The occupational health system in France was established in 1946, and is quite unique even in comparison with those in the other European countries. The system provides health care service to all the workers in France with the cost paid by employers. The service is provided as medical examinations work site inspections by certified physicians occupational medicine; there are 6,300 certified physicians working in company medical departments or interfirm medical departments which are health care delivery organizations scattered all over the country. The occupational physicians act strictly for prevention, and the health examinations by the occupational physicians are mandatory not only for workers at risk of occupational hazards but for all unspecified workers. This 50-year-old system, however, should be adapted to the changes in the occupational landscape of modern French society, such as downsizing of companies, surging of temporary workers, lessening the role of manual work and increasing office staff and service employees. Occupational physicians can be and should be involved more in health and safety training for workers, improving work conditions by ergonomic studies, global prevention including cancer and cardiovascular disease, and environment protection. On the other hand, the shortage of 500 occupational physicians today and the decrease in medical graduates who enter the four-year internship for occupational medicine are very touchy problems in the French occupational health system. And harmonization in the occupational health field among participating countries in the European Union may lead, sooner or later, to dramatic changes in the participants and activities of the French system.
