Background: Statistics on occupational accidents provided by the Italian Institute for Occupatio nal Diseases and Accidents (INAIL, Italian acronym) include only events that occurred in workers with regular employment status. Objectives: The aim of the study was to establish a procedure in order to estimate the rate of occupational accidents in non-European Union (non-EU) workers with irregular employment status and/or irregular immigrant status. Methods: The sources of data were the clinical records of the Emergency Department of San Bonifacio Hospital, and the population data of District 4 of Local Health Authority 20 of Verona, which was considered the catchment area of this hospital. Results: Among 419 cases of accidents occurred in the home from January to December 2004 in non-EU workers, 146 reported clinical histories that contradicted clinical examinations. These suspect cases were the nominator of the rate. The denominator of the rate was estimated by calculating: (1) the subjects of working age resident in District 4 (=83714); (2) the total number of non-EU workers, assuming that the percentage was similar to that in San Bonifacio Municipality (=0,115); the number of irregular non-EU workers, assuming that the percentage was similar to that in north-eastern Italy (= 0,103). Non-EU workers with irregular employment status andZor irregular immigrant status should, according to these calculations, be 992 (=83714x0.115x0.103). The rate -147.2 (=146/992) occupational accidents per 1000 irregular non-EU workers - is more than twice as high as that calculated in 2004 in Italy in regular non-EU workers (approximately 65 accidents per 1000). The difference can be explained by the fact that irregular workers find employment mainly in agriculture, building and the metallurgic industry, which have a high frequency of accidents, and are more willing to accept risky work and longer work shifts. Conclusions: On the assumption that the rate of occupational accidents in the 500000 irregular workers living in Italy in 2004 was 147,2 per 1000 (as in the catchment area of the San Bonifacio Hospital), the number of accidents would be 73,600, against the 116,000 that occurred among regular non-EU workers in 2004 according to INAIL. Official INAIL statistics on occupational accidents therefore show a considerable underestimation.
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