Rationale The phenomenon of repeat work-related accidents has not been sufficiently studied. Objectives To evaluate the role of work-related factors in the occurrence of repeat accidents in Italy, using economic activity and the size of the enterprise as proxies and basing the analysis on available administrative data. Methods The data, provided by the Italian Workers’ Compensation Authority (INAIL), refer to accidents in the industry and artisan sectors and in the service industry between 1994 and 1999. We selected the data on accidents among 633,735 persons 25–55 years of age with a first accident in 1996–1997, and we determined the occurrence of further accidents within two years in the same economic activity, taking into account job mobility and factors associated with underreporting (geographic area, age, and size of the enterprise). The gender-specific relative risk was computed for each economic activity, given by the ratio between the risk of repeat accidents in a given economic activity and the risk in all of the other activities. Results Individuals with a single accident differed from those with a repeat accident in terms of the distribution by gender, age-class, and severity of injury. The economic activities with the highest relative risk were generally those known to represent a risk of accidents in general: metal ore and coal mining, shipbuilding, the manufacturing of railroad equipment, building construction, road and railway construction, the primary iron and steel industry, foundry work, logging/wood manufacturing, slaughtering, and agriculture. However, certain activities not generally considered as hazardous showed a high risk of repeat accidents (e.g., public hygiene, and the manufacturing of bricks, pottery, and glass). Conclusions The epidemiological pattern of repeat accidents by economic activity reflects that of accidents in general, though with exceptions. Results suggest that factors associated with specific technical aspects and production processes are important determinants of safety. The differences between single accidents and repeat accidents by gender, age class, and severity of injury suggest that studying repeat accidents separately from first accidents is quite useful.
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