Contributing to occupational risk prevention through initial and continuing training. A prospective study to 2030

Introduction

A report by the Massachusetts Institute of Technology (MIT)^[1] on changes in work and employment over the next decade in the United States concludes that the limitations likely to occur in the development of technology are not technical, but primarily human. In a context of strong technological changes, the question of access to training will be of particular importance. Increasing automation, the development of remote working, and the continued development of new technologies (linked in particular to the use of artificial intelligence) will disrupt the working environment, cause occupational risks to evolve, and even give rise to new ones. It will therefore be necessary to train workers in appropriate occupational risk prevention^[2],[3].

As stated by Coudounaris^[4], the term "occupational health and safety training" covers very different realities. It applies to the content of part of the training of a student in vocational education as well as to that of an executive who is perfecting their health and safety management techniques. It concerns highly specialised training in driving self-propelled forklifts or in managing electrical risks (without which an employer will not authorise work) as well as general training for technicians or engineers responsible for implementing occupational risk prevention in companies. It can correspond to sessions during which a young worker will acquire the rules of safe working knowledge at the same time as professional gestures, or to other sessions carried out entirely remotely.

In France, the National Institute for Research and Safety^[5] is an organisation whose vocation is to develop and promote a culture of prevention of accidents at work and occupational diseases. To this end, it offers a wide range of training activities: direct training of prevention workers, implementation of initial training schemes, design of continuous training materials allowing for a high degree of multiplication, with remote learning for example.

For several years now, INRS has been carrying out foresight exercises dedicated to occupational safety and health issues in studies devoted to the development of the circular economy^[6], physical assistance robots^[7] and, more generally, the use of new technologies in the workplace^[8]. This work is primarily intended to provide elements of reflection for the social partners (employers and employees) who make up its Board of Directors. It also contributes to the development of multidisciplinarity within the institute and enables collaboration with specialists in the fields studied, companies, the academic world, representatives of associations, etc. At INRS, foresight is obviously a means of helping to decide on the directions to be taken in the years to come, but it is also a means of reflecting on actions already underway^[9].

There are a growing number of articles that point to significant changes in training in the next few years. Needs are expected to change significantly, as are teaching methods^[10],[11]. It was for this reason that the decision was taken to carry out an exercise on developments in occupational risk prevention training up to 2030. The scope of this exercise is broad, since it corresponds to the various training actions and methods mentioned earlier in this introduction. This choice is justified by the position of INRS, which is more or less directly involved in almost all the training OSH operations initiated in France in the public sphere (national education, vocational training). INRS may also participate in the actions of certain professional branches. This exercise was carried out in two parts, which will be described in more detail in the Material and Methods section:

• The first technical phase in which INRS worked with experts in the fields of training and OSH,
• The second phase, characterised as strategic, in which members of its Board of Directors, supported by representatives of employers' organisations and workers' unions, reflected together on possible directions for the Occupational Risks branch of the Social Security system (of which INRS is a part) in the field of prevention training. This reflection was conducted with a ten-year horizon (ca. 2030).

It should be pointed out that in France the social partners have an important role in defining occupational risk prevention policy and that the State most often ratifies the decisions they take in this area within the specialised branch of the Social Security system. The same applies to occupational safety and health training, where the branch plays a major role.

Materials and Methods

First phase of the exercise

The method known as "contrasting scenarios" was used. It has the particular advantage of presenting a whole range of possible situations (desirable or not) in an attractive and easily understandable way and of making it possible to highlight weak signals, technological discontinuities and ruptures. It has sometimes been criticised for being time-consuming, requiring the participation of specialists of the field under investigation and possibly favoring the choice of black and white scenarios or of the most likely scenario (wishful thinking)^[12].

A multidisciplinary working group of fifteen people was formed. It included three specialists in foresight, two specialists in occupational risk prevention (two of the three foresight specialists also had this qualification), three specialists in work issues and seven specialists in training. This group met six times in person.

The first task of the working group was to obtain as accurate a picture as possible of the situation, to understand the context and to identify the main forces of change that are or could be influencing the issue under study. This task led to the identification of thirteen variables, divided into three themes: 1. Transformations in work and professional trajectories (global context) 2. Occupational safety and health management methods (specific context in which the subject of the study is involved: training in occupational risk prevention) 3. The training itself. For each of these thirteen variables, one or two members of the working group drafted a summary note explaining the issue in question, its evolution over the last decade and three or four hypotheses of possible evolution by 2030. These hypotheses are intended to illustrate the whole spectrum of possible futures. They must be contrasted and incompatible with each other. They must be limited to the scope of the variable.

Within each of the themes, the combination of hypotheses from each variable made it possible to construct scenarios that illustrate the possible developments in each of the three themes: these scenarios therefore describe possible and highly contrasting futures (regardless of their desirability).

The coherence of each of the scenarios for the third theme (training) was then tested in relation to each of the scenarios for themes 1 and 2 (global context of work and context of occupational risk prevention): each member of the working group expressed his or her opinion by voting (from -1: incompatible scenarios to +1: compatible scenarios). This work of confronting scenarios with each other made it possible to determine the four main challenges facing OSH training in the years to come.

The flow of this phase of the exercise is summarised in Figure 1.

Imagen

Second phase of the exercise

These four challenges formed the basis of the reflection proposed to the thirteen members of the social partner group in charge of strategic reflection. These members were provided all the material (variables, hypotheses, scenarios) produced during the former phase of the exercise.

This group met six times:

• the first meeting to clarify and set out the framework for the joint work,
• four meetings, each devoted to one of the challenges identified in the first phase of the study,
• a meeting to conclude and definitively validate the work carried out jointly.

Due to the Covid-19 health crisis, these six meetings were held by videoconference. All the meetings were facilitated by two of the three foresight specialists involved in the working group (one of whom was also an occupational risk prevention specialist).

This work resulted in seven strategic questions, i.e. the main topics that the social partners will have to discuss in the competent bodies of the Social Security in the years to come in order to orient OSH training towards a desirable future.  

Results

First phase of the exercise: scenarios

A short summary of each of the thirteen scenarios is provided in this section

Theme 1: Transformations in work and professional trajectories (global context)

Scenario 1.1.: Individualisation and polarisation

Outsourcing (subcontracting) and automation are increasing and work collectives are being undermined. OSH prevention is less and less integrated. The labour market is becoming polarised between skilled workers sought after by companies and workers with few or no qualifications, who are often in precarious situations. Technological and organisational changes result in fragmented career paths.

Scenario 1.2.: Fragmented and heterogeneous career paths

Flexibility, multi-activity and fragmented careers are increasing in a context of strong technical and managerial changes. Companies are asking employees for a great deal of autonomy in the organisation of their work. Older workers are destabilised while younger ones adapt and adhere to these changes. The way in which OSH issues are taken into account varies according to the prevention cultures of the professional branches concerned.

Scenario 1.3.: Stealth companies - Agility for the brand

Outsourcing (subcontracting) and automation are increasing and work collectives are being undermined. OSH prevention is less and less integrated. Companies are providing a global range of services and subcontracting production for the benefit of powerful brands. Employment is precarious and scarce for the less qualified. The most qualified are also subjected to an intensification of work. Exacerbated flexibility takes precedence over corporate policies. Commodification is everywhere: between companies, between companies and workers.

Scenario 1.4.: Flexicurity and a culture of employability

A broad social consensus leads to a pact combining flexicurity (employment flexibility, high compensatory allowances and strong training support), corporate social responsibility and sustainable work. For the organisation of work, workers' experience-based knowledge is considered on the same level as expert knowledge. Training is of great importance and is closely associated with all developments in the organisation of work.

Theme 2: Occupational safety and health management methods

Scenario 2.1.: Occupational health integrated with public health

The occupational health system is integrated in the public health system. Training in a global health culture is provided throughout schooling and continues through awareness-raising activities throughout careers. It may also aim, for example, at preventing people from losing their jobs. These actions are coordinated by the regional health agencies, which provide concrete assistance to the smallest structures. Accident prevention issues remain the responsibility of companies.

Scenario 2.2.: Corporate responsibility for OSH

The employer's responsibility for OSH training has been reinforced. The head of the company must ensure that the worker's OSH skills match the requirements of the job he or she occupies. Employers can refer to the recommendations of a national structure dedicated to OSH training, which develops training standards (by profession) and updates them thanks to an observatory of needs. These training courses are provided by training organisations in the framework of a competitive market.

Scenario 2.3.: The connected work environment

The work environment is very connected. It permits quick alerts, especially for serious and imminent dangers. Depending on the company, the response in terms of prevention is based on automated systems and/or on decisions by specialised OSH teams. In return, the OSH training requirements for general workers have been reduced. As in scenario 2.2, occupational health has been integrated in public health.

Scenario 2.4.: The augmented (and scrutinised) man

The work environment is very connected:  workers, equipped with live monitoring devices for risks, exposure and health status, receive real-time instructions for decision-making on occupational risk prevention. Training in OHS has declined: it is defined by an observatory that develops reference materials for training organisations.

Scenario 2.5.: OSH, a national issue

Faced with the rejection of technology, the public authorities are limiting the use of automated facility management, resulting in a greater transfer of responsibilities to human beings. Training (initial and continuing) in occupational risk prevention is being reinforced through mandatory cross-disciplinary and specialised training. A dedicated structure in an observatory draws up reference systems applicable to all players. Occupational health acquires a high profile and retains its specificity.

Theme 3: OSH training

Scenario 3.1.: Agility and liberalisation guided by the Occupational Risks branch of the Social Security

The Occupational Risks branch of the Social Security establishes the standards for OSH training (initial and continuous). It certifies trainers as well as e-learning or blended learning systems which are becoming very important, as are digital technologies in general. This corresponds to an effort to individualise training.

Scenario 3.2.: E-learning à la carte and insourcing

The Occupational Risks branch of the Social Security is no longer a training operator. Together with the public authorities, it defines the training content required in the field of OSH. Companies use a large number of e-learning offers, that they supplement with on-the-job training. Training courses are increasingly individualised.

Scenario 3.3.: Professional branches as pilots

The public authorities, with the support of the Occupational Risks branch of the Social Security, define the content of the training courses. The implementation of initial and continuing training is ensured by specialised management bodies of the professional branches (except for higher education which is managed by the State). Training organisations are involved in accreditation and certification. New technologies are strongly mobilised, but blended learning is very much in use.

Scenario 3.4.: A national ambition to integrate OSH in training; decentralised implementation

The Occupational Risks branch of the Social Security aims to integrate OSH in all training courses. To do this, it works with all potential partners (employment, training, integration, economic development, professional branches, etc.) at the regional level. Training organisations are involved in accreditation and certification. The choice of techniques (face-to-face, e-learning, blended learning) is made to ensure maximum efficiency at the group and the individual level.

Scenario 3.5.: Disengagement of the Occupational Risks branch of the Social Security. Steering by the branches and regions, rationale of trainer certification.

The management of vocational training is organised at the regional level (employment, integration and economic development actors and professional branches).  The Occupational Risks branch of the Social Security is disengaging. Training organisations are involved in accreditation and certification. Technology is strongly mobilised in training actions.

First phase of the exercise: challenges

The work of comparing the relevance of the scenarios of the third theme (OSH training) with the scenarios of themes 1 (Transformations in work and professional trajectories [global context]) and 2 (Occupational safety and health management methods) has made it possible to highlight the main challenges that OSH training is likely to face in the coming years. There are four of them.

Challenge 1: Adapting OSH training to changes in work organisation

Context

In recent decades, work has been strongly transformed in the direction of increased fragmentation, which has taken various forms:

• automation has increased and, in some cases, resulted in intensifying work for employees^[13],[14].
• outsourcing of activities has increased, often to countries with low labour costs;
• the refocusing of companies on their core business has continued, which has led to an increase in the number of subcontractors working on their sites (in industry as well as in services), multiplying interactions between workers of different statuses, sometimes leading to difficulties in identifying the respective responsibilities of the different employers^[15].

All this is taking place in a context of reduced protection provided by labour regulations for the various employment contracts (including the development of self-employment).

Uncertainties and foresight hypotheses

It seems unlikely that these contextual elements will be fully overcome by the deadline envisaged in the exercise (2030). OSH training will therefore have to deal with these elements. Some companies will consider that the OSH training for which they are responsible is strictly limited to the workers who depend directly on them. On the other hand, others will prefer to consider all the workers present on their site as a community whose understanding and implementation of safety must be unified. We presume that many processing companies will be in the second case because of the potential danger of their installations. However, these companies may adopt different strategies: either identical training for all the players on the site, defined by the company that manages it, or training obligations that meet specifications for subcontractors with approved bodies, or even a combination of both. The question of training for these subcontractors appears to be very important since they are often exposed to the most dangerous tasks, especially in the case of small subcontractors.

These issues are linked to the question of corporate social responsibility (CSR). Some companies are moving away from this model by outsourcing all of their activities and adopting brand behaviour.

The agile behaviour claimed by some companies, marked by their ability to adapt to changes while maintaining strategic and operational continuity, may also have consequences for OSH training. More than in a traditional company, it must enable workers to apprehend and analyze the situation and adapt the prevention of their occupational risks and those of their environment to changing situations. The same applies to so-called "liberated" companies, in which a large part of the initiative is taken by the workers without necessarily referring to a streamlined hierarchy.

Similarly, the increased mobility of workers (working remotely in different locations while maintaining a link with the company via ICT) may also lead to a review of training programs.

Challenge 2: Adapting OSH training to changing career paths

Context

Professional careers are increasingly segmented^[16],[17]. Workers are led to change employers and even occupations more and more often. As mentioned in the previous challenge, this professional mobility is accompanied by increased flexibility linked to the less protective nature of employment contracts and the development of self-employment. In order to be effective, vocational training in general and occupational risk prevention training in particular must therefore accompany more uneven trajectories and facilitate transitions.

At the same time, we are witnessing the increasing standardisation of production methods. This standardisation is linked to the quality and traceability of production, which are themselves linked to the development of subcontracting^[18]. But it also affects the prevention of occupational risks, with the development of safety management policies. Under these conditions, it is important for workers, to be able to apply these policies throughout their professional careers, or else they risk being excluded from the job market. OSH training must be adapted to this situation and is even more important for workers who have been out of work for a long time, who are illiterate or have problems understanding a working language that is not their mother tongue.

Uncertainties and foresight hypotheses

The steady increase in musculoskeletal disorders (MSDs) and psychosocial risks (PSRs), in the context described above of segmented careers and the increasing age of retirement, raises the question of the sustainability of work. However, at the same time, a number of companies are betting on sustainable working conditions achieved through the development of their CSR policies (which generally go beyond the strict perimeter of the company). In this respect, two extreme contradictory developments may occur in the coming decade:

• a hypothesis marked by the development of discontinuous, increasingly fragmented professional trajectories, influenced by the segmentation of the labour market (according to age, skills, gender, etc.) and an intensification of tasks;
• a second hypothesis, based on the emergence of more sustainable and inclusive work organisations and their capacity to integrate compensation strategies developed by workers to preserve their health.

These two types of evolution will coexist with less extreme situations. This diversity of situations clearly shows the heterogeneity of the public and their needs in terms of OSH training. The latter will have to be able to take into account situations such as integration in jobs, the adequacy of the initial or continuing training of workers regarding the needs of companies, age, and the ability to adapt to technological changes. In this respect, workers in the smallest companies must not be left behind, even (and especially) if they are often less visible. Other parameters such as the relationship to the "work value" and attachment to the company should also be taken into account.

Challenge 3: Regulate and manage OSH training

Context

There is a fairly strong requirement for continuous OSH training in France. It can be decided by the social partners (for rescue and first aid at work or for driving forklifts, for example) or be of a regulatory nature (for asbestos treatment work or electrical accreditation).  Many of these training courses are provided within the framework of a multiplier system (training of trainers), with certifications or accreditations issued to training organisations. The French Ministry of Labour and the National Education system define and provide a large number of training courses as part of initial secondary education.

Multiplier system framework In order to increase the number of actions carried out as close as possible to the workplace, the Occupational Risks branch of the Social Security system and INRS entrust the delivery of training to training organisations or companies, provided that they have obtained prior authorisation and that they have certified trainers. To guarantee the quality of the training provided, the systems are based on reference documents and specifications designed by training professionals from the INRS/Occupational Risks branch network. These documents, which can be downloaded from the Internet, present the commitment expected from the entity, the organisation of the training to be complied with, and the skills and certification standards attached to the program[19].

However, although the general principle of training employees in occupational safety and health is mandatory for companies, there is no reference framework specifying the content of basic transverse training in prevention that should be provided to all. Each company is responsible for ensuring that the training provided to employees is appropriate for the positions they occupy. This is obviously a problem for smaller companies that generally do not have the human resources to fully understand (and solve) these issues.

Uncertainties and foresight hypotheses

There is considerable uncertainty as to the evolution of the employer's responsibility for occupational safety and health:

• If the principle of obligation of result prevails, the number of mandatory training courses could decrease in favour of greater freedom for companies in the management of their employees' OSH skills;
• The reinforcement and harmonisation of mandatory training schemes are also possible: the validation of a basic OSH skill base could even become a requirement prior to any hiring.

The Occupational Risks branch of the Social Security, which plays an important role in the application of the policies decided by the social partners (in particular through piloting the multiplication of training courses [training of trainers]), could see its role increase (in particular in initial training) or, on the contrary, decrease. Finally, as workers' career paths are increasingly segmented and atypical, one option could be to strengthen its role and its resources (including financial resources) in the choice of training. It could, for example, introduce aid (including financial aid) to help the smallest companies to set up the occupational risk prevention training they need.

Challenge 4: Adapting the training methods

Context

The deployment of ICT has profoundly changed the way we teach: e-learning, multi-media training materials, simulation tools, etc.^[20],[21]. Learning techniques have also evolved: from a top-down mode from the teacher to the student, they have moved to an accompanying approach to knowledge acquisition. However, regardless of the contribution of ICT, a significant part of OSH training involves an application dimension that can hardly be totally dematerialised and handled remotely: occupational lifesaving, risk prevention (accidents and occupational diseases) related to physical activity or driving forklifts.

Uncertainties and foresight hypotheses

The need to strengthen safety training in general, and occupational risk prevention in particular, in vocational training courses has been recognised for years by almost all the actors involved^[22],[23]. However, according to the same actors, insufficient progress has been made in the past years: the question is therefore the same for the years to come. This type of training is essentially provided in the classroom rather than through remote learning.

The methods of continuing professional education are more diversified: short courses, e-learning, work-study, on-the-job training, blended learning, etc. Self-training (through MOOCs) has played an increasing role in recent years. Overall, the role of ICT should continue to grow. Logically, this raises the question of the level of control of the content provided by these different methods and of their evaluation.

Second phase: Seven strategic issues for OSH training in the next ten years

These seven strategic issues emerged from the strategy group's discussions at four meetings, each devoted to one of the four challenges identified during the first phase. They were validated during the sixth and final meeting.

What are the objectives of OSH training at each stage of education?

In the early grades (< 11 years old), health education allows students to acquire the basics that will be used later for learning OSH issues: for example, teaching life-saving gestures knowledge of which will be useful for occupational life-saving training. In secondary school (between the ages of 11 and 15), the observation course in a workplace during the last year can begin to address the issues of occupational risk prevention.

From the age of 15 onwards, in vocational courses (technical high schools and apprentice training centres) and in professional courses (university), the acquisition of the general rules of occupational risk prevention is important in order to provide each student with the basic, transversal elements of a prevention culture that will be built and maintained throughout his or her career. The capacity for risk prevention must be acquired at the same time as professional practice, which implies that it should be included in the reference programs for diplomas.

The question of specific training for young people in their first job and/or in seasonal employment also deserves consideration in view of the high levels of accidents associated with periods of taking up a new job^[24],[25] (Salminen, 2004; Guerin et al., 2020).

What level of requirement for OSH skills?

Knowledge of OSH must have a significant weight (coefficient) for obtaining diplomas and certifications. This is already the case for a certain number of training courses: for example, for electricians. This concerns all professional training courses, including management courses, so that OSH is considered as essential.

Faced with increasingly non-linear career pathis, hox can OSH skills be maintained, adapted and tracked?

The time and resources devoted to continuing education are decreasing. The modularity of training (knowledge acquired in one course can be omitted in a subsequent course) may be an answer, but it must be accompanied by the possibility of verifying knowledge or by limiting the duration of the module.

The ideal solution would be to set up an "OSH training passport" summarising the knowledge acquired and the traceability of training certificates, but this would pose problems of data confidentiality related to French regulations.

What is the role of professional branches and occupational health services (occupational medicine)?

The money for continuing education is managed at the level of the professional branches by the social partners (employers' organisations and workers' unions). The same actors have an important role in defining occupational risk prevention policy in the Social Security system: better reciprocal information should make it possible to improve the effectiveness of continuing vocational training in OSH. Similarly, synergies should be sought more systematically with the consular chambers, in particular to help the smallest companies in their approach to OSH: training courses could be organised at the level of employment areas.  The occupational health services (occupational medicine), which are in contact with all companies, can also contribute to this type of service.

All these actors are in contact with the smallest companies. They can therefore play a role for these companies, which are often only able to release resources for occupational risk prevention training if there is an obligation imposed by the public authorities or a requirement from a client. However, they have other needs in this area.

What new targets?

Better awareness/training of some actors would be useful, in particular for:

• entrepreneurs and self-employed workers, who are often exposed to the same risks as employees and are involved in prevention; 
• designers (of premises and equipment, as well as of software and work organisation procedures) whose activity is decisive for employees' working conditions;
• institutional players in the field of professional integration (public employment service, temporary employment agencies, etc.).

The training of company directors and managers in safety and in the preservation of the physical and mental health of their teams is also essential: the increasingly rapid turnover in management positions makes this necessary.

OSH training sessions for employees of very small businesses could also be open to company managers. There is also a need to increase the number and accessibility of these courses.

What contribution can ICT make to OSH training?

The growing use of ICTs is inevitable in the years to come. They are changing training paths by allowing:

• autonomous courses via self-training systems, MOOCs (Massive Open Online Courses) and SPOCs (Small Private Online Courses), etc.;
• stronger personalisation of contents;
• tutoring by a distance trainer;
• new possibilities for group facilitation, including face-to-face;
• new possibilities of learning in dangerous environments thanks to virtual reality;
• access to training for certain groups (very small businesses, disabled workers, people who are geographically distant, etc.).

They cannot completely replace certain face-to-face actions (learning mouth-to-mouth resuscitation and/or external cardiac massage on a mannequin or driving a machine, for example).

The use of ICTs also leads to new combinations of online and face-to-face training sequences (blended learning); for example, to acquire the prerequisites before starting a training course. ICTs can also facilitate exchanges between trainers and trainees, before, during and after training courses. ICTs do not solve all the problems of access to training for the least qualified (illiteracy, digital divide, etc.). They may even accentuate them.

What guarantees for a quality OSH training offer?

In France, there is a body called "France Compétences" which brings together the State, the social partners and the regions (the largest subdivision of the local authorities) which ensures the quality and relevance of the content of the vocational training offered on the market. The social partners, whose important role in the prevention of occupational risks in France and their influence in training through INRS and the Occupational Risks branch of the Social Security have been mentioned several times, can make their point of view heard and promote their model of training multiplication (through accreditation and certification).

Discussion

The completion of this foresight study has shown the complexity of the context in which the possible changes in safety health training will take place in the years to come. There is unanimous agreement on the importance of initial and continuing OSH training: the experts are able to identify possible and desirable changes and the decision-makers (in this case the social partners involved in this work) generally confirm the relevance of these developments. However, there are many contradictions that hinder the development of this learning process. These few examples will illustrate this point.

Employers want workers who are both directly employable and whose technical foundations are solid so that they can be effective immediately. At the same time, the recent acceleration in the development of techniques makes them want the same workers to have good general knowledge, including on aspects that go beyond the strict limits of their trade skills. This general phenomenon can be found in the learning of OSH. Employers want safe professional action achieved through good mastery of basic techniques, but they also want workers capable of working safely in diverse and changing environments: workers must be able to assess the main risks encountered as a result of their work or that of colleagues working in the same space.

Training times are not extensible and choices have to be made. Until now, particularly for reasons related to the low coefficients in examinations, learning about occupational risk prevention in initial training has often been the poor relation. It is not enough to have convinced all levels of the company of its importance; it is now necessary to convince the entire educational system that its place in the curriculum must be expanded.

All of this is taking place in a context where, for cost reasons, the time devoted to continuing training is being reduced.

Modularity is presented as a way to overcome this lack of resources and to make continuing education more efficient. The worker, in liaison with their employer, can, throughout their career, determine which modules are useful to them and engage in a more or less long course, more directly efficient to meet their needs. This modularity is facilitated by the use of ICT in the different sessions: thus, the worker can alternate, throughout their career, face-to-face sessions, distance sessions and blend-learning experience. Initial training organisations also see modularity as a way to complete the technical background of their former students over time. In the specific field of occupational safety and health, this modularity of training courses can also prevent basic knowledge (e.g., general principles of prevention, risk assessment methods, the basics of occupational health and safety regulations) from being re-learned during subsequent training. Workers' unions are also in favor of this, provided that the knowledge acquired during the initial training is verified throughout the employee’s career.

Trade unions also attach great importance to the fact that OSH knowledge must not become a discriminating factor in hiring: the risk would be that training which is the employer's responsibility would be financed by the workers from their own funds. In the best-case scenario for the worker, it may be covered by the public authorities in their support for return to work. The unions also point out that, whatever the quality of the training acquired prior to joining a new company, this training must be contextualised according to the specific organisation of the work (and therefore of the occupational risks) in the new structure. This also contributes to the reluctance of some of them to create an individual "safety passport" which could summarise all the training relating to the prevention of occupational risks throughout their career. The risk would be that the coherence of "training and use, under the responsibility of the employer, in the particular context of the company" would be weakened.

The issue of access to training for workers in MSEs is also considered very important: it was the subject of much discussion throughout the work, both in phase 1 (technical) and phase 2 (strategic). Workers in the smallest companies face many difficulties in accessing training. These difficulties are related to issues of resources: financial in particular, since larger companies often spend more on training. This is also the case regarding opportunities: it is often more difficult to replace a worker in a small company during their training time than in a larger company. As a result, training in occupational risk prevention is often limited in the smallest companies to "mandatory" training (such as machine driving or electrical authorisations), which are certainly very useful but restrict the scope of prevention. The question also arises in terms of supply: a large company can organise in-house training or have its specific needs taken into account by the training organisation, but this will only exceptionally be the case for smaller companies.

Discussions during the strategic phase of the foresight exercise therefore often focused on the ability to develop the occupational risk prevention training system so that it is able to offer the training needed by smaller companies. Rather than creating new structures, it appeared that it was necessary to rely on existing structures which already provide services that are appreciated by MSEs but which must be convinced (or helped, including financially) to invest in these new services.

Conclusion

In general, while many articles in the field of vocational training are devoted to the possibilities opened up by advances in ICTs^[26],[27], the two phases of this prospective work devoted to training in occupational risk prevention have resulted in bringing to the forefront the question  of access to such training for workers in the smallest companies, an issue which has been very poorly resolved up to now. The political choice of the priority target has clearly taken precedence over the technical issues relating to teaching. In this context, the preferred choice is to network the various organisations that already provide services to the smallest companies and get them to promote OSH and OSH training.

We cannot prejudge the outcome of this exercise, nor the choices that will be made, but an initial response that was agreed upon by the participants (both employers' and workers' representatives) corresponds to one of the priorities already highlighted by the International Labour Organisation^[28]: that of the smallest enterprises.