The traceability of carcinogenic occupational risks: state of progress in France compared with other European countries.

Occupational risks are constantly evolving. The complexification of these occupational risks, the context of the flexibility with the new forms of organization, the new conditions of use and the increase in occupational mobility are accentuating the difficulties of assessment of the deferred risks for the health of employees. In point of fact, if on the one hand the immediate risk (accidental, corrosive, caustic, explosive...) is properly taken into account, on the other hand this is far from the case for the deferred risk, in particular the carcinogenic risk. Now, the liability of employers (especially with regard to cancers due to asbestos) is incurred more and more often. It is they in fact who bear the brunt of the prevention of occupational risks in France. Since 2002, the French employer has thus a veritable safety performance obligation in terms of preserving the health of the employees. Now, one of the vital keys to the prevention of deferred occupational risks resides in the traceability of the exposures that the employees have undergone throughout their working lives, in particular carcinogenic. In this context, the follow-up of the exposure of the employees to carcinogenic risks then becomes a necessity. The awareness of the necessity of setting in place an occupational exposure follow-up tool is not recent. Traceability procedures exist moreover in a certain number of countries, but so far in France we have only seen ad hoc experiments of a very limited nature for the identification and storage of occupational exposure. These are not of an exhaustive nature or only relate to mainly medical data. There is no systematic tool for the follow-up of carcinogenic exposure. This is due, on the one hand to the technical difficulties of setting in place standardized tools for exposure data collation, and on the other hand to the fact that the traceability of the personal information collated may raise ethical issues of reconciling the right to health of the employees with their right to work and the observing of their individual liberties; lastly, because the amassing of such information may raise issues of liability, in particular for the employer exposing its employees to carcinogens. Such issues transcend frontiers and have to be taken into consideration in order for progress to be made in the area of traceability of occupational exposure. Very few studies have been devoted to this subject so crucial to the prevention of occupational diseases. We propose, initially, to define traceability and the issues involved. Next, we will consider the current regulatory obligations on employers in France that may contribute to the traceability of occupational exposure and their limits. Then we will examine the brakes--the legal, ethical and technical difficulties that explain why France is lagging behind in this field. Finally, we will study the French perspectives with regard to the European advances in the traceability area.