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  • Synonyme d'oxyde de carbone : monoxyde de carbone.

2. PROFESSIONS EXPOSEES

  • Usines à gaz
  • Conduite de gazogènes
  • Fabrication synthétique de l'essence et du méthanol

3. DESCRIPTION - EVALUATION DU RISQUE

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  • Pour toute activité susceptible de présenter un risque d'exposition à des agents cancérogènes, mutagènes ou toxiques pour la reproduction, l'employeur doit procéder à une évaluation des risques encourus pour la sécurité et la santé des travailleurs. Cette évaluation doit être renouvelée périodiquement, notamment à l'occasion de toute modification importante ou avant une activité nouvelle.
  • Les résultats de l'évaluation des risques sont consignés dans le document unique.

3.2. MESURE DE L'EXPOSITION

  • Prélèvements d'atmosphère au moins une fois par an par un organisme agréé pour les substances cancérogènes, mutagènes ou toxiques pour la reproduction
  • Mais en présence de monoxyde de carbone, des contrôles d'atmosphère fréquents sont recommandés
  • En cas de dépassement des valeurs limites d'exposition professionnelle, nouveau contrôle sans délai. Si le dépassement est confirmé, arrêt du travail aux postes concernés jusqu'à la mise en oeuvre des mesures approprié pour remédier à la situation.
  • En cas de modification des installations ou des conditions de fabrication susceptible d'avoir un effet sur les émissions d'agents cancérogènes, nouveau contrôle dans un délai de quinze jours.
  • Communication des résultats au médecin du travail, au CHSCT ou à défaut, aux délégués du personnel.
  • Oxyde de carbone : VME 50 ppm ou 55 mg/m3

3.3. FICHE D'EXPOSITION

Pour l'exposition à des substances cancérogènes, mutagènes ou toxiques pour la reproduction, l'employeur doit établir :

  • Une liste actualisée des travailleurs exposés
  • Une fiche individuelle d'exposition mentionnant :
    • la nature du travail effectué, les caractéristiques des produits, les périodes d'exposition et les autres risques ou nuisances d'origine chimique, physique ou biologique du poste de travail
    • les dates et les résultats des contrôles de l'exposition individuelle au poste de travail ainsi que la durée et l'importance des expositions accidentelles.

Chaque travailleur concerné est informé de l'existence de la fiche d'exposition et a accès aux informations le concernant.

Le double de cette fiche est transmis au médecin du travail.

4. RISQUES POUR LA SANTE

4.1. ACCIDENTS DU TRAVAIL

  • Intoxication aiguë par inhalation

4.2. MALADIES PROFESSIONNELLES

4.2.1. REGIME GENERAL

  • Tableau n°64 RG : Intoxication professionnelle par l'oxyde de carbone

4.2.1. REGIME AGRICOLE

  • Tableau n°40 RA : Intoxication professionnelle par l'oxyde de carbone

5. SURVEILLANCE MEDICALE

5.1. SURVEILLANCE REGLEMENTAIRE

5.1.1. VISITE MEDICALE

  • Visite d'embauche :
    • visite préalable à l'affectation
    • exclusion des femmes enceintes ou allaitantes
  • Visites périodiques :
    • une fois par an

5.1.2. EXAMENS COMPLEMENTAIRES : néant

5.1.3. VACCINATIONS : néant

5.2. SURVEILLANCE CONSEILLEE

5.2.1. VISITE MEDICALE

  • Visite d'embauche : éviter d'exposer des sujets présentant des affections cardio-vasculaires ou neuro-psychiatriques chroniques
  • Visites périodiques : rechercher des signes mineurs d'intoxication oxycarbonée (céphalées, vertiges, asthénie, troubles digestifs)

5.2.2. EXAMENS COMPLEMENTAIRES

On pourra réaliser :

  • Numération formule sanguine (NFS)
  • Electrocardiogramme (ECG)
  • En cas de doute sur une intoxication chronique, indicateurs biologiques : pourcentage de carboxyhémoglobine, taux d'oxyde de carbone sanguin

5.2.3. VACCINATIONS

  • Rappel DTPolio tous les 10 ans

5.3. SUIVI POST PROFESSIONNEL

  • Une attestation d'exposition aux agents toxiques pour la reproduction est remplie par l'employeur et le médecin du travail et remise au travailleur à son départ de l'établissement.

5.4. DOSSIER MEDICAL

Pour l'exposition à des substances cancérogènes, mutagènes ou toxiques pour la reproduction :

  • Contenu du dossier médical :
    • dates et résultats des examens médicaux complémentaires pratiqués
    • double de la fiche individuelle d'exposition établie par l'employeur, transmise au médecin du travail
  • Conservation du dossier médical pendant au moins 50 ans après la fin de la période d'exposition

6. ACTIONS PREVENTIVES

6.1. PREVENTION TECHNIQUE COLLECTIVE

  • Travail en vase clos
  • Captage au plus près de la source d'émission
  • Ventilation générale des locaux
  • Installations exemptes de matériaux susceptibles de donner une réaction avec le monoxyde de carbone
  • Limitation de l'accès à la zone dangereuse

6.2. FORMATION - INFORMATION - SENSIBILISATION

  • L'employeur doit organiser la formation à la sécurité et l'information des travailleurs susceptibles d'être exposés à l'action d'agents cancérogènes, mutagènes ou toxiques pour la reproduction.

6.3. PREVENTION INDIVIDUELLE

  • Port de protections individuelles : mettre à disposition des appareils de protection respiratoire isolants autonomes

7. REGLEMENTATION

7.1. TEXTES LEGISLATIFS ET REGLEMENTAIRES

  • Décret n°2001-97 du 1er février 2001 établissant les règles particulières de prévention des risques cancérogènes, mutagènes ou toxiques pour la reproduction et modifiant le code du travail (deuxième partie : décrets du 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 exposant à des substances et préparations explosives, comburantes, extrêmement inflammables, facilement inflammables, très toxiques, toxiques, nocives, cancérogènes, mutagènes, toxiques vis-à-vis de la reproduction, au sens de l'article R.231-51 du Code du travail.
  • Circulaire du 2 mai 1985 relative aux missions du médecin du travail à l'égard des salariées en état de grossesse. Instruction technique n°115 du 2 mai 1985 définissant le rôle et les missions du médecin du travail à l'égard des salariées en état de grossesse
  • Circulaire du 19 juillet 1982 complétée et modifiée par plusieurs circulaires relative aux valeurs admises pour les concentrations de certaines substances dangereuses dans l'atmosphère des lieux de travail : Oxyde de carbone VME 50 ppm ou 55 mg/m3
  • Arrêté du 11 juillet 1977 fixant la liste des travaux nécessitant une surveillance médicale spéciale (Travaux exposant aux émanations d'oxyde de carbone dans les usines à gaz, la conduite des gazogènes, la fabrication synthétique de l'essence ou du méthanol)
  • Annexe à l'article D.461-1 du Code de la Sécurité sociale. Liste des maladies ayant un caractère professionnel dont la déclaration est obligatoire pour tout docteur en médecine qui peut en avoir connaissance (Numéro d'ordre 6 : Oxyde de carbone)

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

OXYDE DE CARBONE

  • R61 : Risque pendant la grossesse d'effets néfastes pour l'enfant
  • R12 : Extrêmement inflammable
  • R23 : Toxique par inhalation
  • R48/23 : Toxique : risque d'effets graves pour la santé en cas d'exposition prolongée par inhalation
  • S45 : En cas d'accident ou de malaise consulter immédiatement un médecin (si possible lui montrer l'étiquette)
  • S53 : Eviter l'exposition, se procurer des instructions spéciales avant l'utilisation

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 : Janvier 2004

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