Abstract
In France, occupational noise-induced hearing loss is compensated by the "Régime Général" of the French Social Security according to the system of the tables of occupational diseases. If administrative and/or exposure criteria are lacking, the regional occupational disease commission (CRRMP) is seized to pronounce an opinion - favourable or not - on the direct link between occupational activity and the deafness. This study aimed at determining the decisive factors in this opinion. An exhaustive retrospective investigation analysed conclusions of CRRMP of the region Provence-Alpes-Côte d'Azur-Corsica related to the noise-induced hearing loss declarations emitted anonymously between January 1st, 2005 and December 31st, 2007. Favourable and unfavourable opinions were listed then cross-examined against the sociodemographics data of the employees, areas of expertise of the physicians at the origin of the initial medical certificate, grounds for submission to the commission, the occupational physician's opinion on the occupational origin, the results of the engineering consultant's investigation, the audiogram of the first observation of injury and those made in period of noise exposure. One hundred and twenty conclusions were analyzed. Claimants, typically male, 59-year-old on average, mainly came from the sectors of the metal industry (46.7%), transportation (20.8%) and building and civil engineering works (15.8%). All in all, 57.5% of the declarations were refused. These refusals were mainly connected to an opinion unfavourable, unexploitable or absent in the occupational physician, an overrun of the care period when it lasted 5 years and more and the absence of hearing deficit during the exposure. The results of our study lead to recommend the implementation of a certificate of noise exposure and the realization of an audiogram at the end of exposure to reduce the number of badly informed files and bring an answer more adapted to the demands of occupational noise-induced hearing loss acknowledgements.
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