analyzing WI occurrence, as usually done. Prevention actions must be taken to reduce both physical and psychosocial exposure. These results provide keys points for the prevention of WI among care workers.

Effect of Joint Exposure to Psychosocial and Physical Work Factors on the Incidence of Workplace Injuries: Results From a Longitudinal Survey.

OBJECTIVE: To analyze the interaction between physical and psychosocial work factors regarding the workplace injuries incidence among 6900 workers out of a longitudinal survey. METHODS: Based on responses to questionnaires, we obtained exposure groups respectively for physical factors and for psychosocial factors using hierarchical clustering. We performed multiple Poisson regression model with the workplace injuries incidence during 4 years of follow-up as the outcome and the clusters as the independent variables of interest. RESULTS: High psychosocial exposure had a deleterious effect on workplace injuries incidence, which was no longer significant when adjusting for physical factors. The difference in model-based workplace injuries rates between high and low psychosocial exposures seemed to increase (non-significantly) with increasing physical exposure. CONCLUSIONS: The risk of workplace injuries was highest among workers with high physical exposures regardless of the psychosocial exposures.

Bladder cancer and occupational exposure to metalworking fluid mist: a counter-matched case-control study in French steel-producing factories.

OBJECTIVES: To assess the relationship between occupational exposure to metalworking fluids (MWFs) in the steel-producing industry and bladder cancer incidence. METHODS: A nested case-control study on bladder cancer was set up in a cohort of workers from six French steel-producing factories. Three controls were randomly selected for each incident bladder cancer case diagnosed from 2006 to 2012. Controls were matched to cases on age at diagnosis and counter-matched on a surrogate measure of exposure to MWFs derived from a job-exposure matrix. Cases (n=84) and controls (n=251) were face-to-face interviewed. Experts assessed occupational exposure to MWFs (straight, soluble and synthetic) using questionnaires and reports from factory visits. Occupational exposures were based on three metrics: duration, frequency-weighted duration and cumulative exposure index. Conditional multiple logistic regressions were used to determine ORs and 95% CIs, taking non-occupational and occupational exposure into account. RESULTS: In the 25 years before diagnosis, ORs increased significantly with duration of exposure to straight MWFs (OR=1.13 (1.02-1.25)) and increased with frequency-weighted duration of exposure to straight MWFs (OR=1.44 (0.97-2.14)). These results remained valid after adjusting for duration of smoking, average number of cigarettes smoked per day, time since smoking cessation and exposure to polycyclic aromatic hydrocarbons (PAHs). ORs also increased with soluble MWFs but not significantly. No significant association was found with older exposures to MWFs or with exposure to synthetic MWFs. CONCLUSION: The increased risk of bladder cancer observed among workers exposed to straight MWFs and to a lesser extent to soluble MWFs may be explained by the presence of carcinogens (such as PAH) in mineral oils component of straight and soluble oils. Prevention therefore remains necessary in sectors using MWFs.

Effect of occupational safety and health education received during schooling on the incidence of workplace injuries in the first 2 years of occupational life: a prospective study.

OBJECTIVES: This study aimed to determine the effect of occupational safety and health (OSH) education during formal schooling on the incidence of workplace injuries (WIs) in young people starting their careers. We hypothesised that young people who had received OSH education during their schooling would have fewer WIs than those who received no OSH education. Secondary objectives focused on the effect of 'first aid at work' training during schooling and the conditions encountered on arrival in the company (occupational hazard information, safety training and job task training) on WI occurrence. DESIGN: Prospective cohort study. PARTICIPANTS: From 2009 to 2012, French apprentices and students at the end of their schooling and starting their careers were included. OUTCOMES: Occurrence of WIs. METHODS: At the time of inclusion, information about school courses and personal characteristics were collected, and subsequent half-yearly contacts gathered information relating to work and personal data. During the 2-year follow-up, WIs were directly reported by participants and were identified by searching the French National Health Insurance Funds' databases listing compulsory WI declarations. RESULTS: 755 participants reported holding 1290 jobs. During follow-up, 158 WIs were identified, corresponding to an incident rate of 0.12 (0.10 to 0.14) WIs per full-time worker. Subjects who reported having received OSH education at school had two times less WIs than those declaring not having received OSH education (incidence rate ratio (IRR) 0.51, 0.00 to 0.98). A lower WI risk was observed for participants who received the 'first aid at work' training (IRR=0.68, 0.00 to 0.98). The conditions on arrival in company were not associated with WIs occurrence. CONCLUSION: In France, the OSH education provided to apprentices and students is mostly broader than the specific risks related to future jobs. Our results highlight the advantages of reinforcing this approach.

Relationships between organizational workplace characteristics and perceived workplace strain in call-centers in France.

BACKGROUND: Our objective was to study the associations between organizational workplace characteristics (OC) reported by call-center (CC) managers and workplace stressors reported by call-handlers. METHODS: The managers of 107 CCs were interviewed by their occupational physicians using a questionnaire designed to specifically explore OC in the CCs. Four thousand two call-handlers from these CCs completed a self-report questionnaire including the Karasek and Siegrist work stressor questionnaires and two specific items on other workplace stressors. RESULTS: Around one-third of the OC examined were associated with the demand/control ratio, the perception of demanding work and ethical conflicts, however, far fewer OC were associated with the effort/reward ratio. Most OC were associated with higher levels of job stressors. Some had strong, systematic negative associations with stressors (e.g., highly formatted instructions for the client relationship). CONCLUSIONS: These findings could help in targeting job stressor prevention and health improvement strategies in CCs.