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  • Les échanges thermiques de l'homme avec le milieu ambiant se font selon quatre modalités :
    • Convection : perte de chaleur au profit de l'air ambiant par contact du corps avec l'air froid
    • Rayonnement thermique : perte de chaleur au profit de l'environnement due au gradient de température entre l'air et le corps (37°)
    • Conduction : perte de chaleur par contact du corps avec un objet froid
    • Evaporation : perte de chaleur par la transpiration et la respiration
  • L'homme est homéotherme. Pour maintenir sa température centrale constante dans un environnement froid, des réactions physiologiques et comportementales sont mises en oeuvre :
    • Rétention de chaleur : baisse de la circulation sanguine superficielle, vêtements de protection contre le froid
    • Production de chaleur : apport alimentaire, activité physique, frissons
  • La température dans les entrepôts frigorifiques est d'environ -25°. Dans les chambres froides et sur les quais des entrepôts frigorifiques, elle est d'environ 2°.

2. PROFESSIONS EXPOSEES

  • Entrepôts frigorifiques : stockage, préparation des commandes
  • Chambres froides des abattoirs
  • Chambres froides des magasins (grandes surfaces, commerces de détail)
  • Chambres froides en restauration collective

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  • L'employeur transcrit et met à jour dans un document unique les résultats de l'évaluation des risques pour la sécurité et la santé des travailleurs.
  • Cette évaluation comporte un inventaire des risques identifiés dans chaque unité de travail de l'entreprise ou de l'établissement.
  • La mise à jour est effectuée au moins chaque année ainsi que lors de toute décision d'aménagement important modifiant les conditions d'hygiène et de sécurité ou les conditions de travail.

3.2. MESURE DE L'EXPOSITION

  • Thermomètre avec lecture extérieure ; enregistrement de la température

4. RISQUES POUR LA SANTE

4.1. ACCIDENTS DU TRAVAIL

  • Ils sont favorisés par la diminution de la dextérité due au refroidisselent des extrémité et à la diminution des performances musculaires.
    • Accidents de manutention
    • Chutes de plain-pied sur sol glissant

4.2. MALADIES PROFESSIONNELLES

4.2.1. REGIME GENERAL

  • Tableau n°97 RG : Affections chroniques du rachis lombaire provoquées par des vibrations de basses et moyennes fréquences transmises au corps entier
  • Tableau n°98 RG : Affections chroniques du rachis lombaire provoquées par la manutention manuelle de charges lourdes

4.2.1. REGIME AGRICOLE

  • Tableau n°57 RA : Affections chroniques du rachis lombaire provoquées par des vibrations de basses et moyennes fréquences transmises au corps entier
  • Tableau n°57 bis RA : Affections chroniques du rachis lombaire provoquées par la manutention manuelle habituelle de charges lourdes

4.3. AUTRES

  • Gelures
  • Syndrome de Raynaud, acrocyanose
  • Asthénie
  • Gêne respiratoire notamment en cas de bronchite chronique ou d'asthme
  • Aggravation des douleurs rhumatismales
  • Aggravations des troubles cardiovasculaires chez les insuffisants coronariens ou cardiaques

5. SURVEILLANCE MEDICALE

5.1. SURVEILLANCE REGLEMENTAIRE

5.1.1. VISITE MEDICALE

  • Visite d'embauche puis visites annuelles

5.1.2. EXAMENS COMPLEMENTAIRES

  • Néant

5.1.3. VACCINATIONS

  • Néant

5.2. SURVEILLANCE CONSEILLEE

5.2.1. VISITE MEDICALE

  • A l'embauche, recherche d'une pathologie pouvant être aggravée par l'exposition au froid : troubles cardiaques (angor, insuffisance cardiaque), troubles vasculaires (acrosyndrome, syndrome de Raynaud), troubles respiratoires (asthme, insuffisance respiratoire) ; s'enquérir de la consommation d'alcool
  • Au cours des visites annuelles, recherche de signe d'intolérance au froid : syndrome de Raynaud, engelures, gêne respiratoire

5.2.2. EXAMENS COMPLEMENTAIRES

  • Selon la clinique

5.2.3. VACCINATIONS

  • Rappel DTPolio tous les 10 ans

5.3. SUIVI POST PROFESSIONNEL

  • Néant

5.4. DOSSIER MEDICAL

  • Pas de durée réglementaire de conservation du dossier médical mais la prescription en matière de responsabilité médicale est de dix ans à compter de la date de consolidation d'un dommage éventuel.

6. ACTIONS PREVENTIVES

6.1. PREVENTION TECHNIQUE COLLECTIVE

  • Porte de la chambre froide munie d'une poignée côté intérieur
  • Revêtements faciles à nettoyer
  • Sol antidérapant
  • Elaboration de procédures d'hygiène
  • Pauses de durée suffisante pour avoir le temps de se réchauffer (20 minutes), prises dans un local chauffé avec mise à disposition de boissons chaudes

6.2. FORMATION - INFORMATION - SENSIBILISATION

  • Information des salariés sur les risques de l'exposition au froid et sur les moyens de protection
  • Formation de sauveteur secouriste du travail (SST)
  • Formation PRAP (Prévention des Risques liés à l'Activité Physique)

6.3. PREVENTION INDIVIDUELLE

  • Port des protections individuelles de protection contre le froid : combinaison, veste, bottes fourrées antidérapantes, gants épais ou moufles sur une paire de gants fins, grosses chaussettes, bonnet
  • Alimentation équilibrée avec un apport calorique et hydrique suffisant

7. REGLEMENTATION

7.1. TEXTES LEGISLATIFS ET REGLEMENTAIRES

  • Arrêté ministériel du 20 octobre 2004 fixant la liste des travaux effectués dans les entreprises agricoles et nécessitant une surveillance médicale. Travaux exposant à de basses ou hautes températures imposées par les procédés de travail mis en oeuvre.
  • Décret n°2001-1016 du 5 novembre 2001 portant création d'un document relatif à l'évaluation des risques pour la santé et la sécurité des travailleurs, prévue par l'article L.230-2 du code du travail et modifiant le code du travail (deuxième partie : Décrets en Conseil d'Etat).
  • Arrêté du 19 mars 1993 fixant, en application de l'article R.237-8 du Code du travail, la liste des travaux dangereux pour lesquels il est établi par écrit un plan de prévention. Travaux de maintenance sur installations à très haute ou très basse température.
  • Arrêté du 11 juillet 1977 fixant la liste des travaux nécessitant une surveillance médicale spéciale (Travaux effectués dans les chambres frigorifiques).
  • Arrêté du 30 septembre 1957 relatif aux mesures de sécurité applicables aux chambres froides ou climatisées.

7.2. RECOMMANDATIONS - NORMES - ETIQUETAGE (Phrases de risque) et phrases de sécurité)

7.2.1. RECOMMANDATIONS DE LA CNAMTS

  • R 92 Installations frigorifiques fonctionnant à l'ammoniac (1971)
  • R 242 Installations frigorifiques fonctionnant à l'ammoniac ou avec des composés chlorofluorés (1983)

7.2.2. NORMES (AFNOR)

  • NF EN ISO 9886.Juillet 2004. Ergonomie - Evaluation de l'astreinte thermique par mesures physiologiques
  • NF EN ISO 12894. Septembre 2001. Ergonomie des ambiances thermiques - Surveillance médicale des personnes exposées à la chaleur ou au froid extrêmes.
  • NF EN ISO 10551.Juin 2001. Ergonomie des ambiances thermiques - Evaluation de l'influence des ambiances thermiques à l'aide d'échelles de jugements subjectifs
  • NF EN ISO 7730. Décembre 1995. Ambiances thermiques modérées - Détermination des indices PMV et PDD et spécifications des conditions de confort thermique

8. BIBLIOGRAPHIE

AUTEURS : Médecins du travail de l'AMI (75), Nicole Motsch (médecin du travail) (AMETIF) (95)
DATE DE CREATION : Décembre 2001
DERNIERE MISE A JOUR : Novembre 2004

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