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"IntroductionBack problems are a major occupational health issue for prehospital emergency care professionals. The goals of this article are to: 1) provide descriptive data about the prevalence and the severity of lower back and upper back disorders in EMTs and paramedics; 2) identify some individual and collective strategies used by EMTs and paramedics to protect their health as they perform prehospital emergency missions; 3) assess the possible effectiveness of strategies in preventing back problems by exploring associations between the use of strategies and the presence and severity of symptoms.Material and methodsThe method includes a questionnaire survey (sample n = 334; paramedics and emergency medical technicians) and ergonomics work practice analysis involving shadowing ambulance crews in 12 medical emergency services (over 400 h).ResultsA majority of ambulance professionals had experienced back pain in the twelve-month period before the survey. Work practice analysis revealed strategies and tricks of the trade used by ambulance professionals to reduce the chances of back strain while working. Multiple regression analyses showed that self-reported use of such strategies was associated with fewer back symptoms.ConclusionsPreventive strategies should be integrated into specialised training programs for prehospital medical emergency professionals. This approach could also be used in other work settings."

" L'article porte sur les pratiques mises en oeuvre pour prévenir les risques psychosociaux (RPS) dans les entreprises. Selon les connaissances scientifiques actuelles, réduire ces risques requiert une approche intégrée qui vise à développer les ressources collectives et individuelles des travailleurs, ainsi qu'à réduire leurs contraintes professionnelles. Toutefois très peu de publications ont porté sur la façon dont les employeurs appréhendent effectivement ces questions. L'objectif de cette étude est de mieux comprendre les pratiques de prévention déclarées par des dirigeants d'entreprises, en relation avec la manière dont ils perçoivent l'exposition de leur personnel aux RPS. Nous avons élaboré un cadre d'analyse exploratoire des relations entre la prévention des RPS, la perception des facteurs de risques par les employeurs et diverses caractéristiques des entreprises. Ce cadre a servi de base à une enquête auprès de 404 établissements.À partir d'analyses factorielles et de régressions multiples, l'étude a fait émerger deux modes de prévention : 1- des mesures de gestion spécifique des RPS axées sur les procédures et la formation et liées principalement au risque d'atteinte à l'intégrité personnelle (harcèlement, agressions, discrimination, confrontation à des événements traumatisants) ; et 2- des mesures d'amélioration générale des conditions de travail (organisation, horaires, équipements et environnement de travail) qui peuvent contribuer à renforcer les ressources, mais que les employeurs ne perçoivent guère comme de la prévention des RPS. Les pratiques sont liées à des variables structurelles, ainsi qu'aux modes de participation et de gestion des risques professionnels dans leur ensemble, davantage qu'à la perception de l'employeur concernant l'exposition aux RPS.Les résultats soulignent deux défis pour les autorités. Le premier consiste à faire adopter par les entreprises une approche plus globale, non centrée sur les phénomènes de harcèlement. Le second réside dans le renforcement de mesures de prévention ayant un impact favorable sur l'activité réelle de travail. "

"Workplace responses to labour inspectorate interventions regarding psychosocial risks at work are not well known. This study aimed to assess the effects of inspection visits at company level. A survey was conducted in two groups of companies. In one group, companies were visited by a labour inspector some days after the survey, and in the other group, not. The survey was repeated one year later in both groups. It relied on a structured phone interview with the person within the company who best knew about occupational health and safety. We collected information about health and safety management, worker participation, as well as ability, willingness and measures for the prevention of psychosocial risks. Two kinds of prevention measures were distinguished: specific psychosocial risk management measures on one side, and more general improvements of working conditions on the other side. 185 companies with an inspection visit and 161 companies without took part in the study. The results were encouraging, since inspected companies improved their management of health and safety, increased their ability in psychosocial issues, and demonstrated a stronger willingness to act. To a lesser extent, they implemented specific psychosocial risk management measures. However, visits did not lead to improvements regarding scores for employee participation or general improvements of working conditions, such as work organisation, working schedules or staffing levels. A further step for regulatory initiatives would be to emphasise more strongly the need for a prevention approach grounded in the assessment and improvement of job designs, content and organisation."