Journal of Safety Research

Journal of Safety Research

Volume 60, February 2017, Pages 53-69
Journal of Safety Research

Prevention of occupational injuries: Evidence for effective good practices in foundries

https://doi.org/10.1016/j.jsr.2016.11.007Get rights and content

Highlights

  • Prevention of occupational injuries is a priority for safety research and practice.

  • Intervention studies with effectiveness evaluation are seldom performed.

  • A pragmatic multifaceted preventive intervention in Italian foundries is presented.

  • An effective post-intervention reduction of occupational injury rates was shown.

  • Feasible evidence-based good practices and accountable benchmarks were developed.

Abstract

Introduction

Occupational injuries are a relevant research and practical issue. However, intervention studies evaluating the effectiveness of workplace injury prevention programs are seldom performed. Method: The effectiveness of a multifaceted intervention aimed at reducing occupational injury rates (incidence/employment-based = IR, frequency/hours-based = FR, severity = SR) was evaluated between 2008 and 2013 in 29 Italian foundries (22 ferrous; 7 non-ferrous; 3,460 male blue collar workers/year) of varying sizes. Each foundry established an internal multidisciplinary prevention team for risk assessment, monitoring and prevention of occupational injuries, involving employers, occupational physicians, safety personnel, workers' representatives, supervisors. Targets of intervention were workers, equipment, organization, workplace, job tasks. An interrupted time series (ITS) design was applied. Results: 4,604 occupational injuries and 83,156 lost workdays were registered between 2003 and 2013. Statistical analysis showed, after intervention, a reduction of all injury rates (− 26% IR, − 15% FR, −18% SR) in ferrous foundries and of SR (− 4%) in non-ferrous foundries. A significant (p = 0.021) ‘step-effect’ was shown for IR in ferrous foundries, independent of secular trends (p < 0.001). Sector-specific benchmarks for all injury rates were developed separately for ferrous and non-ferrous foundries. Conclusions: Strengths of the study were: ITS design, according to standardized quality criteria (i.e., at least three data points before and three data points after intervention; clearly defined intervention point); pragmatic approach, with good external validity; promotion of effective good practices. Main limitations were the non-randomized nature and a medium length post-intervention period. In conclusion, a multifaceted, pragmatic and accountable intervention is effective in reducing the burden of occupational injuries in small-, medium- and large-sized foundries. Practical Applications: The study poses the basis for feasible good practice guidelines to be implemented to prevent occupational injuries, by means of sector-specific numerical benchmarks, with potentially relevant impacts on workers, companies, occupational health professionals and society at large.

Section snippets

Problem

Occupational injuries are still very common and have strong and serious consequences for workers, employers and companies, and society at large (Castillo & Collins, 2013).

According to the International Labour Organization, 317 million accidents occur worldwide on the job annually; every 15 s 153 workers have a work-related accident and 1 worker dies from a work-related accident or disease, with a vast human cost and an economic burden estimated at 4% of global Gross Domestic Product (GDP) each

Methods

The study was performed in a sample of 33 Italian foundries, mainly located in industrialized areas of Northern and Central Italy, all belonging to the Italian Association of Ferrous and Non-ferrous Foundries (ASSOFOND) that lists more than 200 associated enterprises representing about 20% of the national foundry industry (Ariotti, 2014, Assofond, 2015). No selection criteria were applied; the foundries participated in the study on a voluntary basis. Such voluntary participation was determined

Descriptive data

The 29 foundries, for which three data points after intervention were available, and thus an evaluation of effectiveness was feasible, can be divided into the following:

  • 22 (76%) ferrous (cast-iron and steel) foundries equal to 11% of the Italian ferrous foundries reported from 2007 to 2008, employing 2,750 male blue collar workers per year between 2007 and 2008 equal to 18% of the total workers that were estimated to be occupied in this specific sector in the same period (Assofond, 2015)

  • 7 (24%)

Discussion

The prevention of occupational injuries still represents a priority for occupational safety and health research worldwide (Castillo and Collins, 2013, European Agency for Safety and Health at Work, 2014, Rondinone et al., 2010). Especially, there is a well-established need for the following: more well-conducted multidisciplinary pragmatic intervention studies, including an effectiveness evaluation in order to create an evidence base for the prevention of occupational injuries; efforts to

Summary

Our intervention showed effectiveness in reducing all the main occupational injury rates (incidence/employment-based, frequency/h-based, severity) in ferrous foundries. In particular, a significant ‘step-effect’ was shown for incidence/employment-based rate independent of other changes (e.g., secular trends), which is opposite of the baseline trend observed in the national reference population. Moreover, the intervention determined a reduction of severity rate, although not significant, in

Practical applications

The present study suggests that a multifaceted, pragmatic, accountable intervention leads to a reduction in the burden of occupational injuries in small-, medium- and large-sized enterprises, with good generalizability to other working environments, also by means of sector-specific benchmarks. This translation research potentially provides an effective new model for prevention and management of occupational injuries, especially in smaller businesses that rarely have resources for comprehensive

Acknowledgements

We are very grateful to the Association of Italian Foundries (ASSOFOND) for its full assistance and support as well as to the employers, the occupational health and safety personnel, and the workers of the foundries participating in the study.

We would also like to thank very much Anne and Kaitlin Ryan for their valuable English language editing.

Stefano Porru (MD-1986; certified occupational physician-1991, associate professor of occupational health, School of Medicine-2001) works at the Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia. Responsible for clinical activities at the Occupational Health Unit, General Hospital “Spedali Civili” in Brescia, Italy; Director of the University Research Center Integrated Models for Prevention and Protection in Environmental and

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  • Cited by (0)

    Stefano Porru (MD-1986; certified occupational physician-1991, associate professor of occupational health, School of Medicine-2001) works at the Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia. Responsible for clinical activities at the Occupational Health Unit, General Hospital “Spedali Civili” in Brescia, Italy; Director of the University Research Center Integrated Models for Prevention and Protection in Environmental and Occupational Health” (Mistral).

    He has long been involved in practice and research on prevention, diagnosis and treatment of work-related diseases and injuries, as well as on health surveillance and fitness for work. He dedicates a relevant part of his activities in prevention of occupational injuries especially in the metal sector, with a focus on the role of occupational physicians and effectiveness interventions.

    Stefano Calza (PhD, biomedical statistics, associate professor biostatistics) has a long time experience as applied biostatistician with collaboration in various medical areas ranging from oncology to dentistry. His main areas of expertise are statistical and computational methods applied to genetics and genomics and bioinformatics.

    Cecilia Arici (MD-2004, occupational health physician-2008, research assistant) works in the Section of Public Health and Human Sciences at the University of Brescia, Brescia, Italy. Her main scientific interests are: occupational injuries, immigration and work, occupational cancer, contribution of genetics and genomics to occupational safety and health, systematic search of work-related diseases, biohazards. Especially, since 2008 she is actively involved in the fields of safety intervention research and accidents investigation.

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