Compensation Authority Research Articles

Developing a cost-estimation model for work-related stress: An absence-based estimation using data from two Italian case studies.

Objectives:This paper discusses the development of a cost-estimation model for work-related stress based on psychosocial risk exposure and absence from work. It presents findings from its implementation and evaluation in two organizations in Italy, using national-level tools developed by the Italian Workers’ Compensation Authority (INAIL). It also provides recommendations for the development of similar cost-calculation methods in other countries.Methods:The cost-estimation model was based on the human capital approach using an indirect cost indicator: loss of productivity due to days of absence attributable to work-related stress. Furthermore, the population attributable fraction (PAF) epidemiological measure was used to calculate the impact of exposure to work-related stress on the basis of data collected through validated tools developed by INAIL and salary cost data.Results:The developed model was implemented and evaluated in two organizations, the first in healthcare (N=1014) and the second in public administration (N=534). In the first case, it was found that absence related to work-related stress cost the organization €445 000. In the second case, the cost was €360 000.Conclusions:The proposed model provides an example of how organizations can incorporate well-established indicators associated with work-related stress (eg, various types of absence, psychosocial risk perception, loss of productivity on the basis of salary costs) in a practical way in cost estimations of work-related stress. Such cost estimation can be applied in other countries and organizations to establish the economic and business case of managing work-related stress.

Evidence for implementation of interventions to promote mental health in the workplace: a systematic scoping review protocol

BackgroundMental health problems are common in the working population and represent a growing concern internationally, with potential impacts on workers, organisations, workplace health and compensation authorities, labour markets and social policies. Workplace interventions that create workplaces supportive of mental health, promote mental health awareness, destigmatise mental illness and support those with mental disorders are likely to improve health and economical outcomes for employees and organisations. Identifying factors associated with successful implementation of these interventions can improve intervention quality and evaluation, and facilitate the uptake and expansion. Therefore, we aim to review research reporting on the implementation of mental health promotion interventions delivered in workplace settings, in order to increase understanding of factors influencing successful delivery.Methods and analysisA scoping review will be conducted incorporating a stepwise methodology to identify relevant literature reviews, primary research and grey literature. This review is registered with Research Registry (reviewregistry897). One reviewer will conduct the search to identify English language studies in the following electronic databases from 2008 through to July 1, 2020: Scopus, PROSPERO, Health Technology Assessments, PubMed, Campbell Collaboration, Joanna Briggs Library, PsycINFO, Web of Science Core Collection, CINAHL and Institute of Occupational Safety and Health (IOSH). Reference searching, Google Scholar, Grey Matters, IOSH and expert contacts will be used to identify grey literature. Two reviewers will screen title and abstracts, aiming for 95% agreement, and then independently screen full texts for inclusion. Two reviewers will assess methodological quality of included studies using the Mixed Methods Appraisal Tool and extract and synthesize data in line with the RE-AIM framework, Nielson and Randall’s model of organisational-level interventions and Moore’s sustainability criteria, if the data allows. We will recruit and consult with international experts in the field to ensure engagement, reach and relevance of the main findings.DiscussionThis will be the first systematic scoping review to identify and synthesise evidence of barriers and facilitators to implementing mental health promotion interventions in workplace settings. Our results will inform future evaluation studies and randomised controlled trials and highlight gaps in the evidence base.Systematic review registrationResearch Registry (reviewregistry897)

Genotoxicity of radiofrequency electromagnetic fields: Protocol for a systematic review of in vitro studies

BackgroundExposure to radiofrequency electromagnetic fields (RF-EMF, 100 kHz – 300 GHz) emitted by wireless communication technologies is pervasive and ubiquitous. Concern has been raised about possible adverse effects to human health. In 2011 the International Agency for Research on Cancer has classified RF-EMF as possibly carcinogenic to humans, highlighting that the evidence is weak and far from conclusive. Updated systematic reviews of the scientific literature on this topic are lacking, especially for mechanistic studies. ObjectivesTo develop a protocol for a systematic review of experimental studies investigating genotoxic effects induced by RF-EMF in in vitro cellular models. Genotoxicity is one of the key-biological indicators of carcinogenicity, and the most common characteristics of established carcinogens. The predefined procedures for conducting the systematic review are outlined below. MethodsWe will follow the guidelines developed by the National Toxicology Program-Office of Health Assessment and Translation (NTP-OHAT), adapted to the evaluation of in vitro studies. Eligibility criteriaWe will include experimental in vitro studies addressing the relationship between controlled exposures to RF-EMF and genotoxicity in mammalian cells only. Eligibility for inclusion will be further restricted to peer reviewed articles reporting findings from primary studies. Information sourcesWe will search the scientific literature databases NCBI PubMed, Web of Science, and EMF-Portal. No filter on publication date will be applied. Only studies published in English will be considered. The reference lists of the included papers and available reviews will be screened for unidentified relevant papers. References will be managed through Endnote X9 software. Data extraction and synthesis of resultsData from included papers will be extracted according to predefined forms. Heterogeneity within the available evidence will determine the type of evidence synthesis that is appropriate. Findings will be summarized in tables, graphical displays and in a narrative synthesis of the available evidences. A meta-analysis will be carried out if subgroups of studies homogeneous in terms of exposure characteristics, endpoint, and cell types will be identified. Risk of biasThe internal validity of included studies will be assessed using the NTP-OHAT Risk of Bias Rating Tool for animal studies, adapted to in vitro studies. This stage of the process will be managed through the Health Assessment Workspace Collaborative (HAWC). Evidence appraisalTo rate confidence in the body of evidence, we will use the OHAT GRADE-based approach for animal studies. Framework and fundingThis protocol concerns one of the evidence streams considered in a larger systematic review of the scientific literature on the potential carcinogenicity of RF-EMF, performed by scientists from several Italian public research agencies. The project is supported by the Italian Workers’ Compensation Authority (INAIL) in the framework of the CRA with the Istituto Superiore di Sanità “BRiC 2018/06 – Scientific evidence on the carcinogenicity of radiofrequency electromagnetic fields”.

Implementing Smart Working in Public Administration: a follow up study.

Background:Starting from February 2020, in Italy most organizations have had a forced transition to flexible working practice - called “smart working in emergency” – due to the Covid-19 epidemic outbreak. This allowed to continue work activities and services and contributed to contain the risk of infection in different sectors, particularly in the public administration.Objectives:This follow up study focussed on a panel of 187 workers from the Italian Workers’ Compensation Authority taking part to a pilot project “Smart Working in INAIL” from January 2019 to December 2019. The aim was to investigate the effects of work organization on work attitudes, work-life balance and health outcomes before and after the introduction of the smart working.Methods:The data were collected at two time points through a web-based questionnaire. The first wave aimed to collect information up to one month before the implementation of the smart working. The second wave aimed to collect information about potential changes occurred after one year of smart working.Results:This study showed that high demands, low control and low social support might lead to reduced well-being and less satisfaction with work, and have an effect on work engagement and work-life balance. Particularly, improving social support can moderate the negative impact of high strain on well-being, preventing work-life imbalance and risk of isolation.Discussion:Findings and future perspectives are discussed to support stakeholders in defining policies and practices concerning health and wellbeing at work while preserving productivity, for a successful implementation of smart working in the public administration.

Temporal trend in the compensation claim applications for work-related COVID-19 in Italy.

Introduction:The SARS-CoV-2 pandemic is an impacting challenge for the occupational medicine and epidemiology. The identification of occupational groups most at risk of exposure is critical in contrasting and preventing the epidemic diffusion.Objective:To analyse the compensation claim applications collected by the Italian Workers’ Compensation Authority (INAIL) for identifying the occupational patterns and the temporal trend, in comparison with general population data.Methods:Daily time series of compensation claim applications for COVID-19 injuries in the period March-October 2020, has been analysed, estimating the epidemiological parameters of interest and comparing findings with general population data.Results:In the period March-October 2020, 65,804 compensation claim applications for COVID-19 have been collected by INAIL. The ratio between compensation claims applications and COVID-19 cases in the general population appears decreasing in the period, passing from 20% in the first pandemic period (March-April) to 3-4% in the September-October period. During the summer period, an increase in male and not Italian component and a decrease in mean age, Northern regions, and health care workers contributions to the occupational claims applications have been observed.Discussion:The comparative analyses between occupational and general population data allowed to describe how the so called “second wave” of COVID-19 epidemic in Italy involved the occupational settings less than the other risk factors. There is a need to go towards an occupational surveillance system for COVID-19 infection, with the aim of monitoring and preventing the occupational risk of infection, supporting insurance system effectiveness and managing vaccination policies.

Access of migrant gold miners to compensation for occupational lung disease: Quantifying a legacy of injustice

BackgroundA legacy of the South African gold mining industry, now in decline, is a large burden of silicosis and tuberculosis among former migrant miners from rural South Africa and surrounding countries, particularly Lesotho and Mozambique. This neglected population faces significant barriers in filing claims for compensation for occupational lung disease. The objective of the study was to gain insight into the extent of such barriers, particularly for former miners and cross-border migrants. MethodsThe database of a large gold mining company and the statutory compensation authority were analyzed for the period 1973–2018 by country of origin, age, and employment status at the time of claim filing. Proportions and odds ratios (ORs) for each of the compensable diseases were calculated by the above variables. Processing delays of claims were also calculated. ResultsAnnual company employment declined from 240,718 in 1989 to 43,024 in 2018 and the proportion of cross-border migrants within the workforce from 51.0 to 28.1%. The compensation database contained 68,612 claims. The majority of compensable claims in all diagnostic categories were from active miners. The odds of cross-border miners relative to South African miners filing a claim depended on employment status. For example, the OR for Lesotho miners filing while in active employment was 1.86 (95% CI 1.81, 1.91), falling to 0.94 (95% CI 0.91, 0.98) among former miners. The equivalent findings for Mozambiquan miners were 0.95 (95% CI 0.91, 1.00), falling to 0.44 (95% CI 0.41, 0.47). Median processing delays over the whole period were from 1.1 years from filing to adjudication, and 3.8 years from filing to payment. ConclusionsThe findings provide a quantitative view of differential access to occupational lung disease compensation, including long processing delays, among groups of migrant miners from the South African gold mines. There is a deficit of compensable claims for silicosis and silico-tuberculosis among former miners irrespective of country of origin. While cross-border miner groups appear to file more claims while active, this is reversed once they leave employment. Current large-scale efforts to provide medical examinations and compensation justice to this migrant miner population need political and public support and scrutiny of progress.

Prevalence of work related musculoskeletal disorders in Italian workers: is there an underestimation of the related occupational risk factors?

BackgroundWork-related musculoskeletal disorders (WMSDs) represent an important socio-economic burden. The current risk assessment and management involved in the ethiopathogenesis of WMSDs is based on observational tools and checklists, which have some limitations in terms of accuracy and reliability. The aim of this study was to assess WMSD prevalence and identify possible correlations with several socio-demographic and work-related variables in a large cohort representative of Italian workers in order to improve our understanding of the WMSD phenomenon.MethodsThis study includes data from INSuLa, a cross-sectional nationally representative survey of health and safety at work, developed by the Italian Workers’ Compensation Authority. A total of 8000 Italian workers were included. Multivariate logistic regression analyses were performed to evaluate the association of independent variables, such as workers’ perceptions of exposure to biomechanical/ergonomic and video display unit (VDU) risks (Risk Perceived) and the actual risk exposure (Risk Detected) on Back, Lower and Upper limb pain. Socio-demographic, occupational and other health-related variables were included to investigate possible association with musculoskeletal disorders.ResultsWorkers perceiving a significant exposure to biomechanical/ergonomic and VDU risks but not included in a health surveillance program for them (Risk Perceived/No Risk Detected) have had significantly higher odds of reporting musculoskeletal disorders. Regarding the biomechanical/ergonomic risk these workers are in the 19–24 age range (39.9%), transportation, warehousing/information and communication sectors (38.9%) and are employed in companies with more than 250 workers (35.8%). Regarding VDU risk, workers are in the 45–54 age range (24.5%), professional, financial and business services (38.0%) and come from companies with more than 250 employees (25.6%).ConclusionsWithin the occupational safety and health management systems an appropriate assessment of occupational risk factors correlated to musculoskeletal disorders (mainly biomechanical/ergonomic and VDU) and the correct definition of their exposure levels is essential to adequately prevent the onset of WMSDs. In this regard, our findings provide useful information to design novel approaches, aimed at improving our understanding of emerging risks, identifying gaps in current risk assessment strategies and enhancing workplace interventions are mandatory to improve the occupational risk assessment and management process and therefore implement the subsequent health surveillance systems.

Rethinking Transitional Justice in South Sudan: Critical Perspectives on Justice and Reconciliation

Abstract The horrific violations committed in South Sudan’s civil war led to the establishment of mechanisms ensuring the prosecution of serious crimes and reconciliation within communities shattered by war. Through a peace deal, three mutually supportive but independent institutions of transitional justice were formed: The Commission for Truth, Reconciliation and Healing, The Hybrid Court for South Sudan and The Compensation and Reparation Authority. This article examines the extent to which these mechanisms can achieve their respective aims, and argues that prosecutions need to be implemented in an integrated manner alongside reconciliation and healing because of the massive scale of abuses and enormous number of perpetrators. The article further contends that their collaboration with local, indigenous justice mechanisms is crucial because of the latter’s extensive experience in facilitating accountability and reconciliation within divided communities in South Sudan. The article concludes that whilst a limited amnesty is inevitable, a blanket amnesty is counterproductive to the aims of transitional justice in post-conflict South Sudan. Further, the article cautions against the use of immunity, arguing that this would deny justice to victims and could lead to a rise in revenge or private retribution, lawlessness and impunity.

Embodied truths and authentic selves: The constitution of evidence and credibility in rape cases

In this article, I use the concept of chronotope, which means time-space, to analyse knowledge production at the intersection of science, technology and law. I do a comparative study of written legal decisions regarding criminal injuries compensation in rape cases from two different legal institutions in Norway—namely, the Compensation Authority and the criminal courts. In these written decisions, the two institutions state the reasons and justifications for their decisions by invoking, relying on and dismissing various kinds of knowledge, such as forensic, medical and psychological knowledge. The aim of this comparison is to investigate how these reasons and justifications constitute evidence and credibility. I argue that the two institutions attach themselves to different kinds of expert knowledge because they are chronotopically different and consequently constitute evidence and credibility in different ways.

Gender differences and occupational factors for the risk of obesity in the Italian working population

BackgroundObesity is a multifactorial condition and a major risk factor associated with several non-communicable diseases, such as cardiovascular disease, and with a higher risk of premature death and disability. Sex-specific factors have key roles and must be taken into consideration in studying occupational factors associated with the risk of obesity. The aim of this study was to investigate gender differences in body mass index (BMI) in a large cohort representative of Italian workers and, correlating this index with several demographic and occupational variables, to verify sex- and work-dependent differences in the risk of obesity.MethodsWe utilized data from INSuLa, a cross-sectional, nationally representative survey of the Italian worker population conducted in 2013 by the Italian Workers’ Compensation Authority to investigate health and safety at work. Analyses were run on a sample of 8000 Italian workers, aged from 16 to 64 years. Logistic regression models were employed to assess gender differences in the relation between occupational characteristics and BMI. We adjusted for age, education, variables related to health protection at work, and chronic conditions and diseases.ResultsThere were several significant differences in the BMI between males and females, linked to some occupational factors. For instance, female shift workers were 1.32 times (95% CI 1.11–1.57) more likely to be overweight or obese than normal-weight workers, and this association was maintained when controlling for confounders. The likelihood of overweight or obesity among women who worked 1–2 night shifts per week was significantly higher – 1.5-1.6 times – than those on day shifts.ConclusionsGender-specific differences in occupational factors associated with the risk of obesity are useful with a view to characterizing this risk and helping identify workplace-targeted intervention strategies.

Provision of Italian diagnostic reference levels for diagnostic and interventional radiology.

The diagnostic reference level (DRL) is a useful tool for the optimisation of medical exposures. Thus, a Working Party coordinated by the Italian National Institute of Health and the National Workers Compensation Authority has been formed to provide Italian DRLs, for both diagnostic and interventional procedures, to be used as appropriate for the implementation of the 2013/59 European Directive into the national regulation. The multidisciplinary Working Party was formed by professionals involved in diagnostic and interventional radiology medical exposures and started from a critical revision of both the literature and the results of previous Italian surveys. The procedures were divided into five sections for adult (projection radiography, mammography, diagnostic fluoroscopy, CT and interventional radiology) and two sections for paediatric patients (projection radiography and CT). The provided DRL values have been identified for "normal" adult patients and for age-classes of paediatric patients. Some of the DRL values provided by the Working Party are reported in this study as an example, divided by adult/paediatric patients, radiological technique and examination: specifically, DRLs for new radiological practices and new dose quantities as DRLs metric were introduced. The median value (rather than the mean) for each procedure, derived from a sample of patients, has to be compared with the corresponding DRL value, and dosimetric data related to a minimum number of patients should be collected for each examination. The approach to the definition and use of DRLs through guidelines of national Authorities in collaboration with scientific Associations should simplify the periodical updating and could be useful for keeping the optimisation of medical exposures faithful to the development of radiological practice.

Assessing the Risk of Stress in Organizations: Getting the Measure of Organizational-Level Stressors.

Great Britain’s Health and Safety Executive (HSE) developed the Management Standards Indicator Tool to help organizations to assess and monitor organizational risks of work-related stress through surveying employees about the psychosocial risks for stress in their jobs. The use of employee-level data for deriving an organizational-level measure of psychosocial risks assumes that the constructs have equivalent meanings at different levels. However, this isomorphic condition has never been tested and this study fills this gap. Using data collected by the Italian Workers’ Compensation Authority (INAIL) from 66,188 employees nested in 775 organizations, we demonstrate that the organizational-level measure representing the seven dimensions of the Management Standards Indicator Tool is equivalent, though not identical, to the individual-level measure. This implies that the organizational level is not a mirror of the aggregation of the individual level, and that the risk of work-related stress in an organization may derive not simply from bottom-up processes, but may be generated by top-down influences (e.g., organizational policies). Interventions may then be meaningfully targeted at the organizational level in the expectation that they will reduce the risk of work-related stress among the entire workforce, the valid measurement of which can be performed through the HSE’s Management Standards Indicator Tool.

Prevalence of Hearing Loss among Former Mine Workers of the former Black Homeland of the Transkei, South Africa

Objective: To study the prevalence of loss of hearing among the retired mineworkers of the Transkei region of South Africa. Method: Between May 1997 and May 2011, 2 027 ex-mineworkers were examined at the Benefit Examination Clinic, which is located in the Chest Section of Umtata General Hospital (UGH), the teaching hospital of the University of Transkei Medical School in the Eastern Cape province of South Africa. Results: Hearing loss was indicated by 219 (54%) of the respondents, of whom 72 (33%) were between 40 and 59 years of age. Of the 182 (45%) of workers who had worked for between 10 to 19 years in the mines, 40 (22%) indicated experiencing a loss of hearing. A strong association between hearing loss and years spent mining was detected. Conclusion: Many (54%) of the ex-mine workers from the Transkei were found to be afflicted with hearing loss. Such a health problem demands much attention from occupational hygienists and the compensation authorities.

Nationwide epidemiological study for estimating the effect of extreme outdoor temperature on occupational injuries in Italy

BackgroundDespite the relevance for occupational safety policies, the health effects of temperature on occupational injuries have been scarcely investigated. A nationwide epidemiological study was carried out to estimate the risk of injuries for workers exposed to extreme temperature and identify economic sectors and jobs most at risk. Materials and methodsThe daily time series of work-related injuries in the industrial and services sector from the Italian national workers' compensation authority (INAIL) were collected for each of the 8090 Italian municipalities in the period 2006–2010. Daily air temperatures with a 1 × 1 km resolution derived from satellite land surface temperature data using mixed regression models were included. Distributed lag non-linear models (DLNM) were used to estimate the association between daily mean air temperature and injuries at municipal level. A meta-analysis was then carried out to retrieve national estimates. The relative risk (RR) and attributable cases of work-related injuries for an increase in mean temperature above the 75th percentile (heat) and for a decrease below the 25th percentile (cold) were estimated. Effect modification by gender, age, firm size, economic sector and job type were also assessed. ResultsThe study considered 2,277,432 occupational injuries occurred in Italy in the period 2006–2010. There were significant effects for both heat and cold temperatures. The overall relative risks (RR) of occupational injury for heat and cold were 1.17 (95% CI: 1.14–1.21) and 1.23 (95% CI: 1.17–1.30), respectively. The number of occupational injuries attributable to temperatures above and below the thresholds was estimated to be 5211 per year. A higher risk of injury on hot days was found among males and young (age 15–34) workers occupied in small-medium size firms, while the opposite was observed on cold days. Construction workers showed the highest risk of injuries on hot days while fishing, transport, electricity, gas and water distribution workers did it on cold days. ConclusionsPrevention of the occupational exposure to extreme temperatures is a concern for occupational health and safety policies, and will become a critical issue in future years considering climate change. Epidemiological studies may help identify vulnerable jobs, activities and workers in order to define prevention plans and training to reduce occupational exposure to extreme temperature and the risk of work-related injuries.

Evaluation of an Ultraviolet C (UVC) Light-Emitting Device for Disinfection of High Touch Surfaces in Hospital Critical Areas.

Implementation of environmental cleaning and disinfection has been shown to reduce the incidences of healthcare-associated infections. The effect of an enhanced strategy for terminal room disinfection, applying the pulsed xenon-based ultraviolet light no-touch disinfection systems (PX-UVC) after the current standard operating protocol (SOP) was evaluated. In a teaching hospital, the effectiveness in reducing the total bacterial count (TBC) and in eliminating high-concern microorganisms was assessed on five high-touch surfaces in different critical areas, immediately pre- and post-cleaning and disinfection procedures (345 sampling sites). PX-UVC showed only 18% (15/85) of positive samples after treatment compared to 63% (72/115) after SOP. The effectiveness of PX-UVC was also observed in the absence of manual cleaning and application of a chemical disinfectant. According to the hygienic standards proposed by the Italian Workers Compensation Authority, 9 of 80 (11%) surfaces in operating rooms showed TBC ≥15 CFU/24 cm2 after the SOP, while all samples were compliant applying the SOP plus PX-UVC disinfection. Clostridium difficile (CD) spores and Klebsiella pneumoniae (KPC) were isolated only after the SOP. The implementation of the standard cleaning and disinfection procedure with the integration of the PX-UVC treatment had effective results in both the reduction of hygiene failures and in control environmental contamination by high-concern microorganisms.

Do exposure to outdoor temperatures, NO2 and PM10 affect the work-related injuries risk? A case-crossover study in three Italian cities, 2001–2010

ObjectivesStudies on the effect of temperature on rates of work-related injuries (WRIs) are very recent, and are evolving in depth and scope. However, less is known about potential effects of...

Assessing Objective and Verifiable Indicators Associated With Work-Related Stress: Validation of a Structured Checklist for the Assessment and Management of Work-Related Stress.

Risk assessment represents an essential part of any successful intervention in health and safety at work. The most prominent European methodologies propose multi-method approaches for identifying the risks associated with work-related stress. Nevertheless, the most widely used method is the self-administered questionnaire. By adapting the UK Management Standards approach, the Italian National Workers Compensation Authority (INAIL) developed a checklist for the assessment of objective and verifiable indicators of work-related stress. This checklist is filled in by a steering group composed of homogenous groups of workers. Through a web-platform developed by INAIL, a considerable amount of data over the last 5 years has been collected throughout Italy. The aims of this study are to examine the psychometric properties as well as the practical validity of the checklist in a wide sample of Italian companies. The sample comprised 5,301 homogeneous groups of workers nested within 1,631 organizations. The checklist measures two main areas: (1) the organizational indicators of work-related stress (sentinel events) and (2) four and six factors related respectively to content and context of work. Multilevel and multivariate analyses revealed that the checklist shows adequate factor structure and criterion validity. Results also demonstrate that small companies and the public and healthcare sector show higher risk levels. These results support the use of the checklist as a structured and generalizable tool for assessing and monitoring the risks associated with work-related stress.

Large Occupational Accidents Data Analysis with a Coupled Unsupervised Algorithm: The S.O.M. K-Means Method. An Application to the Wood Industry

Data on occupational accidents are usually stored in large databases by worker compensation authorities, and by the safety and prevention teams of companies. An analysis of these databases can play an important role in the prevention of accidents and the reduction of risks, but it can be a complex procedure because of the dimensions and complexity of such databases. The SKM (SOM K-Means) method, a two-level clustering system, made up of SOM (Self Organizing Map) and K-Means clustering, has obtained positive results in identifying the dynamics of critical accidents by referring to a database of 1200 occupational accidents that had occurred in the wood industry. The present research has been conducted to validate the recently presented SKM methodology through the analysis of a larger data set of more than 4000 occupational accidents that occurred in Piedmont (Italy), between 2006 and 2013. This work has partitioned the accidents into groups of different accident dynamics families and has quantified the severity and frequency of occurrence of these accidents. The obtained information may be of help to Company Managers and National Authorities to better address preventive measures and policies concerning the clusters that have been identified as being the most critical within a risk-based decision-making framework.

Tractor rollover fatalities, analyzing accident scenario

IntroductionIn many countries, traditional data sources for collecting injuries of workers covered by compulsory accident insurance have recently been integrated by new observatories whose results may differ. A comparative analysis of the Italian data collection systems related to fatal tractor accidents in agriculture was performed focusing on tractor rollover fatalities with the aim of analyzing the accident scenario. MethodData from the Operational Archives of the Italian Workers Compensation Authority (INAIL), which collects injuries of workers covered by compulsory accident insurance and those of the National Surveillance System (INAIL_ASL), which provides narrative text reports of work-related fatal accidents have been analyzed and compared to the information collected by the INAIL Observatory. The INAL Observatory was recently set up to complement the collection of fatal accidents involving agricultural machinery. Italian data were then compared to data available at an international level. Fatal tractor accidents vary considerably with respect to fatal accidents in agriculture, being 10.6 and 43.7% for the Operational Archives and Surveillance System, respectively. National Surveillance System records, implemented with narrative texts allowed the accident scenario to be defined. Results71.7% of fatal tractor-related accidents refer to non-ROPS equipped vehicles and of these, 26.5% involved machines originally mounted with a ROPS that had been removed or was inoperative in the folded-down position during the rollover event. Just one fatal event from a collapsed ROPS on the overturned tractor was recorded. It is interesting that 16.6% of fatal accidents involved a clear environmental factor. Practical applicationA campaign to train tractor drivers on the correct use of the combination ROPS and seatbelt can contribute to decreasing rollover events with fatal outcomes. Contemporarily a strict requirement to install ROPS and a seatbelt on tractors, combined to an official inspection at the farm level, can increase the chance of survival in a rollover accident.

Ethical Dilemmas Experienced by Australian Rehabilitation Counsellors

Private sector rehabilitation counsellors operate in a dynamic and complex environment in which their decisions are influenced by several stakeholder interests including workers’ compensation authority regulators, scheme appointed agents, employers, and injured workers. The potentially competing interests of all parties often challenge the values and professional responsibilities of rehabilitation counsellors. The current study aimed to address the gap identified in the literature concerning ethical dilemmas unique to private sector rehabilitation counselling in Australia. A qualitative methodology was adopted to examine: a) the types of ethical dilemmas most encountered by rehabilitation counsellors working in the context of private sector settings; and b) rehabilitation counsellors' preferred methods for resolving ethical dilemmas in this context. Findings revealed that rehabilitation counsellors interviewed had experienced an array of ethical dilemmas in their practice, reflecting some of the inherent challenges in Australia’s private rehabilitation sector. The findings have implications for the ethics education and professional development of rehabilitation counsellors, and provide a foundation for future ethics research in rehabilitation counselling.