Protecting pregnancy at work: Normative safety measures and employees' safety strategies in reconciling work and pregnancy

Background: In Switzerland, occupational risks for pregnant workers are covered by specific maternity protection legislation (MPL); however, studies show significant shortcomings in the implementation of these policies among companies. Aims: Analyse the gaps between the provisions of Switzerland's MPL, the protective measures companies plan to take and actual protection practices. We also aim to understand how employees develop their own strategies in order to make up for the shortcomings or contradictions of companies' measures. Methods: Interviews with 46 different stakeholders from organisations in the healthcare sector and the food industry were transcribed and analysed thematically. Results: Some of the organisations used procedures apparently in line with legislation, while others planned more informal approaches to managing on a case-by-case basis. Normative safety measures within the framework of national legislation served as resources for both managers and their employees. However, implementing these measures ran up against real-world workplace constraints, which sometimes rendered them impracticable. Employees adapted some measures considered insufficient or developed their own strategies to reconcile work and pregnancy. Conclusions: Being pregnant is challenging to represent in occupational settings; it is not a disease, but it involves important physical and biopsychosocial changes, which affect women's occupational life. The multidimensional, evolving, and yet temporary nature of pregnancy represents a significant challenge to the implementation of MPL within companies. Linking the normative safety measures stipulated in the legislation with pregnant employees' needs-and their job-related knowledge and skills-could be an interesting pathway towards improving maternity protection at work

Implementation, mechanisms and effects of maternity protection legislation: a realist narrative review of the literature.

Most industrialized countries have introduced maternity protection legislation (MPL) to protect the health of pregnant workers and their unborn children from workplace exposure. This review aimed to assess this legislation's level of implementation, barriers and facilitators to it, and its expected or unexpected effects. A realist narrative review was conducted. Keyword searches of the PubMed, CINAHL, PsycINFO, MIDIRS, Sociological abstracts and Google Scholar electronic databases were performed in March 2018. The 42 publications included show that the implementation of MPL is deficient in most countries. Allowing pregnant women to withdraw from work on preventive leave or sick leave is favored over workplace adaptations or worker reassignments. The publications highlight mechanisms which encourage or obstruct the enforcement of legislation at the levels of the individual, the physical and social environment, and the macrosocial context. The delay between the conception and implementation of maternity protection measures appears to be a major barrier to the efficacy of MPL. The literature also suggests that unexpected adverse effects, such as degradation in working relationships or discrimination can obstruct the implementation of protective measures. This study showed the need for a better implementation of MPL during pregnancy. Further research and recommendations for improvements in MPL should consider the diverse mechanisms and effects of its implementation. Barriers and adverse effects of this implementation do not only ensure a lack of information or awareness about MPL, but are also linked to contradictions between requirements to protect employment and protect pregnancy

Exposure to field vs. storage wheat dust: different consequences on respiratory symptoms and immune response among grain workers.

The aim of this study was to understand the differential acute effects of two distinct wheat-related dusts, such as field or stored wheat dust handling, on workers' health and how those effects evolved at 6 month intervals. Exposure, work-related symptoms, changes in lung function, and blood samples of 81 workers handling wheat and 61 controls were collected during the high exposure season and 6 months after. Specific IgG, IgE, and precipitins against 12 fungi isolated from wheat dust were titrated by enzyme-linked immunosorbent assay, dissociation-enhanced lanthanide fluorescence immunoassay, and electrosyneresis. The level of fungi was determined in the workers' environment. Levels of exhaled fraction of nitrogen monoxide (F <sub>E</sub> NO) and total IgE were obtained. Exposure response associations were investigated by mixed logistic and linear regression models. The recent exposure to field wheat dust was associated with a higher prevalence for five of six self-reported airway symptoms and with a lower F <sub>E</sub> NO than those in the control population. Exposure to stored wheat dust was only associated with cough. No acute impact of exposure on respiratory function was observed. Exposure to field wheat dust led to workers' sensitization against the three field fungi Aureobasidum, Cryptococcus, and Phoma, although exposure to storage wheat dust was associated with tolerance. The level of Ig remained stable 6 months after exposure. The clinical picture of workers exposed to field or storage wheat dust differed. The systematic characterization of the aerosol microbial profile may help to understand the reasons for those differences

La femme enceinte : congé maternité

Inaptitude ou incapacité de travail de la travailleuse enceinte par le gynécologue. Une ordonnance que tout médecin de la spécialité doit prendre en considération et que tout médecin généraliste doit connaître

Environnement professionnel et santé : prévention des risques professionnels : organisation de la médecine du travail

- Expliquer le cadre d'action du médecin du travail et ses relations avec les autres partenaires de santé. - A propos des risques liés aux solvants organiques, au plomb, à l'amiante, aux bruits, aux mouvements répétés ou à la manutention, savoir expliquer les possibilités d'action préventive du médecin du travail. - Evaluer l'impact du travail sur la santé et rapporter une pathologie aux contraintes professionnelles. - Mettre en relation pronostic médical et pronostic socioprofessionnel

La méthodologie du consensus formalisé en santé au travail (l'exemple des recommandations pour le suivi médical des travailleurs du bois)

La méthode de consensus formalisé est une démarche mise en place récemment par la Haute Autorité de Santé pour élaborer des recommandations médicales professionnelles lorsque les données bibliographiques sur le thème abordé sont peu nombreuses. L objectif de la thèse est d analyser la faisabilité et la pertinence de ce type de méthode en médecine du travail à partir de la première application dans cette discipline : recommandations sur le dépistage des cancers ORL chez les salariés exposés aux poussières de bois . Après avoir pris connaissance de cette méthode, préconisée par la HAS, mon travail a consisté à suivre le déroulement du processus par la prise en charge du secrétariat scientifique en appui du responsable du projet et ce depuis la décision du conseil scientifique de la Société Française de Médecine du Travail d initier l étude jusqu à la publication des recommandations. Il s agit d une procédure lourde mais rigoureuse avec ses avantages et ses inconvénients.ST QUENTIN EN YVELINES-BU (782972101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Accidents du travail et maladies professionnelles : définitions

- Définir un accident du travail (AT), une maladie professionnelle (MP), une incapacité permanente (IP), une consolidation. - Se repérer dans les procédures et en comprendre les enjeux