¹Univ Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail)-UMR_S 1085,SFR ICAT, Angers, France
²Santé publique France - Direction santé environnement travail, Saint-Maurice, France
³Université Paris Cité, Unité “Cohortes en Population” INSERM, Université Paris Saclay, Villejuif, France
⁴Département des relations industrielles, Université Laval, Québec, Canada
⁵Univ Angers, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail)-UMR_S 1085, SFR ICAT, Angers, France

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Introduction: As part of the 2023 pension reform in France, a fund for the prevention of occupational wear and tear (called FIPU) has been created to prevent premature aging and musculoskeletal disorders. According to French law, the FIPU only considers exposure to three biomechanical criteria: manual handling of loads, strenuous postures and mechanical vibrations. The aim of our study was to identify the occupational categories most exposed to the three FIPU criteria, as well as an additional biomechanical risk factor of musculoskeletal disorders (MSD): repetitive work.

Methods: Cross-sectional analyses involved 23,092 adults aged 45 or over and working at inclusion in the French CONSTANCES cohort (Consultants des centres d'examens de santé), in 2013–2017. Exposures to the three FIPU criteria and to repetitive work were described according to gender and occupational categories (based on a French group of occupations nomenclature (FAPs)). The analysis considered the sampling design and the correction for non-participation. A participant was considered exposed if, for manual handling of loads, high perceived physical exertion reached ≥ 15 on the Borg scale and >2 h/day for carry heavy load [1]; for strenuous postures the cut-off was set at >2h/day [2] and for mechanical vibrations >2h/day for the use of vibrating tools and >4h/day for operating a construction vehicle [3]. A participant was considered to be exposed to repetitive work with >4 h/day of exposure [3].

Results: Some groups of occupations (FAPs) were found to be more exposed than others to the criteria identified by FIPU. For men, the FAPs most exposed to at least one of the three FIPU criteria were skilled construction workers (structural and finishing work: 95.8% and 88.1%) and metal forming (86.0%). For women, the FAPs most affected were home care aides (80.3%), care assistants (79.2%) and childcare assistants (77.1%). The addition of the repetitive work factor increased the proportion of exposed workers, particularly women, and brings out new occupations compared to those obtained with the FIPU criteria. These include workers in process industries and cashiers.

Discussion: This study provides precise quantitative data on exposure to biomechanical risk factors in France, differentiated by gender. Our study is based exclusively on the three FIPU criteria and includes repetitive work. However, based on these criteria, defined by law, it does not consider other known MSD risk factors, such as psychosocial and organizational factors.

Conclusion: Results of this study could be useful in helping the FIPU to better target the populations of workers concerned and to guide actions to prevent occupational wear and tear and premature ageing in France.

Literatur

[1] Institut national de recherche et de sécurité, Assurance Maladie (Risques professionnels). Méthode d’analyse de la charge physique de travail. 2019.
[2] Sluiter JK, Rest KM, Frings-Dresen MH. Criteria document for evaluating the work-relatedness of upper-extremity musculoskeletal disorders. Scand J Work Environ Health. 2001;27 Suppl 1:1-102.
[3] Direction de l’animation de la recherche, des études et des statistiques. Métiers potentiellement les plus concernés par les critères ergonomiques. 2023.