Impact of organization on occupational injury risk: evidence from high-speed railway construction.

BACKGROUND: The construction industry is at the top of the list of priorities for surveillance and research, although it is often difficult to perform detailed analysis of the risk factors. In mid-2002, construction work started on the Torino to Novara high-speed railway line. A Regional Epidemiological Observatory developed a standardized data collection system that provided a rare opportunity for researchers in Italy to analyze risk factors for occupational injury in a large cohort of workers involved in a single major construction project. The aim of this study is to describe the characteristics of a cohort of workers employed at construction sites of the high-speed Torino to Novara railway between 2003 and 2005, analyze the main determinants of occupational injury risk and estimate incidence rates. METHODS: Frequency rates of occupational injury were calculated by characteristics of workers and firms and relative risks were estimated using a Poisson model. RESULTS: Annual injury incidence decreased over the period and was higher than the Italian construction industry rate. The risk was highest among workers performing the least skilled jobs and with the shortest contracts. Moreover the risk was higher in large enterprises. CONCLUSIONS: Although calculated within a specific context, the results provide information applicable to all construction sites. The high risk of occupational injury associated with short-term contracts suggests, at such large and long-term construction sites, to engage workers on a permanent basis for the duration of the construction project.

[Evaluation of the effectiveness of occupational safety and health inspections of construction sites in the Piedmont region from 2001 to 2005]. / La valutazione di efficacia delle attività di vigilanza in regione Piemonte: i progetti "sicurezza nei cantieri edili" anni 2001-2005 e "prevenzione per le grandi opere" (la valutazione di efficacia delle attività di vigilanza).

OBJECTIVES: To assess the effectiveness of safety inspections in the construction industry in Piedmont in terms of exposure to risk and injuries. METHODS: We conducted a retrospective analysis of the surveillance activities carried out in Piedmont between 2001 and 2005: to this purpose, we used a logical framework and we identified indicators to evaluate the process and its impact on exposure and injuries. PROCESS: fixed standards involving the number of safety inspections and the type of constructions under control were respected; there was always sufficient diversity among the public works under control, although local health units used different working methods. Impact on exposure and injuries: injury rates in the construction industry in Piedmont showed a decreasing trend and systematically lower values compared to national rates. Injury rates in the "roads and railways" sector showed an increasing trend owing to the great number of public works under construction. In this case, the effect of preventive measures seems less noticeable, but this mainly depends on methodological limits, such as mismatch between numerator and denominator, difficulties in estimating the number of workers actually present on the sites, underreporting of minor events. CONCLUSIONS: Despite the limitations of a retrospective analysis, the Piedmont safety inspection programme for the construction industry showed coherence with the objectives and had a positive impact on injury rates.

[Injury rates and severity during the construction of High Speed Train Track Torino-Novara: which are the expected risks?]. / Frequenza e gravità infortunistiche nei cantieri dell'alta velocità Torino-Novara: qual e il rischio infortunistico atteso?

BACKGROUND: Construction of the Torino-Novara High Speed Train Track (TAV) provided a unique opportunity to describe the magnitude of accidents on a major construction project for which complete data were available for 123 companies with over 10,000 employees. OBJECTIVES: To describe the rate and severity of accidents during the construction of TAV and to compare this with national indexes. The limits and critical points of the national surveillance system are discussed and solutions for responding to public occupational safety and health service needs are proposed. METHODS: 1,691 injuries with more than 3 lost work days were recorded between 2003 and 2005 by the TAV Surveillance System (Orme-TAV). Accident rate and severity indexes (Orme indexes) by year and occupation, were compared with indexes for Piedmont and Italy for the period 2002-04 provided by INAIL (National Institute for Insurance against Occupational Accidents and Diseases) for the Construction sector and the Road and Railway Construction sub-sector. A comparison with the accident rate of the same 123 firms calculated for all construction yards in Italy in 2003-04 (national indexes) was also made. RESULTS: Accident rates decreased from 152 in 2003 to 72 in 2005 per 1,000 workers, but were higher than the national indexes (the Orme indexes/national indexes ratio was 1.75 in 2003 and 1.67 in 2004). Accident severity indexes were lower than the national figures. DISCUSSION: Complete reporting, facilitated by the existence of a Surveillance System, yielded accident rates that were more reliable than those previously reported. Data suggest that the discrepancy is due to both underreporting and exposed worker assessment difficulties. The burden of on-site work-related accidents in the construction sector appears to be higher and more costly than what has been desumed from national data.