Entre 1946 et 2016, ce sont plus de vingt cas de recours à des experts par les instances de représentation du personnel qui ont été créés, dont huit sur les trois dernières années. La possibilité sans cesse étendue de recourir à l’assistance d’experts pourrait laisser penser que le régime du recours à l’expertise est efficient. La facilité avec laquelle la loi associe désormais l’expert à chaque nouvelle mesure prise en faveur du dialogue social masque cependant mal l’incapacité croissante du législateur à préserver la fonction initiale de l’expertise : une fonction informative. Signe des dysfonctionnements qui grèvent le régime actuel du recours à l’expertise, le sujet est hautement polémique et fait l’objet d’un contentieux florissant. L’étude du périmètre ainsi que des modalités du recours à des experts exhorte à la construction d’un régime plus cohérent, de nature à assurer l’effet utile de l’expertise tout en préservant la compétence et la parole des représentants du personnel. / Between 1946 and 2016, this is more than twenty new cases in which the employee representatives were granted the right to resort to the services of experts, and only eight in the last three years. The ever-expanded possibility to be assisted by external experts might suggest that the expertise statutory regime is efficient. The ease with which the law associates experts to each new measures taken in favor of the social dialogue cannot hide the persistent difficulties encountered by the legislator to preserve the original function of expertise : an informative function. The controversial nature of the right to resort to the services of experts and the increasing amount of litigation in this area are manifestations of its failures. A study of the scope and the conditions under which the experts might be appointed urges to the construction of a more coherent system, that would ensure the effectiveness of the right to resort to experts while maintaining the employee representatives’ competence and voices.

Dans cette étude, nous proposons une analyse du contexte marocain de la santé et de la sécurité au travail, aussi bien sur le plan social et culturel que législatif. L'exploration du système de gestion de la santé et de la sécurité au travail nous a amené à mettre en lumière non seulement les sources législatives internationales du Code du travail marocain, mais aussi les différentes méthodes de management de la santé et de la sécurité dans les entreprises. Nous proposons également une étude statistique qui permet de mieux comprendre la gestion, les processus de prévention et les techniques de management de la santé-sécurité au sein des entreprises marocaines. En même temps, afin de proposer un modèle de management qui servirait de base à la croissance et au développement économique et social de l’établissement, une recherche-intervention a également été réalisée au sein d’une entreprise marocaine. Ainsi, les raisons de l'insuffisance du respect des lois déjà existantes ont donc pu être mises en évidence et des solutions claires à partir de l’utilisation d’outils pour améliorer l’organisation et les conditions de travail à des coûts réduits, ont été proposées. / In this study, we propose an analysis of the Moroccan context of health and safety, both in the social and cultural that legislation. Exploring the management system of health and safety at work has led us to highlight not only the international law sources of the Moroccan labor code, but also the different methods of managing health and safety in companies. We also propose a statistical study to better understand the management, prevention processes and technical management of health and safety within Moroccan companies. At the same time, in order to propose a management model as a basis for growth and economic and social development of the institution, intervention research was also conducted in a Moroccan company. Thus, the reasons for the lack of compliance with existing laws have therefore been highlighted and clear solutions from the use of tools to improve the organization and working conditions at a reduced cost, have been proposed.

The significance of risk is growing in many Western societies, a phenomenon linked to increasing individualism, personal choice, and outcome uncertainty in multiple spheres of life. Despite being healthier and more physically protected from harm than any previous society, a serious concern for safety and risk control is emerging as a defining characteristic of modern social life. Within the context of a risk-averse society, this thesis investigates the nature and relevance of risk in natural resource recreation and tourism settings. Millions of people every day visit national parks and other protected areas around the world in which natural hazards inhere. Many visitors fail to recognise these hazards, creating moral, legal, and ethical issues for natural resource managers. People travel to national parks anticipating a degree of adventure, to escape routines, and to witness the grandeur of nature. Ironically, the very qualities that attract people to natural areas may also put them at risk. Managers of natural resource tourism and recreation areas in New Zealand are confronted with a paradox born out of visitor demand for nature experiences, a legal obligation to facilitate free access, and a growing social emphasis on health and safety. In particular, this study assesses the risk perceptions of visitors to the Fox and Franz Josef glaciers, popular tourist attractions on the West Coast of New Zealand's South Island, and explores the risk perceptions and beliefs of resource management agency staff. The study also investigates the issue of risk communication at these two sites, and the degree to which existing hazard messages are successful at encouraging appropriate visitor behaviour. Pictorial hazard warning signs are introduced to the sites and their effectiveness evaluated. The findings show that many visitors (especially international visitors) have relatively poor awareness of natural hazards, and behave in ways which potentially compromise physical safety. It is argued that perceptions and behaviour are a consequence of diverse individual and situational factors including limited knowledge of the sites, beliefs about management, poor comprehension of hazard warning signs, and freedom from the normative constraints of everyday life. In contrast to visitors, managers at the glacier sites consider the risks to be significant, and, potentially, severe. It is argued that managers' perceptions of risk are influenced by several important social and site-specific factors, including their own experiences of hazards at the glaciers, perceived legal and moral obligations, the organisational culture, and impressions of high societal expectation concerning safety. The situation is further complicated by the freedom of access principle in national parks, and increasing tourist demand for nature-based experiences. These factors governed beliefs about the subject of risk. This study identifies several dimensions of risk in nature-based recreation and tourism settings. Visitors are at risk of personal accident or injury at certain tourism attractions. Awareness of hazards is limited, visitor behaviour compromises safety, and existing communication strategies are only partially effective. Risk is also apparent in the agency responsible for management of outdoor recreation areas. Site managers perceive a risk in their failure to prevent visitors from harm, whereas senior managers identify risk as primarily financial, legal, and political. Collectively, these factors demonstrate that the phenomenon of risk is increasingly important in the tourism and recreation context, and has the potential to influence significantly both management and experience of protected natural areas in New Zealand.

The title of the research is Sustainability Performance Evaluation Management Systems Model for Individual Organizations and Supply Chains. This research has achieved its aim to develop and demonstrate the practical implementation of a simple and objective sustainability performance evaluation management system model for individual organizations and supply chains. It has resulted in the recognition that a new concept – Network of Interested Partners – underpins the achievement of sustainability. The term acknowledges the interdependence and reflects the essential cooperation that must be achieved between business organisations, their commercially related entities and the local community if progress towards sustainability is to be achieved. It therefore encompasses and extends the concept of a supply chain as currently used. Sustainable Development is defined by the World Commission on Environment and Development as development, which meets the needs of the present without compromising the ability of future societies to meet their own needs. Organizations, as part of human activities, also have to be sustainable. The sustainability of organizations is directly linked to the continual improvement of business performance. Many organizations have found a way to improve performance through the establishment of management systems. International Organization for Standardization (ISO) standards are recognized worldwide as reliable and efficient tools for the implementation of management systems. However, they do not always result in the desired improvement in outcomes. Therefore, if the required improvement of business performance is to be achieved, improved methodologies for development and implementation of performance evaluation (PE) processes are necessary. These methodologies must take into consideration sustainability principles. They also have to be applicable to individual entities and supply chains, with or without management systems in place. Supply chains are important because it is being increasingly recognized that overall supply chain performance is a means of adding value and competitive advantage to all businesses. In the first part of the research a performance evaluation model or PE (version 1 model) was developed. This was used as criteria to compare and evaluate existing performance evaluation processes and outcomes of individual organisations and their respective supply chain within the Gladstone region, Australia. Questionnaires have also been used to identify and evaluate the needs of the interested parties in relation to the organizations’ and supply chains’ business performance and processes of performance evaluation. All the information provided in the first part of the research was used by the researcher to develop the Sustainability Performance Evaluation Management Systems model or SPEMS (version 2 model). This incorporates the concepts of Network of Interested Parties/Partners. In particular, one of the outcomes is recognition that organizations need to establish partnerships if effective supply chain performance improvement is to be achieved. Therefore the establishment of partnerships has become a key requirement for the implementation of SPEMS. The establishment of partnership among participants of a supply chain of Gladstone and implementation of the eight first steps of the SPEMS (version 2 model) in this supply chain was commenced successfully through workshops. The supply chain was formed by commercial organizations, government entities and interested parties from the community. SPEMS requires that partners all have the same level of ownership and authority in the decisions of the supply chain. Some new terms and their definitions have been created within the research to support the new SPEMS model. They include: Network of Interested Partners, sustainability for organizations, sustainability KPI and sustainability friendly organizations. All of the above are encompassed within the final SPEMS (version 3 model).

Objective: To determine if paternal preconception exposure to ionizing radiation through uranium mining increases the risk of congenital anomaly (CA) in offspring. Methods: A population-based matched case-control study was conducted. Cases were infants with CAs recorded in the Canadian Congenital Anomalies Surveillance System and born alive in Ontario 1979-86 (ICD-9 codes 740-759); controls were liveborn infants without CAs identified from Ontario birth certificates and individually matched to cases (case-control file {CCF}). Exposed fathers were identified through the linkage of the CCF to the Mining Master File or the National Dose Registry file, which include those who worked in Ontario uranium mines 1952-1986. For men who linked with a case or control child, radon, gamma and total gonadal doses were estimated for three preconception periods: entire, 3-months and 6-months. Odds ratios were estimated using conditional logistic regression. Results: Linkage of 28,991 uranium miners and 40,482 case-control pairs of fathers and offspring in the CCF identified 431 discordant pairs. There was no evidence of increased risk of a child having a CA if the father was ever a uranium miner before conception of the child (OR=0.89, 95% CI=0.74–1.08). Since gamma radiation (especially during the 6-month preconception period) is more biologically relevant to gonads than radon, further analyses were performed on 117 discordant pairs where data on gamma exposures were available. When ever/never miner, exposed to gamma (yes/no), and gamma dose-response variables were all in the model, there was no ever/never miner effect (OR=1.20, 95% CI=0.85–1.69, p-value=0.30), an inverse association for exposure to gamma (OR=0.42, 95% CI=0.25–0.71, p-value=0.001), but most importantly, there was no statistically significant dose-response relationship between gamma dose during the 6-month preconception period and all CAs (OR=1.15 per loge {mSv+0.01}, 95% CI=0.83–1.59, p-value=0.40). Similarly, no dose-response relationship was observed for exposure to gamma radiation in the 3-month preconception period, or for radon or total gonadal radiation in the 3- or 6-month preconception periods. Conclusion: There was no increased risk of a CA among liveborn children of Ontario uranium miners who were exposed to radon, gamma or total radiation during the 3- or 6-month periods before conception.

Objective: To determine if paternal preconception exposure to ionizing radiation through uranium mining increases the risk of congenital anomaly (CA) in offspring. Methods: A population-based matched case-control study was conducted. Cases were infants with CAs recorded in the Canadian Congenital Anomalies Surveillance System and born alive in Ontario 1979-86 (ICD-9 codes 740-759); controls were liveborn infants without CAs identified from Ontario birth certificates and individually matched to cases (case-control file {CCF}). Exposed fathers were identified through the linkage of the CCF to the Mining Master File or the National Dose Registry file, which include those who worked in Ontario uranium mines 1952-1986. For men who linked with a case or control child, radon, gamma and total gonadal doses were estimated for three preconception periods: entire, 3-months and 6-months. Odds ratios were estimated using conditional logistic regression. Results: Linkage of 28,991 uranium miners and 40,482 case-control pairs of fathers and offspring in the CCF identified 431 discordant pairs. There was no evidence of increased risk of a child having a CA if the father was ever a uranium miner before conception of the child (OR=0.89, 95% CI=0.74–1.08). Since gamma radiation (especially during the 6-month preconception period) is more biologically relevant to gonads than radon, further analyses were performed on 117 discordant pairs where data on gamma exposures were available. When ever/never miner, exposed to gamma (yes/no), and gamma dose-response variables were all in the model, there was no ever/never miner effect (OR=1.20, 95% CI=0.85–1.69, p-value=0.30), an inverse association for exposure to gamma (OR=0.42, 95% CI=0.25–0.71, p-value=0.001), but most importantly, there was no statistically significant dose-response relationship between gamma dose during the 6-month preconception period and all CAs (OR=1.15 per loge {mSv+0.01}, 95% CI=0.83–1.59, p-value=0.40). Similarly, no dose-response relationship was observed for exposure to gamma radiation in the 3-month preconception period, or for radon or total gonadal radiation in the 3- or 6-month preconception periods. Conclusion: There was no increased risk of a CA among liveborn children of Ontario uranium miners who were exposed to radon, gamma or total radiation during the 3- or 6-month periods before conception.

Legislation demands that health and safety of humans at work must be secured. Today, far from every company has a functioning systematic management of occupational health and safety (OHS) in place to fulfill its legal obligations. Instead, other day-to-day tasks appear to have greater priority. The overall aim of this thesis was to investigate prerequisites and possibilities for manufacturing companies to prioritize and manage OHS, with focus on professional roles, company size, safety culture, and financial performance. Four papers (I–IV) are included in this thesis, based on three data collections. A questionnaire measuring the priority accorded to work environment was completed by 249 representatives of 142 manufacturing companies (I & II). Focus group interviews were conducted with 66 workers at a large steel-manufacturing company, discussing their experiences and perceptions of safety and risks at work (III). A questionnaire measuring OHS management practices, safety culture, and priority given to work environment was completed by 280 representatives of 197 manufacturing companies (IV). Information regarding the companies’ financial performance was retrieved from a credit bureau database. The main findings of the four papers demonstrated that profitability was considered as the most prioritized interest in the companies (I), and that trade-offs between productivity and safety is an obstacle to working safely (III). Managers generally perceived their companies to prioritize work environment factors more than the safety delegates did (I & IV). Perceptions of work environment priority did, however, not differ depending on company size (II & IV). Responsibility for safety was perceived to rest on the individual to the largest extent, and risk-taking was believed to originate from a combination of individual factors and external circumstances in the work environment (III). Larger company size, positive safety culture, and low risk in creditworthiness were found to be associated with better OHS management practices in companies (IV). Correspondingly, smaller company size, negative safety culture, and high risk in creditworthiness were found to be associated with worse OHS management practices. In summary, structural, social, and financial aspects seem to be important in companies’ possibilities for prioritizing and managing OHS. Recommendations for industry and future research are discussed. / Arbetsmiljölagen kräver att människors hälsa och säkerhet på arbetet ska tryggas genom att risker kontinuerligt ska bedömas och åtgärdas. Många företag saknar idag ett fungerande systematiskt arbetsmiljöarbete (SAM) som uppfyller lagens krav fullt ut. Istället tycks andra dagliga aktiviteter ha högre prioritet. Det övergripande syftet med denna avhandling var att undersöka förutsättningar och möjligheter för tillverkande företag att prioritera och arbeta med säkerheten och arbetsmiljön; med särskilt fokus på yrkesroller, företagsstorlek, säkerhetskultur och finansiella nyckeltal. Fyra delstudier (I–IV) ingår i denna avhandling, vilka är baserade på tre datainsamlingar. En enkät som mätte arbetsmiljöprioritering besvarades av 249 representanter vid 142 tillverkande företag (I & II). Fokusgruppintervjuer genomfördes med 66 arbetare på ett stort ståltillverkningsföretag, där deras erfarenheter och uppfattningar om säkerhet och risker i arbetet diskuterades (III). En enkät som mätte SAM, säkerhetskultur och arbetsmiljöprioritering besvarades av 280 representanter vid 197 tillverkande företag (IV). Information om företagens finansiella nyckeltal hämtades från ett kreditupplysningsföretag. De viktigaste resultaten från de fyra delstudierna kan bland annat sammanfattas med att lönsamheten uppfattades vara det mest prioriterade intresset vid företagen (I), och att avvägningar mellan produktivitet och säkerhet ansågs vara ett hinder för att kunna arbeta på ett säkert sätt (III). Chefer uppfattade generellt att arbetsmiljön prioriterades mer på företagen än vad skyddsombuden gjorde (I & IV). Uppfattningar om arbetsmiljöprioritering skiljde sig dock inte åt beroende på företagsstorlek (II & IV). Ansvaret för säkerheten på arbetet ansågs främst vila hos den enskilda individen, och risktagande betraktades komma ur en kombination av individuella faktorer och yttre omständigheter i arbetsmiljön (III). Att vara ett större företag, ha positiv säkerhetskultur och hög kreditvärdighet visade sig ha samband med att också ha ett bättre utvecklat SAM (IV). På motsvarande sätt, att vara ett mindre företag, ha negativ säkerhetskultur och låg kreditvärdighet befanns ha samband med att också ha ett sämre utvecklat SAM. Sammanfattningsvis verkar därmed strukturella, sociala såväl som ekonomiska aspekter vara väsentliga för företags möjligheter att prioritera och arbeta med säkerheten och arbetsmiljön. Detta ger uppslag till rekommendationer för industrin samt vidare forskning. / Das Arbeitsschutzgesetz verlangt, dass die Sicherheit und Gesundheit (SG) von Menschen am Arbeitsplatz gewährleistet werden muss, indem Risiken kontinuierlich überprüft und behoben werden. Vielen Unternehmen fehlt heutzutage eine systematische Handhabung von SG, die den gesetzlichen Anforderungen vollständig entspricht. Stattdessen scheinen andere alltägliche Tätigkeiten eine höhere Priorität zu haben. Das übergeordnete Ziel der vorliegenden Abhandlung war es zu untersuchen, welche Voraussetzungen und Möglichkeiten herstellende Unternehmen besitzen, SG am Arbeitsplatz zu priorisieren und handzuhaben – unter besonderer Berücksichtigung von Berufsrollen, Unternehmensgröße, Sicherheitskultur und Finanzleistungen. Die vorliegende Abhandlung besteht aus vier Teilstudien (I–IV), die auf drei Datensammlungen basieren. Die Priorisierung von SG wurde mit einem Fragebogen untersucht, der von 249 Vertretern aus 142 herstellenden Unternehmen beantwortet wurde (I & II). Fokusgruppeninterviews wurden mit 66 Arbeitern eines großen Stahlherstellers durchgeführt, in welchen die Arbeiter ihre Erfahrungen und Wahrnehmungen von Sicherheit und Berufsrisiken diskutierten (III). Ein weiterer Fragebogen enthielt Fragen zur systematischen Handhabung von SG, Sicherheitskultur und Priorisierung von SG und wurde von 280 Vertretern aus 197 herstellenden Unternehmen beantwortet (IV). Angaben zu den Finanzleistungen der Unternehmen wurden einem öffentlichen Register entnommen. Die wichtigsten Ergebnisse der vier Teilstudien können unter anderem damit zusammengefasst werden, dass die Rentabilität des Unternehmens als höchste Priorität wahrgenommen wurde (I) und dass Kompromisse zwischen Produktivität und Sicherheit als Hindernis für eine sichere Arbeitsweise beurteilt wurden (III). Manager waren im Allgemeinen häufiger als die Sicherheitsbeauftragten der Unternehmen der Auffassung, dass SG priorisiert werden (I & IV). Der Unterschied in der Wahrnehmung der Prioritätensetzung hing jedoch nicht von der Unternehmensgröße ab (II & IV). Sicherheit am Arbeitsplatz wurde in erster Linie als die Verantwortung des einzelnen Mitarbeiters angesehen und das Eingehen von Risiken als eine Kombination aus individuellen Faktoren und äußeren Umständen im Arbeitsumfeld beurteilt (III). Ein großes Unternehmen zu sein, eine positive Sicherheitskultur zu haben und niedriges Risiko in der Kreditwürdigkeit, erwies sich mit einer besser entwickelten systematischen Handhabung von SG in Zusammenhang zu stehen (IV). Dementsprechend erwies es sich, dass kleine Unternehmen, eine negative Sicherheitskultur und hohes Risiko in der Kreditwürdigkeit, mit einer schlechter entwickelten systematischen Handhabung von SG in Zusammenhang stehen. Zusammenfassend scheinen also strukturelle, soziale und finanzielle Aspekte grundlegend dafür zu sein, ob ein Unternehmen die Möglichkeit hat, SG zu priorisieren und zu handhaben. Dies dient als Vorlage für Empfehlungen für die Industrie und zukünftige Forschung.

Le facteur le plus important de pronostic de l'asthme professionnel (AP) est la durée des symptômes avant le retrait de lʼexposition à lʼagent causant lʼAP. La qualité de vie réduite, la détresse psychologique et les maladies psychiatriques sont des conditions souvent associées à l'AP. Notre objectif était d'identifier les facteurs, incluant le statut socioéconomique, qui ont une influence sur lʼintervalle de temps nécessaire pour présenter une requête à une agence médicolégale à la suite de lʼapparition de symptômes dʼasthme et de confirmer qu'un tel délai est associé à un moins bon pronostic respiratoire et à des coûts directs plus élevés. En outre, nous avons examiné la relation entre les variables cliniques et socio-économiques dʼune part et leur influence sur les facteurs psychologiques et économiques dʼautre part chez des travailleurs atteints d'AP. Ensuite, nous avons voulu évaluer si les individus souffrant de détresse psychologique (DP) et de morbidité psychiatrique pourraient être identifiés en utilisant un instrument mesurant la qualité de vie (QV). Lʼétude a été effectuée auprès dʼindividus ayant déposé des demandes d'indemnisation pourʼAP auprès du Commission de la sécurité et de la santé du travail du Québec (CSST). Les données ont été recueillies au moment de la réévaluation, soit environ deux ans et demi après le diagnostic. Outre la collecte des marqueurs cliniques de l'asthme, les individus ont été soumis à une évaluation générale de leur histoire sociodémographique et médicale, à une brève entrevue psychiatrique (évaluation des soins primaires des troubles mentaux, PRIME-MD) et à un ensemble de questionnaires, incluant le Questionnaire sur la qualité de vie - AQLQ(S), le Questionnaire respiratoire de St. George (SGRQ) et le Psychiatric Symptom Index (PSI).Soixante personnes ont été incluses dans l'étude. Etre plus âgé, avoir un revenu supérieur à 30 000$ CA etêtre atteint dʼAP dû à un allergène de haut poids moléculaire ont une association positive avec le nombre dʼannées dʼexposition avec symptômes avant le retrait. Au cours de la période de suivi, le nombre dʼannées dʼexposition avec symptômes était plus grand chez les individus ayant une hyperréactivité bronchique persistante. Par ailleurs, la présence de symptômes au poste de travail pendant moins d'un an est associée à une réduction des coûts directs. Les paramètres de QV et de DP avaient des corrélations modérées avec les marqueurs cliniques de lʼAP. Les plus fortes associations avec ces variables ont pu être observées dans les cas de la sévérité de l'asthme, des statuts dʼemploi et matrimonial, du revenu et de la durée de la période de travail avec l'employeur. Un seuil de 5,1 au niveau de la sous-échelle de la fonction émotionnelle de lʼAQLQ(S) sʼest avéré avoir la meilleure valeur discriminante pour distinguer les individus avec ou sans détresse psychiatrique cliniquement significative selon le PSI. Nous avons été en mesure d'identifier les variables socio-économiques associées à un intervalle plus long dʼexposition professionnelle en présence de symptômes dʼasthme. De même, une plus longue période d'exposition a été associée à un moins bon pronostic de la maladie et à des coûts de compensation plus élevés. Ces résultats s'avèrent utiles pour la surveillance de lʼAP qui pourrait cibler ces sous-groupes d'individus. La QV et la PS sont fréquemment réduites chez les individus atteints d'AP qui perçoivent une compensation. Elles sont associées à des marqueurs cliniques de lʼasthme et à des facteurs socio-économiques. En outre, nos résultats suggèrent que le questionnaire de lʼAQLQ(S) peut être utilisé pour identifier les individus avec un niveau de détresse psychologique potentiellement significatif. / The most important factor in the prognosis of occupational asthma (OA) is the length of exposure with symptoms prior to removal from exposure. Impaired quality of life, psychological distress and psychiatric disease are conditions frequently associated with OA. Our goal was to identify factors, including socio-economic status, that can influence the delay in submitting a claim to a medicolegal agency after the onset of asthmatic symptoms, and to confirm that such a delay is associated with a worse respiratory prognosis and higher direct costs. Further, we examined the association between clinical and socio-economic variables and their influence on psychological and cost outcomes in individuals with OA. Next, we wanted to evaluate whether individuals with clinically significant psychological distress (PD) and psychiatric morbidity could be identified by using a quality of life (QOL) measurement instrument. This is a study of individuals who filed claims for compensation for occupational asthma from the Workersʼ Compensation Board of Quebec (the CSST). Data were collected at re-evaluation, approximately two and a half years after diagnosis. Besides collecting clinical markers of asthma, individuals underwent a general socio-demographic and medical history evaluation, a brief psychiatric interview (Primary Care Evaluation of Mental Disorders, PRIME-MD) and completed a battery of questionnaires, including the Asthma Quality of Life Questionnaire - AQLQ(S), the St. Georgeʼs Respiratory Questionnaire (SGRQ), and the Psychiatric Symptoms Index (PSI). Sixty individuals were included in the study. Being older, having a revenue of >$30,000 Can. (CAD$) and having OA due to high- molecular- weight agents were all positively associated with the number of years of exposure with symptoms before removal from exposure. Individuals with persistent airway hyperresponsiveness at follow-up had a higher number of years with symptoms. Experiencing symptoms in the workplace for less than one year generated lower direct costs. QOL and PD parameters had moderate correlations with clinical markers of OA. Asthma severity, employment and marital status, income and length of employment with the employer showed the strongest associations with QOL and PD. More impaired QOL was associated with higher direct costs for compensation. A cut-off of 5.1 on the AQLQ(S) emotional function subscale had the best discriminative value to distinguish individuals with or without clinically significant psychological distress according to the PSI. We were able to identify socio-economic variables that were associated with a longer interval during which individuals remained symptomatic in the workplace before being removed from exposure. This longer exposure time was associated with worse disease outcomes and higher compensation costs. These findings could prove to be useful in surveillance programs that could be preferentially targeted for these subgroups of individuals. Impaired QOL and PD are frequent among individuals with OA receiving compensation and are associated with clinical markers of OA and socio-economic factors. Further, our findings suggest that the AQLQ(S) questionnaire could be used to identify individuals with potentially clinically significant levels of psychological distress.

Orientador: Otávio José de Oliveira / Banca: Márcio Minto Fabricio / Banca: Adilson Renofio / Resumo: Para que as organizações sejam competitivas e aumentem as chances de sobrevivência no mercado competitivo, é necessária a gestão do processo produtivo cada vez mais eficiente. Nesta gestão são utilizados sistemas focados em qualidade, meio ambiente, segurança e saúde no trabalho, entre outros. A integração desses sistemas otimizam recursos, processos e melhoram a imagem da organização, influenciando, assim, a lucratividade. Esta dissertação tem como objetivo formular diretrizes para o planejamento e implementação de sistema de gestão integrada em empresas da construção civil. Para a elaboração deste trabalho, foi adotada a pesquisa qualitativa, exploratória, bibliográfica com a realização de dois estudos de caso sobre os elementos do sistema de gestão integrada de duas construtoras certificadas em ISO 9001, ISO 4001 e OHSAS 18001 fazendo com que o pesquisador, se ambiente ao universo de estudo. Um referencial teórico foi apresentado sobre as características do processo produtivo, sistema de gestão da qualidade, meio ambiente, saúde e segurança no trabalho e integração desses. Conclui-se que, o objetivo traçado, foi devidamente alcançado, pois foram apresentados os elementos do sistema de gestão integrada nas duas construtoras, sendo identificadas as boas práticas e pode-se propor, diretrizes para o planejamento e implamentação do sistema de gestão integrada em empresas da construção civil / Abstract: To ensure that organizations are competitive and increase the changes of survival in competitive market, it is necessary to management of the productive process ever more efficiently. This management systems are used raised in quality, environment, health and safety at work, among others. The integration of these systems optimize resources, process, and improve the image of the organization, influencing, thus, the profitability. This dissertation has like objetctive, formulate guidelines for the planning and implementation of integrated management system in civil construction companies. For this work was adopted the qualitative research, exploratory, bibliographic with the achievement of two case studies about the elements of the integrated management system of two construction companies certifieds in ISO 9001, ISO 14001, and OHSAS 18001 making the researcher, environment the universe of study. A theoretical reference was presented about the characteristics of the production process, a system of quality management, environment, health and safety at work and integration of these. It concludes that, the outlined objective was duly achieved, because the elements of integrated management system were submitted in the two construction companies, being identified the good practices and could propose, guidelines for the planning and implementation of integrated management system in civil construction companies / Mestre

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