Care workers in hospitals exposed to high level of risks

Some 86% of care workers in French hospitals are women. According to an analysis of the SUMER 2003 survey results, their job is characterised by a significantly higher level of exposure to professional risks in relation to working time, organisational and physical strains, as well as exposure to radiation and biological or chemical products. However, they do not express a greater desire to change their job than workers in other sectors of the economy.

High proportion of female care workers in hospitals

In total, French hospitals employ just over one million workers, 75% of whom work in public sector hospitals. The largest group of workers – numbering 600,000 – are care workers, 86% of whom are women. Although a large majority of these workers remain in their job – 59% have worked in the same institution for over 10 years – they are exposed to a large number of occupational risks or demands, according to an analysis of the SUMER 2003 survey results.

The SUMER Medical Monitoring of Risks (Surveillance Médicale des Risques) survey draws up an inventory of worker exposure to the main occupational risks in France and is carried out by the Research, Analysis and Statistics Department (Direction de l’Animation de la Recherche, des Études et des Statistiques, Dares) of the Ministry of Labour, Social Relations, Family Affairs, Solidarity and Urban Affairs (Ministère du Travail, des Relations Sociales, de la Famille, de la Solidarité et de la Ville).

Exposure to many occupational risks

Working time and work pace

Care workers, and more specifically those working in the public sector, are subjected to a large number of working time constraints, such as shift work, night work and weekend work.

Moreover, care workers are subjected to a large number of work pace constraints: their work depends on colleagues; they have to meet production targets, respond immediately to external demands and frequently interrupt their work for unscheduled tasks.

Psychosocial issues

They work in contact with the public and are significantly more exposed to risks of verbal aggression or physical assault. In fact, 41% of the care workers experienced verbal aggression and 7% reported physical assault in the 12 months preceding the SUMER survey, compared with respectively 22% and 2% of all workers.

Thus, the level of demands on care workers is high, while the resources and decision latitude are relatively low. The number of colleagues is often insufficient for the work to be done. For a significant proportion of care workers, they neither have clear enough information nor appropriate training to do the work. These two points are of particular concern since, for any care worker, an error at work can result in a danger to themselves and others, or severely affect the service quality.

As a result, referring to the Karasek model, one out of three care workers is in a situation of ‘job strain’, compared with less than 20% in the whole population (FR0704029I).

Physical risk exposure

Care workers are also exposed to two major ergonomic strains: standing and walking more than 20 hours a week, and lifting or moving people. These features are all the more strenuous since they are combined with insufficient equipment and the necessity to work at a high speed.

Beyond ergonomic risk factors, care workers are also exposed to radiation (12%), chemicals (15% are exposed to one of the carcinogens identified in the SUMER survey and 50% to surface-active substances) and biological products (91%).

The table below provides an overview of the frequency of risk exposure of healthcare workers in relation to the whole working population covered by the SUMER survey. For example, 51.2% of healthcare workers are subject to shift work, compared with 14.8% of all workers.