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Leptospirosis

An underestimated, potentially serious infectious disease

A recognized occupational disease

Faced with potentially serious harm, and even death, workers exposed to leptospirosis as part of their job are covered by various laws.

A large number of workers affected

Leptospirosis is recognized as an occupational disease on a global, European and national level. In France, for example, tables of occupational diseases suggest a list of at-risk activities that fall under the following definition: “work that exposes staff to contact with animals likely to be carrying bacteria, usually performed in contact with water or in humid places likely to be contaminated with the excrement of such animals”(1,2). Epidemiology studies show that, in mainland France, one third of all identified leptospirosis cases are of occupational origin. Among the section of the population of working age, 54% of cases identified were contracted at work(3,4).

In the United Kingdom, the Health and Safety Executive (HSE), which has responsibility over occupational health and safety, also lists some professions carrying the risk of leptospirosis (Weil’s disease): watersports instructors; workers in outdoor leisure industries, particularly if in contact with water; sewage and waste water workers; construction/demolition/building renovation workers – where there are rodents or stagnant water; farm workers; and pest control workers(5).

Leptospirosis is also a disease associated with leisure activities(6), and can be contracted when swimming or during freshwater activities such as rafting, canyoning, triathlon, fishing and even hunting and trapping, etc.

Recherche et prévention autour de la Leptospirose - Imaxio

General Regulations

Date created: Decree of 12 July 1936 | Most recent update: Decree of 7 October 2009

Designation of diseases Treatment time Non-exhaustive list of principal working activities likely to cause these diseases
All clinical manifestations of leptospirosis caused by Leptospira interrogans. The disease should be confirmed by identifying the bacteria, or using agglutination serodiagnosis to determine a sufficient level.
21 days
The following work involves exposure to animals likely to be carrying the bacteria, particularly tasks performed in contact with water and in humid locations which may be contaminated with animal excrement:
a) Work conducted in mines, quarries (underground work), trenches, tunnels, galleries, subterranean areas; engineering works;
d) Work conducted in sewers, basements, cellars;
c) Maintenance of streams, canals, marshes, ponds and lakes, reservoirs and lagoons;
d) Maintenance and supervision in water parks and treatment plants;
e) Drainage work, clearing ditches, laying water and sewage pipes, maintaining and emptying septic tanks and organic waste recovery tanks;
f) Work conducted in dairies, cheese factories, fishmongers, kitchens, canned food factories, breweries, feed mills;
g) Work conducted in abattoirs, rendering plants, recovering and using the fifth quarter of slaughtered animals;
h) Work conducted on boats, barges, port facilities; marine and dock work;
i) Deratting and destroying captive rodents in an aquatic environment;
j) Caring for vertebrate animals;
k) Work in bacteriology or parasitology laboratories;
l) Fish farming and production;
m) Supervising activities in a natural aquatic environment (except maritime): nautical, fishery, subaquatic activities;
n) Assistance, search and rescue in a natural aquatic environment (except maritime);
o) Banana growing, sugar cane cutting.

Agricultural Regulations

Date created: Decree of 17 June 1955 | Most recent update: Decree of 19 July 2007

Designation of diseases Treatment time Non-exhaustive list of working activities likely to cause these diseases
All clinical manifestations of leptospirosis caused by Leptospira interrogans.
The disease should be confirmed by identifying the bacteria, or using agglutination serodiagnosis to determine a sufficient level.
21 days
The following work involves exposure to contact with animals likely to carry the bacteria, particularly tasks performed in contact with water and in humid locations, likely to be contaminated with excrement:
a) Work conducted in trenches, tunnels, galleries, subterranean areas;
d) Work conducted in sewers, basements, cellars;
c) Maintenance of streams, canals, marshes, ponds and lakes, reservoirs and lagoons;
d) Maintenance and supervision in water parks;
e) Fish farming, water bailiff, professional freshwater fishing;
f) Drainage work, clearing ditches, laying water and sewage pipes, maintaining and emptying septic tanks and organic waste recovery tanks;
g) Banana growing, sugar cane cutting;
h) Work conducted in dairies, cheese factories, fishmongers, kitchens, canned food factories, breweries, feed mills;
i) Work conducted in abattoirs, rendering plants, recovering and using the fifth quarter of slaughtered animals;
j) Deratting, trapping, gamekeeping;
k) Caring for vertebrate animals.

Cases of occupational leptospirosis identified in France in recent years

Table 19A of the General Regulations and 5 of the Agricultural Regulations Study 1 Study 2 Study 3 Study 4 Autres études
Work conducted in mines, quarries (underground work), trenches, tunnels, galleries, subterranean areas; engineering works check check check check Study 5Study 6
Work conducted in sewers, basements, cellars check check Study 7Study 8
Maintenance work on streams, canals, marshes, ponds and lakes, reservoirs and lagoons check check Study 9Study 10
Maintenance and supervision in water parks and treatment plants check check check Study 11
Drainage work, clearing ditches, laying water and sewage pipes, maintaining and emptying septic tanks and organic waste recovery tanks check check
Work conducted in dairies, cheese factories, fishmongers, kitchens, canned food factories, breweries, feed mills check check Study 10
Work conducted in abattoirs, rendering plants, recovering and using the fifth quarter of slaughtered animals check check Study 11
Work conducted on boats, barges, port facilities; marine and dock work check
Deratting and destroying captive rodents in an aquatic environment Study 12Study 13
Caring for vertebrate animals check check check check Study 10Study 11Study 14Study 15Study 16
Work in bacteriology or parasitology laboratories Study 17
Fish farming and production check check check Study 10
Supervising activities in a natural aquatic environment (except maritime): nautical, fishery, subaquatic activities) Study 18
Assistance, search and rescue in a natural aquatic environment (except maritime) check check Study 19Study 20
Banana growing, sugar cane cutting Study 21
Fish farming, water bailiff, professional freshwater fishing check check check Study 10
Deratting, trapping, gamekeeping Study 12Study 13
Other professions Studies
Maintaining green spaces (foresters, gardeners, landscapers, etc.) Study 22Study 23Study 24
Agricultural professions Study 22Study 26Study 27Study 28Study 29Study 30
Military personnel, firefighters, traditional miners, truckers etc. Study 31Study 25Study 23Study 27

Responsibilities of employers in France:

The employer has a duty of care to employees, which means they must ensure safety, and protect the physical and mental well-being of employees, in accordance with article L4121-1 of the Labour Code. If they fail to do so, in extreme cases, employers risk:

  • An increase of up to €539,000 in the AT/MP business account, to be reimbursed to social security(7). Up to five years in prison(8), with a fine for the management team in the event of negligence, breach of the safety obligations or inexcusable fault, causing harm to an employee. Even in the absence of illness, some companies have been prosecuted for not taking adequate protective measures for employees potentially at risk of leptospirosis.
  • In recent years, at least a half-dozen cases that came before the courts resulted in compensation of up to €23,000(9). The plaintiffs had not necessarily contracted the disease.

Appropriate medical monitoring for this Group 2 biological agent

In the context of the new labor law and decree no. 2016-1908, published in December 2016, those exposed to Group 2 biological agents, including leptospirosis, should be seen by an occupational health professional:

  • for an initial appointment that should take place before the job starts (Information and Prevention Visit)
  • for periodic medical appointments, which should be scheduled every five years at most, and which should be adjusted as needed (applying a vaccination schedule, for example).

leptospirosis, an occupational disease

(1) Décret n° 2009-1194, Journal Officiel du 07/10/2009 (Code de la Sécurité Sociale)
(2) Décret n° 2007-1121 du 19/07/2007 (Code de la Sécurité Sociale)
(3) Baranton G, Postic D Centre National de Référence des leptospires, Institut Pasteur Paris, Synthèse La leptospirose en France de 2001 à 2003 : 1-8
(4) Watrin M. Étude descriptive des cas de leptospirose diagnostiqués en Normandie sur la période 2010-2014. Saint-Maurice : Institut de veille sanitaire ; 2016 : 1-28.
(5) Health and Safety Executive. Leptospirosis (Weil‘s disease and Hardjo). 3. http://www.hse.gov.uk/agriculture/zoonoses-data-sheets/leptospirosis.pdf
(6) Avis du Conseil Supérieur d’Hygiène Publique en France relatif aux recommandations pour la prévention de la leptospirose dans la population générale (séance du 30 septembre 2005)
(7) J.O. n°0288 du 10.12.2017
(8) Code Pénal – Article 221-6
(9) Cass. Soc. 14.10.2011 : n° 11/01292