International Open Access Journal of Prevention and Research in Medicine
Director Prof. Francesco Tomei

Background: Traumatic events or serious injuries, or death occurring to foreigners are mostly events of nature work, and it lies within the competence of INAIL to compensate accidents at work (and occupational diseases). An accident at work is defined as a traumatic event occurred through a violent cause during  work hours, resulting into a worker's personal injury identified in a temporary incapacity, permanent disability, (allowance for damage between 1 and 5%, with a lump sum payment for the damages ranging between 6 and 15%, with monthly income for damages equal to or greater than 16%) or death. In recent years, Italy has shown a general reduction in the number of harmful events and fatalities, which was also the case for foreign workers, but notwithstanding the foregoing, the persistence of a significant number of serious multiple injuries and deaths has come to light.
 
Objectives: To evaluate the possible additional risk factors and possible preventive measures.
 
Methods: The present study investigated the time course of serious and fatal injuries in foreign workers from 2008 to 2011, and more specifically the events for the year 2011, taking into account the business sector, the course of the event, the spatial distribution and the nationality of the workers, based on the data obtained from INAIL  Annual Reports . As concerns  serious injuries, a progressive decrease in the number of foreign workers affected was observed during the years 2008 to 2011, in industry and services and, to a lesser extent, in agriculture. Data on fatalities show instead a substantial numeric stability, both in percentage and in numeric values.
 
Discussion: It is possible that the factors contributing to an increased risk of serious and fatal events in foreign workers may be related to : the poor familiarity with the Italian language, the lack of specific training in relation to occupational hazards, the irregularity and uncertainty that often characterizes their work activities, an excessive consumption of alcohol, which can lead to higher risks for some occupations dangerous in themselves.
 
Conclusions: The main objective has to be an "effective preventive action" , considered as an  essential element in view of reducing the number of accidents and occupational diseases. Prevention must take place in a business environment inspired to  "social responsibility" values.
In this prevention work,  it is fundamental to ensure the commitment of all public and private institutions involved in the workplace health and safety : primary care physicians and hospitals, universities, advocacy organizations and representative associations; it is likewise important to make companies aware of the costs associated with an unsafe working environment and also inform them of the economic benefits resulting from an effective prevention policy .

Traumatic events, serious injury or death occurring to foreigners are mostly events of nature work. It falls within the competence of INAIL to compensate  accidents at work (and occupational diseases).
An accident at work is defined as a traumatic event occurred through a violent cause during the work, determining a worker's personal injury identified in a temporary incapacity, permanent disability, (allowance for damage between 1 and 5%, with a lump sum payment for the damages ranging between 6 and 15%, with monthly income for damages equal to or greater than 16%) or death.
The study of work- related injuries in Italy has recently shown a reduction in the overall number of harmful events and fatalities. A decrease of injury occurrences was also observed  in foreign workers but, in spite of such data, a persistent increase in the number of serious multiple accidental traumas and fatalities was observed.
However, it is difficult to estimate the exact number of injuries of varying severity, sustained by illegal foreign workers who are not reported for fear of retaliation, dismissal, discrimination of various kinds.

The purpose of this study was to evaluate the possible presence of additional risk factors in the foreign workers in Italy.

Based on the data obtained from INAIL Annual Reports (1, 2, 3, 4), it was possible to observe a progressive decrease in the number of foreign workers affected  by serious injuries during the years 2008 to 2011, in industry and services and, to a lesser extent, in agriculture. (Fig. 1). 

 
 
Fig. 1 - Serious injuries (damage equal to or greater than 16%) occurred to foreign workers for the years 2008-2011.

 

This decrease could result from the failure to file injury reports (for irregularities or threat of dismissal) and from the consequences of the economic crisis (with a decrease in the number of workers employed), but also from the possible positive effects of the prevention work so far implemented. Data on fatalities show instead a substantial stability, both in percentage and in numeric values ​​(Fig. 2), which seems closer to reality. Possible causes could be identified in the use of not properly trained foreign workers in more dangerous working activities, as well as  in the substantial inability to prevent the reporting of a deadly event, but also, probably, in the emphasis on the risks associated with alcohol abuse and other individual habits .

 
 
Fig. 2 - Fatal accidents occurred to foreign workers for the years 2008-2011.

 

With regard to the sectors most at risk, the data show the percentage prevalence of severe accidents in the  building sector, followed by transport, services and metals industry (Tab. 1 – Fig. 3) which confirms the trend resulting from the general data as concerns  the increased risk exposure of construction workers and those who work on the road.
As concerns fatalities, the data show the percentage prevalence in the building sector, followed by transport and agriculture. These data confirm the results of the general data with regards to the increased risk exposure for construction workers and for those who work on the road, but also point out  that the agricultural sector is more at risk for fatal injuries, mainly due to agricultural vehicles rollover episodes and falls from a height (Tab. 1 – Fig. 4).
 
 
Tab.1 - Occupational accidents to foreign workers in 2011 and compensated by INAIL ( management and main sectors of economic activity)


Fig. 3 - Accidents at work occurred to foreign workers in 2011 and compensated by INAIL (management and main sectors of economic activity) - DISABILITY Permanent (grade> = 16%).

 

With regard to the causes and circumstances of the event, we cannot fail to notice the difficulty to frame approximately 1/3 of the cases (other uncoded / Permanent - Permanent Disability> = 16%: 115 cases, 54 death cases). It should be noted, however, that the most serious accidents originate, in  almost equal measure, from falls and loss of control of a machine or machines. These data substantially confirm that the sectors most at risk of serious events are the construction and transport (Tab. 2 – Fig. 5).
As concerns fatalities, data show that about 2/3 of them are caused by loss of control of a machine or machinery, followed by events caused by rupture or collapse and fall, which confirms that the sectors most at risk of fatal events are the construction industry, transport and agriculture (Tab. 2 – Fig. 6).
 
 
Tab. 2 - Fatal and serious accidents occurred to foreign workers in 2011 and compensated by INAIL – data based on course of  event.

What may be, then, the factors behind the serious and fatal injuries occurring to foreign workers? The factors contributing to an increased risk of serious and fatal events in foreign workers could be:
1. the poor familiarity with the Italian language;
2. the lack of specific training in relation to occupational hazards;
3. the irregularity and uncertainty that often characterize these jobs;
4. an excessive consumption of alcohol that can lead to higher risks for some occupations dangerous in themselves.

The main objective has to be an "effective preventive action" , considered as an  essential element to reduce accidents and occupational diseases. Prevention must take place in a business environment inspired by  "social responsibility" values.
In this prevention work,  it is fundamental to ensure the commitment of all public and private institutions involved in the workplace health and safety standards respect : primary care physicians and hospitals, universities, advocacy organizations and representative associations; the latter, in particular, can play a crucial role in the full integration of foreign citizens in the workplace and in safeguarding them  in case of accidents and occupational diseases, since they could act as mediators for the transfer of new skills and training to workers from different cultures and traditions, who are sometimes forced to operate in unsafe environments and in situations of discrimination. It is likewise important to make companies aware of the costs associated with an unsafe working environment and also inform them of the economic benefits resulting from an effective policy of prevention.(5, 6, 7, 8, 9, 10, 11, 12, 13).