Women's wrist and elbow at work: analysis of acute injuries and cumulative trauma disorders to improve ergonomics in female-dominated activities.

The aim of this study is to analyse women's wrist and elbow acute work injuries together with cumulative trauma disorders, such as carpal tunnel syndrome (CTS) and epicondylitis. Five years records (2015-2019) on women's wrist/elbow acute work injuries and CTS/epicondilytis, from Italian National Compensation Authority, were collected and pooled all together as 'dis-ac' (disorders + acute) events. A statistical analysis was performed in comparing the different female-dominated work sectors. Results showed that hairdressing/laundry sector was associated with the highest risk for wrist acute work injuries and cleaning for elbow while manufacturing for CTS and epicondylitis. Hairdressing/laundry and manufacturing were associated with the highest risk for dis-ac events (hairdressing: wrist dis-ac OR: 4.89; CI 95% 4.22-5.67; elbow dis-ac OR: 3.70; CI 95% 2.99-4.58; manufacturing: wrist dis-ac OR: 3.39; CI 95% 3.13-3.66; elbow dis-ac OR: 2.45; CI 95% 2.20-2.73). The relationship between acute injuries and cumulative trauma disorders is discussed to preserve women's safety and health in ergonomics.Practitioner Summary: Women's wrist and elbow acute work injuries and cumulative trauma disorders (carpal tunnel syndrome and epicondylitis) were analysed and studied all together (dis-ac events) in female-dominated activities. Hairdressing and manufacturing work sectors were associated with the highest risk, showing the need to safeguard the health and safety of female workers.

[Commuting accidents while walking: a women occupational risk]. / Gli infortuni in itinere a piedi: un rischio al femminile.

BACKGROUND: there are few studies in occupational health literature addressing the issue of work injuries among women. OBJECTIVES: the purpose of this study is to examine gender differences in the occurrence and causes of one type of work injuries which is more frequent among women: the commuting accident while walking. DESIGN: this study is based on the data of recognized commuting while walking injuries in the industrial and service sectors recorded by the Italian National Institute for Insurance against Accidents at Work during the last five years (2014-2018). SETTING AND PARTICIPANTS: Italy; all compensated workers for commuting while walking injuries. MAIN OUTCOME MEASURES: number of injuries, rate incidence, incidence rate ratio, odds ratio. RESULTS: commuting while walking injuries in the last five years were three times more frequent among women, with an increasing incidence over the years and by age (women: 1,31‰ vs men 0,40‰; IR 3,24; 95%CI 3,19-3,30). Women were more often injured going to work, in winter, on Mondays, in the North-Western areas of the country. Female mail-carriers, cleaners, care givers, public administrators were particularly vulnerable, especially the less young (>=50 years old). Females were at a higher risk for fractures particularly of wrist, elbow, and foot, while males had a higher risk for hand, knee, and chest injuries. Gender difference in incidence rate and type of commuting while walking injuries may be also due to a diverse work and home exposures together with fall dynamics. CONCLUSIONS: commuting while walking work injuries show the higher incidence rate among women and the need to gender oriented prevention.

Surviving monotony and repetitiveness at Hawthorne Works: the case of Geraldina "Jennie" Sirchio (1907-1992) and the other migrant girls in the test-room.

BACKGROUND: The research studies in the test room (t-room) at the Hawthorne Works still represent a «mythical¼ experiment, the most important one. In 1928 the experiment took flight with the Italian Geraldina Sirchio. -Objectives: Reporting the living and working conditions of Geraldina and young migrants. METHODS: The 22 interviews with Geraldina (1931-1932) conducted by Igemon Rousseau were acquired from Cornell University. The original video of the work in the t-room was analyzed with the method of organizational congruencies. RESULTS: Geraldina left school to work at the age of 14. At 21 she was asked to work in the t-room. She was the fastest girl, unmarried and the "breadwinner" of her family. She was petite, smart and emancipated. Working conditions in the t-room were less challenging than in the "big department" and Geraldina defended them by guaranteeing continuity and very high productivity. In the interviews, she often reported constraints such as low wages, high speed, short breaks, back pain, heat, swollen feet, weight loss and the fainting of girls for "heat prostration". The interviewer always attributed Geraldina work-related problems to her housework duties. In June 1932, during the last interview, Geraldina expressed her anger for the layoffs, particularly on behalf of the other Italian Antoinette Parillo and the Polish Theresa Layman, both fired despite having to support families with numerous children. She herself was fired five months later. CONCLUSIONS: The "Geraldina's effect" is discussed through her own words offering a truthful picture of the migrant working conditions during the Great Depression.

Non-vehicle commuting in Italy: need for ergonomic action for women's lower limbs?

INTRODUCTION: The aim of this paper is to examine gender differences in the occurrence of accidents among workers while walking to or from their workplace (non-vehicle commuting accidents). We have previously found that the lower limb is more often injured at work among women, compared to men, so the paper concentrates on lower limb injuries. METHODS: Using the records of the National Institute for Insurance against Injuries at Work (INAIL), we focused on the non-vehicle commuting accidents of women and men recognized as work-related for the period 2013-2017. In particular, we examined the gender difference by work sector and type of trauma suffered with particular attention to lower limb injuries. RESULTS: The rate of non-vehicle commuting accidents (n. 60,936) among women was significantly higher than for men (1.29‰ vs 0.40‰ men, p < 0.001) for the period studied. Lower limb injuries (50.5% for women and 43.7% for men, p < 0.001) constituted the large majority of these injuries. In particular, dislocation of the ankle (78% for women vs 65.5% for men, p < 0.001), bruise of the knee (71.2% for women vs 54.9% for men, p < 0.001) and fracture of the foot (41% for women vs 33.6% for men, p < 0.001) were all significantly higher among women. The work sectors with higher injury rates were: Transport and Warehouse, Public Administration, Health and care services and Wholesale and retail trade. This result may be due to wear and tear from conditions at work. The women injured were on the average, a decade older than men (50-59 vs 40-49 years old). CONCLUSIONS: Non-vehicle commuting represents an important, albeight neglected, preventable risk for women workers, causing lower limb trauma particularly at the ankle, the foot and the knee. These areas may be particularly injure-prone among women in specific sectors, due to the work environment. Effective prevention of these injuries requires gender-oriented ergonomic actions at work and in the commuting environment.

The contribution of Italian migrant women in the New World to health and safety at work.

BACKGROUND: Many Italian migrant women left Italy for the United States of America (USA) in the years 1881-1932. In the USA they could only find poor jobs such as home work or unskilled jobs in the developing American manufacturing industries. OBJECTIVES: Analysis of the contribution of Italian migrant women to the improvement of working conditions in the USA. METHODS: Five case-studies have been selected and analyzed by national and international literature. RESULTS: Case studies were: 1. Florence Kelley's research on insanitary working conditions among Sicilian home workers in Chicago (1899); 2. Death of forty-two Italian women in the Triangle Shirtwaist Factory fire in New York and the claim of Anna Gullo in the trial against the employers; 3. The report on the condition of Italian migrant women in the USA by Irene de Bonis dei Baroni de Nobili and the Women's Trade Union League (1911); 4. The Maggia sisters Amelia, Quinta and Albina and the trial for compensation of radium related diseases (1928); 5. The contribution of Italian migrant Geraldina "Jennie" Sirchio to the T-room experiment at the Hawthorne Works in Chicago (1928). CONCLUSIONS: Italian migrant women, among others, played an important role in the USA social and economic development. Women were particularly exposed to infectious disease, fire risk, radium painting, repetitiveness, etc. Important trials, inquiries and legislation together with recognition of occupational diseases were fostered thanks to their often unknown sacrifice. Today as yesterday migrant workers should be valued and prevention improved.

Gender and Country of birth inequalities in occupational diseases compensation rate in Italy: INAIL data base analysis (2010-2013). / Ineguaglianze per genere e per Paese di nascita nel riconscimento delle malattie professionali in Italia: analisi dalla ganca dati statistica INAIL (2010-2013).

BACKGROUND: In Italy and in Europe occupational diseases (OD) claims are growing among women, and international studies show women's lower compensation rate. OBJECTIVES: Analysis of occupational diseases compensation rate among "Italian" women (country of birth: Italy) and "immigrant" women (country of birth: not Italy) focusing on biomechanical overload of the upper limb, the most common OD in Italy. METHODS: INAIL (Italian National Institute for Insurance against Accidents at Work) statistical data (2010-2013) on ascertained OD in Industry-Services (I-S) were analyzed by gender and country of birth with particular attention to biomechanical overload of the upper limb and to occupational diseases not included in the official OD list. RESULTS: A significantly lower compensation rate was found among women (Italy: 39% females vs 43% males; not Italy: 32.5% females vs 36% males). Women's lower success rate was also found for biomechanical overload of the upper limb (Italy: 73% females vs 76% males; not Italy: 64% females vs 70% males), including carpal tunnel syndrome (Italy: 72% females vs 74% males; not Italy: 62% females vs 64% males) and supraspinatus muscle tendinitis (Italy: 71% females vs 79% males; not Italy: 62.5% females vs 72.5% males). Women's claims were more frequent for OD not in the official list (Italy: 53% females vs 51% males; not Italy: 54% females vs 53% males) and had a lower rate of recognition and compensation (Italy: 13% females vs 19% males; not Italy 10% females vs 14% males). Since 2010 women compensation rate has shown a reduction after the initial amelioration in 2008 when biomechanical overload of the upper limb was included in the official list of OD. CONCLUSIONS: An overall lower compensation rate among "Italian" and "immigrant" women was found for biomechanical overload disorders of the upper limb and for not officially recognized occupational diseases. Good gender-oriented preventive practices should be promoted.

Universal Expositions, physics-chemistry and new occupational diseases: the case of Marie Sklodowska Curie and radium girls. / Esposizioni universali, la fisica-chimica e le nuove malattie da lavoro: il caso di Marie Sklodowska Curie e le ragazze del radio.

BACKGROUND: Radium discovery by Marie and Pierre Curies caused previously unknown diseases. Marie Sklodowska Curie (1867-1934) suffered from radiations effects, as did girls in the radium dial watches factories. Therapeutic effects of radium were soon discovered, its unhealthy effects were as yet unheard of. OBJECTIVES: Analysis of Marie Sklodowska Curie (Marie) and radium girls occupational exposure, taking scientific debate on radium dangerous effects into account. METHODS: analysis of occupational exposure and diseases of Marie and radium girls in major documents, including Curie archive letters. RESULTS: Marie had dermatitis, radiodermatitis, tinnitus, one abortion, cataracts, tubercolosis, aplastic anemia. She also was a victim of mobbing. Women employed in the New Jersey radium dial watches factories, often immigrants, died of jaw necrosis, sarcoma of femur, anemia, leukemia and other radium related diseases. Marie was first asked about radium adverse effects by the New Jersey Department of labour (1925), Lise Meitner (1928) and the American Society for Cancer Control (1929). In 1928 Alice Hamilton organized a radium conference in order to find a solution to the radium girls' new disease. In 1929, during her second visit to the United States of America (USA), Marie declared how only prevention could save "radium girls". In 1934 she died of aplastic anemia, just like many radium girls. That year International Labour Office listed the new disease as due to "radium, radioactive substances, X-rays"; it was followed in 1937 by five USA states. CONCLUSIONS: Unheard of knowledge, conflict of interest, scientific delay, incompetence and no prevention were yesterday, as they are today, the cause of many preventable women deaths.

Gender differences and commuting accidents in Italy: INAIL Data Base analysis on fatalities (2009-2013). / Differenze di genere negli infortune in itienere: analisi dei casi mortali dalla Banca Dati Statistica INAIL (2009-2013).

BACKGROUND: Commuting accidents represent the leading cause of work-related fatalities among women in Italy. For working women, the journey from home to work is the most dangerous part of the day. OBJECTIVES: Analysis of data on fatal commuting accidents in order to identify risk factors among women. METHODS: INAIL Statistical Data (2009-2013) related to fatal commuting were analyzed by gender, age, immigration, activities, geographical area, working time, month and day of the week. RESULTS: Italian and immigrant women die mainly from commuting accidents (207 cases out of 371; 56%), a significant number of immigrant women also die in commuting accidents involving no vehicles (4%); Italian and immigrant men die mainly from causes related to the work environment (48%), especially immigrants (54%), and not from commuting accidents (921 out of 3997; 23%). Prevalent age at commuting fatality is 35-49 years, and among immigrant women 18-34. Deaths among women occur mostly in Northeast Italy, and among women working in health and social services; among immigrant women accommodation and catering services are also relevant. The highest number of fatal accidents among men occurs in Northwest Italy, among men working in wholesale trade. All fatalities take place mainly going to work, between 5-10 a.m., among women from October to December, among men from July to September, among Italian women are significantly higher on Saturday, among immigrant women on Sunday. Deaths among men are significantly higher in the eighth hour of work, between 3- 8 p.m. and on Monday among Italian workers, on Wednesday among immigrant men. CONCLUSIONS: Commuting fatalities among women, according to INAIL Statistical Data, show specific risk conditions by age, immigration, work activity, geographical area, working time, month and day of the week that require targeted preventive policies.

[Mental health in the hospital. Analysis of conditions of risk by department, age and gender, for the creation of best practices for the health of nurses]. / Salute mentale in ospedale. Analisi delle condizioni di rischio per reparto, età e genere orientata alla costruzione di buone pratiche per la salute delle infermiere.

BACKGROUND: Nurses mental health is still a major and unachieved goal in many public hospital settings. Hospital work organization analysis shows differences in health professions, hospital units, age and gender. OBJECTIVES: To analyse work organisation and its effects on nurses mental health in three high risks hospital units (Oncoematology, First Aid, General Medicine) in order to improve good practices for nurses health. METHODS: The Method of Organizational Congruences (72 hours of observation) has been used to detect organizational constraints and their possible effects on nurses' mental health. General Health Questionnaire (Goldberg D., 12 items) and the Check up Surveys for burnout (Leiter MP and Maslach C.) have been used to evaluate the mental health status of the 80 nurses employed (78% women). RESULTS: High emotional work load in oncoematology Unit, high monotony and repetitiveness with lower emotional load in first Aid Unit, High mental and physical workload in General Medicine Unit. Burnout was significantly higher in General Medicine Unit, followed by First Aid Unit and oncoematology Unit. Female nurses reported more chronic diseases than males. The GHQ showed high frequency of minor psychiatric disorders (58%) in all units, higher in General Medicine Unit (78%). CONCLUSION: The overall results show how organizational constraints and mental health conditions differ per hospital units, age groups and gender. Good nursing practices, to prevent mental health problems, should therefore be developed specifically in each hospital unit according to these results.

Women, work and health between the nineteenth and twentieth centuries from a national and international perspective.

BACKGROUND: A few years after a series of meetings of Italian scientists were convened prior to the unification of Italy, the first women qualified in medicine and other dedicated women participated in founding a movement for the improvement of living and working conditions of women and children in Italy. OBJECTIVES: analysis of Italian women's contributions in the proceedings of the International Council of Women Congresses and their impact on increasing the number of women's occupational health studies presented at the fourth National Congress on Occupational Diseases held in Rome in 1914. METHODS: Analysis of the proceedings of the International Council of Women Congresses (Washington, Chicago, London), and of the Women's National Council and other documents so as to obtain a picture of Italian women's working conditions at that time. RESULTS: Women and children worked an excessive number of hours per day, were underpaid, and had a legal status of inferiority. The main work sectors were sewing, embroidery, lace making, ironing, cooking, washing, dressmaking, millinery, fashion design, typing, weaving, artificial flowers, etc. The same sort of work was available to Italian women who emigrated to the United States of America. The success achieved by the women's movement is shown in the paper presented by Irene de Bonis "Occupational diseases among women" and published in the proceedings of the fourth National Congress on Occupational Diseases held in Rome, 9-14 June 1914. CONCLUSIONS: The article outlines the main features of the women's movement at the turn of the twentieth century, focussing on their publications describing Italian women's working conditions, considered in an international context. The movement's engagement in the promotion of women's occupational health at international and national level was successful but the First World War was to transform this achievement into the women's peace movement.

Women's working conditions in hospital cleaning: a case study.

Hospital cleaning work, as health care work, is mainly performed by women all over Europe. Hospital cleaning activities represent a poorly studied sector although very important also for patient's health. We applied the Method of Organizational Congruencies to study cleaning work in three typical hospital units (Emergency Room, Haematology, General Medicine) of a roman University hospital where 198 women cleaners work. We analyzed the 731 technical actions performed in the three shifts and the related Organizational Constraints (OC). Working outsourcing, no occupational risks training, washing personal equipment at home, standing, long walking, early morning and night shift in emergency room, high monotony (>10 actions per hour) contact with biological and chemicals materials, risk conditions of accidents, artificial lights, hot microclimate and working in a cure setting represent the main Organizational Constraints. Differences among the three Units are discussed together with the importance of considering cleaning hospital as a preventive action towards hospital clinical risk.

Job strain in different types of employment affects the immune response.

The immune system, in cooperation with neuroendocrine functions, defends from cancer and infections mainly by the activity of blood natural killer (NK) cells. Blood NK activity may be influenced by the type of employment since work is the central part of life; moreover, job stress is a situation affecting both neuroendocrine and immune systems. This study examines anxiety (by STAI 1 and 2), job strain (by the Karasek's JCQ) and blood NK activity (by an in vitro radio-isotopic method) of 134 male workers. These men, over 38 years old with stable employment, were working in factories, in construction yards, in offices, as hospital attendants or as self-employed craftsmen. Workers in factories and in construction yards, with high job strain, showed lower NK activity, while office employees, with low job demand, and craftsmen with low anxiety and elevated decision latitude, showed higher NK activity; the level of NK activity of the hospital attendants was between the other groups. In conclusion, this study confirms that the type of employment, related to job stress, affects blood NK activity. Moreover, blood NK activity may be used in the bio-monitoring of workers at high risk.

Gender and ergonomics: a case study on the 'non-formal' work of women nurses.

Women's work activities are often characterised by 'non-formal actions' (such as giving support). Gender differences in ergonomics may be due to this peculiarity. We applied the method of organisational congruencies (MOC) to ascertain the 'non-formal' work portion of nurses employed in three hospital units (haematology, emergency room and general medicine) during the three work shifts in a major University Hospital in Rome, Italy. We recorded a total of 802 technical actions performed by nine nurses in 72 h of work. Twenty-six percent of the actions in direct patient's care were communicative actions (mainly giving psychological support) while providing physical care. These 'double actions' are often not considered to be a formal part of the job by hospital management. In our case study, the 'non-formal' work of nurses (psychological support) is mainly represented by double actions while taking physical care of the patients. The dual task paradigm in gender oriented research is discussed in terms of its implications in prevention in occupational health. PRACTITIONER SUMMARY: The main purpose of the study was to assess all the formal and non-formal activities of women in the nursing work setting. Offering psychological support to patients is often not considered to be a formal part of the job. Our case study found that nurses receive no explicit guidelines on this activity and no time is assigned to perform it. In measuring the burden of providing psychological support to patients, we found that this is often done while nurses are performing tasks of physical care for the patients (double actions). The article discusses the significance of non-formal psychological work load of women nurses through double actions from the ergonomic point view.

[The women's contribution to occupational health at the end of the nineteenth century]. / Il contributo femminile alla medicina del lavoro di fine ottocento.

In the late nineteenth century Italian working class was mainly represented by women. An extraordinary women movement (Laura Solera Mantegazza, Gualberta Adelaide Beccari, Anna Maria Mozzoni, Ersilia Majno Bronzini, Nina Rignano Sullam, Giuseppina Poggiolini among others) including the first Italian women physicians (Anna Kuliscioff, Maria Montessori, Gina Lombroso, Linita Beretta and the very close to become physician Anna Fraentzel Celli) build up associations, journals, books, schools, researches, and petitions. The first law on women and child labour (1902), the First Congress on Occupational illnesses (1906), the birth of the Clinica del Lavoro (1910) represent only part of this contribution which has been almost forgotten and should be enlightened.

An outstanding female figure in the history of occupational health: Ersilia Majno Bronzini.

BACKGROUND: Starting with the obituary "Ersilia Majno Bronzini: an outstanding female figure in Occupational Health", probably written by Luigi Devoto and published in the journal La Medicina del Lavoro (1933), a reappraisal is made of Majno Bronzini's contribution to occupational health. METHODS: Most references were collected from the archives of the journal Il Lavoro (1901), the archives of the association "Union of Women", the periodical founded by Majno Bronzini (1899) and other material. RESULTS: Majno Bronzini's selected published papers (1895, 1900, 1902) on the working conditions of women and child labour proposing a national occupational health law were found. The importance of a women's network for occupational health is also shown in Majno Bronzini's correspondence with Anna Celli Frantzel and Maria Montessori. In 1902 Angelo Celli officially congratulated Majno Bronzini's (and Anne Kuliscioff's) efforts to promulgate the first law on women and child labour during his speech before the Italian Parliament, published by II Lavoro. Majno Bronzini and Nina Rignano Sullam were the only two women participating in the First International Congress on Occupational Health in Milan (1906). The correspondence between Majno Bronzini and Devoto (1901-1933) and Devoto's formal acknowledgement of Majno Bronzini (1910) when inaugurating the new "Clinica del Lavoro" institute is well documented. CONCLUSIONS: Majno Bronzini dedicated a significant part of her life to occupational health, together with Anna Celli Frantzel and Maria Montessori along with many others. This research shows how important her contribution was to occupational health development.

Occupational risk due to violence in a psychiatric ward.

OBJECTIVES: This study aimed to elucidate causes of aggression from clinical records of a psychiatric ward of a major urban public hospital where aggression towards Health Care Workers [HCWs] was the second leading cause of hospital work-related injuries after needlesticks. METHODS: Psychiatric patients'clinical records for the period 2002-2005 were examined and coded. Data were analysed with the case-control approach to identify the determinants of the aggressive behavior towards HCWs, after adjustment for age, gender, nationality and diagnosis of the patients. RESULTS: We examined 2.196 records and identified 321 individuals who had become violent at least once towards nurses, pshysicians or other patients or relatives during their hospitalization. The victims of the aggressive behavior were mainly nurses. A history of involuntary admission was strongly associated with aggression [OR 4.5, 95% CI 3.4-5.9]. Diagnosis, gender and nationality of the patients were not predictive of aggressive behavior towards HCWs. CONCLUSIONS: Involuntary admission to a psychiatric ward might be a cause of violent behavior towards health care workers, mainly nurses.

[Mobbing and working environment: towards an organizational prevention]. / Violenza morale (mobbing) nei luoghi di lavoro: analisi per una prevenzione organizzativa.

BACKGROUND: Psychological violence in the workplaces is increasing and the Italian national health service and trade unions are mostly involved in single cases of diagnosis strategy. OBJECTIVES: To analyse published mobbing cases using a mobbing prevention approach that takes account of the main civil rights violation in mobbing actions. METHODS: 25 cases were analysed in order to identify the type of mobbing, gender, the professional position and the main civil rights that were violated. RESULTS: Seven main civil rights had been violated in the 25 mobbing cases: health, work, professional skills, equal treatment, legality, diversity, dignity. Men working in unhealthy conditions, mostly due to unhealthy working environments, were forced to leave under the pressure of moral violence. In women, equal treatment and diversity were the main rights that were violated. Co-worker support was absent in all cases. CONCLUSIONS: A civil rights assessment to prevent mobbing is considered. Italian legislation, particularly the Civil Code, can be the legislation key for prevention, with the employer responsible for providing a violence-free environment as indicated in European Directive 626/94.