Program as a professional health risk management tool

Since the 1990s, the program has been a modus operandi in the field of population health. The national nutrition and health program and the women's breast cancer screening program are two well-known public health examples. This way of organizing action is still little used in occupational health. Yet it is provided for in the 1989 European directive and underpins the contracts of objectives and means introduced by the 2011 law on occupational health.

Basically, a program is an approach that explicitly links means and results. It is not a question of implementing a specific action, but a set of actions of various kinds aimed at achieving predetermined common objectives. The development of a program must therefore begin with a diagnosis of the problem to be solved, from which one or more objectives are set. Next, a program enables us to select the most effective intervention tools and to articulate them in an intervention strategy based on an analysis of the feasibility and acceptability of the actions envisaged. Last but not least, a program must include an evaluation system to ensure continuous improvement.

This approach is justified above all by a concern for efficiency. One-off preventive actions can only deliver one-off results. Only sustainable, systemic preventive action can deliver tangible results. As most occupational health problems are multi-factorial in nature, their prevention requires the involvement of a wide range of players, all of whom need to be properly coordinated. With the program-based approach, employers have a global traceability tool at their disposal, enabling them to justify their choices.

Using concrete examples, notably that of sick building syndrome, this article aims to provide a framework for the development and implementation of an occupational health program approach. It begins by defining the characteristics of an occupational health program in the first section. The steps involved in developing a health program are described in the second section. The final section discusses the conditions for a successful program, illustrates the value of this approach and discusses the skills required for its success. All of this is summarized in the form of a prevention algorithm.