Monitoring, Observation, and Diagnosis in Occupational Health at a Territorial Level - Multisources, multilevels - Modernet
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Monitoring, Observation, and
Diagnosis in Occupational Health
at a Territorial Level
Multisources, multilevels
Maylis Telle-Lamberton, Nathalie Bouscaren
(Regional Health Observatory Île-de-France)
Context
The 3rd Health at Work plan (2016-2020):
Importance of quantitative observation tools
« for [...] diagnosis and action [in occupational health] »
• action 3.10 inventory of existing data
• action 3.12 construction of a « health and safety at work dashboard »
• action 3.13
Develop a methodology for grouping data intended for all regions, enabling an
operational territorial diagnosis to be established and animated
Carry out an inventory of the various cross-referencing and data exploitation
systems developed at regional level
DIRECCTE
The 3rd Regional Health at Work plan Île-de-France
Regional Health and Safety at Work Dashboard
2
REGULAR and STRUCTURED
OBSERVATION of occupational
health a valuable aid for
GUIDING PREVENTION
ACTIONS
Which tools are used in the
regions ?
What are their potential ?
Which tool for Île-de-
France ?
3
METHODS
Dashboards
Regional characteristics
National Federation of
Health Observatories
Systematic search
Complementary
internet searches
Search engine
Current region
Old region
Working group
4
Used and usable Data Sources
National socio-economic statistics (population of
TOOLS working age)
Regional level Industrial sectors
Occupations
Employment status (salaried, self-employed)
National surveys on occupational exposures
ECT, survey on working conditions
SUMER survey
Work-related diseases
MCP program
RNV3P network
Acronyms
SUMER: Surveillance médicale des expositions des Evrest observatory
salariés aux risques professionnels
ECT: enquête nationale sur les conditions de travail
MCP: Maladies à caractère professionnel Statistics on occupational accidents and diseases
Evrest : évolutions et relations en santé au travail
RNV3P: réseau national de vigilance et de prévention des compensated by the social security
pathologies professionnelles.
5
Directly Usable Sources
Île-de-France level? National socio-economic statistics (population of
working age)
Industrial sectors
Occupations
Employment status (salaried, self-employed)
Statistics on occupational accidents and diseases
compensated by the social security
We will also highlight the ability of some devices to
propose an approach ranging from the individual
situation of the worker to the collective level of the
company, the sector of activity, the occupation or
the territory.
Regional What are the barriers to the development of these
level "dashboard" or "Atlas" ?
6
Data available at regional level
socio-economic statistics
Unemployment / Employment / Inactivity
Distribution of the 15-64 year-old working
population by Socio-professional status and sex in
Île-de-France and metropolitan France – 2016 (%)
Men Women
Unemployment rate – 2016 (%)
Field : France (Metropolitan) and Île-de-France
Source : Insee RP 2016 (Population census) – employment – active
population, data available at municipality level, data on line on 25/06/2019
7
Data available at regional level
occupational accidents and diseases
Example: number of OA/1 million worked hours by industrial sectors (TF) Île-de-France, 2017
Main Sectors
Source : Cramif, data analysis ORS
Field : Salaried workers with CNAM-TS insurance
8
Data available at regional level
occupational accidents and diseases
Example: number of OA/1 million worked hours by industrial sectors (TF) Île-de-France, 2017
Detailed sectors with more than 500 employees and the highest accident frequency rates
Source : Cramif, data analysis ORS
Field : Salaried workers with CNAM-TS insurance
9
Undirectly Usable Sources
Île-de-France level? National surveys on occupational exposures
ECT, survey on working conditions
SUMER survey
Work-related diseases
MCP survey
RNV3P
Evrest observatory
We will also highlight the ability of some devices to
propose an approach ranging from the individual
situation of the worker to the collective level of the
company, the sector of activity, the occupation or
the territory.
Regional What are the barriers to the development of these
level "dashboard" or "Atlas" ?
10Data more difficult to obtain at regional level
National Surveys
ECT national survey on working conditions: no regional representiveness
Example: psychological demand and decision latitude
Sumer 2017, Idf provisional data: by economic sector, Île-de-France, 2017
26000 workers at national level
6000 workers at Île-de-france level
Other regions: no regional analyses
Use of surrogate:
National results: professions exposed
Region: number of exposed people
From exposed professions
Source : SUMER 2017, data analysis service études-statistiques-
évaluation (SESE), DIRECCTE Île-de-France
Field : Salaried workers with CNAM-TS insurance, civil servants;
excluded: agriculture sector, activities of households as employers
and temporary workers (interim)
11Data more difficult to obtain at a regional level
Work-related disease data
MCP program: a surveillance program
2 fortnights with active recording of work-related diseases by occupational
physicians
Not yet developed everywhere, no immediate benefits for participating
physicians
RNV3P: hospital consultation data, no « denominator »
There use to be an extension with a sentinel approach, difficult to maintain,
borderline from the main objectives of the RNV3P network (vigilance)
Evrest observatory:
An observatory created for and by occupational physicians
A two sided questionnaire on:
working conditions,
symptoms
their consequences in carrying out the work
12Evrest questionnaire
recto
Source :
http://evrest.istnf.fr/_docs/Fichier/2018/4-181227125838.pdf
Accessed on 26/11/2019
13Evrest questionnaire
verso
Source :
http://evrest.istnf.fr/_docs/Fichier/2018/4-181227125838.pdf
Accessed on 26/11/2019
14Data more difficult to obtain at a regional level
Work-related disease data
Evrest observatory:
Could be a solution.
Advantages:
A multi-level approach, usable:
• During the consultation, at an individual level
• For a set of workers either followed by an occupational health service, an
enterprise, a sector
• At a territorial level:
• regional if good participance
• National with data collected for a systematic sample of workers (october
sample)
Shortcomings:
Symptoms collected, not diseases
Extension to include WRD should be examined,
Towards a combined approach: Evrest-MCP
15MCP report form
Source : Lemaître A, Valenty M. Programme de surveillance
des maladies à caractère professionnel (MCP) en France.
Résultats des Quinzaines MCP 2008 à 2011. Saint-Maurice:
Institut de veille sanitaire; 2014. 101 p.
16CONCLUSION
Relevant data, their accessibility and their potential for
use as indicators for action and prevention in OH were
identified
Importance of a cross look between data of following
axes
socio-economic
occupational accidents and occupational diseases
exposures
work-related diseases
complete overview of workers' health
multi-source data to be combined as best as possible
diagnosis as objective as possible.
17PERSPECTIVES
Multi-level approach:
Involvement and motivation of the OH physicians and their teams
essential in an observation system,
Immediate interest in participating necessary
multi-level approach from the individual worker to a
group of workers, to territory
Towards an interactive approach?
Dashboards: a photograph of occupational health.
Interactive approach: production of quantified indicators associated with
the sharing of these indicators between the actors concerned:
occupational physicians, employees, employers or preventers.
AtlasT project deployed within the framework of PST3.
To be tested in Île-de-France region.
18Acknowledgements to the working group
Dr Pascal DUPRAT DIRECCTE
Dr Guy MARIGNAC DIRECCTE
Mme Elisabeth CHARRIER Employeurs
Dr Jean-Louis ZYLBERBERG Salariés
M. Julien TONNER Assurance maladie, risques professionnels
Dr Fabrice LOCHER Services de santé au travail interentreprises
Mme Maylis TELLE-LAMBERTON ORS IDF
Dr Isabelle GREMY ORS IDF
Mme Nathalie BOUSCAREN ORS IDF
Mme Lise JANNEAU ARS Île-de-France
Dr Mireille LOIZEAU APST-BTP-RP
Dr Antoine HAUTER APST-BTP-RP
M. Philippe TRAN TAN HAI Assurance maladie, MSA
M. Sébastien ABLINE SESE, La DIRECCTE
Mme Anne-Lise AUCOUTURIER SESE, La DIRECCTE
M. Hajer BEN TAMANSOURT Statisticien, CRAMIF
M. Philippe RODRIDE Statisticien CRAMIF
M. Frédéric RAMBINAISING CRAMIF
M. Eric BONGRAND ARS, Île-de-France
Mme Gwénaëlle LE BRETON ARS, Île-de-France
Mme Louise CHESNEAU ARS, Île-de-France
19Acknowledgements to
DIRECCTE Île-de-France
THANK YOU FOR
YOUR ATTENTION
maylis.telle-lamberton@institutparisregion.fr
nathalie.bouscaren@institutparisregion.fr
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