[Occupational medicine in France: the current situation in 2024]. / Médecine du travail en France, état des lieux en 2024.

OCCUPATIONAL MEDICINE IN France : THE CURRENT SITUATION IN 2024. Occupational medicine has evolved since its creation in 1946. Occupational medicine services have become Occupational health services (OHS) and medical examination in nowadays only a part of their missions, which include helping the employers to perform risk assessment, patients to stay at work, and implementing health promotion in the workplaces in order to prevent disabilities. To fulfill those missions, OHS can rely on health specialists (occupational physicians and nurses) but also on a wide range of competencies, from toxicologists to ergonomists, and from psychologists to occupational hygiene specialists, all gathered in multidisciplinary teams, leaded by the occupational physician. Optimizing cooperation between general practitioners and occupational health physicians is still needed to improve the worker journey, to facilitate his ability to return to work and to ameliorate his long-term health follow-up according to his previous occupational exposures.

MÉDECINE DU TRAVAIL EN FRANCE, ÉTAT DES LIEUX EN 2024. La médecine du travail a peu à peu évolué, depuis sa création en 1946. Les services médicaux du travail sont devenus des services de prévention et de santé au travail, et le suivi de santé ne représente désormais qu'une partie de leur activité. L'aide à l'évaluation des risques, le maintien en emploi, les actions de promotion de la santé dans une perspective de prévention de la désinsertion professionnelle ont pris une place grandissante. Cela s'est accompagné d'une évolution des compétences au sein de ces services. Outre la compétence santé représentée par le binôme médecin-infirmier, des ergonomes, psychologues et toxicologues sont désormais présents ; ils interviennent en prévention des risques professionnels et constituent des équipes pluridisciplinaires, animées et coordonnées par le médecin du travail. Une meilleure collaboration entre médecin du travail et médecin traitant reste nécessaire pour améliorer le parcours du travailleur, son maintien en emploi et son suivi de santé au long cours en fonction de ses expositions professionnelles passées.

Curb Heroin In Plants (C.H.I.P.): Revisiting a Mid-1970s Intervention Into Workplace Heroin Addiction Created and Led by Detroit Autoworkers.

This article analyzes archival records to revisit Curb Heroin In Plants (C.H.I.P.), a public health intervention focusing on drug dependence that was created and led by Detroit, Michigan, autoworkers during the mid-1970s. Responding to widespread heroin use in Detroit auto plants, C.H.I.P. combined methadone maintenance with counseling on and off the job to treat heroin dependence while supporting autoworkers in continuing in employment and family life. Although C.H.I.P. ultimately failed, it was a promising attempt to transcend medical/punitive approaches and treat those with substance use disorder in a nonstigmatizing way, with attention to the workplace dimensions of their disorder and recovery. I argue that revisiting C.H.I.P. speaks to current public health debates about the intersection between the workplace and harmful drug use and how to create effective interventions and policies that are mindful of this intersection. For historians, C.H.I.P. is a valuable example of the crucial role of workplace actors in the early war on drugs and of an early methadone program that was not strongly concerned with crime reduction but incorporated social externalities (specifically job performance) to measure success.

Médicos al servicio de los trabajadores en la ciudad de México, 1930-1944 / Physicians at the service of workers in Mexico City, 1930-1944

El artículo reflexiona en torno a la importancia que revistió formar a especialistas en medicina del trabajo en la ciudad de México a partir de la década de 1930, destacándose la manera en la que esa naciente especialidad se asoció con algunas de las ideas en ese momento trazadas por la medicina social. De igual forma, se presta atención a la gradual transformación por la que atravesó esa asociación al iniciar la década siguiente, cuando se consideró que era vital consolidar y ampliar una moderna red hospitalaria al instituirse el régimen de seguridad social e iniciar la prestación de servicios médicos para los trabajadores asalariados urbanos por parte del Instituto Mexicano del Seguro Social en enero de 1944. En suma, lo que se argumenta es que, los paralelismos y las correspondencias entre la medicina del trabajo y la medicina social, reiterados por distintos médicos, entre éstos Alfonso Pruneda, adoptaron otras acepciones al ocupar un lugar preponderante el ámbito hospitalario estatal. En el mismo, la pericia técnica, la especialización médica y los datos clínicos ocuparon un lugar primordial para enfrentar y atender los problemas de salud de los trabajadores

This article reflects on the importance given to the training of specialists in occupational medicine in Mexico City from the 1930s. It highlights the association between this growing specialty and some ideas about social medicine that were developed at the same time. Attention is also paid to the gradual transformation of this association at the beginning of the next decade, when it was considered vital to consolidate and expand a modern hospital network, with the institution in January 1944 of a social security regime and the provision of medical services for urban salaried workers by the Mexican Institute of Social Security (Instituto Mexicano del Seguro Social). In summary, it is argued that the parallelism and correspondence between work and social medicine reiterated by different physicians, including Alfonso Pruneda, took on other meanings with the predominance of the state hospital system, in which technical skills, medical specialization, and clinical data played a vital role in their approach to workers' health problems

Salud ocupacional con énfasis en la protección del trabajador/a en Paraguay / Occupational health with emphasis on the protection of workers in Paraguay

Esta revisión en salud ocupacional con énfasis en la protección del trabajador/a del Paraguay tiene por objeto dar una mirada desde la historia para comprender la relación entre los sistemas de protección social, las coberturas en riesgos profesionales, los determinantes sociales, y la salud ocupacional, además de la importancia de la cobertura de estos riesgos, y la situación en Paraguay en referencia a estas coberturas en los diferentes sectores económicos y categorías ocupacionales como el empleado privado, el del sector público y el trabajador por cuenta propia. También se analiza el papel de los diferentes organismos del estado y las legislaciones vigentes, finalizando con las futuras legislaciones y los cambios necesarios para asegurar una protección eficaz en riesgos profesionales para los trabajadores y trabajadoras del país.

This review on occupational health with an emphasis on the protection of workers in Paraguay aims to take a look from history to understand the relationship between social protection systems, occupational risk coverage, social determinants and occupational health, also the importance of coverage of these risks, and the situation in Paraguay in reference to these coverage in the different economic sectors and occupational categories such as the private employee, the public sector and the self-employed. It also analyzes the role of different state agencies and existing legislation, ending with future legislation and the necessary changes to ensure effective protection of occupational risks for workers in the country.

Work and health care in Milan, 1864-1874. / Lavoro e assistenza sanitaria a Milano, 1864-1874.

In 1864 in Milan, Giovanni Rosmini (1832-1896) opened an ophthalmic dispensary for workers. In 1874 this dispensary was transformed into the first ophthalmic hospital of the city. This hospital still exists today. The authors analyze a document that belonged to the lawyer Enrico Rosmini (1828-1898), brother of Giovanni, which helps to piece together the early years of the dispensary, where about 4,000 surgeries were carried out in the first four years of activity. This historical document is valuable as it sheds light on one of the first healthcare institution for workers in Milan.

[History of mandatory (set by decree) preliminary and periodic medical examinations of workers in hazardous work conditions].

The article deals with over a hunderd years history of foundation and pregress in organization and process of mandatory preliminary and periodic medical examinations of workers exposed to hazardous work conditions.

(Un)healthy relationships: African labourers, profits and health services in Angola's colonial-era diamond mines, 1917-75.

The Companhia de Diamantes de Angola, or Diamang, mined for diamonds in colonial Angola from 1917 until independence in 1975. The enterprise's Health Services Division (SSD) was responsible for supplying mine managers with an African labour force comprised of healthy, and therefore productive, employees. In practice, though, this otherwise 'healthy' system did not always work. While SSD personnel attempted to fulfil their charge by implementing a series of screening measures, production targets and a scarcely-populated regional labour pool regularly prompted senior officials to compel the SSD to clear recruits who were otherwise unfit for mine service. Drawing upon interviews with former SSD staff and African labourers, as well as company and colonial archival sources, this article focuses on the interplay over time between the SSD, the company's production demands and these labourers.

[The occupational physician in France].

The French Labor law defines the role and its allocation criteria of the occupational physician (OP) the same as in Japan. In France, occupational medicine is one of the medical specialties. The OP resident must follow the 4 years clinical training before certification. After having finished their residency, they are entitled to work for the occupational health service office of a company or company association (in the case of small and medium sized companies). The most important characteristics of the French system is that they cover all workers regardless of company size. The main role of the OP is prevention of work related diseases and accidents. They are not allowed to do clinical services except for emergency cases. Their main activities are health examinations, health education, patrol and advice for better working condition. Formerly, it was rather difficult to attract the medical students for OP resident course because of its prevention oriented characteristics. A growing concern about the importance of health management at the work site, however, has changed the situation. Now, the number of candidates for OP resident course is increasing. Their task has expanded to cover mental health and other life style related diseases. The 2011 modification of law redefines the role of the OP as a director of an occupational health service office who has a total responsibility of multidisciplinary services. The French and Japanese occupational health systems have many of similarities. A comparative study by researchers of UOEH is expected to yield useful information.

'For the convenience and comfort of the persons employed by them': the Lowell Corporation Hospital, 1840-1930.

The first industrial hospital in America opened in 1840 in Lowell, Massachusetts. The Lowell Corporation Hospital was sponsored by the town's textile employers for ninety years. This article analyses the contextual complications surrounding the employers' sustained funding of the hospital. Motivations for sustained sponsorship included paternalism, clinical excellence, business custom, the labour situation in Lowell, civic duty and the political advantages of paternalism. By analysing the changing local context of the hospital, this article argues that a broader, more integrated approach to healthcare histories and institution histories is needed if we are to fully understand the myriad of healthcare providers and their local and national importance.

[Features of morbidity formation in industrial environment and new technologies].

The article deals with analysis of dependence of transitory disablement morbidity levels from work characters, duration and changes in staffers' functional load--i.e. dynamics of work application at various stages of industry development in Russia over 90 years (1920-2010). To preserve and strengthen workers' health during innovation period, the authors suggest measures of "social regulation" and development of "rehabilitation medicine" on individual basis.

[Medicine and the sexual distribution of work: an analysis of the scientific discourse on the role of the "human factor" in improving performance at work (Spain, 1922-1936)]. / El "factor humano" y la distribución sexual del trabajo en el discurso de la organización científica del trabajo (España, 1922-1936).

During the first third of the twentieth century, and especially after the 1920s, a discourse on occupational hygiene and safety began to develop in Spain. This discourse, without rejecting the value of the work carried out in the factory environment, particularly stressed the need to take into account what was called the "human factor." Promoted mainly by the budding occupational doctors and psychologists, this discourse became part of both the lines of biological thinking of constitutional pathology as well as the economic ideas of the so-called OCT, and it expounded the need to take the somatic and psychic characteristics of people into account in order to carry out "rational" distribution of the same in the workplace. The article aims to highlight the way in which this discourse contained elements that would help to attribute specific roles within the workplace based on the biological and psychological characteristics of men and women, so facilitating the legitimisation of a sexual distribution of work which helped to reinforce the social organization of gender at that time.

[Company centredness in the rehabilitation system of the German Democratic Republic, GDR]. / Die Betriebszentrierung im Rehabilitationssystem der DDR.

This article describes major aspects of the rehabilitation system of the former German Democratic Republic, GDR. Based on presentation of the actors in the medical and occupational rehabilitation system, differences are pointed out in comparison to the notion of rehabilitation in the former Federal Republic of Germany, FRG. The article focuses on the system of rehabilitation after stroke, which is outlined with relevant scientific literature. The health and rehabilitation system of the GDR was company-centred. Patients in rehabilitation received comprehensive care and guidance, and especially the companies played an integrative part and adjusted the occupational activity of the patients in rehabilitation to their physical and mental abilities in order to avoid early retirement. On account of the political and social transformation process as well as transfer of the health and rehabilitation legislation of the old FRG, the company-centred rehabilitation system of the GDR was replaced, implementing West German rehabilitation structures in East Germany as well.

[Detection and prevention of occupational diseases by physicians from the Dutch Labour Inspectorate (1903-1986)]. / Opsporing en preventie van beroepsziekten door medici bij de arbeidsinspectie (1903-1986).

The Dutch government started to organize medical care for workers at the end of the 19th century in order to prevent work-related damage to health. From 1903 on, medical advisors were appointed by the Labour Inspectorate to signal the development of occupational diseases and to take preventive measures. For this purpose, thousands of medical check-ups of workers were performed. A second main task was the detection and study of occupational diseases in specific branches of industry. With the rise of the industrial health services, as propagated by the medical advisors, the medical department finally closed down in 1986.

[The development of health care for workers through history]. / Prepoznavanje potrebe zdravstvene skrbi o radnicima tijekom povijesti.

The definition of occupational health has changed significantly over time to cover broader aspects of health care and to promote worker's health. Over the centuries, the relationship between workplace hazards and occupational health care has been influenced by the character of work, social evolution and changes in manufacture, economy and demographics of the working populations. Numerous old civilizations showed deep prejudice towards human work. Very often manual work was done by slaves, and their health and safety were neglected. A spectrum of occupational diseases (acute, chronic, malignant and damage of reproduction) cover all organic body system, each of which can be affected by exposure to specific agents at workplace. Work and working conditions may deteriorate and worsen an existing illness which is not necessarily work-related. Living habits may also interfere with occupational factors leading to the development of a disease. Today, occupational medicine is the only medical field encompassing occupation and environment and health. This article also describes the historic development of occupational medicine in Croatia and some of the current regulations on occupational health in the country.

SPATTER! SPATTER! SPATTER! Workers' health and the spray machine debate.

A conflict between industrialization and worker health developed in the painting industry during the early 1900s with the introduction of the spray machine. This technological innovation allowed the application of paint at greater speed and lower cost than hand painting and increased the rate at which painters were exposed to lead and other toxins contained in paint. From roughly 1919 to 1931, the painters' trade union clashed with employers, paint manufacturers, and legislatures over the impact of the spray machine on the health of workers and the need to enact legislation to regulate its use. While painters made gains on local, state, and national levels during the 1920s to prevent the use of the spray machine, their efforts ultimately failed.

A saúde do operário têxtil em Cataguases, Zona da Mata mineira, 1941 / The health of the textile worker in Cataguases, Zona da Mata Mineira

Observa como o registro médico dificulta o estabelecimento do nexo entre a doença e o processo de trabalho e também mostra como o diálogo de diversas fontes torna possível esta discussão.

A saúde do operário têxtil em Cataguases, Zona da Mata mineira, 1941 / The health of the textile worker in Cataguases, Zona da Mata Mineira

Observa como o registro médico dificulta o estabelecimento do nexo entre a doença e o processo de trabalho e também mostra como o diálogo de diversas fontes torna possível esta discussão.(AU)