The Italian National Surveillance System for Occupational Injuries: Conceptual Framework and Fatal Outcomes, 2002-2016

Abstract

Background. A national database of work related injuries was established in Italy since 2002, collecting information on the injured person, his/her work tasks, the workplace as well as risk factors contributing to accident dynamics, according to a model called Infor.Mo. Methods. The present is a qualitative description of occupational fatal injuries, excluding work-related fatal traffic injuries, that occurred in Italy from 2002 to 2016 (15 years). Results. Among 4,874 victims involved, all were males, mainly of >51 years of age (50.5%), predominantly self-employed (27.8%) or workers with non-standard contracts (25%). About 18.4% and 17.3% of fatal accidents occurred in micro-enterprises belonging to, respectively, Construction and Agriculture. A wide range of nationalities (59 countries in addition to Italy) was identified. 18.9% work related fatal injuries were due to some form of dangerous energy ‒ mechanical, thermal, electrical, chemical ‒ freely present in the workplace. Workers’ falls from height (33.5%), heavy bodies falling on workers from height (16.7%) and vehicles exiting their route and overturning (15.9%) were the accidents causing the greatest proportion of occupational fatal injuries either in the present study (from 2002 to 2016) and in the initial pilot phase, focused on years 2002-2004, with a similar distribution between the latter two time periods. The activity of the injured person made up 43.3% of 9,386 risk factors identified in 4,874 fatalities. Less common risk factors were related to: work equipment (20.2%); work environment (14.9%); third parties’ activity (9.8%); personal protective equipment/clothing (8.0%) and materials (3.7%). The activity of the injured person remained the most relevant contributing factor even when the accident was caused by two or more risk factors. Discussion. Occupational fatal injuries occurred mainly in small size firms featured by deteriorated workplaces and undocumented workers. Small companies generally have less resources to catch up with the continuously evolving health and safety at work regulations; moreover, they tend to be less compliant with occupational health and safety regulations since are less likely to be inspected by occupational vigilance services. As a result, the enforcement of regulations to control the occupational risk factors of occupational injuries is seemingly costly and scarcely effective. Perspectives. An approach that is being introduced in Italy rely on the use of economic incentives to promote safe and healthy workplaces. Randomization of firms to intervention companies and “waiting list” controls could allow an unbiased evaluation of financial incentives to prevent work related injuries.