The majority of the provisions of the law aimed at “strengthening occupational health prevention” came into force on March 31, 2022, three months before the congress. The calendar was therefore optimal for taking stock of the main measures of the text. Transition from occupational health services (OHS) to prevention and occupational health services (SPST), evolution of the single occupational risk assessment document (Duerp), post-exposure or post-occupational surveillance, implementation of the prevention passport, modification and addition of missions to the SPST, integration of these into the territorial structures of health cooperation… So many changes which imply a new organization, an evolution of practices.
From SST to SPST
“With this law, the emphasis is on prevention. The new SPST must contribute to the achievement of public health objectives to preserve, during the working life, a state of health of the worker compatible with his maintenance in employment, explains Sophie Fantoni-Quinton, professor of occupational medicine at the University Hospital of Lille. In addition, they participate in actions to promote health in the workplace, including vaccination and screening campaigns, awareness-raising actions on the benefits of sports practice and information and awareness-raising actions on disability situations. at work. » The missions of the SPSTs are therefore expanded. The Duerp is also subject to modifications. From now on, its elaboration is no longer the exclusive competence of the employer. The latter must establish it by associating the occupational health referents, the SPSTs and the members of the Social and Economic Committee (CSE). In addition, it must be kept for at least 40 years. Another measure: the law introduces the creation of a “prevention passport”. All training taken by the worker on health and safety must be included.
Delegation of missions
With the decree of April 26, 2022 (n° 2022-679), “the law provides for the implementation of the delegation of certain missions to the members of the multidisciplinary team, under the responsibility of the occupational physician and in compliance with the multi-year service plancompletes Professor Fantoni-Quinton, who insists on the fact that this provision is surrounded by guarantees. The sharing of tasks between doctors and nurses is strictly governed by the public health code, to prevent the illegal practice of medicine. In addition, the missions delegated to the members of the multidisciplinary team remain under the authority of the occupational physician and within the limits of the skills recognized for each category of health professionals. » Visits can for example be delegated, under certain conditions, respecting a strict framework. It should be noted that the nursing interview is a specific mission, rather than a task carried out by delegation from the occupational physician. It gives rise to a certificate of follow-up, without mentioning the medical aptitude of the employee.
All in all, Professor Fantoni-Quinton believes that the ambitions of this reform (harmonization of the services provided by the SPSTs, job retention, better prevention of occupational risks) must be accompanied by points of vigilance. It evokes in particular the weight of the individual (versus the collective), the issue of prevention (which differs from reparation and judicialization) or even the effectiveness of the texts.
Highlight: Expanded missions with prevention in sight
“New practices in occupational health”, Plenary 5.