Risques professionnels, mieux vaut prévenir

Voici une décision ((Cass. Civ. 2ème, 18 novembre 2010, n°09-17.275, Mme M-R. c/ CPAM de Nanterre et autres : JurisData n°2010-021320.)) qui intéressera sûrement les établissements de santé privés, mais qui à terme devraient également concerner les établissements publics de santé, d’un point de vue de l’hygiène et de la sécurité. La morale est la suivante : en fait de risques professionnels, ne rien faire peut coûter cher.

Il s’agissait en l’espèce d’un agent des services hospitaliers (ou agent room service, cela fait plus chic), salariée de l’association American Hospital of Paris (l’association) de 1990 à 2005, dont les tâches étaient les suivantes :

  • préparation et chargement des chariots repas au niveau de la cuisine centrale ;
  • manutention pour transporter les chariots au niveau de l’étage (un ou deux en fonction du nombre de lits à servir) ;
  • distribution et enlèvement des plateaux repas dans les chambres, tâches effectuées matin, midi et soir ;
  • prise en compte des demandes supplémentaires des patients ou des accompagnants lors du service ou en dehors des heures de repas (déplacement et manutention).

Elle a été reconnue victime d’une maladie figurant au tableau n°57 C des maladies professionnelles (pathologie des poignets). Le taux d’IPP (incapacité permanente partielle) avait été fixé à un niveau extrêmement bas, soit 2%. Mécontente, la salariée avait alors saisi la juridiction de sécurité sociale afin d’obtenir une indemnisation complémentaire pour faute inexcusable de l’employeur.

D’après le code du travail, l’employeur doit prendre les mesures d’organisation appropriées, ou utiliser des moyens appropriés, en particulier des équipements mécaniques, afin d’éviter le recours à une telle manutention ((Article R.4541-3 du code du travail.)). Dans certaines hypothèses, la manutention manuelle ne peut être évitée. L’employeur doit alors s’efforcer de limiter l’effort physique et de réduire le risque encouru lors des opérations de manutention ((Article R.4541-4 du code du travail.)).

De façon erronée, les juges du fond avait considéré que l’article R.231-66 ancien du code du travail ne pouvait suffire à établir que l’employeur aurait dû avoir conscience des dangers résultant de la manutention prolongée de plateaux. Ces juges s’étaient fondés en l’espèce sur le défaut de précisions relatives aux charges pensant sur les poignets de la salariée et l’absence de prescriptions précises ou de mises en garde émanant du CHSCT ou du médecin du travail.

La Cour de cassation a néanmoins une vue plus large. Il est acquis en effet que l’employeur est tenu d’une obligation de sécurité de résultat envers son salarié. Lorsqu’on se rend à son travail le matin, on peut légitimement s’attendre à en revenir le soir sur ses deux jambes. Le manquement à cette obligation a le caractère d’une faute inexcusable au sens de l’article L.452-1 du code du travail lorsque l’employeur avait ou aurait dû avoir conscience du danger auquel il exposait le salarié et n’a pas pris les mesures nécessaires pour l’en préserver ((Cass. Soc., 27 juin 2002, n°00-14.149.)).

Par « manutention manuelle », il faut entendre toute opération de transport ou de soutien d’une charge, dont le levage, la pose, la poussée, la traction, le port ou le déplacement, nécessitant l’effort physique d’un ou de plusieurs salariés ((Article R.4541-2 du code du travail.)). Ces diverses manipulations de charges provoquent immanquablement des pathologies variées, par exemple, une tendinopathie de la coiffe des rotateurs (pathologie bien connue des épaules subie classiquement par les aides-soignantes et les agents des services hospitaliers), ou bien encore comme en l’espèce aux poignets, aux bras, à la colonne vertébrale, au dos (hernie discale, par exemple).

Peu importe le poids de l’objet, il suffit par exemple que les mouvements répétitifs des bras ou des mains que le poste impose au salarié soit de nature à provoquer des douleurs qui s’accentuent avec l’ancienneté dans l’entreprise et qui génèrent des pathologies professionnelles visées par tel ou tel tableau des maladies professionnelles, annexé au code de la sécurité sociale. C‘est le phénomène d’usure professionnelle provoqué notamment par des « conditions ergonomiques défavorables ».

Dans le monde hospitalier, l’hôtellerie n’est pas le seul secteur concerné. On peut également penser à la filière ouvrière et technique (ambulanciers, jardiniers, serruriers, menuisiers, etc.).

Confronté à un secteur où les patients peuvent difficilement être servis par des machines pour cause de qualité du service proposé à la clientèle, l’employeur hospitalier doit veiller à préserver la santé de ses salariés. La gestion des risques joue, à ce titre, une fonction essentielle.

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