Contenu du sommaire : Recherches en sante dans l'entreprise. L'exemple d'Électricité de France - Gaz de France

Anne Chevalier, Jean-François Chastang, Claude Blanc: A Comparison of Maie and Female Medically Justified Absenteeism at Electricité et Gaz de France. Sickness absence at the French National Electricity and Gas Company was studied according to the sex of workers. Women are found to be more frequently absent from work than their maie colleagues. The proportion of absentees and the annual mean duration of absence per absent worker are higher among women than among men. Age, family status and salary, although important absence factors, do not explain the female excess of absence. More useful to the understanding of gender differences is the analysis of the medical causes of absence : they are different for men and women, probably because of real differences in disease incidence but also because of differences in attitudes towards health. Professional status and working conditions could be other factors playing a part in gender differences in sickness absence.

Danièle Luce: Health Problem Régional Disparity Factors: The Case of EDF-GDF The aim of this work is to analyse geographical differences regarding the distribution of health problems among the population of workers at the «Electricité et Gaz de France». Important regional differences are observed concerning work accidents and medical absenteeism. These differences remain when the main démographie and socioprofessional factors are controlled. The same is true when factors describing the structures of the company are taken into account. The analysis shows that variables from the external regional environment of the company can explain to a certain extent the observed differences.

Renée Bourbonnais: Geographical Mobility and Medically Justified Absenteeism. This article presents a study of the profile of short-term absenteeism for reasons of health, one year before and one year after a geographical transfer, in staff of a large company. The hypothesis under study relates to the ill effects of moving on health, based on the degree of absenteeism. The comparison of the percentage of absences and the average cumulative annual duration of these for each of the two years investigated reveals a statistically significant difference between the transfer group and the non-transferred control group. However, the latter are absent in greater numbers and for a greater cumulative average duration. The differences cannot be entirely explained in terms of the variables under study. The original hypothesis is not confirmed; and transfer in itself cannot be said to have adverse effects on health expressed in terms of absence from work.

Catherine Godard: The Link between Indicators of Absenteeism and the Prognostication of Serious Health Problems: High Risk of Mortality in a Population of Salaried Employees in Apparent Good Health. The aim of this study was to confirm the existence of a relation between the company's diagnosed sick ratio related to sick-lines, and mortality of the active workforce in staff where there was no administratively recorded life risk pathology. Those showing high regular absenteeism, notably in terms of duration of absence, were generally subject to a higher risk of death. It was further observed that,whatever the type of individual habitual absenteeism, there occurred a notable increase in absences in ail measurements or absenteeism, in the two years prior to death. This increase was particulary in evidence for cancer victims or in sudden death cases, and minor absences were notably «prolonged» in suicide cases and road accident victims. This study therefore lends substance to the hypothesis of a relatively strong link between serious health problems leading to death and a previous history of absences from work.

Dominique Folliot, Christiane Chevalier, Henri Pons: Two Exemples of French National Electricity and G as Board Medical Supervision of Workers Exposed to Certain Products. From the vantage point of the organisation of medical staff in the French National Electricity and Gas Board, the way in which the company monitors employees exposed to potentially noxious chemical products is described. Two highly controversial areas, Polychlorinated biphenyl (PCB) and oils containing esterphosphates, are used to illustrate this. Joint action by Electricity and Gas Board medical and safety staff and outside toxicology experts has made follow-up and codification possible, and even research, with a view to determining the best criteria for preventive action, for monitoring exposure to products employed and introducing technical improvements in certain cases.

Henry-Georges Schlumberger, Jean-Claude Sagot: Evaluation of Thermal Constraints. Application of an adéquate WBGT and Sweat Rate Index. Industrial work in a very hot environment may cause disorders due to hypothermia where normal body température regulation is upset. French standards offer two indices for the calculation of working time limits in such conditions — the wet bulb globe temperature index (WBGT) and the required sweat rate index. In addition, the latter, which is more difficult to calculate, makes it possible to evaluate employee thermal stress. This research involved the perfecting of a simplified easy-to-use required sweat rate index for use in EDF thermal production power plants. When finalised, the results were then widely diffused among users, task designers, medical staff, and employees at ail levels in the hierarchy.

Marie-José Cabrol et al : Installation of Sight-Testing facilities at the Workplace: A Preliminary Investigation. An observatory of visual health at the work place could improve knowledge of eyesight and the way it evolves in the working population, carry out studies into, for example, the epidemiology of intervention, and centralize data on eyesight and visual ergonomy for the use of manufacturers, designers and occupational physicians. We have demonstrated the feasibility of an observatory of this kind that could be supported by the medical staff in several different firms.

Thierry Schneider, Jacques Lochard, Francis Fagnani: The Introduction of Management Techniques into the Prevention of Radiological Risks in Nuclear Power Stations. Research and Active Policy Results. The Nuclear Protection Evaluation Centre (CEPN - Centre d'étude sur l'évaluation de la protection dans le domaine nucléaire) and INSERM's unit 240 have ten years experience of collaborating with the Electricity Board (EDF) on research and practice in evaluating radioprotettion policies for the general public and for workers in the electronuclear industry, with special reference to Pressurised Water Reactors (REP - Réacteurs à eau pressurisée). The principal results of this cooperation, conditions for its further development, and the interest it holds for a research team involved in determining economie priorities in prevention and public health policies in the area of environmental and professional risks originating in industry are presented and discussed.

Lucien Abenhaim, Denis Bard: Pyralene. Case Studies and Analytical Background to Public Health Decisions. Polychlorinated Biphenyls (PCB) are used in electrical equipment as means of prevention of fires. However, when a fire does occur, different substances may be produced, such as furans, dioxins, biphenylenes, etc. Among the hundreds of isomeres of these products, some show an acute and subacute toxicity : chloracnes and foetotoxic effects have been described at the doses of exposure that can be measured in PCB transformer fires. However, these effects have never in fact been observed during such accidents certainly because measures have been taken in each case so as to lower the actual exposure of populations. Many levels of uncertainty still remain when such an accident occurs: what are the actual substances involved (laboratory results may take a week to be available)? What are the effects of exposure low dose? How should we take into account the possible acute effects, given their low medical seriousness but high psychological impact? Is the risk acceptable for people involved? PCBs and dioxins are strong carcinogens in animais; no data stet available for furans and other concerned compounds. In humans, the carcinogenicity of PCBs, dioxins and furans has been suggested but is still not confirmed. We discuss the influence of taking into account différent epidemiological measures of risk in the assessment of the significance of the risk (relative risk, attributable risk, etiological fraction of risk, absolute risk). We also discuss the différent aproaches for the determination of an acceptable exposure dose (NOEL, probabilistic models) and their implication for the décision in the case of uncertainty after PCB fires. Finally, the qualitative criteria for decision making on this public health problem are provided.

Hélène Y. Meynaud, Catherine Carde: Working in Ionising Radiation Conditions, and the Place of Women in EDF Nuclear Power Stations. This article is focused on the insertion of women in technical jobs at EDF Nuclear power plants. We first review the current legislation about work in radiation conditions, and the consequent possible restraints for women of procreating age. Then we consider the role of occupational doctors towards women. This is particularly important in cases of pregnancy. Finally, using interviews from a recent sociological study (1985-1987), we analyse women's attitude to technical work, their motivation, their perception of working in an ionizing environment and their views on motherhood. We also examine company attitudes to female workers at différent hierarchical levels, and the feelings of fellow teammembers after a first experience of working with women.

Danièle Luce et al.: Mobility and Health: From Sociology to Epidemiology? This article presents the results of a research carried out in parallel by epidemiologists and social science researchers into the relations between geographical mobility and health in the widest sense of the term. The quantitative and qualitative approach used demonstrated that this occupationally etermined phenomenon could only be understood if considderations of family and locality were taken into account. This enabled the carrying out of critical analysis of certain models of social aetiology of the illness and the reflection that individuals contribute to the building of their own life patterns and social network.