[Primary care and suffering at work situations]. / Conduite à tenir pour le médecin de premier recours face aux situations de souffrance et travail.

Work is a social determinant of health. When it is adapted to the worker, its effects on health are beneficial. Unhealthy working conditions, with inadequate or absent management of psychosocial risk factors, can have negative consequences on workers' health. General practitioners are often on the front line in diagnosing these disorders and coordinating their treatment. In this article, we outline the key elements of an initial consultation with the general practitioner for situations of suffering and work and propose a draft structure for a care chain.

Le travail est un déterminant social important de la santé. Quand il est adapté, ses effets sur la santé des travailleurs sont bénéfiques. Des conditions de travail, rendues délétères par une gestion inadéquate d'éventuels facteurs de risque psychosociaux, peuvent entraîner des conséquences négatives sur la santé des travailleurs. Les médecins de famille sont souvent en première ligne pour établir le diagnostic de ces atteintes et coordonner leur prise en charge. Dans cet article, nous exposons les éléments-clés d'une première consultation chez le médecin de famille pour les situations de souffrance et travail et proposons une ébauche de structuration d'une filière de soins.

Implementation of the Swiss ordinance on maternity protection at work in companies in French-speaking Switzerland.

BACKGROUND: Switzerland's Ordinance on Maternity Protection at Work (OProMa) requires that companies take the necessary measures to ensure that pregnant employees can continue working without danger. OBJECTIVE: To investigate the extent of compliance with OProMa within companies in French-speaking Switzerland as well as factors which facilitate and obstruct the ordinance's implementation. METHODS: A stratified random telephone survey of 202 companies from the healthcare and food industry was conducted. Descriptive and correlational statistics were calculated. Responses to open questions were analysed thematically. RESULTS: Only a minority of companies performed risk analyses or adapted employees' workstations, as per the legislation. OProMa was implemented more effectively in larger companies than smaller ones, in public rather than private ones, in the healthcare sector rather than the food industry, and when the person responsible for the wellbeing of pregnant employees within the company had undergone specific training on the subject. Data extrapolation suggested that only 2% of pregnant employees in French-speaking Switzerland's food industry and 12% in its healthcare sector are properly protected according to OProMa's provisions. CONCLUSIONS: Maternity protection in French-speaking Switzerland's companies urgently requires improvement. In addition to the apparent need for stronger incentives and for monitoring of companies, our findings indicate a need to provide them with resources to meet OProMa's provisions.

Protection of pregnant women at work in Switzerland: practices, obstacles and resources. A mixed-methods study protocol.

INTRODUCTION: Like most industrialised countries, Switzerland has introduced legislation to protect the health of pregnant workers and their unborn children from workplace exposure. This legislation provides for a risk assessment, adaptations to workplaces and, if the danger is not eliminated, preventive leave (prescribed by a gynaecologist). This study's first objective is to analyse the degree to which companies, gynaecologists and midwives implement the law. Its second objective is to understand the obstacles and resources of this implementation, with a focus on how relevant stakeholders perceive protective measures and their involvement with them. METHODS AND ANALYSIS: Data will be collected using mixed methods: (1) online questionnaires for gynaecologists and midwives; telephone questionnaires with company human resources (HR) managers in the healthcare and food production sectors; (2a) case studies of 6-8 companies in each sector, including interviews with stakeholders such as women workers, HR managers and occupational health physicians; (2b) two focus groups, one involving occupational physicians and hygienists, one involving labour inspectors.Quantitative data will be analysed statistically using STATA software V.15. Qualitative data will be transcribed and thematically analysed using MaxQDA software. ETHICS AND DISSEMINATION: The Human Research Ethics Committee of the Canton Vaud (CER-VD) has certified that this research study protocol falls outside of the field of application of the Swiss Federal Act on Research Involving Humans.The publications and recommendations resulting from this study will form the starting point for future improvements to the protection of pregnant women at work and their unborn children.This study started in February 2017 and will continue until January 2020.