Last April, Editions La Découverte published a work entitled Les risques du travail or “The risks of work”, with the shock subtitle: Pour ne pas perdre sa vie à la gagner or “How not to lose your life while earning a living”. Thirty years earlier, the first edition had been an unexpected success (25 000 copies sold). We asked the work’s four coordinators to give their opinion on the changes that have occurred in the world of work since then, and on the current and future challenges for occupational health.

On the intensification of work

Since the mid-1980s, the service sector has grown throughout Europe. The reduced role played by agriculture and industry in the job market should have resulted in workers being less exposed to harsh working conditions. However, the decline in heavy industry has not led to the disappearance of "arduous occupations", which remain in both traditional sectors and in the booming service sector.

Despite huge technical progress, the statistician and ergonomist Serge Volkoff notes the trend towards the intensification of work: "The current prevailing idea is that the intensification of work is the very condition for ensuring the survival of businesses. New occupations have even grown out of this intensification, such as in fast food, call centres and mass distribution logistics platforms, where the main objective is to shorten timescales, primarily for consumers and users. The intensification of work is alarming in how it individualises work situations, impacting on each person’s own work strategies: their health, their skill set, their preferences in terms of how to act, etc. As a result, workers are confronted with a very personal situation, which is further reinforced by increasingly individualised assessment and remuneration methods, pressure exerted by employment blackmail, constant changes that increasingly mean that people are not working with the same colleagues from one day to the next, and of course all the outsourcing and subcontracting systems. People are progressively coming into conflict with their own work, which is accentuated by a production system that is demanding on them in terms of quantity, quality and adaptability."

On social inequalities in health

In Les risques du travail, occupational doctor Philippe Davezies highlights that surveys conducted in France show that workers in the least skilled jobs view their working conditions less harshly than those whose career has been more favourable and who enjoy better situations.

He explains this by the fact that most people in such jobs come from working-class families: "In working-class families, people learn to cope and not complain. Having to confront social adversity over a long period of time, and particularly during infancy, forces them to develop defence mechanisms allowing them to distance themselves from, deny and understate their emotions. If you live in socially deprived circumstances, without any possibility of escape, you are not going to spend your time whining. Primarily because the people around you will not put up with it. Your suffering must be suppressed. These are the processes that allow you to keep going, even though it is extremely tough. For people who come from social categories that are not really exposed to suffering and who have hopes, when they come up against difficulties, they express their suffering. This expression of suffering tends to galvanise the compassion of others, i.e. social support. When you express your suffering, for example when you cry, this soothes you because this expression of your emotions is supported by all the background mechanisms, such as the secretion of cortisol, the stress hormone. There is a close link between the expression of physical suffering and the secretion of cortisol. For people who have developed the ability to keep going when they are suffering, and who distance themselves from their emotions, the biological mechanisms and cortisol reaction are disrupted. Stress generates inflammation, but for these people, when in a stressful situation, their anti-inflammatory defences are not triggered. Instead of becoming depressed or exploding, they suffer in silence, which leads to primarily somatic pathologies, cardiovascular disorders and the whole litany of chronic diseases."

On the increasing insecurity of work

Over the last 30 years, the job market has become very insecure. The proportion of part-time jobs in the European Union increased from 12.7% in 1987 to 20.9% in 2009. Over the same period, fixed-term contracts increased by over 4%. Women, young people and migrant workers are over-represented in terms of these "atypical" employment contracts.

For sociologist Annie Thébaud-Mony, people on such contracts are at much greater risk of being confronted with working conditions that are harmful for their health: "People on permanent contracts who work for multinationals established in Europe are the best protected. In the major US, Indian and Japanese companies, respect for labour rights has already become much more lax. When you look at subcontracting, the rights contained in the European legislation on health and safety at work are being seriously challenged. For example, in the nuclear and petrochemical industries, production workers are fairly well protected, particularly when they are in a position where their representative bodies are working effectively for them. However, as soon as you turn to subcontracting, particularly for jobs involving maintenance, cleaning and waste management, the situation is entirely different. The major risks are clearly being transferred to these categories of workers. Job insecurity has therefore utterly compromised not only their pay and working conditions, but also their representation by representative bodies. The committees for health, safety and working conditions are fairly effective in companies such as EDF. However, for employees of maintenance subcontractors in the nuclear industry, when they try to set up a trade union branch or organise a committee for health, safety and working conditions, they come up against the clients who no longer want them to have access to their facilities."

On a lack of action

Despite the multiple studies over the last 30 years into the main risk factors present in the workplace and the success achieved by works of general interest, particularly those focusing on suffering at work, the improvement of working conditions no longer seems to be an absolute priority for the trade union movement. This is despite the fact that social movements in the 1960s and 1970s produced a flurry of slogans inviting employees to transform their work. Laurent Vogel, a researcher at the European Trade Union Institute, feels that this is a direct consequence of job insecurity.

"There is no automatic link between knowledge and action. It is primarily the realisation that a collective problem exists that enables action. This was undoubtedly easier at a time when very precise groups of workers were subject to very specific exposures. For example, with regard to silicosis among miners, there was a very high percentage of miners who fell ill with a very specific disease, whereas nowadays we are instead seeing a multitude of risks that are affecting workers with a variety of consequences. The realistion that a collective problem exists is more difficult to achieve in this context. Furthermore, it is clear that we are paying this price because of increasing job insecurity, which is an intentional strategy on the part of employers. Just as inequality has increased in terms of income, wealth sharing, health, etc., it has also increased in terms of working conditions. It is harder to create solidarity when many workers are on fixed-term and temporary contracts and many others are unemployed. When there is mass unemployment, people clearly sometimes have the impression that fighting for occupational health is a luxury."

On the crisis in representation

In the vast majority of European countries, the rate of unionisation has dropped in the last decade. The increasing weight of small businesses in the economy is encouraging this trend, because national laws do not require employee representation bodies to be created until a certain number of employees has been reached. The multiplication of insecure contracts (fixed-term, temporary, zero hour and false self-employment contracts) is clearly not helping the mobilisation of workers.

Laurent Vogel has coordinated the part of the work focusing on action against risks in the workplace. He calls for new forms of worker representation: "We must create bodies that go beyond the legal limits of individual companies, with representation systems that cover all workers in a sector in a given territory. However, to do this, we must have a trade union strategy. There is no use appointing x people to represent workers if those representatives themselves are not firmly backed by the trade unions and equipped with the tools for research, understanding and mobilisation. Change is needed: firstly in legal terms, by giving all workers this minimum degree of democracy, i.e. being represented in the workplace, and secondly through political change, which involves trade unions putting the issue of improving working conditions at the heart of their demands. This will not happen automatically, as it is well-known that, in a period of crisis, the tendency is to sacrifice demands to improve working conditions in favour of keeping jobs and purchasing power."

On new alliances

Given the difficulties faced by the workers’ movement in counteracting the work intensification and insecurity phenomena, Annie Thébaud-Mony calls for new alliances that go beyond the usual reference frameworks: "The main trade unions have not sufficiently recognised what the new forms of work organisation are in the process of unravelling in terms of trade union rights. We need to rethink how to organise ourselves in order to combat this situation. In the shipyards of Saint-Nazaire, which have made considerable use of posted workers, awareness has grown within the trade union organisation of the need to combat the division organised by clients and to rebuild solidarity among workers deprived of trade union rights (read the ‘From the unions’ article in HesaMag No 10). With the support of local, regional or federative trade unions, these mobilisations may prove successful. In terms of occupational health issues, new forms of citizen solidarity become possible when trade unionists appeal to those health and occupational health professionals, researchers, legal experts, lawyers and doctors who are refusing to care for people indefinitely without asking questions about what is making them ill. These forms of solidarity are necessary in order to re-establish the checks and balances within companies in terms of occupational health issues."•

Further reading

Annie Thébaud-Mony, Philippe Davezies, Laurent Vogel and Serge Volkoff (ed.), Les risques du travail. Pour ne pas perdre sa vie à la gagner. La Découverte, 2015, 608 p.

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From the unions

Table of contents

A book to regalvanise occupational health