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98% of firms coming under the French general social security scheme employ fewer than 50 employees. Although small enterprises do not see risk prevention as a priority, the statistics show without doubt that the majority of occupational accidents occur in such small businesses in many sectors of activity. How can we raise their awareness and encourage them to prevent occupational risks? By implementing appropriate approaches based on a better knowledge of SMEs and by collecting their needs, their interest for OSH issue becomes stronger. These approaches, usually used in marketing, reduce the gap between the weaknesses of the OSH competences of SMEs and the requirements for occupational risk prevention.


Improving occupational safety and health in small enterprises has been a recurring topic over the last three decades. This is probably due to the lack of solutions adapted to this category. Today, occupational safety and health (OSH) institutions hope to better reach small enterprises, as demonstrated by the emphasis placed on this category of enterprises in French national OSH strategy. The particularities to be considered regarding small enterprises are due to their large numbers, the lack of in-house skills and their little interest in occupational risk prevention topics. In order to encourage these small enterprises to take action in prevention, approaches suited to their particularities should be proposed. This article presents recommendations for designing such approaches.

Prevention in microenterprises

Number of enterprises

In France, the term “very small enterprise" relates to companies with fewer than 20 employees, “small and medium-sized enterprises", from 20 to 249 employees. In 2008, the definition of micro, small and medium-sized enterprises was harmonised at European level for statistical and economic analysis criteria. “Microenterprise" refers to an establishment with fewer than ten employees, and annual turnover or balance sheet total not exceeding two million euros.

Figure 1: Breakdown of establishments and employees by company size
Figure 1: Breakdown of establishments and employees by company size

With regard to the health and safety of employees, the number of employees criterion is sufficient for initial analysis. The ceiling of 20 and 50 employees serves to group together companies with a similar organisation in terms of prevention. It must also be noted that companies in France with at least 50 employees are required to set up a committee for health, safety and working conditions (CHSCT) and it has been observed that companies with at least 50 employees adopt a prevention strategy. In the remainder of this article, we shall use the term “small enterprises" to designate enterprises with fewer than 50 employees.

Grouping companies or establishments according to their number of employees is key for addressing prevention in small enterprises. It reveals that a vast proportion of companies in France are in fact small enterprises. Establishments with fewer than 20 employees account for 92% of all establishments, while those with fewer than 50 employees account for more than 98%.

This breakdown concerns all of the activity sectors under the general social security scheme (as opposed to the public, agricultural and self-employed regimes), but varies considerably depending on the activity. It takes into account the 1.8 million companies in France with at least one employee. It therefore excludes the 2.7 million enterprises, including one million self-employed workers, that have no employees.

Main features of small enterprises

Companies with fewer than 20 employees are characterised by a company manager who performs the same activity as the employees. This person is therefore well-versed in the activity and the related risks, especially when the risk causes occupational accidents. However, the manager does not always make the connection between disease and the professional activity, particularly in the case of occupational cancers: in fact, the possible connection between the work and the disease is often denied.

While the occurrence of an accident in the company may raise the awareness of risks, it should not be forgotten that on average, for a company with three employees, an accident occurs only once every twelve years.

The low number of worker representatives in these companies does not facilitate staff involvement in the prevention of occupational risks. In the light of this situation, the French Labour Code now requires the appointment of an in-house person in charge of employee protection and occupational risk prevention activities in the company (Article L.4644-1 of the Labour Code).

Accident statistics

In terms of accident statistics, the situation in small companies can be assessed through the frequency and severity indices. The values of these indicators depend on the size of the company. The analysis of the number of accidents based on company size is also very important, as it sheds a different light on accident occurrence.
Fig 2: Accident statistics for all employees (data 2012)
Fig 2: Accident statistics for all employees (data 2012)
Figure 3: Accident statistics for car repair industry (data 2012)
Figure 3: Accident statistics for car repair industry (data 2012)

The frequency index (FI) (number of accidents with absence from work (x10000)/number of employees) follows a peculiar curve: it varies according to the size of the establishment, with a maximum value for enterprises with around 50 employees and the lowest value for large companies (>200 employees) and companies with fewer than 10 employees.

This indicator should be interpreted with caution, since it measures the number of accidents compared to the number of employees. A low indicator means that the number of accidents/number of employees ratio is low.

However, in looking at the breakdown of the number of accidents, a low frequency index can correspond to a high number of accidents for a given profession. This is the case for numerous professions comprising mostly small enterprises, for example, the masonry and heavy construction work sectors and the catering industry. The car repair sector is a characteristic example. In this sector, 88% of employees (this activity accounts for 92.000 employees in France) work in very small enterprises (<20 employees). Figure 3 shows that these enterprises account for 82% of work accidents (total of the first two grey columns). Although the frequency index is lower in the very small enterprises in this sector, most accidents occur in these companies. Inversely, enterprises with 50 to 99 employees, in which the FI is highest, account for only 3% of accidents.

Prevention obstacles and drivers

The effective implementation of prevention in companies is reflected either in the existence of a health and safety management system or an action plan (adjustment of work stations or equipment, training, organisational changes, etc.). Studies show such measures are rarely implemented in small enterprises.

There is room for improvement if the prevention approaches take into account the observations made in the 2009 Enterprise Survey on New and Emerging Risks (ESENER), which are, by increasing order of importance: the perception that the activity does not involve any risks, the lack of skills, lack of time, lack of interest, and to a lesser extent, lack of financial resources. These conclusions mirror those of another study commissioned by INRS which highlights that prevention takes a backseat to other more pressing issues related to the continuity of the activity (funding, commercial development, etc.). To that is added the lack of connection between small enterprises and prevention bodies. Despite efforts by Social Security – 15 to 20% of its direct interventions concern enterprises with fewer than 10 employees -, their direct actions cover less than 1% of these companies.

An important characteristic of small companies relates to their organisation: centralised organisation relying on the leader, versatile employees and lack of support functions devoted to health and safety (human and legal resources, quality, etc.). Prevention, which requires legal, technical and health knowledge, is a complex topic that is difficult to grasp by small enterprises because of their lack of in-house skills in these fields that would enable them to adopt prevention messages which are often quite conceptual. Most often, this results in a lack of prevention organisation and planning . However, centralisation of management can also be an asset, driving the entire enterprise to adopt a prevention approach. Lastly, small enterprises express very few needs in terms of prevention apart from some form of support or operational tool in order to comply with legal obligations.

Principles for building a prevention approach

On the basis of these elements, a certain number of principles that contribute to the success of prevention approaches can be highlighted: the need for a “job-based" approach, support for small companies and the setting up of partnerships.

Job-specific approach

Prevention programmes, which are heavily based on technical skills, often address prevention from a risk perspective. This approach does not hold the attention of small enterprises either because they do not break down their activity according to risk, or because they do not always find operational elements specific to their activity in these approaches. By addressing prevention from a job perspective, small enterprises become more receptive to the prevention messages that directly concern their activity. This approach also enables the introduction of prevention measures adapted to these companies.

Approaches directed at small enterprises must take into account the obstacles mentioned above: poor prevention skills, lack of experts, and more pressing concerns that do not involve prevention. Introducing a company assistance, to close the gap between intention and action, can encourage the company to take an interest in prevention.

Partnership approach

Since individual support to companies cannot be envisaged by prevention institutions, collective support should be provided or associations made with some of the company’s other partners by encouraging those partners to include prevention within their scope of action. This support can take the form of regional meetings, training sessions, a telephone assistance service, etc. In this case, it may require minimal resources focusing on the approach objectives and stages, with deadlines being set to spur the company into action.

To minimise resources devoted to this support, the approach should promote actions that the company can carry out on its own. IT tools can be used for that purpose. Partnerships are necessary for implementing approaches aimed at small enterprises, particularly because of the large number of companies concerned. They enable the action to be spread to a greater number of enterprises. The type of partner depends on the objective set: in addition to spreading the action, some partners can also give credibility to the action. The choice is made among the following categories:

  • Partners in the profession: trade organisations or associations, technical centres and centres of innovation are important players for the elaboration and spread of prevention approaches. Their ability to mobilise companies and their credibility in the eyes of companies are their main assets. Their knowledge of the profession is also key for success in taking into account the needs of the companies and the adaptation of the approach to the particularities of each profession;
  • Institutional partners: inter-company occupational health services, local and regional health insurance funds, relevant ministerial departments, etc. can all spread the approach and support companies;
  • Social partners contribute to giving the approach credibility and are information and promotion relays;
  • Socio-economic partners: chambers of commerce and industry can spread actions and provide support. They are located in the different regions and can rally enterprises or identify all business takeover, development and creation projects;

Other non-prevention relays that are closely tied to companies, such as insurance firms and accountants and training centres are also potential partners that enterprises easily address about issues not relating to occupational risks. These relays can play a role in raising awareness of companies or rallying them, and also in recommending approaches when these are designed for autonomous use.

Depending on the activity sector, clients can contribute to making health and safety requirements be taken into account, in the same way that material and product suppliers can steer companies towards safer products and techniques.

The complexity of prevention approaches for small companies, in terms of partnerships, resources, duration, etc., calls for rigorous management.

Methodological elements for the microenterprise approach

Fig 4: The six stages in building prevention approach
Fig 4: The six stages in building prevention approach

An approach is constructed in six stages (See Fig 4) and can be applied regardless of the target. In the case of small enterprises, it is important to specifically identify their needs and draw on those needs to produce a suitable offer.

These stages must follow the order indicated. Since there can be frequent interactions between several stages, it is possible to go back to a stage several times.

Starting a project by building a prevention offer, without any knowledge of the target and its needs, presents the risk of being ill-adapted to the target or completely out of sync with the need.

Knowing the target

First, better knowledge of the target is required, in particular, the number of enterprises concerned, the number of employees, accident statistics indicators, the structure of the profession, training programmes, techniques implemented, etc. Social Security provides accident statistics for each profession.

Understanding the needs

The next stage consists in seeking out the needs of the target, which, initially, are envisaged in very broad terms: productivity, profitability, legal compliance, information, etc. This stage can be carried out using tools borrowed from marketing strategy (telephone surveys, online questionnaires, etc.).

Needs can be expressed in different ways (need for information, training, support, etc.) and can vary considerably depending on the size of the company and its activity, history, actions already undertaken, etc. The type of need will depend on the adoption of prevention in the company and the relevant resources available.

Dividing the target into segments

The third stage consists in segmenting the target: each segment is a group of enterprises with the same characteristics and similar needs. It is this homogenous target (segment) that will be the subject of reflection concerning the prevention offer.

The segments can be done with the enterprises having the same activities, or with the similar number of employees, or with companies where an accident occurred, ...

Building an offer

The actual design of the offer includes actions intended for the target and must be consistent with the previous stages. This is a complex and sometimes resource-intensive operation. It requires a strategic objective (or outcome) to be clearly formulated, which will then be broken down into several operational objectives. These objectives must be formulated such as they are perceived by the company in order for the indicators for assessing the action to enable the company’s progress in terms of prevention to be measured.

Prevention approaches have three types of objectives:

  1. To raise awareness in order to draw the attention of a “broad target" and thus reveal a need.
  2. To obtain support for the need or to make it attractive, rendering it a priority. Highlighting the potential profits, using proof or testimonials all serve to meet this objective.
  3. To spur to action targets that have had a top-priority need revealed.

For small enterprises, preference must be given, initially, to easily achievable prevention approaches, with quick and visible effects, in order for them to not be discouraged. For example, the introduction of collective (or personal) protective equipment is a means of motivating very small enterprises to invest in prevention.

Different types of tools may be developed (or reused if they exist) to construct this prevention offer. Regardless of the type, tools for very small companies must be easily accessible, simple and quick to use, if possible, with the necessary and sufficient information allowing it to be used autonomously. INRS studies reiterate that it is indeed necessary to approach small companies with operational and realistic tools, and to give priority to prescriptive messages and to tools combining risk identification with concrete solutions.

IT tools improve the autonomy of the company by facilitating access to information (internet) and by offering methodological tools. Moreover, their content is easily updated and their effective use can be followed (number of users, percentage of completion in the tool). Regardless of the tool selected (document, computer application), it is necessary to schedule a pre-test phase with the target in order to verify the relevance of the product. This stage serves to validate the choices made and, if required, to develop the tool based on the comments made by a small number of users before the tool is disseminated.

Implementing actions and communicating

Second-to-last stage: implementation of the approach. To put in place actions aimed at a broad and widespread target, communication is of the utmost importance. It is built based on the needs identified in stage 2. A same action can be aimed at gaining productivity, improving working conditions, retaining customers, keeping the activity running, complying with regulations, improving social dialogue, etc. Properly positioning the action echoes the needs of the target, which favours adoption by the target. The right approach also stems from the first two stages. Its goal is to adapt communication to the target and therefore has an indirect impact on the implementation of the action.

Communication must also take account of the external players associated and their own positioning. The message will also assist in reaching the prevention objective, and the means of communication will be chosen accordingly: communication through the use of existing media, communication specific to the project, etc.

Assessment and experience capitalisation

The last stage, which is essential, consists in assessing the actions in order to verify whether the objective has been reached but also to be able to rapidly develop an action that has not achieved its objective. The assessment also serves to compare the effectiveness and efficiency (cost/benefit ratio) of the different actions or means of action, in order to move towards best practices. Assessment is only possible if the objective is clearly defined and must necessarily be factored in when the action is designed. Each objective is associated with one or several indicators to assess the level of success. As indicated above, the assessment is facilitated by the precise and quantifiable definition of the objective and the associated indicators.


Approaching very small companies requires methods adapted to their size and culture. In addition to the dual profession/partnership approach, this involves major coordination among players at regional and national level. Lastly, it entails innovative adaptation of approaches and tools, enabling them to be spread more widely and allowing companies to more easily embrace them.

Further reading

  • Connaissances et perceptions des dirigeants de TPE à l’égard des risques de cancers professionnels - Eclairage sur les leviers et les freins d’implication » - Étude qualitative BVA-CARSAT PL October 2010
  • Les PME et les risques professionnels, Etude quantitative LH2 - INRS December 2010
  • « La prise en charge de la sécurité dans les PME », Marc Favaro INRS - ND 2096 (1999).

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Patrick Laine

'Institut National de Recherche et de Sécurité