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

Background: The problem of occupational injuries (OI) is still very relevant, with significant impacts on workers, companies and society. However, intervention studies with effectiveness evaluation of OI prevention programs are seldom performed. Objectives: To present the results of a pragmatic field study with effectiveness evaluation of a multifaceted intervention to prevent traumatic OI, with an interrupted time series (ITS) design. Methods: The study was carried out during 2008-2010 in 33 Italian foundries (23 ferrous=A; 10 non-ferrous=B; 3306 male blue collars/year). The research followed a preliminary analysis showing high OI rates. Each foundry was invited to establish a multidisciplinary prevention team for risk assessment, monitoring and discussion of OI, with involvement of employers, occupational physicians, health and safety personnel, workers’ representatives, supervisors. Overall targets of intervention were: workers, equipment, organization, workplace and job tasks. The outcomes were reduction in standardized OI rates (incidence=OI/workersx102, frequency=OI/working hoursx105, severity=workdays lost-WDL/working hoursx103) and in specific OI types and body sites. Results: 4368 traumatic (e.g. burns, wounds, dislocations, strains, sprains, fractures, eye injuries) OI and 80157 WDL were formally registered in 2003-2010. The most frequent modes of injury were ‘struck by’, ‘contact with’, ‘trapped and crashed’ with main material agents ‘materials, objects, products, machine components, debris, dust’. ITS analysis displayed sustained decreasing trends for all OI rates (incidence: -14% p<0.01 in A, -8% p=0.342 in B; frequency: -9% p=0.048 in A, -5% p=0.628 in B; severity: -13% p=0.102 in A, -12% p=0.194 in B); negative slope changes for incidence rates were significantly (p<0.001, p=0.002) greater than those of reference categories. Before-after analysis showed significant reduction in specific OI types (e.g. ‘burns, scalds’: -29% p=0.031 in A, -50% p=0.052 in B) and body sites (e.g. eye injuries: -34% p<0.01 in A, -59% p<0.01 in B). Sector-specific benchmarks for OI rates were also developed to promote the implementation of good practices. Conclusions: The study indicates that a multifaceted pragmatic intervention leads to a reduction in the burden of traumatic OI in small-, medium- and large-sized enterprises in the foundry sector, with overall good external validity.