Estryn-Behar Madeleine, Amar Emile, Choudat Dominique
Université de Paris, France.
Rech Soins Infirm. 2013 Jun(113):51-60.
sick-leave in the course of pregnancy play a role under estimated according to several studies.They bring to light the existence of risk factors concerning the physical load for contractions, sick-leave, hospitalizations and prematurity.The data obtained on the totality of the wage earners of the AP-HP allow to avoid all the possible bias and to determine the potential impact of a policy of reduction of the physical load
The data of four years could be analyzed.The used database is PILOT RH, intranet application restoring information extracted from GIPSIE who was until 2008 the institutional software of management of the careers of all the workers of the AP-HP.
In 2008,3 937 women having had a maternity leave (ML) accumulated 132 360 days of ordinary sick-leave (OL) (that is 33,6 days on average) without inclusion of the 15 days accepted for "pathological pregnancy" (PP) and "post pregnancy leave". Ordinary sick-leave of all the 53 132 women amounts to 11.5 days by agent. But, the set apart of the women having had a ML reduces the number of days of sick-leave to 9,7 days This difference weighs for 15.6 % of the total of the absenteeism OL. The results are similar on the four years. The analysis by occupational catégory, for 2008, shows that the average number of days of sick-leave, after exclusion of women having had a ML, decreases with the physical load of the posts estimated by the study PRESST-NEXT :ancillary staff 19.9 days, nursing aids 13.7 days, registered nurses 8.2 days, specialized nurses 7.7 days, medico - technical workers 5.7 days and head nurses 5.1 days. For the women having had a ML, the average number of days of ordinary sick-leave, is the most raised for nursing aids (41.9 days) followed by the ancillary staff (36 days) and the registered nurses (36 days) and slightly less for the specialized nurses (28.3 days). On the other hand, in the professions having least physical load the women have less than 25 days of ordinary sick-leave the year of their pregnancy :medico-technical workers 21.3 days, head nurses 23.1 days and administration staff 23.7 days.The results are similar on the four years. For the nurses, it is 25.5% of total ordinary sick-leave that are attributable to the women having had a pregnancy, and 34.4 % if we add OL and 15 days of official "pathological pregnancy".
An intervention to reduce the physical load in test hospitals could be led.The reduction of sick-leave in the course of pregnancy can be a fast indicator of evaluation of the efficiency of the investments. The improvements will benefit to all the agents, in the medium term, with a reduction of the risks of musculoskeletal disorders. Such an action also allows to maintain the employability of the older employees and to integrate) persons into situation of handicap in a work which has for them a strong sense and which they do not want to give up.
多项研究表明，孕期病假的影响一直被低估。这些研究揭示了与体力负荷、病假、住院和早产相关的风险因素。从巴黎公立医院集团（AP-HP）全体工薪族获取的数据，有助于避免所有可能的偏差，并确定减轻体力负荷政策的潜在影响。
对四年的数据进行了分析。所使用的数据库是PILOT RH，这是一个内联网应用程序，可恢复从GIPSIE提取的信息，GIPSIE在2008年之前是AP-HP所有员工职业管理的机构软件。
2008年，3937名休过产假（ML）的女性累积了132360天的普通病假（OL）（平均33.6天），未计入“病理妊娠”（PP）和“产后病假”所允许的15天。所有53132名女性的普通病假人均为11.5天。但是，排除休过产假的女性后，病假天数降至9.7天。这一差异占缺勤总天数的15.6%。四年的结果相似。2008年按职业类别分析表明，排除休过产假的女性后，病假平均天数随PRESST-NEXT研究估计的岗位体力负荷而减少：辅助人员19.9天，护理助理13.7天，注册护士8.2天，专科护士7.7天，医技人员5.7天，护士长5.1天。对于休过产假的女性，普通病假平均天数最高的是护理助理（41.9天），其次是辅助人员（36天）和注册护士（36天），专科护士略少（28.3天）。另一方面，在体力负荷最小的职业中，女性在怀孕当年的普通病假少于25天：医技人员21.3天，护士长23.1天，行政人员23.7天。四年的结果相似。对于护士而言，怀孕女性占普通病假总数的25.5%，如果加上OL和官方规定的15天“病理妊娠”，则占34.4%。
可以在试点医院开展减轻体力负荷的干预措施。孕期病假的减少可以作为评估投资效率的快速指标。从中期来看，这些改善将惠及所有员工，同时降低肌肉骨骼疾病的风险。这样的行动还能维持年长员工的就业能力，并使残障人士融入对他们有重要意义且他们不愿放弃的工作岗位。
