Effects of heat exposure on occupational injuries in the agricultural sector in Italy

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Background and aim – The health effects of extreme temperatures at population level are well known. However, the effects on occupational injuries in different sectors have been scarcely investigated. Methods - We collected work-related injuries in the agriculture sector occurring in the 8,090 Italian municipalities from the Italian national workers’ compensation authority (INAIL) between 2014-2018. Daily air temperatures from Copernicus ERA5-land were used to define exposure at municipality level. First, we applied distributed lag non-linear models (DLNM) to estimate the association between daily mean air temperature and injuries at regional level; then meta-analysed results to have overall estimates. The relative risk (RR) and attributable cases of agriculture-related injuries for an increase in mean temperature above the 75th percentile were estimated, as well as heatwave effects. Analysis were also stratified by age, duration of leave and professional qualification. Results - Analysis were conducted on 150,422 agricultural injuries. The overall relative risk of agricultural work-related injuries for an increase in temperatures was 1.13 (95%CI: 1.08; 1.18). The number of injuries attributable to heat is of 2050 cases in the considered period. A higher risk was observed among young workers (1.23 95% CI: 1.14; 1.34) and seasonal workers (1.25 95% CI: 1.03; 1.52). When considering duration of leave, a proxy of severity of heat-related injuries, the greatest risk and frequency was observed for short duration between 0-14 days (1.21 95% CI: 1.10; 1.33) with a decreasing trend. Considering extreme heat wave events, the risk of injuries in the agricultural sector was of 1.04 (95% CI: 1.01; 1.08). Conclusions - Occupational exposure to extreme temperatures is a critical issue considering climate change especially among sectors engaged in outdoor and labour-intensive activities such as the agricultural sector. These results can help promote specific prevention actions for workers. Keywords - Work-related injuries; heat waves; agricultural sector.