The complex economic and employment situation in the Livorno province has direct repercussions on the subject of safety at work. The interrelation between the various aspects which cause work injuries requires detailed analysis, observation over a sustained period of time, and comparison with the situation in other regions.

Injuries at work and professional illness can be used as indicators to compare different areas.

There are two sources providing data on work injuries in the Livorno province:

1)                 INAIL, which records bare numbers and after two years reports on frequency (the number of incidents divided by an estimate of the number of insured workers; and

2)                 USL 6, where the Department of Prevention, in co-ordination with the Livorno Provincial Authority, monitors the number of injuries on the basis of the diagnoses carried out by the emergency wards of the four Livorno hospitals and the official injury reports presented by workers and employers.

The analyses of these two organisations are made from different points of view and therefore provide a good all-round impression of the work injury situation. The main difference between the two systems of observation are as follows:

-                     INAIL processes data according to the area in which the company is registered

-                     USL processes it according to the area where the injury happened               

-                     INAIL also takes account of “travelling” injuries and road accidents

-                     USL only takes account of certain “travelling” injuries and no road accidents                   

-                     INAIL has no information on maritime injuries

-                     USL collects information on maritime injuries, sailing and non-sailing                

-                     INAIL collects data on household injuries

-                     USL classifies household injuries under other headings                   

-                     INAIL counts the total number of days absent from work

-                     USL collects only the initial prognosis   

-                     INAIL uses the data for the purposes of administrative checks

-                     USL uses information on injuries in order to intervene in those work places were the 200 most serious           injuries are reported.

Despite these differences, the total number of injuries reported by the two organisations are largely similar. Each year the Inter-institutional Co-ordination Panel examines the data and makes a comparative analysis. This procedure is governed by Art. 27 of the Legislative Decree 626.

There are around 7,500 injuries in the Livorno area every year. Seven workers on average have lost their lives in recent years as a consequence of work injury.

The table below shows the situation in recent years:

WORK INJURIES (AGRICULTURE-INDUSTRY-SERVICES)

YEAR	1997	1998	1999	2000	2001
INAIL DATA	7,138	7,356	7,477	7,610	7,512
USL 6 DATA	6,857	7,350	7,043	7,530	7,373

The situation revealed by these figures is similar both in terms of numbers and changes over time. The trend is of an increase of 1.5% annually (around 100 additional cases each year) up until 2001, when the trend inverted.

As mentioned above, INAIL also provides information on frequency of injuries, based on an estimate of the work force as declared in annual reports. For 2001 the figure showed an encouraging decrease, notwithstanding an increase in the size of the work force (an additional 2% of employees in the province as a whole).

The following observations can be made from an analysis of the USL 6 data on injuries during the year 2001.

As far as age is concerned, and excluding students who are injured at school (around 400 cases), 52% of injuries occur to those aged between 31 and 50, and 22% to those aged between 22 and 30.

In all four areas the age-band receiving most injuries is that between 31 and 40 years.

Initial prognoses are an indicator of the seriousness of an injury. Although the prognosis does not always correspond with the final outcome, it is a method of quantifying the seriousness of the injury as it appears on arrival in an Emergency ward.

24% of injuries receive a prognosis of 3 days or less, and are classified as light injuries. In 2001 there were around 1,900 light injuries, while in the year 2000 there were 978. The marked increase may be due to increased awareness and degree of attention paid to the work injury phenomenon.

Around 80% of injuries have initial prognoses of less than 10 days while 3% are immediately judged to be serious, requiring more than 30 days. In 2001 there were 210 serious injuries, double the figure for the year 2000.

As regards the division of injuries over the year, March, June and July have the greatest frequency of injuries, a result of the greater number of working days and the concentration of certain seasonal work. The island of Elba is particularly noticeable, registering 50% of its total injuries in the four months of summer.

As far as regards the parts of the body which are most frequently affected, 28% of cases involve the hands and 45% the extremities in general (arms and feet). The eyes, with 8% of cases, merit particular mention (splashes and flying splinters) and the head is involved in 7% of cases.

Bruises and sprains account for 53% of cases. Then follow fractures, which are responsible for a good part of the more serious prognoses, with 6%. Loss of a body part accounts for only a small fraction of cases (0.5%) but given the seriousness of this type of injury is a cause for great concern.

In 2001 the most common description of the way an injury occurred was “struck by…”, “hit by…”, “crashed into”, “struck against…” and  “falls”. “Crushed by…”, “ran into…”, “run over by…” and “grabbed by…” are of particular note for the seriousness of the consequences which often result.

Among the agents causing the injury the most common are various types of material (30%), the work environment (25%) and lifting apparatus (14%).

Analysis of the sectors where work injuries most frequently occur show that foremost among these are public administration and the metal mechanic sector.

On the basis of the data on frequency published by INAIL for the three-year period 1997-1999 it can be noted that the risk of receiving a work injury is greater for those working in the construction and metal-mechanic industries and also for those in public administration.

INAIL data can also be used to compare the situation in Livorno with that of the Tuscany region as a whole and that of Italy in general.

From this it emerges that the Livorno territory is among the highest in the Region for frequency of work injury, and the Region itself ranks among the highest in Italy. Analysis of the situation in the construction sector shows that Livorno is one of the more “virtuous” provinces in Tuscany, but still higher than the average in Italy.

In the public administration sector, Livorno has one of the highest risks of injury in Tuscany, and has almost double the average for Italy.

In the health sector the risk of injury is one for every 1000 employees, a figure more or less in line with that for Tuscany as a whole, and slightly above that for Ital

FREQUENCY OF INJURIES PER 1000 WORKERS
INAIL DATA - 1997-1999 AVERAGE

ALL WORK SECTORS
	TEMPORARY INCAPACITY	PERMANENT INCAPACITY	DEATHS	TOTAL
LIVORNO	51.15	2.56	0.07	53.72
TUSCANY	41.53	2.44	0.08	44.05
ITALY	37.99	1.90	0.09	39.98

CONSTRUCTION SECTOR
	TEMPORARY INCAPACITY	PERMANENT INCAPACITY	DEATHS	TOTAL
LIVORNO	65,64	4,44	0,13	70,21
TUSCANY	69,49	5,65	0,17	75,31
ITALY	63,30	5,29	0,25	68,84

 

PUBLIC ADMINISTRATION AND DEFENCE SECTOR
	TEMPORARY INCAPACITY	PERMANENT INCAPACITY	DEATHS	TOTAL
LIVORNO	44,16	1,76	0	45,92
TUSCANY	31,25	1,44	0,03	32,71
ITALY	24,17	1,11	0,02	25,30

 

HEALTH SECTOR
	TEMPORARY INCAPACITY	PERMANENT INCAPACITY	DEATHS	TOTAL
LIVORNO	22,76	0,68	0,05	23,49
TUSCANY	22,04	0,94	0	22,99
ITALY	18,18	0,66	0,02	18,86

The table below shows figures on injuries resulting in death.

YEAR	1997	1998	1999	2000	2001
USL DATA	3	6	6	7	7

In recent years an average of 6 - 7 workers per year have died as a result of work injury (excluding those dying as a result of road accidents).

The data indicates that the situation in the last four years appears to be stabilising.

Some observations on recent work injuries contain indications as to how such injuries could be avoided.

During 2001 four of the seven mortalities occurred during loading and unloading of material, two on building sites due to falls from roofs and one inside the steelworks.

Two of the seven who died were workers from outside the European community (Albania and Morocco).

Work injuries are the result of numerous different interacting factors: company organisation, provision of training to eliminate incorrect behaviour, company work load, the use of external contractors for more difficult and dangerous work, an ethic of safety at work and the provision of training for new employees. Other factors include the recent introduction of atypical work contracts, the use of labour from outside the community and ever-higher production rhythms.

The effect of all these conditions makes it even more important to ensure that employers, workers representatives for safety and other supervisory organs are alert to the need to constantly improve conditions of safety in the workplace.

The Livorno area presents a challenge from this point of view and the relevant organisations and institutions must continue to work to make the idea of prevention a reality in workplaces in the province.

The main actions taken to this end by the USL Department of Prevention are:

1)                 increasing the degree of operator specialisation by the creation of two Functional Units (the PISLL for the port of Livorno and the PISLL for large companies in the Val di Cornia);

2)                 making information for workers more readily available, with the setting up of a free phone (0800 271 171) and a promotional campaign to increase awareness of safety matters;

3)                 the development of all types of co-ordination between supervisory organisations (USL, the Work Management Office, INPS and INAIL) to improve the distribution of useful information and to rationalise the interventions of each individual organisation by providing a single record of “public work yards”;

4)                 further development of relationships with the Provincial Authority for spreading the safety culture in schools;

5)                 the organisation of campaigns in higher-risk sectors (construction, agriculture, ports, large companies, contractors) and the provision of a continued presence in those sectors at greatest risk, such as construction;

6)                 more direct contact with new roles in prevention (particularly the Workers Representatives on Safety);

7)                 prompt interventions in work places where more serious or multiple injuries occur. 216 enquiries were led into more serious injuries in 2001.

Danilo Zuccherelli
Manager of the Prevention department
Az. USL6 Livorno