A study published by the Research Department of the Ministry of Labour revealed that 10.4% of employees – 2.247 million people – were exposed to at least one harmful substance in 2010. However, the number of employees exposed to such substances has decreased since 2003 and protective measures have been strengthened.
Around 5% of cancers in France are linked to occupational exposure to harmful substances, representing 15,000 to 20,000 cases each year. Information regarding the exposure to carcinogenic, mutagenic or reprotoxic (CMR) substances at work is necessary to bolster the implementation of effective prevention policies to prevent the spread of occupational diseases. Relevant information in this field can be found in the Sumer study (Repeated cross-sectional study on medical surveillance for occupational risk exposure) which maps exposure to major occupational risks in France. The latest Sumer survey, published in 2010, was launched and managed jointly by the General Directorate of Labour, the Occupational Health Inspectorate and Dares. This article is based on the results of this study.
The Sumer study ran from January 2009 to April 2010. Some 47,983 employees, interviewed by 2,400 voluntary occupational physicians, responded to the survey. The physicians randomly selected employees from among those who had been invited for a periodic medical check-up. Some 97% of the employees agreed to answer the questionnaire. The selected employees are representative of almost 22 million employees and the study covers 92% of the total workforce. According to the authors, the validity of this survey is demonstrated because:
Potential exposure to CMRs is based on the situation during the last week at work before the study and on exposure to substances defined as carcinogenic, mutagenic or reprotoxic by the International Agency for Research on Cancer (IARC) or by the European Union. Employees are deemed to be exposed if this is stated by the company doctor, even if they use protective measures or if the exposure is residual.
According to the study, exposure to CMRs account for 90% of exposure to harmful substances. Some 10% of all employees are exposed to carcinogens. Some 234,000 employees (1.1% of total employees) are exposed to at least one chemical agent affecting the fertility of men or women, or the development of an unborn child. About 184,000 employees (0.9% of all employees) are exposed to at least one mutagenic chemical agent – substances that cause alterations in the number of chromosomes in cells. Of the 28 harmful chemical agents identified in the Sumer study, three are particularly important.
Exposure to these gases has fallen slightly between 2003 and 2010 (a reduction of 51,000 in exposed workers), but it still affects the greatest number of employees: around 798,000 in 2014 (4%), mostly men (6% of men against fewer than 1% of women), skilled workers (11%) and employees working in the maintenance sector (27%). Furthermore, exposure levels are high: 20% of exposure occurs for more than 20 hours per week.
Between 2003 and 2010, the number of workers exposed to dust declined by 43,000 workers and represented less than 2% of the workforce in 2010. One explanation for this is the implementation of a law in 2005 regulating exposure levels.
In 2010, 58,000 employees were exposed to phthalates (0.3% of the workforce), which are chemicals used to soften and increase the flexibility of plastic and vinyl. The authors of the study stated that evolution of the exposure to phthalates is of particular concern. The percentage of exposure increased sharply (+65%) from 33,140 employees in 2003, to 54,570 in 2010. Moreover, the duration and intensity of exposure are also higher: in 2010, a third of exposures lasted 20 hours or more per week. Over the period 2003–2010, protection measures – individual or collective – have decreased.
Workers’ exposure to harmful chemical substances is variable. Men are clearly more exposed than women (16.4% compared with 3.1%) as are interns and trainees (24% compared with 10.9% of employees on a permanent employment contract). More generally, those under 25 (15.8%) are heavily affected. According to Dares, ‘this statistic is important to consider in order to improve prevention early in their careers and thus preserve their long-term health’, adding that younger workers with ‘less experience and more subject to difficult working conditions tend to take more risks with their health’. Some 28.5% of skilled workers and 19.2% of unskilled and agricultural labourers are exposed, compared with 5% of service workers and 2.3% of managers. In terms of activity, the study finds that exposure to CMRs is most prevalent in the maintenance sector (42.9%).
In 19% of cases, no protective measures against harmful chemical substances had been put in place, according to the physicians’ findings. Collective protection, considered the most effective, is available in 21% of cases. However, the most exposed workers are not usually the best protected, with almost 28% of managers benefiting from protection, compared with only 12% of factory workers. Between 2003 and 2010, in parallel with the 20% decline in exposure to harmful chemical agents, protective measures – individual and collective – have increased overall. However, individual protection, arguably less effective, has been strengthened and collective protection is becoming rarer.
The Sumer study highlights a decrease of exposure to CMR agents, falling from 13% in 2003 to 10.4% in 2010. Although this trend is encouraging, slightly over 10% of the workforce remain exposed, especially among younger workers. Significant inequalities persist between occupational groups and ‘the risk of exposure remains imperfectly controlled’, according to the authors. They argue that the priority for prevention policies is to take into account ‘the disparities between men and women in terms of exposure, but also the over-representation of young people among employees exposed’. Specific policies to target these issues independently would be an effective way of improving the risk prevention of occupational cancers.